Five "Scientific" Myths about Fat
When it comes to nutrition, the medical community and so-called scientific studies may be the greatest spreaders of myth and misinformation in the world today. And now they're at it again.
Scientists have known for nigh on half a decade that the hypothalamuses of overweight animals - including humans -- show signs of inflammation, a typical reaction to injury. The crucial question, of course, is whether the inflammation is the result of becoming obese, or does it occur before the obesity occurs and triggers the obesity? And also, as the lead investigator, Michael Schwartz, said, "What is causing the inflammatory response and could that have something to do with the obesity itself?" A recent study published in the Journal of Clinical Investigation attempted to answer that question.1
However, as we will discuss later, this study contains a fatal flaw that renders its conclusions moot.
Specifically, the purpose of the study was to determine the role hypothalamus inflammation plays in obesity. To answer the question, the research team put laboratory mice and rats on a high-fat diet to make them gain weight. When they looked for evidence of inflammation in their brains, they made a startling discovery. "We were frankly shocked to realize the inflammation became apparent within 24 hours of the switch in diet," says Schwartz.
Needless to say, the media has had fun with this study. Headlines appeared reading:
- High-fat foods cause brain scarring -- CNN2
- Fatty food linked to brain damage, new study shows -- The Australian3
- Scientists link obesity to brain damage -- The Vancouver Sun4
And my personal favorite:
- Fat May Put Hypothalamus on the Fritz -- Scientific American5
Unfortunately, once again, the media headlines misrepresent the reality. The study, as mentioned above, had a fatal flaw, which led to a totally unsubstantiated conclusion. But before we take a closer look at the study to see where it went wrong, it's probably worth taking a moment to let the media off the hook on this one. In most situations where a flawed study is promoted in the media, I call the media to task for not doing simple due diligence. But in this case, simple due diligence wouldn't have helped very much. You would actually have to know something about nutrition to identify the flaw. Now that excuses CNN, The Australian, and all of the other newspapers and TV networks that reported on the study -- but not Scientific American. They should have known better. And with that said, let's take a look at the study and see where it went wrong…which will lead us nicely into our discussion of the five myths about fat that are widely promulgated by the scientific community.
Obesity associated with brain damage study
About five years ago, studies first started identifying in animals the connection between being overweight and inflammation in the hypothalamus, a typical reaction to injury. What was not known, however, was which was "cause" and which was "effect" -- or as lead researcher Michael Swartz said, "Is it simply a consequence of becoming obese or does it occur before the obesity occurs? And what could be driving that response? What is causing the inflammatory response and could that have something to do with the obesity itself?"
According to the study's authors, growing evidence implicates immune cell triggered tissue inflammation as a key link that ties obesity to insulin resistance in metabolically active organs. In addition, previous research has shown that when rats and mice are fed a high-fat diet (HFD) that induces obesity, inflammation of the hypothalamus is measurable and likely contributes to leptin resistance and weight gain. (Leptin is one of the two hormones that regulate appetite.) The goal of the current study, then, was to nail down the actual mechanisms of obesity-associated hypothalamic inflammation and to determine whether similar responses occur in humans.
The protocol was fairly simple. Weight-matched male rats and mice were housed in controlled environments and fed either standard laboratory chow from PMI Nutrition International or a high-fat chow/diet (HFD) from Research Diets for periods ranging from 1 day to 8 months. Body weight and food intake were monitored daily. The research team was fully expecting to see evidence of inflammation in the brains of their rodents over time; what they were not expecting was how short that time would be. "We were frankly shocked to realize the inflammation became apparent in as little as 24 hours of the switch in diet," says Schwartz.
Unlike inflammation in peripheral tissues, which develops over an extended period of time as a consequence of obesity, the indicators of inflammation of the hypothalamus during this study were evident in both rats and mice within 1 to 3 days of being put on the high-fat diet -- even prior to any substantial weight gain. Furthermore, within the first week of HFD feeding, major markers suggestive of neuron injury were observed in the hypothalamuses of the rats and mice, including a proliferation of astrocyte cells.
And then it got even more interesting. At first the inflammation appeared transient, as it was quickly followed by a strong and rapid neuro-protective response, as cells were activated in an automatic self-defense response to repair the damaged neurons. But then over time, with continued HFD feeding, the animals, who were kept on the high-fat diet for nine months, eventually displayed the "permanent" inflammation of the hypothalamus previously associated with obesity.
The researchers then analyzed MRI scans to determine if the same markers of hypothalamus injury could be found in obese humans. They were. Based on this data, the researchers concluded, "These findings collectively suggest that, in both humans and rodent models, obesity is associated with neuronal injury in a brain area crucial for body weight control." And it was these conclusions that made their way into media headlines.
All neat and clean! So what's the problem?
Breaking down the study
As it turns out, the devil is in the details -- specifically the PMI Nutrition International and Research Diets laboratory chow used in the study. The question one must ask is: what was the makeup of the fats used in these lab chows, and could the composition of those fats have affected the results beyond any quantity issues?
Well, other than naming the companies that provided the lab diets, the researchers weren't specific about exactly what diet was used. But tracking down PMI Nutrition, we find that they produce their chow under the Lab Diet brand.6 And under that brand, they produce a "Rat Diet" and a "Mouse Diet." Since the researchers did not specify, we are left to assume that they fed their normal diet rats and mice Rat Diet and Mouse Diet respectively. Although slightly different, they are extremely similar in two crucial ways.
First, the ratio of Omega-6 to Omega-3 fatty acids was similar: about 7:17 in the Mouse Diet formula. But the key similarity was in the calories provided by proteins, fats, and carbohydrates in the two diets.
% of cal from Protein
% of cal from Fat
% of cal from Carbs
In fact, the actual crude fat content of the two diets was extremely low -- about 4% in the rat chow and 11% in the mouse chow. We'll come back to the importance of these numbers in a moment, but first we need to discuss the high fat diet (HFD) from Research Diets.
When you visit the Research Diet website, you'll find an extremely interesting article on how they create a high fat chow -- not as simple as it sounds.8 There are actually two problems that need to be dealt with. First, creating a high fat chow can dilute other nutrients. In other words, the more fat you add to the chow, the less of some other nutritional ingredient (protein for example) you can include in the same amount of chow. Research Diet opted to substitute fats for carbohydrates on a calorie-for-calorie basis. In their D12492 chow, the one used in the study, Research Diets uses soybean oil and lard as their high-fat modifiers.9 The net result is a high-fat feed that has about a 6:1 ratio of Omega-6 to Omega-3's, but as with regular rat chow, the key numbers to look at are the calories provided by proteins, fats, and carbohydrates…
% of cal from Protein
% of cal from Fat
% of cal from Carbs
HFD Test Diet
…and the percentage of actual crude fat in the chow, which in the HFD was 35%.10
This means that although the Omega-6 to Omega-3 ratios in the standard diets were slightly worse (7:1 and 10:1) than in the high fat diet (6:1), this was more than offset by the fact that the HFD provided around 2.5 -- 4.8 times as many calories from fat as the standard diet and between 2.7 -- 8.8 times as much crude fat. This is crucial because the high quantity of 6:1 fats provided by the high fat diet will produce a far greater quantity of NEFAs (non-esterified fatty acids) in the blood versus the significantly lower quantity of fat in the standard diet because NEFAs in the blood are caused by a build-up of excess omega-6 fats in the body. In this case, quantity trumps quality.
Why is this crucial?
NEFAs (non-esterified fatty acids)
Studies have consistently shown that NEFAs are associated with systemic inflammation -- everything from arterial tissue11 to lung tissue.12 It is hardly a stretch to think they might also cause inflammation in brain tissue as well. In fact, studies already indicate as much.13 The bottom line is that until the NEFA variable in the rat diets is accounted for, it is impossible to conclude that the brain inflammation seen in the study was caused merely by the quantity of fats in the diet as opposed to the capacity of high polyunsaturated, omega-6 loaded diets to generate NEFAs in the bloodstream.
This is not just a semantic issue. If NEFAs turn out to be the culprit, then high consumption of fat is not necessary to cause an inflammation of the hypothalamus. All it would take is a couple of tablespoons of safflower oil a day, with its 77:1 ratio to do the trick. Or corn oil at 46:1 would be almost as bad.
The bottom line is that the researchers conducting the study were operating under a myth commonly believed by those in mainstream nutrition. They think that when it comes to health, fats can be classified into one of three groups: unhealthy saturated fats, unhealthy trans-fatty acids, and healthy unsaturated fats. (That is "Myth 1.") In truth, the biggest problem with fats is not which group they fall into, but what is the ratio between omega-6 and omega-3 fatty acids, both of which reside in the same group: unsaturated fats.
Does that mean that the study is wrong? Not necessarily -- only that by not accounting for NEFAs, you can't come to any supportable conclusion at this time.
The four other mainstream fat myths
Number 2 - all saturated fats are bad
One of the bromides of mainstream nutrition is that it's important to reduce saturated fat intake since high levels of saturated fat increase the risk of cardiovascular disease. But that's a myth -- for two reasons. First, not all saturated fat is bad; in fact, a certain amount is essential, and some saturated fats are extremely health promoting. Second, prolonged experience with the high meat/high fat/low carb diets has shown that natural saturated fat does not necessarily raise cholesterol levels and clog arteries (although these diets are quite likely to promote osteoporosis and colon cancer -- but that has nothing to do with fat). The "simple" truth is that the whole issue of saturated versus unsaturated fats is mostly false.
As just mentioned, certain saturated fats are extremely healthy and even essential to good health...such as coconut oil. For a number of years, coconut oil has been vilified by the medical health authorities due to its saturated fat content, but coconut oil is unique in its structural makeup. It is not only the highest source of saturated fats (92 percent), yet included in that number are the medium-chain triglycerides (MCTs), which are extremely beneficial to the body. In addition, approximately 50 percent of these MCTs are made up of lauric acid, the most important fatty acid in building and maintaining the body's immune system. The only other source of lauric acid found in such high concentrations is mother's milk.
Number 3 - all trans fats are bad
Are trans fats bad? Absolutely…sort of…not really! In fact, in early editions of my book, Lessons from the Miracle Doctors, I called products made with trans-fats (partially hydrogenated oils) the number one killer in our diet. Back then, I felt a bit like John the Baptist -- a voice crying in the wilderness. But this is one area that has seen a dramatic change in the last quarter century. Whereas at one time, medical authorities promoted products such as oleomargarine as "healthy" alternatives to saturated fat products such as butter (which, when it comes from grass fed cows, is extremely healthy), these same authorities gradually became aware (about thirty years after the alternative health community) that trans-fats were, in fact, decidedly unhealthy. They now have jumped on the "kill all trans fats" bandwagon.
Yes, artificial trans fats are major contributors to cancer, heart disease, and diabetes. Over the last couple of years, government agencies have also jumped onboard, under prodding by the medical community, and started pressuring food companies and restaurants to ban trans-fats from our diets. And even if late, they are correct…up to a point. These fats are absolutely unnecessary and have no place in your diet -- or in any of the foods you eat -- if you wish to be healthy. But as defined by mainstream nutritionists, trans fats have become a mythical boogie man. Once again, mainstream medicine has turned yet another nuanced nutritional concept into a false dogma. The bottom line, as with saturated fat, is that not all trans fats are unhealthy. Yes, synthetic trans fats created through hydrogenation are extremely harmful, but naturally occurring trans fats, not so much. In fact, some natural trans-fats are downright healthy. One such trans fat is CLA (conjugated linoleic acid). CLA is both a trans-fatty acid and a cis-fatty acid. (The cis bond causes a lower melting point and may account for its health benefits.) What health benefits are we talking about?
Well, for one thing, studies have indicated that CLA is a potent cancer fighter across a wide variety of tumors, including cancers of the skin, breast, prostate, and colon.14 And whereas most anti-cancer agents block only one of cancer's three stages (initiation, promotion, and metastasis), very small amounts of CLA have been shown to block all three. In addition, CLA has been found to lower LDL levels and prevent bone loss and atherosclerosis, while at the same time helping to build the immune system.
And where is CLA found?
In the meat and dairy of grass fed cows. In fact, it is produced naturally from linoleic acid by bacteria in the stomachs of herbivores (such as cows). It can also be produced synthetically by heating linoleic acid in the presence of a base. However, there may be some issues as to whether synthetic CLA performs as well as natural CLA. And take note: I did say grass fed cows. As it turns out, grazing animals have 3-5 times more CLA than grain fattened animals -- providing yet one more reason for consuming grass fed animal products.
As a side note, the breast milk of mothers who consume foods high in CLA is likewise high in CLA, providing tremendous health benefits for the baby. If you are looking to supplement CLA, your best bet is probably butter oil -- made seasonally from May through October, from the milk of cows feeding on rapidly growing pasture grass. Rapid growth in the grass is the key to high CLA levels, not to mention high alkylglycerol content, and naturally occurring vitamin K2 (the Activator X first identified by Dr. Weston Price).15
The bottom line here is that once again, by disdaining nuance and instead opting for media talking points, the medical mainstream is setting the stage for the elimination of key nutrients from our diet. As things now stand, selling prepared foods rich in CLA will get you in trouble in many municipalities. Can that be considered a good thing?
Number 4 - you don't need to supplement non essential fatty acids
Mainstream nutritionists define nonessential fatty acids as those fats manufactured by the body and are thus not required in the diet or in supplements. That means pretty much every fat or oil other than omega-6 and omega-3. To be fair, though, more knowledgeable nutritionists outside of the medical mainstream have a third category called "conditionally essential," which contains gamma-linolenic acid (an omega-6 fatty acid) , lauric acid (the saturated fat in coconut oil that we talked about earlier), and palmitoleic acid (an omega-7 monounsaturated fat). But that still leaves a number of fats classified as nonessential (primarily omega-7's and omega-9's) that don't make it into mainstream supplements or diets -- and that aren't produced in the body in meaningful quantities. For example:
- Oleic acid is an omega-9, monounsaturated fat that is essential to the human body, but humans can only manufacture a limited amount. Among the benefits of consuming oleic acid in your diet are that it lowers the risk of heart attacks, arteriosclerosis, and aids in cancer prevention. Common sources include avocado (50%), Macadamia nuts (45%), apricot seeds (35%), almonds (33%) and olive oil (28%).
- CMO is the common name for cis-9-cetyl myristoleate, an omega-9, monounsaturated fat variant found in certain animals, including cows, whales, beavers, and mice -- but not in people. CMO was discovered in 1972 by Harry W. Diehl, Ph.D., a researcher at the National Institutes of Health. At the time, Dr. Diehl was responsible for testing anti-inflammatory drugs on lab animals. In order for him to test the drugs, he first had to artificially induce arthritis in the animals by injecting a heat-killed bacterium called Freund's adjuvant. Dr. Diehl discovered that Swiss albino mice did not get arthritis after an injection of Freund's adjuvant. Eventually, he was able to determine that cetyl myristoleate was the factor present naturally in mice that was responsible for this protection. When CMO was injected into various strains of rats, it offered the same protection against arthritis. As it turns out, oral supplementation in humans seems to provide the same benefits. There have been three notable studies on humans.
- Palmitoleic and vaccenic acids are both omega-7 unsaturated fatty acids. Supplementation promotes healthy skin, shiny hair, and improved digestive health. In addition, palmitoleic acid is used in topical preparations to treat skin burns and radiation burns.16 Dietary sources include a variety of animal oils, vegetable oils, and marine oils. Macadamia oil and sea buckthorn oil are botanical sources with high concentrations of palmitoleic acid, 17% and 40% respectively. As for vaccenic acid (VA), studies have shown that it can reduce risk factors associated with heart disease, diabetes, and obesity. Results indicate this benefit is due in part to the ability of VA to reduce the production of chylomicrons -- particles of fat and cholesterol that form in the small intestine following a meal and that are rapidly processed throughout the body.17 The role of chylomicrons is increasingly viewed as a critical missing link in the understanding of conditions arising from metabolic disorders. Even better, recent data suggest that consumption of vaccenic acid may impart health benefits beyond those associated with CLA.18
Number 5 - fats, as is true with most nutrients, do not exist in isolation
The biggest problem that mainstream nutritionists have when dealing with any aspect of how nutrients relate to health is their fundamental need to view things in isolation. I've talked about this many times before. Although Modern Medicine likes to trace its roots to Hippocrates, the patron saint of today's doctors, the fact is that the roots of Modern Medicine are sunk much deeper in the Newtonian views of the 17th century when philosophers and scientists defined the universe as a giant machine ruled by physics and math. According to this view of the universe, objects behave in predictable ways unless acted upon by outside forces. Physicians of that era were not immune to this new paradigm and likewise began to define the human body as a machine that would run smoothly until acted upon by some outside agent. According to this new paradigm, the human body could be analyzed, catalogued, adjusted, and tweaked as required.
This viewpoint became more and more dominant as time went by, until by the 19th century:
- The human body was no longer viewed as a holistic entity, but rather as a grouping of separate parts and pieces.
- Disease was no longer viewed as a body state, but rather as a set of symptoms.
- Medical research was defined as the observation and classification of both the body parts and its sets of symptoms.
- The physician's job was then defined as eliminating (or at least managing) those symptoms.
- In other words, disease (or illness or injury for that matter) manifests as symptoms entirely separate from the body as a whole. Eliminate the symptoms, and you eliminate the problem.
As it turns out, this paradigm works extremely well when it comes to surgical repair. If you break an arm, the doctor works with that part of the body and repairs the arm. If you're shot by a bullet, the doctor removes the bullet and repairs all of the separate parts of your body damaged by the bullet. It's pretty much a direct one-to-one correlation. Unfortunately, the paradigm fails when it comes to disease.
And nutrition, modern medicine's bastard child, was likewise reduced to a series of isolated parts, each existing in a vacuum, including: proteins, fats, carbohydrates, vitamins, minerals, and antioxidants, etc. And like medicine, this nutritional paradigm works extremely well in a limited arena -- when it comes to package labeling. If you want to know how much protein is in a food bar, for example, the label will tell you. But the paradigm falls apart if you want to know how quickly you're going to break that particular protein down in your digestive tract, or if you are likely to have low level digestive problems or allergic reactions to it, or even how much of that protein listed on the label your body is actually going to be able to utilize.
The fundamental problem for nutritionists is the same problem faced by medical doctors: the body is not an assembly of isolated pieces. But rather, it is comprised of a myriad of systems, organs, cells, and chemical systems all working together to create one integrated, holistic entity -- you. Like the proverbial butterfly of chaos theory that can start a hurricane by flapping its wings half a world away, denying your body one crucial element today, may cause a fatal disease several years down the road. It's not a question of nutrients in isolation, but how those nutrients work together. Forgetting to balance the ratio of omega-6 to omega-3 fatty acids in your body today can result in a heart attack in 2022. Supplement with thousands of milligrams of calcium today as your doctor instructs and you can still be stricken with osteoporosis by the time you turn 55 if you don't also supplement with magnesium, boron, and vitamins K and D. Go on a high protein diet today and forget to balance the acidifying effects of the diet with lots of alkalinizing fresh vegetables and you're looking at cancer, arthritis, and heart disease by the time you retire.
Your body is a holistic creation -- and the nutrients that support it are too. Forget that fact, as too many physicians and nutritionists do, and you will pay the price down the road.
The fundamental question I ask over and over is, "Why would you listen to a medical doctor when it comes to nutrition?" They barely study it in medical school. They really know very little about it. All you have to do is look at the food served in a hospital to understand the limits of their knowledge. Beyond providing proteins, fats, and carbohydrates, does anyone really think that hospital food promotes rapid recovery? Does it in any way feel nutritious, energizing, or life sustaining? Doesn't every hospital patient try and have friends and family smuggle in "real" food? What does that tell you? And make no mistake, the dieticians and nutritionists who make up those meals serve at the whim of the doctors who run the hospital.
If you want to know what nutritious food is, then look at the people who are thriving into their 80's and 90's. Yes, there are the exceptions like Hugh Hefner who drink Pepsi and smoke a pipe and keep bedding 20-year-old girls into their 80's. But they are one in a million. Eat badly, drink a dozen sodas a day, and smoke cigarettes, and the odds are much better that you're going to die of emphysema, diabetes, and lung cancer before you turn 60.
Eat living foods, avoid excess, and exercise daily, and the odds are better that you'll celebrate your 80th birthday by choosing to get handcuffed and shackled in order to fight strong winds and currents and swim 1.5 miles while towing 80 boats with 80 people from the Queensway Bay Bridge in the Long Beach Harbor to the Queen Mary.19 Or perhaps just dancing up a storm all night with your significant other!
Back to the hypothalamus study
Oh yes, and if you're still worried about obesity permanently causing inflammation in your hypothalamus, thus dooming you to a life of uncontrolled appetite, you might try a little exercise. Studies have shown that exercise can both reverse hypothalamic inflammation and restore insulin and leptin sensitivity in the hypothalamus.20
- 1. Joshua P. Thaler, Chun-Xia Yi, Ellen A. Schur, Stephan J. Guyenet, Michael W. Schwartz, et al. "Obesity is associated with hypothalamic injury in rodents and humans." J Clin Invest. 2012;122(1):153--162. <http://www.jci.org/articles/view/59660>
- 2. Jacque Wilson. "High-fat foods cause brain scarring." 6 Jan 2012. CNN.com. <http://thechart.blogs.cnn.com/2012/01/06/study-high-fat-foods-cause-brain-scarring/>
- 3. Amos Aikman. "Fatty food linked to brain damage, new study shows. " 28 Dec 2011 The Australian. (Accessed 7 Jan 2012.) <http://www.theaustralian.com.au/news/health-science/fatty-food-linked-to-brain-damage-new-study-shows/story-e6frg8y6-1226231599891>
- 4. Sharon Kirkey. "Scientists link obesity to brain damage." 28 Dec 2011. The Vancouver Sun. (Accessed 7 Jan 2012.) <http://www.vancouversun.com/health/Scientists+link+obesity+brain+damage/5918240/story.html>
- 5. Katherine Harmon. "Fat May Put Hypothalamus on the Fritz." 27 Dec 2011. Scientific American. (Accessed 7 Jan 2012.) <http://www.scientificamerican.com/podcast/episode.cfm?id=fat-may-put-hypothalamus-on-fritz-11-12-27>
- 6. Lab Diet. "About Us." (Accessed 8 Jan 2012.) <http://www.labdiet.com/about_us.html>
- 7. Rat Diet. Lab Diet. (Accessed 8 Jan 2012.) <http://labdiet.com/pdf/5012.pdf> [/f] in the Rat Diet formula and about 10:1
Mouse Diet. Lab Diet. (Accessed 8 Jan 2012.) <http://labdiet.com/pdf/5015.pdf>
- 8. Matthew R. Ricci, Ph.D. and Edward A. Ulman, Ph.D. "Laboratory Animal Diets:A Critical Part of Your In Vivo Research." Research Diets. (Accesseed 8 january 2012.) <http://www.researchdiets.com/pdf/Laboratory%20Animal%20Diets-Europe.pdf>
- 9. "Product Data - D12492." Research Diets. (Accessed 8 Jan 2012.) <http://www.researchdiets.com/ >
- 10. "DIO Rodent Purified Diet w/60% Energy From Fat." Test Diet. (Accessed 8 Jan 2012.) <http://www.testdiet.com/PDF/58Y1.pdf>
- 11. Mas S, Martínez-Pinna R, Martín-Ventura JL, Pérez R, et al. "Local non-esterified fatty acids correlate with inflammation in atheroma plaques of patients with type 2 diabetes." Diabetes. 2010 Jun;59(6):1292-301. Epub 2010 Mar 3.<http://www.ncbi.nlm.nih.gov/pubmed/20200316>
- 12. Wood LG, Scott HA, Garg ML, Gibson PG. "Innate immune mechanisms linking non-esterified fatty acids and respiratory disease." Prog Lipid Res. 2009 Jan;48(1):27-43. Epub 2008 Nov 5. <http://www.ncbi.nlm.nih.gov/pubmed/19017534>
- 13. Gloudina M Hon DTech, Mogamat S Hassan MSc, Susan Janse van Rensburg PhD, et al. "Plasma non-esterifi ed fatty acids in patients with multiple sclerosis." Neurology Asia 2011; 16(3) : 217 -- 222 <http://www.neurology-asia.org/articles/neuroasia-2011-16(3)-217.pdf>
- 14. Ip C, Scimeca JA, Thompson HJ. "Conjugated linoleic acid. A powerful anticarcinogen from animal fat sources." Cancer. 1994 Aug 1;74(3 Suppl):1050-4. <http://www.ncbi.nlm.nih.gov/pubmed/8039138>
- 15. Chris Masterjohn. "On the Trail of the Elusive X-Factor: A Sixty-Two-Year-Old Mystery Finally Solved. 13 Feb 2008. The Weston A. Price Foundation. (Accessed 7 Feb 2012.) <http://www.westonaprice.org/fat-soluble-activators/x-factor-is-vitamin-k2>
- 16. Wang ZY, Luo XL, He CP. "Management of burn wounds with Hippophae rhamnoides oil." Nan Fang Yi Ke Da Xue Xue Bao. 2006 Jan;26(1):124-5. <http://www.ncbi.nlm.nih.gov/pubmed/16495193>
- 17. Wang Y, Jacome-Sosa MM, Ruth MR, Goruk SD, et al. "Trans-11 vaccenic acid reduces hepatic lipogenesis and chylomicron secretion in JCR:LA-cp rats." J Nutr. 2009 Nov;139(11):2049-54. Epub 2009 Sep 16. <http://www.ncbi.nlm.nih.gov/pubmed/19759243>
- 18. Field CJ, Blewett HH, Proctor S, Vine D. "Human health benefits of vaccenic acid." Appl Physiol Nutr Metab. 2009 Oct;34(5):979-91. <http://www.ncbi.nlm.nih.gov/pubmed/19935865>
- 19. David Moye. "Jack LaLanne's 10 Strangest Stunts." 24 Jan 2011. AOLNews. (Accessed 7 Feb 2012.) <http://www.aolnews.com/2011/01/24/jack-lalannes-10-strangest-stunts/>
- 20. Eduardo R. Ropelle1, Marcelo B. Flores1, Dennys E. Cintra1, Guilherme Z. Rocha1, et al. "IL-6 and IL-10 Anti-Inflammatory Activity Links Exercise to Hypothalamic Insulin and Leptin Sensitivity through IKKß and ER Stress Inhibition." August 2010 Issue of PLoS Biology. <http://www.plosbiology.org/article/info:doi/10.1371/journal.pbio.1000465>