5.12.11

What They Don't Tell You About Low Carb Diets

What They Don't Tell You About Low Carb Diets

The purpose of this site is to give you the information you need to succeed on a low carb diet used primarily for weight loss.

Information about how to adapt a low carb diet to control diabetes can be found HERE.
How Much Will You Lose in a Month?

How Much Will You Lose in a Month?
Water Weight vs. Fat Weight

Water Weight vs. Fat Weight
When You Crash Off Your Diet

When You Crash Off Your Diet

Updated!
Use Our Nutrition Calculator to Break Through Stalls!

Use Our Nutrition Calculator to Break Through Stalls!
When You Stall

When You Stall
Are You Heading  Towards Diabetes?

Are You Heading Towards Diabetes?

Starving? Try the Two Gram Cure

Starving? Try the Two Gram Cure
Learn from Successful Dieters

Learn from Successful Dieters
Marketing Tricks: Net Carbs, Sugar Alcohols, Tricky Portion Sizes

Marketing Tricks: Net Carbs, Sugar Alcohols, Tricky Portion Sizes

Hidden MSG Hidden Makes You Fat

Hidden MSG Hidden Makes You Fat
Indispensable Low Carb Treats

Indispensable Low Carb Treats
When Low Carb Isn't Working

When Low Carb Isn't Working

How Blood Sugar Works

How Blood Sugar Works
Do Starch Blockers Work?

Do Starch Blockers Work?
No More Ketobreath!

No More Ketobreath!

How To Go From Sedentary to Fit

How To Go From Sedentary to Fit
Studies Proving the Safety and Efficacy of the Low Carb Diet

Studies Proving the Safety and Efficacy of the Low Carb Diet
Low Carb Forums and Recipes

Low Carb Forums and Recipes

Is Your Low Carb Diet Safe?

Is Your Low Carb Diet Safe?
Is the Glycemic Index a Scam?

Is the Glycemic Index a Scam?
Don't Be Taken in By Fake Weight Loss or Fake Gain

Don't Be Taken in By Fake Weight Loss or Fake Gain

Credibility and the "Safe Starch" Debate - Low Carb Wisdom

Low Carb Wisdom

Credibility and the "Safe Starch" Debate

"It is difficult to get a man to understand something, when his
salary depends upon his not understanding it." --Upton Sinclair

Are all carbohydrates bad? No. In a post today on Robb Wolf's blog about meat and potatoes, Matt Lentzner said: "Judging a food solely by its macronutrient composition is stupid. It’s hard to believe it has taken us 50 years to figure that out. We have good fats (saturated and omega-3’s) and bad fats (omega-6’s), good carbs (starch) and bad carbs (fructose), good proteins (meat) and bad proteins (gluten). It’s the quality of the macronutrient, not it’s classification, that makes it good or bad."

I agree with Lentzner that it is quality, not classification, and that it is stupid to judge a food solely by its macronutrient composition. I didn't always believe this, but I do now.

Why is it so hard to understand that there might be "good carbs," or, in the parlance of the debate du jour, "safe starches?" Why is the idea of a "safe starch" so threatening to so many people? The whole safe starch debate was really surprising to me, until I stumbled across the quote above by Upton Sinclair. Then, all of a sudden, a light went on.

It appears to me that the major proponents of the "all carbs are bad" school of thought (I won't name names, but it isn't too hard to do) all make a good portion of their livelihood (if not all of their livelihood) from promoting this idea. It also appears to me that the major defenders of the safe starch debate, Paul and Shou-Ching Jaminet, do not make their livelihood promoting the Perfect Health Diet, so they are more flexible in and open to accepting new information. The same is true with Kurt Harris and his Archevore diet and for others. Their livelihood does not depend on defending a certain belief or viewpoint at all costs, so they are able to go against the grain when strong evidence is available.

The idea that there may be "safe starches" (good carbs) must be incredibly threatening to those whose livelihoods depend on not believing this idea. So they reflexively defend it at all costs. As a professor at a state-sponsored university, I do the same thing when people suggest cutting state funds for higher education. I am not immune to the impulse. Even if I intellectually understand the arguments about out-of-control higher education spending, I am viscerally against them, as my livelihood is at stake. So I am not throwing stones, just seeking more wisdom on the topic.

But it does lead me to this conclusion: arguments made by those without a vested interest in the debate are more credible than those made by people whose income is threatened by the debate. Just as I lack credibility on questions of funding for higher education.

"Heart disease and molecular degeneration" by Chris Masterjohn on Vimeo

"Heart disease and molecular degeneration" by Chris Masterjohn on Vimeo



ABSTRACT: When researchers first produced atherosclerosis in rabbits by feeding them cholesterol, they argued that atherosclerosis was of an "infiltrative" rather than "degenerative" character. That is, cholesterol was so abundant that it infiltrated the blood vessel wall. Over the decades it has become clear, however, that atherosclerosis is an attempt to protect the lining of the blood vessel from toxic waste generated by the degeneration of vulnerable lipids. The process of molecular degeneration can be likened to breaking glass, and the formation of atherosclerosis can be likened to the process of cleaning up the broken shards. The danger is not gone forever, though, because these toxic waste management sites (or barrels of broken glass) can eventually burst and spill their contents into the blood, leading to clotting, oxygen starvation, and the death of local tissue that can result in a heart attack or stroke. The key to preventing heart disease according to the new paradigm is preventing the molecular degeneration in the first place. Understanding this will help us achieve the protection from heart disease that our ancestors had.

SLIDES: slideshare.net/ancestralhealth/ahs-slideschris-masterjohn

"Heart disease and molecular degeneration" by Chris Masterjohn from Ancestry on Vimeo.

Good Lard, Bad Lard: What Do You Get When You Cross a Pig and a Coconut? | Mother Nature Obeyed - Weston A Price Foundation

Good Lard, Bad Lard: What Do You Get When You Cross a Pig and a Coconut? | Mother Nature Obeyed - Weston A Price Foundation

Good Lard, Bad Lard: What Do You Get When You Cross a Pig and a Coconut?

An estimated 50,000 mice worldwide are charting new territories of chubbiness as they chow down on the infamous, lard-based, high-fat rodent diet, “D12492.” As I reported a few days ago over at The Daily Lipid, it turns out these mice are chowing down on twice the amount of polyunsaturated fatty acids (PUFAs) as Research Diets, the producer of D12492, has heretofore been reporting. In this post I’ll address a few questions that came up in the comments, like which fatty acids the PUFAs had displaced, and what we can expect from higher-quality, pastured lard.

Here’s a graph showing the difference between the new and old estimates (1):

The high-fat, lard-based rodent diet D12492 is much higher in PUFA than previously reported.The graph shows the difference between the actual fatty acid profile as determined by direct analysis of the lard and the previously reported fatty acid profile, which had been estimated using the USDA database. We can see that the actual fatty acid profile is much higher in PUFAs, at the expense of both saturated and monounsaturated fats. In fact, the company had originally estimated the diet to provide 17 percent of its fat as PUFA, but now estimates it to provide a whopping 32 percent!

The particular fatty acids that are decreased the most are palmitic, stearic, palmitoleic, and oleic acids. These are the primary fatty acids that pigs, humans, and other animals produce when we make fat from carbohydrate. This suggests that the pigs are consuming seed oils, which would increase their intake of PUFAs at the expense of the carbohydrates found in grains and legumes.

The ratio of omega-6 linoleic acid to omega-3 linolenic acid is almost double what had been estimated based on the USDA database, suggesting that the oils the pigs are consuming are particularly rich in omega-6 fatty acids.

Raising pigs on pasture isn’t in itself a very effective way to reduce the PUFA content of lard. In one study (2), lard from pigs fed pasture and acorns was 8.7 percent PUFA while lard from pigs fed barley, wheat bran, soy meal, lard, and nutritional supplements was 6.9 percent PUFA. Grass has many benefits, but including it doesn’t lower the PUFA content of lard beyond what could be accomplished simply by banishing vegetable oils from these poor piggies’ diets.

The most effective way to minimize the PUFA content of lard that I’m aware of is to feed the pigs a traditional Pacific Island diet rich in coconut. Here is the fatty acid profile of lard from the island of Tokelau (3):

Lard from Tokelau is only 3.1% PUFA.The lard is only 3.1 percent PUFA — more than ten times lower in PUFA than that darned chubby-mouse diet — and the ratio of omega-6 linoleic acid to omega-3 linolenic acid is 3.3. At least this was the case when it was measured back in 1981. Even the chicken fat on this island was only 3.2 percent PUFA.

The islanders reserved meat for special feasts. Day by day they subsisted mostly on coconut, fish, and various starches. As a result, they obtained about half their calories from saturated fat, but only two percent of calories from PUFA, most of which came from fish.

In the grand scheme of things, then, we can say that the lard used in Research Diets D12492 is incredibly high in PUFA, and the diet itself, which also contains a small amount of soybean oil, is a very high-PUFA diet. We can probably expect at least one new high-profile study using this diet to hit the press every couple of months. Will they continue to blame the effects on “saturated” fat? Only time will tell.

References

1. Dr. Matthew Ricci, Vice-President and Science Director of Research Diets. Personal communication. November 18, 2011.

2. Timon ML, Martin L, Petron MJ, Jurado A Garcia C. Composition of subcutaneous fat from dry-cured Iberian hams as influenced by pig feeding. J Sci Food Agric. 2002;82(2):186-91.

3. Prior IA, Davidson F, Salmond CE, Czochanska Z. Cholesterol, coconuts, and diet on Polynesian atolls: a natural experiment: the Pukapuka and Tokelau island studies. Am J Clin Nutr. 1981;34(8):1552-61.

This entry was posted in WAPF Blog and tagged . Bookmark the permalink.

One Response to Good Lard, Bad Lard: What Do You Get When You Cross a Pig and a Coconut?

STG says:

Chris:

Excellent post. How many studies have erroneous conclusions and results based on this rodent diet? The devil is in the details!

Why Did Steve Jobs Die? - Dr John MacDougall

Why Did Steve Jobs Die?
Steve Jobs gave tacit permission and encouragement for me to write this newsletter article about the medical and nutritional aspects of his life when he commissioned his biographer to tell a true account. “I wanted my kids to know about me…” “Also, when I got sick, I realized other people would write about me if I died, and they wouldn’t know anything.

They’d get it all wrong. So I wanted to make sure someone heard what I had to say.”(556) Jobs would have been pleased to hear my challenging second opinions about his pancreatic cancer and his diet, because my thoughts are in agreement with what he intuitively and factually knew to be correct. Hopefully, my account will bring some peace of mind to his family and friends after his untimely death.
This article is not meant as a critique of his doctors and their medical care. I am certain these professionals performed their best for him. In hindsight, everything is clearer. The purpose of this article is to set the record straight.
Jobs’ Cancer Began and Metastasized When He Was a Young Man 
“In October 2003 he happened to run into his urologist who had treated him, and she asked him to get a CAT scan of his kidneys and ureter.(453) It had been 5 years since his last scan. The new scan revealed nothing wrong with his kidneys, but it did show a shadow on his pancreas.” By the time a tumor is large enough to be seen on a CAT scan it has grown to a size of at least 2 millimeters (mm) (half the size of a BB, twice the size of a period on this page). My guess is that the shadow seen on his pancreas was at least one centimeter (cm) in diameter (the size of an eraser on a pencil). This size mass contains 1 billion cells and has been growing on average for 10 years. Death usually occurs when the size of individual tumors reaches ten centimeters in diameter (4 inches). Pancreatic neuro-endocrine (islet cell) tumors, the kind that Jobs had, fit this pattern of growth.
The natural history of the growth of Steve Jobs’ pancreatic cancer can be determined by mathematical calculations. The interval between his diagnosis at age 48 and his death at age 56 was approximately 8 years (October of 2003 and October 5, 2011). From these dates it can be determined that the tumor mass in his pancreas doubled in size every 10 months. (Commonly, solid tumors of various organs double in size every 3 to 9 months.) His was a very slow growing tumor.
By knowing this stable rate of doubling (every 10 months), the date when Jobs’ cancer began can be calculated. His cancer started when he was a young adult, possibly as young as 24 years old. Similar calculations show that his cancer spread from his pancreas to his liver (and other parts of his body) more than two decades before his surgery on July 31, 2004. (Exact methods for doing these calculations are found at the end of this article.)
One of Jobs’ greatest regrets when he found out he had incurable cancer was that he had refused to have surgery for 9 months after being diagnosed. He believed he might have been cured if he had acted earlier. Since he was in his mid-twenties when the cancer spread throughout his body, removing his CAT-scan-detected cancer in October of 2003 would never have cured him.



Cancer Caused Steve Jobs Troubles in His Thirties and Forties

A report about Jobs’ mannerisms during meetings in 1987 said, “His hands, which are slightly and inexplicably yellow, are in constant motion.”(223). Yellow discoloration of the skin is a classic sign of jaundice. Cancer in the head of the pancreas commonly causes blockage of the flow of bile, resulting in jaundice. Possibly, the tumor was at this time (1987), causing partial and intermittent obstruction.

His cancer also caused him abdominal and back pains at least 5 years before his diagnosis in October of 2003. “I was driving up to Pixar and down to Apple in my black Porsche convertible, and I started to get kidney stones. I would rush to the hospital and the hospital would give me a shot of Demerol in the butt and eventually I would pass it.”(334) The CAT scan obtained in October of 2003 (which showed the shadow on his pancreas) revealed nothing wrong with his kidneys.(453) 

Kidney stones are caused by a diet high in animal protein. As a strict vegan, it is unlikely that Jobs had kidney stones. I do not have his medical reports, however, I believe some or all of these episodes of pain were misdiagnosed and mistreated as pain from kidney stones. Jobs was actually suffering from the cancer growing in his pancreas.

Proof that the cancer had been present for at least 10 years before the time of diagnosis came at the time of his surgery on July 31, 2004. “Unfortunately, the cancer had spread. During the operation the doctors had found three liver metastases.”(456) For his surgeons to see these tumors on the surface of his liver with the naked eye, each cancer would likely have been at least 1 cm in size. As I explained above, these metastasizes began more than two decades before, when Jobs was in his mid-twenties. Finding tumors on the liver means the cancer has also spread to other organs of the body many years before.

Jobs considered himself to be a very intuitive person, who relied on his own gut feelings. At some level of consciousness he may have known that he had disease twenty or more years before his diagnosis. In 1983, “Jobs confided in John Sculley (Apple’s CEO) that he believed he would die young.”(155) Jobs was only 28 years old when he spoke this prophecy. 

Lead (Pb) and Other Carcinogens from Computers Caused Jobs’ Cancer

Jobs would speculate that his cancer was caused by the grueling year that he spent, starting in 1997, running both Apple and Pixar.(452, 333) He guessed, “That’s probably when this cancer started growing, because my immune system was pretty weak at that time.”(452) However, based on reliable calculations, his cancer likely started decades earlier, as a young adult, when he was building computers and other electronics by his own hands without adequate safety precautions. 

The summer after his freshman year at Homestead High School in Los Altos, California, Jobs called Bill Hewlett of HP on the phone, “And he answered and chatted with me for about twenty minutes. He got me the parts, but he also got me a job in the plant where they made frequency counters.”(17) Here he was exposed to toxic chemicals, known to cause cancer of the pancreas. Another example; Jobs soldered circuit boards in the early days of Apple.(67) This compound (solder) is typically an alloy containing lead, tin, and other metals. Lead is classified as a probable human carcinogen, a class of substances that are directly responsible for damaging DNA, and promoting or aiding cancer. Lead is suspected of causing cancer of the pancreas.

Steve Jobs may be the best-known example of the high risk of cancer for people working in the electronics industries from occupational exposure to carcinogens. The metals contained in personal computers include aluminum, antimony, arsenic, barium, beryllium, cadmium, chromium, cobalt, copper, gallium, gold, iron, lead, manganese, mercury, palladium, platinum, selenium, silver, and zinc.
Steve Jobs getting cancer was an unfortunate accident—like being struck by lightning or hit by a car. The carcinogen(s) entered his body and due to genetics, “bad luck,” or other unknown and uncontrollable factors his body was susceptible. The cause of his cancer was not due to his vegan diet. In fact, his healthy diet likely slowed the growth of his tumor, delayed the time of diagnosis, and prolonged his useful life.

Jobs Suffered with Unfounded Regret, Believing He Had Hastened His Own Death

Jobs lived the final 8 years of his life with regret, guilt, and remorse over delaying his surgery for 9 months after the initial diagnosis of cancer. With one honest sentence his doctors could have relieved him of this heavy burden. This simple fact could have been told: “Mr. Jobs, you had a body full of cancer long before October of 2003, when you were diagnosed by a needle biopsy.” Apparently, not one of his doctors—not Jeffrey Norton, who had operated on his pancreas in 2004, nor James Eason, who had performed his liver transplant in 2009—told Jobs this indisputable truth.

In October of 2003, after confirming he had a mass in his pancreas, one of his doctors “suggested that he should make sure his affairs were in order, a polite way of saying that he might have only months to live. That evening they performed a biopsy by sticking an endoscope down his throat and into his intestines so they could put a needle into his pancreas and get a few cells from his tumor…It turned out to be an islet cell or pancreatic neuro-endocrine tumor…”(453) 

Jobs initially refused surgery to remove the cancer. “I really didn’t want them to open my body, so I tried to see if a few other things would work.”(454) Nine months later, “In July 2004 a CAT scan showed that the tumor had grown and possibly spread.”(455) Jobs underwent surgery on Saturday, July 31, 2004, at Stanford Medical Center. He had a modified Whipple procedure, which took part of his pancreas.(455) He reassured his Apple employees the next day when he wrote in an e-mail that the type of cancer he had, “represents about 1% of the total cases of pancreatic cancer diagnosed each year, and can be cured by surgical removal if diagnosed in time (mine was).”(455) In retrospect, all would agree this statement was untrue. 

Unfortunately, he spent the remainder of his life believing he could have been cured if he had not delayed his surgery for nine months. “According to Steve Jobs’ biographer, Walter Isaacson, the Apple mastermind eventually came to regret the decision he had made years earlier to reject potentially life-saving surgery in favor of alternative treatments like acupuncture, dietary supplements and juices. His early resistance to surgery was apparently incomprehensible to his wife and close friends, who continually urged him to do it.” “We talked about this a lot,” says his biographer. “He wanted to talk about it, how he regretted it. … I think he felt he should have been operated on sooner.” This falsehood was repeated to the world shortly after Jobs death in a 60-minutes interview with Mr. Isaacson.
By the beginning of 2008 it was clear to Jobs and his doctors that his cancer was spreading.(476) In April 2009 he underwent a liver transplant. “When his doctors took out his liver, they found spots on the peritoneum, the thin membrane that surrounds internal organs. In addition, there were tumors throughout the liver, which meant it was likely that the cancer had migrated elsewhere as well.”(484) “But, by July 2011, his cancer had spread to his bones and other parts of his body…”(555). Almost everyone had admitted defeat. He died October 5, 2011 from a body full of cancer that began when he was a young adult working in Silicon Valley.

The overall consensus was, and still is, that Jobs acted selfishly, stupidly, and irresponsibly when he refused surgery in October of 2003, at the time of his original diagnosis. Based on the natural history of his disease, Jobs acted in none of these ways. The cancer had spread many years before his diagnosis, and was unstoppable by any means.

Job’s Vegan Diet Prolonged His Life

Jobs became a vegetarian in his freshman year at Reed College in Portland, Oregon.(36) He would at times eat only fruit, and considered himself a fruitarian.(63, 68, 83) He was a lifelong strict vegan (no animal foods), except for occasional lapses.(91, 155, 260, 458, 527, 528) Jobs often became very upset when his meals were not prepared to his specifications. When a waiter at a restaurant served him a sauce with sour cream, Jobs got nasty.(185). He was observed to “spit out a mouthful of soup one day after he learned that it contained butter.”(260)

Throughout most of his life he was considered a “prickly, whip-thin vegetarian.”(243) He was described as looking “rather like a boxer, aggressive and elusively graceful, or like an elegant jungle cat ready to spring at its prey.”(297) However, most of his family, friends, and coworkers did not understand or sympathize with Jobs’ vegan diet. 

His diet was in sharp contrast to that of his Apple co-founder, Steve Wozniak, who ate at Denny’s and whose favorite foods were typical American pizzas and burgers.(189) Wozniak, who is overweight, was four years older than Jobs and is still alive. Because of this apparent paradox many people discount the importance of a healthy vegan diet. 

After he developed cancer Jobs remembered some of his earlier teachings about the benefits of low-protein vegetarian diets for cancer.(548) I believe Jobs was right, and a healthy low-fat vegan diet will slow the growth (doubling times) of a cancer and prolong a patient’s life. However, animal fats, animal proteins, vegetable oils, and vegetarian foods made with isolated soy proteins can promote cancer growth. Steve Jobs ate in restaurants often. His vegan diet was likely too high in vegetable oils and “fake” meats and cheeses (foods with high amounts of isolated soy proteins). 

The Ultimate Insult: Jobs Was Forced to Eat Meat 

“One of the side effects of the operation would become a problem for Jobs because of his obsessive diets and the weird routine of purging and fasting that he had practiced since he was a teenager. Because the pancreas provides the enzymes that allow the stomach to digest food and absorb nutrients, removing part of the organ makes it hard to get enough protein.”(455) He was advised to eat meat and fish.(455) Lack of protein in Jobs’ diet was not his problem, however his friends, family, biographer, nutritionist, and physicians would not stop attacking his weird obsession with extremely restrictive diets.(477) Jobs lost 40, and then eventually 50 pounds, which was from the partial loss of his pancreas from the initial surgery, the use of morphine to control his pain, his chemotherapies, his liver transplant surgery and drugs used to suppress organ rejection.(477) Until his death, his doctors begged him to consume high quality protein.(548) Obviously the insistence that he eat animal foods made no difference at all in his health; and part of the reason is that the advice was incorrect. 

“Powell (Jobs’ wife) had been a vegan when they were first married, but after her husband’s operation she began to diversify their family diet with fish and other proteins.”(477) Jobs eventually did succumb to these intense demands and ate seafood and eggs.(527,528) For the false hope that eating animals would help, he was forced to turn his back on what he knew to be good for his body, his religious beliefs, and his concerns for the welfare of animals and the environment.

The overall consensus was, and still is, that Jobs acted selfishly, stupidly, and irresponsibly by being a vegan. But, he lived more than 30 years with cancer of the pancreas. (His medical treatments did little or nothing to prolong his life, and caused him great misery at huge expense.)

Summary Comments 

Neither Steve Jobs’ vegan lifestyle nor turning down surgery were the acts of an insane man. Rather both decisions demonstrate his rationality, genius, intuitiveness, and internal strength to stand up for what he knew to be right. The truth may now give family and friends some peace of mind. Also those who tied Jobs’ cancer to his vegan diet can now go back to healthy eating. Understanding and publicizing the cause of his cancer should also focus more attention on the serious harms caused by chemicals used in the electronic industries. 

Consider the misfortune that happened to Steve Jobs, one of the wealthiest and most powerful men to have ever lived. A little cost-free, harmless, and honest counsel would have greatly improved the physical, mental, and emotional wellbeing of Jobs—especially during the last 8 years of his life, when he gave so much to us. I own two MacBook Pro computers, an iPhone, an iPad2, use iTunes daily, and my grandchildren love Pixar movies. Thank you Steve Jobs—I offer this report as a small gratitude for all you have done.

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How Cancer Grows

People unfamiliar with the manner in which cancer grows are easily fooled into thinking it spreads like wildfire, almost overnight, because one moment the person appears to be in good health, and then the next moment the patient has a body full of disease. When the cancer is first diagnosed people believe that this is “early disease,” that can be “caught in time and cured” if removed. This fairytale view is, unfortunately, untrue.

Cancer grows at a steady rate (referred to as the doubling time). Early growth is invisible because the cancer is microscopic in size. This increase in size of the cancer is hidden from view as one cancer cell divides into two cells, two into four, and so on. The doublings remain undetectable until the cancer reaches a size of 1 mm (period-size), which now contains a million cells, after about 6 years of growth. After 10 years of growth, the tumor is 1 cm in diameter (eraser-size) and contains one billion cells. At this point in its natural history the doublings become very apparent: one billion cancer cells divide into a mass containing two billion cells, and with the next doubling there are 4 billion cancer cells inside the patient’s body. Thus, cancer is undetectable by the patient and his physician for the first two-thirds of its natural history, and this leads to confusion.


Calculations on the Growth of Steve Jobs’ Cancer of the Pancreas

Use the doubling time calculator found at: http://www.chestx-ray.com/spn/DoublingTime.html. This calculator is a simple math tool—it makes no difference what kind of cancer cell (lung or pancreas) is being examined.

Calculations from the time of diagnosis in October of 2003:

Using the doubling time calculator (enter the day of his diagnosis, say October 15, 2003 and the day of his death, October 5, 2011) to determine that the tumor was growing for 2912 days (~8 years) during the time Jobs was known to have cancer.

Assume that the tumor mass—the shadow found on the CAT scan in October of 2003—was 10 mm (1 cm) in size (likely the tumor was much larger, but I do not have his medical records). When he died more than 8 years (2912 days) later the tumor would have grown to about 100 mm (10 cm), if it had not been removed.

Entering the size of the initial tumor in the pancreas (10 mm) and the size at death (100 mm), and the 2912 days it took for the cancer to grow during this interval, the calculator tells us that the doubling time of his tumor was 292 days (meaning the tumor doubled in size about every 10 months).
Calculating backwards to find the time when the cancer began: enter a figure of 10 micrometers (um) (use .01 mm) for the size of the first cancer cell in his pancreas, and enter 10 mm for size of the tumor found by CAT scan on October 15, 2003. (One micrometer (um) = 1/1,000,000 meter = 0.000001 meter = 1/1000 millimeter (mm) = .001 millimeter (mm); therefore 10 um = .01 mm.)

With this doubling time of 292 days, the time to grow from 10 um to 1 cm would be 8,740 days or about 24 years. (The number of 8,740 is determined by guessing various time intervals in the doubling time calculator, so that the correct doubling time is reached.) Jobs was 48 years old when diagnosed.  Subtracting 24 years means he could have been as young as 24 years old when the cancer started. By no coincidence this is just after he started working at Hewlett Packard and continued over the next several years to work intimately with many carcinogenic substances found in the electronics industries.

Calculations about the metastatic disease found on Jobs’ liver during his surgery on July 31, 2004:

Using the doubling time calculator (entering the day of his surgery, July 31, 2004, and the day of his death, October 5, 2011) means Jobs’ tumors in his liver (and the rest of his body) were known by his doctors to be growing for 2622 days (~7 years) during this time interval.

Assume that the 3 metastatic tumors found on the surface of his liver at the time of his initial surgery on July 31, 2004 were each 1 cm (10 mm) in size. When he died more than 7 years later (2622 days), then these tumors would have grown to about 100 mm (10 cm) in size each (if his liver had not been removed during his 2009 liver transplant).

Entering the size of the liver tumors at the time of surgery (10 mm) and the size at the time of death (100 mm), and the 2622 days it took for the cancer to grow during this interval, the calculator tells us that the doubling time of his liver tumors was 263 days (meaning every 8½ months the tumor in his liver doubled in size). The doubling times of the original pancreatic tumor and the metastatic liver tumors should be the same; and they are similar: 10 vs. 8½ months.

Calculating backwards to find the time when the tumor metastasized to his liver (and his bones and the rest of his body): enter the figure of 10 micrometers (.01 mm) used for the first cell that spread to the liver, and 10 mm for the tumor found on July 31, 2004 on the liver.  You then look for a time interval that would fit for a doubling time of 263 days. The time to grow from 10 um to 10 mm would be 7,870 days or about 22 years. At the time of his surgery, on July 31, 2004, when he was found to have metastatic cancer, he was 49 years old.  Subtracting 22 years from this age means he was 27 years old when his pancreatic cancer metastasized.

The best-case scenario would be that the tumors seen on Jobs’ liver during his July 31, 2004 surgery were only 1 mm in size (period-size, seen with a magnifying glass or microscope.) The doubling time would then have been every 132 days. (Enter into the calculator 1 mm and 100 mm and 2622 days to get a 132-day doubling time.)

Calculating backwards from 1 mm to .01 mm at a doubling time of 132 days would mean the tumor started growing in Jobs’ liver more than 7 years (2640 days) before his surgery on July 31, 2004. Under this best-case scenario, he would have been 42 years old when the tumor had spread from his pancreas to his liver and the rest of his body.

There is no possible way that the cancer could have been caught in time (before it spread), even if he would have submitted to surgery at the time of his initial diagnosis in October of 2003, or even 6 years before this date. However, because no one told him these easy-to-determine facts, well known in the medical-scientific community, he lived for 8 years until his death with unfounded and unnecessary guilt. Until now, his family and friends have lived under that same dark cloud.
Calculations and text updated on 12/2/2011 (math error corrected)

3.12.11

Return of the Meat-Eaters: Many Lapsed Vegetarians Become ‘Ethical Omnivores’ | NewsFeed | TIME.com

Return of the Meat-Eaters: Many Lapsed Vegetarians Become ‘Ethical Omnivores’ | NewsFeed | TIME.com

Return of the Meat-Eaters: Many Lapsed Vegetarians Become ‘Ethical Omnivores’

Schuster, A./plainpicture/Corbis
Schuster, A./plainpicture/Corbis
Are you a vegetarian? Stats say you’re probably a woman. You probably bid adieu to four-legged creatures for ethical reasons. And you’ll probably be a carnivore again in no time.
In 2005, a CBS News study found that ex-vegetarians outnumber current vegetarians by a ratio of three to one, suggesting that 75% of vegetarians lapse. A survey by Hal Herzog and Morgan Childers found that these born-again omnivores were mostly women (as many vegetarians are) an average age of 28 years old and had been vegetarians for nine years when they reverted. The majority went vegetarian due to concerns about the treatment of animals and returned to meat because of declining health (“I will take a dead cow over anemia any time,” one man told Psychology Today), logistical hassles, social stigmas, and meat cravings. Only two of the seventy-seven former vegetarians surveyed resumed meat-eating because their moral views changed.

(PHOTOS: Cow-Pooling)
For some, like Berlin Reed, 29, the return to meat has ironically been a humane one. Reed, who went vegetarian at age 12, was such a die-hard that his friends once staged a “bacon intervention.” He has the world “vegan” tattooed on his neck. But these days, he both eats meat and works with it, calling himself “the ethical butcher.” He insists that changes in the butchery profession are crucial to improving the meat system. “I don’t eat beef from factory farms for many of the same reasons I won’t buy clothes from The Gap,” Reed told the Today show. “It’s all about the industries and practices that are polluting our world, not whether or not it is okay to kill for food.”

(MORE: Animal Cruelty: Could a Barbaric Pig-Handling Video Hurt Major Grocery Chains?)
Indeed, it seems that the latest form of animal activism is not not eating meat, but rather only eating ethical, sustainable meat. What’s that? It depends on the perspective, though it can include some combination or permutation of industry terms like “organic” “free-range,” “cruelty-free,” and “natural,” and labels about animal welfare from certification companies. Sustainable meat-eating is particularly suitable for those who return to omnivorism because of health problems, like nutritionist Julie Daniluk, 38, who co-hosts a cooking show on the Oprah Winfrey Network, where she promotes conscientious meat-eating and weekly “vegetarian days.”

Most of us will never be able to quit meat cold turkey. But maybe the cold turkey can find its way back to the fridge in a more humane form.
LIST: Top 10 Animal Stories
Related Topics: butcher, meat, nutrition, omnivore, psychology, vegetarian, vegetarianism, Food & Drink, Lifestyle

Read more: http://newsfeed.time.com/2011/06/30/return-of-the-meat-eaters-many-lapsed-vegetarians-become-ethical-omnivores/#ixzz1fPAhXh5Y


CertifiedHumane.org
Ayrshire Farm's calves, which live on lush pasture with free access to feed, shelter and companionship, received a Certified Humane seal of approval.
By
TODAY.com
updated 6/28/2011 11:09:32 AM ET
    A feisty vegetarian since age 12, Berlin Reed was a self-described “punk” who swore to abstain from supporting corporations that he believed profited from mistreating animals, abusing labor practices and “destroying” the environment.
    “I have ‘vegan’ tattooed on my neck,” said Reed, 29. “You could say I was a little passionate about it.”
    Today, however, he’s known as “the ethical butcher,” a title which might seem odd for someone whose friends once arranged a “bacon intervention” to sway him to omnivorism. “It wasn’t a moment of weakness,” Reed said of the switch; instead it was motivated by his realization that, as a butcher, he was in a position to affect the industry he once protested. Reed holds that the butchery trade, in constant contact with customers, is the key to a better and more sustainable meat system.
    “I don’t eat beef from factory farms for many of the same reasons I won’t buy clothes from The Gap,” Reed said. “It’s all about the industries and practices that are polluting our world, not whether or not it is OK to kill for food.”

    Like many former vegetarians, Reed isn’t content to simply sit back and gnaw on his turkey bone. According to a recent study by Psychology Today, most vegetarians return to eating meat. But half of the survey’s respondents originally gave up meat for ethical reasons, and as such, were still concerned with animal protection: “The participants’ original reason for giving up meat did affect their level present meat consumption,” writes Psychology Today.
    Are you a former vegetarian who went back to eating meat?
    Food & Wine profiled several meat-eating “converts” who consider purchasing sustainable meat a new form of activism. “For many of our ex-vegetarian friends, the ethical reasons for eating meat, combined with the health-related ones, have been impossible to deny,” wrote Christine Lennon.

    What’s in a label?

    But “ethical” and “humane” mean different things to different people. The concepts can involve a mishmash of several industry terms, including “organic,” “cruelty-free,” “natural” or “free-range,” whose standards vary. Those concerned with animal welfare try to rely on certification companies whose labels are increasingly popping up on meat packages.
    “We all have our ideas of what ‘free-range’ should be — animals roaming out on lush pasture, et cetera — but that is rarely the case,” said Adele Douglass, executive director of Humane Farm Animal Care, a nonprofit organization that monitors treatment of livestock. “I never buy ‘natural’ or ‘free-range’ or ‘on pasture’ because anyone can say those things and they can mean nothing.”

    Who are the sexiest vegetarians of 2011?
    Although Humane Farm Animal Care hasn’t seen a dramatic increase in vegetarians jumping ship, it has received enthusiastic consumer feedback, especially from vegans and vegetarians who are looking for way to ethically feed loved ones who love a good, juicy steak. “This program gives consumers a way to vote with their pocketbooks,” Douglass said.
    Meat-ing of minds?

    For those who are physically unable to keep up with the challenges of the vegetarian life, ethical omnivorism is a liberating conscience-saver. Nutritionist Julie Daniluk, 38, was plagued by guilt when she returned to eating meat, but 13 years of vegetarianism hadn’t suited her immune system. “I became a vegetarian because I love animals and want to preserve the environment,” Daniluk told TODAY.com. “But I also became anemic as a vegetarian.”

    No matter how many iron supplements Daniluk took, she could not defeat her constant fatigue and the dark circles under her eyes. Hesitantly, she incorporated meat into her weekly diet, but was determined to do so responsibly.



    Berlin Reed, known as “the ethical butcher,” is an ex-vegetarian concerned with animal protection.
    Daniluk sought out farmers markets that sold organic, naturally raised, grass-fed animal meat. Today, as co-host of “Healthy Gourmet,” a cooking show on the Oprah Winfrey Network, Daniluk preaches responsible meat-eating — including taking a “vegetarian day” once a week.

    New breed of butchers works against the grain
     
    Some ex-vegetarians return to meat with gusto. Take Sasha Wizansky, who once shunned eating animals but now actually runs Meatpaper, a quarterly print journal devoted to all things meat. “Vegetarianism became part of my identity — a promise to myself — and I mostly stuck to it for seven years,” said Wizansky, who currently avoids consuming factory-farmed poultry, endangered species of fish and, more important, “mysterious ground meat.” Although her job is obsessed with barbecue fodder, the 37-year-old admits her daily diet tends to be largely vegetarian. “I believe in having rules, and also occasionally breaking them in the interest of balance.”

    And Wizansky is far from the only one who straddles two worlds. As the ethics and interests of vegetarians and sustainable meat eaters become more shared, the more crossover there is between the two groups.

    Mad science? Growing meat without animals
     
    “Ten years ago or so, it seemed that most of San Francisco identified with a vegetarian lifestyle, but that has really changed,” Wizansky observed. “Meat producers couldn't even get a booth at Bay Area farmers markets. Now, local, organic, humane producers have a huge presence at those same markets.”

    As several testified, the return to meat is all the easier when you have community support, be it the local farmers market, friends or family.

    “My grandmother is German,” “ethical butcher” Reed told TODAY.com. “She was just happy she could cook for me again.”


    © 2011 MSNBC Interactive. Reprints



    Animals and Us

    The psychology of human-animal interactions

    Why Do Most Vegetarians Go Back To Eating Meat?

    For most people, vegetarianism is temporary phase. Why?

    I am interviewing Staci Giani who is forty-one but looks ten years younger. Raised in the Connecticut suburbs, she now lives with her partner Gregory in a self-sustaining eco-community deep in the mountains twenty minutes north of Old Fort, North Carolina. Staci radiates strength, and when she talks about food, she gets excited and seems to glow. She is Italian-American, attractive, and you want to smile when you talk to her. She tells me that she and Gregory built their own house, even cutting the timber and milling the logs. I think to myself, "This woman could kick my ass."

    Staci wasn't always so fit. In her early 30's, Staci's health started going downhill. After twelve years of strict vegetarianism, she began to suffer from anemia and chronic fatigue syndrome, and she experienced stomach pains for two hours after every meal. "I was completely debilitated," she tells me. "Then I changed the way I ate."
    "Tell me about your diet now. What did you have for breakfast today?" I ask.
    "A half pint of raw beef liver," she says.

    Ok....Staci is a bit extreme in her carnivory -- these days she prefers her meat raw, and she eats a lot of it. But the transformation from hard-core vegetarian to meat-eater that Staci illustrates is surprisingly common. Indeed, according to a 2005 survey by CBS News, three times as many American adults admit to being "ex-vegetarians" than describe themselves as current vegetarians. This suggests that roughly 75% of people who quit eating meat eventually change their minds and return to a diet that includes animal flesh. It seems that for most people, vegetarianism is a phase rather than a permanent change in lifestyle. Why?
    Perhaps because I was raised a Southern Baptist, I have always been fascinated by backsliders, so I decided to find out why so many vegetarians eventually give up their all-plant diet. To study the motivations of ex-veggies, Morgan Childers and I set up a website that included a survey related to eating.Then we put out a call for ex-vegetarians through Internet sites devoted to topics like health, nutrition, and the treatment of animals.

    Over the next week or so, seventy-seven former vegetarians took our survey. As is true of vegetarians generally, the majority of the participants were women. Their average age was 28, and on average, they had been vegetarian for nine years before for reverting back to eating animals. We asked the participants to indicate the primary reasons they quit eating meat in the first place and why they subsequently decided to give up their all-plant diet. They also had the opportunity to comment at length on the reasons for the changes they had made in their eating habits.

    Why Did They Stop Eating Meat In The First Place?

    As other researchers have reported about vegetarians, our participants originally quit meat for a variety of reasons. The most common reasons in our study were ethical concerns about the treatment of animals (57%), followed by health and environmental reasons (15% each). Fewer people stopped eating meat because they did not like the taste of animal flesh or because of social pressure from friends, spouses, etc.

    Why The Ex-Veggies Resumed Eating Animals

    Reasons For Resuming
    Meat-Eating
    The reasons that the ex-vegetarians gave for reverting to omnivory fell into five categories.
    Declining Health. In his book The Face on Your Plate: The Truth About Food, Jeffrey Moussaieff Masson extols the health benefits of an all plant diet. He writes, "Now at 68, several years a vegan, I find I have never been healthier. I weigh less than I did at thirty; I am stronger than when I was forty; I have fewer colds or minor illnesses than at fifty." While Masson may have thrived on a meatless diet, this is not always the case with vegetarians. In fact, thirty-five percent of our participants indicated that declining health was the main reason they reverted back to eating flesh. For example, one wrote, "I was very weak and sickly. I felt horrible even though I ate a good variety of foods like PETA said to." Another wrote, "My doctor recommended that I eat some form of meat as I was not getting any better. I thought it would be hypocritical of me to just eat chicken and fish as they are just as much and animal as a cow or pig. So I went from no meat to all meat." The most succinct response was by a man who wrote, "I will take a dead cow over anemia any time."

    Hassles and Social Stigmas. About a quarter of our ex-veggies described the hassles they said were associated with strict vegetarianism. They complained that it was difficult to find high quality organic vegetables in their local supermarkets at a reasonable price. Others began to resent the time it took to prepare meatless dishes, and some said they simply grew tired of the lifestyle.

    A related reason for returning to meat consumption, one mentioned by 15% of our subjects, was that vegetarianism was taking a toll on their social life. The degree that vegetarianism and particularly moral veganism can screw up your day to day existence was nicely summed up in a New York Times op ed by the philosopher Gary Steiner titled, appropriately, "Animal, Vegetable, Miserable." In describing his personal experience with giving up the consumption of animal products, he wrote "What were once the most straightforward activities become a constant ordeal."

    Irresistible Urges. About one in five of our participants had developed an irresistible urge to taste cooked flesh once more. This occurred even among some long-term vegetarians. Participants talked about their protein cravings or how the smell of sizzling bacon would drive them crazy. One, for example, said "I just felt hungry all the time and that hunger would not be satisfied unless I ate meat." Another described his return to meat in mathmatical terms:
    Starving college student + First night back home with the folks + Fifty or so blazin' buffalo wings waiting in the kitchen = Surrender.

    Shifts in Moral Thinking. About half of the respondents originally gave up meat for ethical reasons. Yet only two of our ex-vegetarians said changes in their views of the morality of killing animals motivated their decision to resume meat consumption. In fact, most of the former vegetarians were still concerned with animal protection and the ethical issues associated with eating animals. The participants' original reason for giving up meat did affect their level present meat consumption. Individuals who had given up eating meat primarily for social reasons indicated that they ate meat much more frequently than did people who originally became vegetarian for ethical or environmental reasons.*

    The Bottom Line

    For most people, the draw of meat is powerful -- often irresistible. This is not a justification for slaughtering creatures because they happen to taste good. Philosophers correctly warn against committing "the naturalistic fallacy" - assuming that because a behavior is "natural," it is also ethical. In fact, I believe the case against eating other creatures is strong on moral, environmental, and health grounds. Why then do even most vegetarians eventually cave to the desire to eat animal flesh? Is meat-eating in our genes? I will take this question up in a future PT blog. Stay tuned.

    Note: This is the third in a series of posts on the human-meat relationship. Here are the first two:

    Having Your Dog And Eating It Too?
    Eating Disorders: The Dark Side of Vegetarianism
    Hal Herzog is Professor of Psychology at Western Carolina University and the author of Some We Love, Some We Hate, Some We Eat: Why It's So Hard To Think Straight About Animals.

    Why Vegetarians Are Eating Meat

    A growing number of vegetarians are starting to eat humanely raised meat. Christine Lennon talks to a few converts—including her husband and famed author Mollie Katzen.
      By Christine Lennon
    To a die-hard meat eater, there's nothing more irritating than a smug vegetarian. I feel at liberty to say this because I am one (a steak lover) and I married the other (a vegetarian with a pulpit). For me, "Do you now, or would you ever, eat meat?" has always been a question on par with "Do you ever want to get married?" and "Do you want children?" The answer to one reveals as much about a person's interior life, and our compatibility, as the response to the others. My husband Andrew's reply to all of those questions when I asked him three years ago was, "No."

    Obviously, we're now married. We had twins earlier this year. And somewhere in between those two events, the answer to the third question was also re-evaluated, and the vegetarian soapbox was put to rest, too.

    Yes, my husband has started eating meat again after a seven-year hiatus as an ethically motivated and health-conscious vegetarian. About a year ago, we arrived at a compromise: I would eat less meat—choosing mostly beef, pork and poultry produced by local California ranchers without the use of hormones or antibiotics—and he would indulge me by sharing a steak on occasion. But arriving at that happy medium wasn't as straightforward as it sounds. In the three years we've been together, several turns of events have made both of us rethink our choices and decide that eating meat selectively is better for the planet and our own health. And judging by the conversations we've had with friends and acquaintances, we're not the only ones who believe this to be true.

    For Andrew and about a dozen people in our circle who have recently converted from vegetarianism, eating sustainable meat purchased from small farmers is a new form of activism—a way of striking a blow against the factory farming of livestock that books like Michael Pollan's The Omnivore's Dilemma describe so damningly. Pollan extols the virtues of independent, small-scale food producers who raise pasture-fed livestock in a sustainable and ethical manner. In contrast, he provides a compelling critique of factory farms, which cram thousands of cows, pigs or chickens into rows of cages in warehouses, feed them drugs to plump up their meat and fight off the illnesses caused by these inhumane conditions, and produce innumerable tons of environmentally destructive animal waste.

    The terms "grass fed" and "pasture raised"—meaning that an animal was allowed to graze the old-fashioned way instead of being fed an unnatural and difficult-to-digest diet of mostly corn and other grain—have now entered the food-shoppers' lexicon. But Andrew and I didn't fully understand what those phrases meant until we got to know Greg Nauta of Rocky Canyon Farms. Nauta is a small-scale rancher and farmer from Atascadero, California, who grows organic vegetables and raises about 35 animals on pastureland. Since we met him at the Hollywood Farmers' Market a year ago, it has become even clearer to us that supporting guys like him—by seeking out and paying a premium for sustainably raised meat—is the right thing for us to do.

    Nauta's cattle graze on 200 leased acres of pasture in central California and are fed the leftover vegetables and fruits he grows that don't sell at the farmers' market, supplemented by locally grown barley grain on occasion. "That's dessert," he says of the barley, "not a main course. That would be like us eating ice cream every day."

    Three times a week, Nauta loads his truck full of coolers stocked with cattleman's steaks and handmade pork sausages and drives to the Los Angeles–area farmers' markets. Selling his vegetables and meat directly to conscientious eaters, people to whom he talks weekly about rainfall averages and organic produce, Nauta says, is "the best way small guys like me can compete." In the past several months, Nauta has noticed a handful of curious vegetarians, like Andrew, wandering over to his booth to ask questions. And they're satisfied enough with the answers to give his meat a try—and come back for more.

    If preserving small-scale farming isn't a compelling enough reason to eat beef or pork, consider the nutritional advantages grass-fed meat has over the factory-fed kind. "One of the benefits of all-grass-fed beef, or 'beef with benefits,' as we say, is that it's lower in fat than conventionally raised beef," says Kate Clancy, who studies nutrition and sustainable agriculture and was until recently the senior scientist at the nonprofit Union of Concerned Scientists. "The other thing is that the meat and milk from grass-fed cattle will probably have higher amounts of omega-3 fatty acids, which may help reduce the risk of heart disease and strengthen people's immune systems. What's good for the environment, what's good for cattle, is also good for us."

    Combine these findings with the questions being raised about meat replacements derived from soy and wheat gluten, and the real thing seems better by the minute. "What we know about soy is that as you process it, you lose a lot of the benefits," says Ashley Koff, a Los Angeles–based registered dietician. "Any soy-based fake meat product is incredibly processed, and you have to use chemicals to get the mock flavor. Any other whole-food diet is going to be a lot better for you." Vegetarians like Andrew—he once brought a tofu sandwich to a famous Texas barbecue restaurant—may now have a harder time justifying their "healthier" dietary choices.

    Former vegetarians are some of the most outspoken proponents of eating meat. "I was vegan for 16 years, and I truly believed I was doing the right thing for my health," says the actress and model Mariel Hemingway, who is the author of Healthy Living from the Inside Out. "But when I was vegan, I was super-weak. I love animals, and we should not support anything but ethical ranching, but when I eat meat, I feel more grounded. I have more energy."

    Even chef Mollie Katzen, author of the vegetarian bible the Moosewood Cookbook, is experimenting with meat again. "For about 30 years I didn't eat meat at all, just a bite of fish every once in a while, and always some dairy," she says. "Lately, I've been eating a little meat. People say, 'Ha, ha, Mollie Katzen is eating steak.' But now that cleaner, naturally fed meat is available, it's a great option for anyone who's looking to complete his diet. Somehow, it got ascribed to me that I don't want people to eat meat. I've just wanted to supply possibilities that were low on the food chain."

    Recently, when responding to the invitation to her high-school reunion, Katzen had to make a choice between the vegetarian and the conventional meal. She checked the nonvegetarian box. "The people who requested the vegetarian meal got fettuccine Alfredo," she says. "It's a bowl full of flour and butterfat. I'd much rather have vegetables and grains and a few bites of chicken."

    For Andrew and many of our ex-vegetarian friends, the ethical reasons for eating meat, combined with the health-related ones, have been impossible to deny. "The way I see it, you've got three opportunities every day to act on your values and have an immediate effect on something you're concerned about," Andrew says. "You're probably worried about Darfur, too, but what can you do about that every single day? Write a letter? It doesn't have the same kind of impact."

    Supporting ranchers we believe in, and the stores and restaurants that sell their products, has a very tangible impact that we experience firsthand all the time. But ask most vegetarians if the battle between small, sustainable ranchers and industrial farming is at the top of their list of concerns about eating meat, and you'll probably be met with a blank stare. "For people who are against eating meat because it's wrong or offensive to eat animals, even the cleanest grass-fed beef won't be good enough," Katzen says.

    Convincing those people that eating meat can improve the welfare of the entire livestock population is a tough sell. But we'll keep trying. What we've discovered is that you can hover pretty close to the bottom of the food chain and still make a difference, quietly. We've found a healthy balance somewhere between the two extremes—which, come to think of it, is also a good way to approach a marriage.

    Christine Lennon is a freelance writer in Los Angeles who regularly contributes to InStyle and Time.