Category Archives: Diet and Mortality

How Much Oxalate Is Too Much? n=1 Analysis

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Papers referenced in the video:

Dietary oxalate to calcium ratio and incident cardiovascular events: a 10-year follow-up among an Asian population

Predicting Age by Mining Electronic Medical Records with Deep Learning Characterizes Differences between Chronological and Physiological Age

Association between low-density lipoprotein cholesterol and cardiovascular mortality in statin non-users: a prospective cohort study in 14.9 million Korean adults

Joint distribution of lipoprotein cholesterol classes. The Framingham study) AND abbott lipoproteins 1983

Incidental lymphopenia and mortality: a prospective cohort study

Blood counts in adult and elderly individuals: defining the norms over eight decades of life

Effect of Aging on Serum Uric Acid Levels: Longitudinal Changes in a Large Japanese Population Group

Liver enzymes and risk of all-cause mortality in general populations: a systematic review and meta-analysis.

Increased red blood cell distribution width (RDW) is associated with higher glycosylated hemoglobin (HbA1c) in the elderly

AGE Products Impact Lifespan: Impact Of Hyperglycemia, Kidney Function, And The Microbiome

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Papers referenced in the video:

Oral glycotoxins determine the effects of calorie restriction on oxidant stress, age-related diseases, and lifespan

Reduced oxidant stress and extended lifespan in mice exposed to a low glycotoxin diet: association with increased AGER1 expression

Gut microbiota drives age-related oxidative stress and mitochondrial damage in microglia via the metabolite N 6-carboxymethyllysine

Plasma Carboxymethyl-Lysine, an Advanced Glycation End Product, and All-Cause and Cardiovascular Disease Mortality in Older Community-Dwelling Adults

Advanced glycation end products and their circulating receptors predict cardiovascular disease mortality in older community dwelling women

Acute Hyperglycemia Causes Intracellular Formation of CML and Activation of ras, p42/44 MAPK, and Nuclear Factor KappaB in PBMCs

Experimental Hyperglycemia Alters Circulating Concentrations and Renal Clearance of Oxidative and Advanced Glycation End Products in Healthy Obese Humans

Novel associations between blood metabolites and kidney function among Bogalusa Heart Study and Multi-Ethnic Study of Atherosclerosis participants

Serum Carboxymethyl-lysine, a Dominant Advanced Glycation End Product, is Associated with Chronic Kidney Disease: the Baltimore Longitudinal Study of Aging

Calcium Intake Affects The Association For Dietary Oxalate With CVD-Event Risk

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Papers referenced in the video:

Dietary oxalate to calcium ratio and incident cardiovascular events: a 10-year follow-up among an Asian population

Effect of Different Cooking Methods on Vegetable Oxalate Content

Oxalate in renal stone disease: the terminal metabolite that just won’t go away

Epidemiological Studies vs n=1: What’s Optimal For Dietary Cholesterol?

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Papers referenced in the video:

Dietary Intakes of Eggs and Cholesterol in Relation to All-Cause and Heart Disease Mortality: A Prospective Cohort Study

Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality

Which Gut Bacteria Are Associated With Poor Health, And How Can We Limit Them?

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Papers referenced in the video:

Human microbiome: an academic update on human body site specific surveillance and its possible role…

Taxonomic signatures of cause-specific mortality risk in human gut microbiome…

The Role of Short-Chain Fatty Acids From Gut Microbiota in Gut-Brain Communication…

Inhibiting antibiotic-resistant Enterobacteriaceae by microbiota-mediated intracellular acidification…

Short chain fatty acids in human large intestine, portal, hepatic and venous blood

Age-Associated Changes in Gut Microbiota and Dietary Components Related with the Immune System in Adulthood and Old Age: A Cross-Sectional Study…

The microbiome of professional athletes differs from that of more sedentary subjects in composition and particularly at the functional metabolic level…

Exercise Alters Gut Microbiota Composition and Function in Lean and Obese Humans

Vitamins K1 And K2 Are Associated With Cardiovascular Disease-Related Hospitalization Risk

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Vitamin K Intake and Atherosclerotic Cardiovascular Disease in the Danish Diet Cancer and Health Study…

Vitamin K2 amounts in food: Menaquinones, Bacteria, and Foods: Vitamin K2 in the Diet…

Multiple Vitamin K Forms Exist in Dairy Foods…

Menaquinone Content of Cheese…

Determination of Phylloquinone and Menaquinones in Food Effect of Food Matrix on Circulating Vitamin K Concentrations…

Vitamin K1 intakes derived from

Selenium: How Much Is Optimal For Health?

For those who track their diet, eating only the RDA for many nutrients may not optimize health. For example, the RDA for selenium is 55 micrograms per day, but is that amount optimal for reducing risk of death for all causes?

HDL Update: Age-Related Changes, All-Cause Mortality Risk, And Progress Towards The Optimal Range

In November 2020, I made a HDL video based on a meta-analysis in ~3.4 million subjects that was published in July 2020. In Dec 2020, a larger study (n=15.8 million subjects) was published-those data are presented in the video, and compared against the meta-analysis.

In addition, I’ve tested my HDL 2 more times since November 2020, so how’s my progress for getting it into the optimal range? Also, I attempt to derive clinical significance by identifying correlations for higher HDL with lower Lp(a) and hs-CRP.

Video link:

Kidney Function: The Missing Link In The TMAO-Health And Disease Story?

Animal products, including meat, cheese, and eggs contain carnitine and choline, metabolites that are converted by gut bacteria into TMA, which is then converted by the liver into TMAO. Plasma levels of TMAO are associated with an increased risk of disease and death, so should we limit intake of these animal products? Separately, fish contains relatively high levels of TMAO, and blood levels of TMAO spike after fish consumption, but there is a decreased all-cause mortality risk for fish consumers. To explain these disparate findings, other factors may be involved in the TMAO-health and disease story. In the video, I discuss the impact of kidney function on plasma levels of TMAO, disease and mortality risk.

Eat more green leafy vegetables, reduce mortality risk?

Vitamin K is found in 2 predominant forms, Vitamin K1 (phylloquinone), found almost exclusively in green leafy vegetables, and Vitamin K2 (Menaquinone), found in fermented foods, organ meats, meat, butter and eggs. In the data below (Juanola-Falgarona et al. 2014), we see that Vitamin K1 (phylloquinone) is negatively associated with death from all causes:

all cause mortl phylo

Death from all causes was assessed based on the average value for four groups of Vitamin K1 intake: 171 ug/day = blue line, 276 ug/day =red line, 349 ug/day = green line and 626 ug/day = the yellow line. In the data above, Vitamin K1 values less than 349 ug/day are about the same in terms of all-cause mortality risk. However, those who ate 626 ug/day of Vitamin K1 had about half of the mortality risk compared to the lower K1 intake groups! Interestingly, the RDA for Vitamin K, at 90 ug/day seems to be outdated, based on the data above. Also, Vitamin K2 was not associated with all-cause mortality risk, as shown below:

k2 all cause

Based on the K1 mortality data, 626 ug/day seems like a good goal. However, osteocalcin is a Vitamin K-dependent protein that has been shown to be maximally active in the presence of 1000 ug of Vitamin K1 (Binkley et al. 2002)! Osteocalcin is involved in pathways that decline with aging: insulin secretion and β-cell proliferation in the pancreas, energy expenditure by muscle, insulin sensitivity in adipose tissue, muscle and liver, and increased testosterone production (Karsenty and Ferron 2012). Therefore, getting 1000 ug+ per day of Vitamin K1 may optimize all of these functions and, decrease mortality risk!

What’s the take home from these data? Eat more leafy greens! How much is needed to get 1000 ug  per day? Shown below is a short list of foods rich in Vitamin K and the serving size needed to reach 1000 ug. Approximately 4 ounces of cooked kale or 7 oz. of raw spinach will suffice, and at a low calorie yield. Other foods, like broccoli, brussel sprouts or romaine lettuce would need to be consumed in far greater amounts to reach 1000 ug.

k osteo

What’s my daily K1 intake? Shown below is my 7-day average (7/16/2015 – 7/22/2015) for K intake, derived almost exclusively from plant sources. 1379 ug/day puts me well above the 626 ug/day that was associated with reduced mortality risk, and above the 1000 ug/day needed for maximal osteocalcin activation.

my k intake

Here’s this post in video form!

If you’re interested, please have a look at my book!


Binkley NC, Krueger DC, Kawahara TN, Engelke JA, Chappell RJ, Suttie JW. A high phylloquinone intake is required to achieve maximal osteocalcin gamma-carboxylation. Am J Clin Nutr. 2002 Nov;76(5):1055-60.

Juanola-Falgarona M, Salas-Salvadó J, Martínez-González MÁ, Corella D, Ostrich R, Ros E, Fitó M, Arós F, Gómez-Gracia E, Fiol M, Lapetra J, Basora J, Lamuela-Raventós RM, Serra-Majem L, Pintó X, Muñoz MÁ, Ruiz-Gutiérrez V, Fernández-Ballart J, Bulló M. Dietary intake of vitamin K is inversely associated with mortality risk. J Nutr. 2014 May;144(5):743-50.

Karsenty G, Ferron M. The contribution of bone to whole-organism physiologyNature. 2012 Jan 18;481(7381):314-20.