Optimal Nutrition: True Personalization Means Throwing Away the Rulebook

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In this episode, James Maskell nails it when he says that the 20th century was about creating rules for everyone to live by. One example: dietary guidelines. Jeff Bland watched the rule-making unfold. As a nutrition expert, he saw flawed logic from the start in the one-size-fits all philosophy. Ready to break free from outdated thinking? Self-ownership of your metabolism—what a concept! This discussion is packed with facts, insights, and tips for how to get started.

James Maskell: 00:07 Hello and welcome back to the Big Bold Health Podcast, making health personal in a world of disease. Today, we’re going to be talking about nutrition. Over the last few episodes, we’ve been talking really about this difference between a disease care system and a health care system, and how they are very, very different. A typical entry point for this kind of conversation is what we eat. Ultimately, I feel that the Big Bold Health Podcast has something to offer to contextualize where we’ve gone wrong and where we should be looking for the future. So why is this such a pervasive conversation, and why is it in need of rebooting?

Jeffrey Bland: 00:46 Yeah, I think, James, that one of the biggest challenges that we’ve had to follow through with health and behavior changes that people might make to really improve their health is a disillusionment that comes from them locking onto a single person who says they have the solution to everybody’s problems, and that really relates to diet. You know, how many diet books I have seen in my life of 40 years as a professional in this field that have claimed that this is the diet for everybody, this is the solution to all problems?

I can’t even really speculate how many it’s been, but what I guess we can say without any doubt is that there is no one diet that’s optimal for everyone. And, because the Big Bold Health Podcast is all around personal affirmation of health, it doesn’t really matter what might be the best diet for somebody else. It’s really, what’s the best diet for that person to achieve their own personal health? So, the questions that we might ask to identify what is the diet of our specific need are different than the question of, can I find the author who has the bestselling book that one diet fits all?

James Maskell: 02:00 The concept of a diet book where one fits all is actually a product of the old way of thinking, right?

Jeffrey Bland: 02:08 Yes.

James Maskell: 02:08 Of us as a group, and maybe you could just unpack a little bit of where that thinking comes from and why disease-based thinking has made its way into health creation.

Jeffrey Bland: 02:19 Yeah, thank you. I think this really relates to the whole nature of the origin of the science of nutrition and how that translates into diet recommendations. If you’d bear with me just for a sec, let me give a brief capsulated view of my kind of a Classics Illustrated view of the history of nutrition. So, about the turn of the last century, that would be the 19th going into the 20th century, the science of nutrition was just starting. And, there was a gentleman by the name of George Atwater, who has very famous, that lived during this period of time, who wanted to understand the energy capabilities of food because it was recognized that we ate food for energy, first kind of concept of nutrition going way back.

He wanted to know, what is the energy potential of food? He thought, “Well, how would I measure that?” And I would measure that like I might measure the heat content of any substance that I would like burn in a fire, like a log. So he said, “Different kinds of wood have different heat potential,” like a hardwood would burn different in a fire than a softwood. So, maybe foods burn differently in the body—I’m using an analogy here.

He used the technique that was used to determine the heat content of materials—this came from physics—called a calorimeter. A calorimeter is a device, it measures heat output of burning something. You can’t burn people up, obviously, so what he did is he took food that people ate, and he said, “What happens if I partitioned the food into the three major sources of energy?” And, those are carbohydrate, fat, and protein.

He said, “What happens if I then purified fat, protein, and carbohydrate, and I put them in a calorimeter, and I burned them and saw how much heat they would produce?” So, I would take so many ounces of carbohydrate, put it into a calorimeter, and look at the heat produced. When he did that, he was able to show, just like if it was a physics experiment with wood or any other combustible material, how much heat was produced. And what do physics use? What term did they use to define heat content? It’s called the calorie.

James Maskell: 02:19 Calorie, yep.

Jeffrey Bland: 04:33 So he said, “Aha! Food has potential calories, it’s potential energy.” He measured then, the potential energy of carbohydrate, and he found out that it has 4,000 calories of energy per gram of being burned in the calorimeter. And then he tried protein, and he found, lo and behold, protein has about the same, about 4,000 calories per gram—these are little calories. Then fat, it was a higher heat content; it had around 9,000 calories per gram. That didn’t get translated from the physics calorie, which is called the kilocalorie, the thousands of calories, to the nutrition calorie, which is a capital C. So one nutritionist calorie is a thousand little calories.

So, we moved from physics now into nutrition. When we talk about four calories per gram per carbohydrate, that would be like 4,000 of the little calories from physics. Everybody got thinking, “Oh, my word, okay, now I can really understand food as an energy source because that means if I eat a lot of fat, I’m going to get almost two and a half times more energy per mouthful than if I ate carbohydrate or protein, because those are only four calories per gram.” This was the whole basis of the concept of dieting and obesity for years, and years, and years.

It was built on the primacy of the calorie, and it was assumed that everyone burned these calories in their body the same, and that they were always the same from person to person, just like as if we were all calorimeters. Well, now we look back, and we say that was pretty stupid, because we’re not calorimeters. We are very complex physiological instruments, that regulate carefully, the production of energy from our food in ways that are controlled by multiple hormones, and enzymes, and various vitamins and minerals, and differ from person to person based on our genes.

So, we just can’t say a food, no matter what it is, would always produce the same energy potential in a person. Now, why is that an important concept for 21st century nutrition? It’s important because we have seen over the last 50 years, multiple public health nutrition programs focused on how to treat obesity by counting calories—by you’ve got to cut back calories this, cut back calories that, that fat calories are bad, that carbohydrate calories there’s no difference, whether it’s complex carbohydrate coming from unrefined grains, or if it’s simple carbohydrate coming from white flour and sugar. It’s all the same heat potential.

So, it leads people to a completely erroneous view as to how to really manage their diet based on their own unique physiology. There is no primacy of calories as a central guiding principle. Now, you might say, “Well, gee-whiz, does that mean we just throw the calorie entirely out? It has no relevancy?” No, it still has relevancy. I don’t want to say it’s immaterial, but what I want to say is that—as we’re defining in the Big Bold Health approach towards personalized nutrition—how each one of those foods gets used by the body is independently unique to that person.

So, for one person, they may be very adept at burning up carbohydrate, at using it as a source of energy. Another person might be really—because of the whole way that their body manages carbohydrate, which as you know is composed of a glucose which is the building block of carbohydrate—they may be much less adept at managing that than if they’re managing protein, or if they’re managing fat. And so, what we need to start doing is to really understanding the unique predisposition of that person, how their body specifically converts food into energy and function, and that stores it as a source of energy for a rainy day that never comes that we call body fat.

That is very interesting to think of—why would the body store energy when the person is behaving as if they were lower energy? Have you ever seen that before, with a person that looks like they’re overweight, and you would say, “Wow, that person has so much stored energy, they must have energy galore,” but when you watch how they’re actually performing in life, they’re low energy, they’re tired, they’re worn out, they feel like they have to get more food in to keep up their energy?

Why is that? Because their body has what I call, switched metabolism. It is taking the energy of food, because it’s inappropriate for their specific type, and it’s converting into a storage form that’s called fat stored in our body, for which it’s a rainy day that never is used up. So, I think that we are starting to see a whole different evolution of how to personalize nutrition to lead to proper body composition, to proper energy, to proper cellular regulation, so that we’re not kind of having this fallacy that one diet fits all.

James Maskell: 09:18 So, the 20th century really looked to create kind of rules to live by for everyone.

Jeffrey Bland: 09:22 Yes.

James Maskell: 09:23 And there was a small subsection of humans that those rules worked quite well for and they operated well. But, outside of this sort of middle of the bell curve of all these outliers, that actually end up probably being the majority of the population for which it’s not working. I know that one of the things that you advocate for, you’re interested in is this idea of personalized public health, so it’s to think differently about it. We’re designing public health now for the 21st century. What do nutrition guidelines look like in a Big Bold Health world?

Jeffrey Bland: 09:55 Oh, boy, that’s a really important frontier-level question that is going into exactly where the puck is going, not where it’s been, but where we should be skating to meet it. So, it turns out that public health, which certainly has made contributions, no doubt, to community health—things like sanitation, hygiene, and nutrition certainly have come out of public health principles, which have been advantageous for eradicating many infectious diseases in developing countries, including the United States, led to sanitation and various things that are really important, hygiene principles.

But then, if we get down to personalized health, as we’re talking about in Big Bold Health, the equation kind of shifts over to say, okay, then how do we take what we’ve learned about generalized health principles and precisely deliver it to the individual? That’s the emergence of this new field that you alluded to called precision public health. It almost sounds like an oxymoron. How do you make precise public health? And, the way that this is occurring is quite fascinating. I think it’s reflective of exactly the whole trend of going from a life for the average to life of the individual.

That’s a major cultural shift in everything, in consumer products, in health care, in technology, in music, and arts. We’re moving from that of the average to that of the individual. So, how does precision public health emerge out of public health? So, thanks to extraordinary work that’s been done by the Institute for Health Metrics and Evaluation in Seattle—it’s a Gates Foundation funded organization—for this global project to actually evaluate down to the community level, down to actually the individual small township level, what are the actual health indicators at that particular region?

Because we’re almost segmented by our zip codes, aren’t we, into our various health and lifestyle factors, and so what they started to do was to take these public health principles and to actually translate them down into precision understanding of individual communities, down to actually individual block area health-related factors. And, when they did that, they developed what was called quality of life years lost, QALYs, Q-A-L-Ys, which says in this community, those people that are doing these things are losing this many quality life years because it’s not that they’re necessarily dying young, but their quality of life is being adversely affected.

Now, when you introduce quality into the equation, you’ve moved away from the old model because the old model was the absence of disease is the presence of health. Now we’re saying, “No, it’s not just the absence of disease, it’s the presence of function that relates to your health.” So, quality life years, how do you measure quality of life? Well, you measure quality of life in the way you assess it, as I do, as does anybody. So, when you start saying quality of life years lost, and tie that to public health, it’s much more precise to say, what’s going on in that individual, maybe home, or that individual community, that is actually relating to the stealing from them of quality life years lost?

And, I think that this is a trend that is giving rise to the convergence or the intersection between public health now and what we’re calling personalized health care. This is not like two completely separate fields, they’re sharing similar bodies of data so that, ultimately, what we will deliver, as we are talking about in the Big Bold Health, is health is a personal matter that is individualized, and the community health is dependent upon not only what the community is exposed to, but how each individual personalizes their approach in delivery of that to their lives.

And, I think diet is an extraordinarily good example, because there are certain general principles that we know are probably applicable to everybody. Like, if you eat junk, no matter what your genes are, you’re going to be probably less than ideally affected. But then the question is, okay, within the scope of individuals trying to eat a reasonably good diet, how does it affect their specific affects or their specific outcomes? So, you can use gluten as an example—not everybody needs to be on a completely gluten-removed diet, eliminating all sorts of gluten.

But, there are certain individuals for which this protein that’s found in grains is a foreigner in their body, and their immune system responds by producing not only problems of their digestive system, but systemic problems that can even be related to their brain function. In fact, now there’s a well-known association between early stage dementia and gluten sensitivity that goes back probably 20 years in our understanding. Does that mean everybody should remove gluten entirely from their diet? No, that doesn’t necessarily say that, but what it does say is that there are individuals who are uniquely sensitive based upon the way their immune system—built upon their genomic book of life—determines a response to that material.

Then we start saying, “Well, if it’s gluten, what other things, what other additives, what other proteins, what other substances would send signals to an individual’s immune system to produce an adverse effect that would be called lack of health or dysfunction?” That’s the way that this field is really evolving, is to go down the lexicon of foods, and that’s why things like food elimination diets allow us to kind of explore individually how this affects us.

James Maskell: 15:15 Well, I wanted to ask you about that because you used the word delivered a few times, and if we think of the old way of delivering public health, it was professional sort of bestowing it upon the individuals. Where it sounds like what you’re talking about when you talk about delivery of precision public health, is that the onus is a lot more on the individual to work it out for themselves. What are some of the sort of the ways that you’ve seen that that’s happening in a way that’s affordable and accessible to everyone?

Jeffrey Bland: 15:42 I think the powerful part of this movement, which it’s almost like Power to the People, it reminds me of my ’60s experience, is that we’re starting to recognize that so much of our health is really owned by us. If we only understood how to regain ownership. Because, in the end, even if we have a health professional that’s very skilled in the art to assist us in making intelligent decisions, it’s us that will go home and eat, and us that will go home to have activities, or sleep, or rest, or whatever it is that we do, will ultimately become our own responsibility.

It’s not as simple as just taking a pill and trying to stay adhering to your medicines; it’s really trying to be engaged in a life design in which you’re the master of your own destiny. So, how does that work? Well, in terms of diet, I think for many individuals the approach that engages a food elimination, reintroduction approach is a very educational experience. I started doing this really in the ’70s when I met some of the early developers of food elimination diets.

This was from the Institute of Environmental Medicine and individuals that were involved with really the early stage of doing any clinical evaluation of their patients of food elimination reintroduction diet. What you find when you do that yourself, is that it takes about five days to kind of get your system removed from any kind of an immune response that you might’ve had to the food you were eating. So, you’re kind of in a clearer state, so to speak. Then you start introducing one food at a time, and you just look over the next few hours after you’ve consumed that food, as to what your physiological response is.

Does your heart start racing? Do you get hives? Do you get a fuzzy head with a cloudy mentation? Do you feel low energy? Do your joints start to hurt? There are all sorts of … do you get digestive upset? So, you start to recognize that there may be certain foods that you’re including in your diet that actually, for you, are producing not so good a response. It wouldn’t necessarily be a food allergy, it’s a food intolerance or adverse food response. So then you design a diet—you say, “Okay, I’m going to kind of rotate those foods out of my diet, or I’m going to only eat them periodically; they’re not going to be the main or major part of the foods that I eat.”

And by the way, it’s been found with nutrition studies that, believe it or not, 80% of the calories people eat, 80% of their food energy comes from less than 15 foods. Think of that, so less than 15 foods, and most people, actually over 50%, comes from less than seven foods. So, we eat pretty monotonous diets, we might think, “Oh, no, I eat a whole variety of foods,” but most of them are really insignificant relative to the total volume of foods that we eat.

It really comes down to a certain, very small set of foods that really define most of our intake. So, maybe one of those foods, one of those major foods, what I call a driver food, becomes recognized as a problem for us. When we do the elimination, reintroduction, provocation, we say, “Wow, I wouldn’t have ever known that because that problem was masked by the other things I was eating, and I would have these kind of low-grade symptoms that was not necessarily identified with that specific food.”

That’s one kind of way of getting to it. Another way is to engage in intermittent fasting, which has now become a very interesting and popular concept, produces intermittent, what’s called ketone increases, which beta-hydroxybutyrate, or BHB, is one of the ketones. It’s produced during these intermittent fastings that has favorable effects on all sorts of things, lowered inflammation, improved brain function, improved insulin signaling.

And you can, by intermittent fasting, also identify certain things that were in your diet that may be producing symptoms you didn’t even recognize, because you just are in only one body with one set of experiences, and you assume that whatever you’re eating is doing fine for you. But after going intermittent fasting and reintroduction, you say, “Whoa, some of these foods I was eating really are not fully delivering to me what I want.” So, when we talk about the word delivery, it’s really the individual delivering this information to themselves and taking charge of it.

James Maskell: 19:47 Millennials have been accused of killing certain industries—I could see that if they were to really adapt into this, they could kill the diet book.

Jeffrey Bland: 19:54 Well, I don’t think necessarily they’ll kill the diet book because I think that will live on, but it may kill the one-size-fits-all diet book. It may actually help us to understand better in these future diet books how to differentiate, how to personalize. I mean, the whole theme of the Big Bold Health Podcast, I think is a very important theme, and that is moving us from the mentation of the average to the view of the individual. We are individual, and Roger Williams, who in 1949 wrote this landmark article in The Lancet, called “Biochemical Individuality,” which at the time seemed very ahead of his time, and people didn’t accept it.

“What’s this nutrition guy from the University of Texas talking about in a medical journal? He shouldn’t be talking about things like that. He’s not a doctor.” But now, over the course of now 70 years, what Dr. Williams was talking about doesn’t look so silly, that we are all much more unique in our biochemical response to our diet and lifestyle than we ever fully understood in the beginning. We thought that we could put a recommendation in the back of cereal boxes called the RDIs, or used to be called the RDAs, and used to be called the MDRs, minimum daily requirements became the recommended dietary allowances became the reference dietary intakes of today, that we would then guide our lives by these principles.

But, they’re principles for the average, they’re not principles for the individual. What Williams found is that the range of difference from person to person is far greater than we would’ve ever expected when we actually start doing the right studies. We might look similar, we all have, or most of us have 10 fingers, and two ears, and two eyes, but in terms of our biochemistry—how we actually metabolize and utilize our foods—very different from individual to individual.

James Maskell: 21:35 What is some of the mechanistic side of this that is guiding it?

Jeffrey Bland: 21:39 Well, I think the most significant part of the mechanistic driver for this is the marrying of the age of the genome with the age of nutrition, and this is what the term is called nutrigenomics. That’s the new buzzword. It’s marrying our individual genetic response to our diet, to our way that we eat, and seeing how nutrition influences our outcome, called our phenotype or our health. And so, nutrigenomics starts with, you could do a gene test to start to understand this, or you could just become a good student of how diet, and nutrition, and foods influences your own health, recognizing that you are a unique facet on the diamond of life.

I want to say that again. When we think of it, this is a pretty interesting moment in our history in which for the first time we have gotten a very clear view that there has never been an us ever formed before, and there’ll never be another like us identical to us. There may be people similar to us, maybe even identical twins don’t share, as you know, identical response in their genes to their environment. As we’ve seen more recently by the NASA astronauts, one who stayed on ground, and the other identical twin was up at Skylab and what did they find? That the one in Skylab, being in outer space, that his epigenetic—meaning above his genome signaling—changed in space, so he was no longer identical to his brother in the way his genes were responding when he came back to earth.

Now, it did happen that they returned back similar over time, but the point I’m trying to make is that we are unique, and the most precious thing we own is our book of life, and it shouldn’t be defaced, it shouldn’t be taken for granted, it shouldn’t be despoiled, it shouldn’t be burn singed or water spotted. We should protect our book of life by recognizing its uniqueness, the precious gift it is, and then doing all we can to have it read, so that the stories of bliss are experienced to us and not the stories of tragedy.

James Maskell: 23:44 Absolutely, it is on all of us to participate in this way and to learn about ourselves, because no one really has the opportunity to learn about yourself better than you. There’s no health professional out there who’s going to solve this for you. We look forward to more conversations in the Big Bold Health Podcast about bringing this down to the individual. It’s been great to share this time about nutrition. I hope you’ve learned something. Thanks so much for watching. I’m your host, James Maskell, and we’ll see you next time.

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Online Commerce

 

Certain sections of the Site may allow you to purchase many different types of products and services online that are provided by third parties. We are not responsible for the quality, accuracy, timeliness, reliability or any other aspect of these products and services. If you make a purchase from a merchant on the Site or on a site linked to by the Site, the information obtained during your visit to that merchant’s online store or site, and the information that you give as part of the transaction, such as your credit card number and contact information, may be collected by both the merchant and us. A merchant may have privacy and data collection practices that are different from ours. We have no responsibility or liability for these independent policies. In addition, when you purchase products or services on or through the Site, you may be subject to additional terms and conditions that specifically apply to your purchase or use of such products or services. For more information regarding a merchant, its online store, its privacy policies, and/or any additional terms and conditions that may apply, visit that merchant’s website and click on its information links or contact the merchant directly. You release us and our affiliates from any damages that you incur, and agree not to assert any claims against us or them, arising from your purchase or use of any products or services made available by third parties through the Site.

 

Your participation, correspondence or business dealings with any third party found on or through our Site, regarding payment and delivery of specific goods and services, and any other terms, conditions, representations or warranties associated with such dealings, are solely between you and such third party. You agree that COMPANY shall not be responsible or liable for any loss, damage, or other matters of any sort incurred as the result of such dealings.

 

You agree to be financially responsible for all purchases made by you or someone acting on your behalf through the Site. You agree to use the Site and to purchase services or products through the Site for legitimate, non-commercial purposes only. You also agree not to make any purchases for speculative, false or fraudulent purposes or for the purpose of anticipating demand for a particular product or service. You agree to only purchase goods or services for yourself or for another person for whom you are legally permitted to do so. When making a purchase for a third party that requires you to submit the third party’s personal information to us or a merchant, you represent that you have obtained the express consent of such third party to provide such third party’s personal information.

 

Interactive Features

 

This Site may include a variety of features, such as bulletin boards, web logs, chat rooms, and email services, which allow feedback to us and real-time interaction between users, and other features which allow users to communicate with others. Responsibility for what is posted on bulletin boards, web logs, chat rooms, and other public posting areas on the Site, or sent via any email services on the Site, lies with each user – you alone are responsible for the material you post or send. We do not control the messages, information or files that you or others may provide through the Site. It is a condition of your use of the Site that you do not:

  • Restrict or inhibit any other user from using and enjoying the Site.
  • Use the Site to impersonate any person or entity, or falsely state or otherwise misrepresent your affiliation with a person or entity.
  • Interfere with or disrupt any servers or networks used to provide the Site or its features, or disobey any requirements, procedures, policies or regulations of the networks we use to provide the Site.
  • Use the Site to instigate or encourage others to commit illegal activities or cause injury or property damage to any person.
  • Gain unauthorized access to the Site, or any account, computer system, or network connected to this Site, by means such as hacking, password mining or other illicit means.
  • Obtain or attempt to obtain any materials or information through any means not intentionally made available through this Site.
  • Use the Site to post or transmit any unlawful, threatening, abusive, libelous, defamatory, obscene, vulgar, pornographic, profane or indecent information of any kind, including without limitation any transmissions constituting or encouraging conduct that would constitute a criminal offense, give rise to civil liability or otherwise violate any local, state, national or international law.
  • Use the Site to post or transmit any information, software or other material that violates or infringes upon the rights of others, including material that is an invasion of privacy or publicity rights or that is protected by copyright, trademark or other proprietary right, or derivative works with respect thereto, without first obtaining permission from the owner or rights holder.
  • Use the Site to post or transmit any information, software or other material that contains a virus or other harmful component.
  • Use the Site to post, transmit or in any way exploit any information, software or other material for commercial purposes, or that contains advertising.
  • Use the Site to advertise or solicit to anyone to buy or sell products or services, or to make donations of any kind, without our express written approval.
  • Gather for marketing purposes any email addresses or other personal information that has been posted by other users of the Site.

COMPANY may host message boards, chats and other private/public forums on its Sites and on other platforms. Any user failing to comply with the terms and conditions of this Agreement may be expelled from and refused continued access to, the message boards, groups, chats or other such forums in the future. COMPANY or its designated agents may remove or alter any user-created content at any time for any reason. Message boards, chats and other public forums are intended to serve as discussion centers for users and subscribers. Information and content posted within these public forums may be provided by COMPANY staff, COMPANY’s outside contributors, or by users not connected with COMPANY, some of whom may employ anonymous user names. COMPANY expressly disclaims all responsibility and endorsement and makes no representation as to the validity of any opinion, advice, information or statement made or displayed in these forums by third parties, nor are we responsible for any errors or omissions in such postings, or for hyperlinks embedded in any messages. Under no circumstances will we, our affiliates, suppliers or agents be liable for any loss or damage caused by your reliance on information obtained through these forums. The opinions expressed in these forums are solely the opinions of the participants, and do not reflect the opinions of COMPANY or any of its subsidiaries or affiliates.

 

COMPANY has no obligation whatsoever to monitor any of the content or postings on the message boards, chat rooms or other public forums on the Sites. However, you acknowledge and agree that we have the absolute right to monitor the same at our sole discretion. In addition, we reserve the right to alter, edit, refuse to post or remove any postings or content, in whole or in part, for any reason and to disclose such materials and the circumstances surrounding their transmission to any third party in order to satisfy any applicable law, regulation, legal process or governmental request and to protect ourselves, our clients, sponsors, users and visitors.

 

Registration

 

To access certain features of the Site, we may ask you to provide certain demographic information including your gender, year of birth, zip code and country. In addition, if you elect to sign-up for a particular feature of the Site, such as chat rooms, web logs, or bulletin boards, you may also be asked to register with us on the form provided and such registration may require you to provide personally identifiable information such as your name and email address. You agree to provide true, accurate, current and complete information about yourself as prompted by the Site’s registration form. If we have reasonable grounds to suspect that such information is untrue, inaccurate, or incomplete, we have the right to suspend or terminate your account and refuse any and all current or future use of the Site (or any portion thereof). Our use of any personally identifiable information you provide to us as part of the registration process is governed by the terms of our Privacy Policy.

 

Passwords

 

To use certain features of the Site, you will need a username and password, which you will receive through the Site’s registration process. You are responsible for maintaining the confidentiality of the password and account, and are responsible for all activities (whether by you or by others) that occur under your password or account. You agree to notify us immediately of any unauthorized use of your password or account or any other breach of security, and to ensure that you exit from your account at the end of each session. We cannot and will not be liable for any loss or damage arising from your failure to protect your password or account information.

 

Limitation of Liability

 

UNDER NO CIRCUMSTANCES, INCLUDING, BUT NOT LIMITED TO, NEGLIGENCE, SHALL WE, OUR SUBSIDIARY AND PARENT COMPANIES OR AFFILIATES BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL OR CONSEQUENTIAL DAMAGES THAT RESULT FROM THE USE OF, OR THE INABILITY TO USE, THE SITE, INCLUDING OUR MESSAGING, BLOGS, COMMENTS OF OTHERS, BOOKS, EMAILS, PRODUCTS, OR SERVICES, OR THIRD-PARTY MATERIALS, PRODUCTS, OR SERVICES MADE AVAILABLE THROUGH THE SITE OR BY US IN ANY WAY, EVEN IF WE ARE ADVISED BEFOREHAND OF THE POSSIBILITY OF SUCH DAMAGES. (BECAUSE SOME STATES DO NOT ALLOW THE EXCLUSION OR LIMITATION OF CERTAIN CATEGORIES OF DAMAGES, THE ABOVE LIMITATION MAY NOT APPLY TO YOU. IN SUCH STATES, OUR LIABILITY AND THE LIABILITY OF OUR SUBSIDIARY AND PARENT COMPANIES OR AFFILIATES IS LIMITED TO THE FULLEST EXTENT PERMITTED BY SUCH STATE LAW.) YOU SPECIFICALLY ACKNOWLEDGE AND AGREE THAT WE ARE NOT LIABLE FOR ANY DEFAMATORY, OFFENSIVE OR ILLEGAL CONDUCT OF ANY USER. IF YOU ARE DISSATISFIED WITH THE SITE, ANY MATERIALS, PRODUCTS, OR SERVICES ON THE SITE, OR WITH ANY OF THE SITE’S TERMS AND CONDITIONS, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE USING THE SITE AND THE PRODUCTS, SERVICES AND/OR MATERIALS.

 

THIS SITE IS CONTINUALLY UNDER DEVELOPMENT AND COMPANY MAKES NO WARRANTY OF ANY KIND, IMPLIED OR EXPRESS, AS TO ITS ACCURACY, COMPLETENESS OR APPROPRIATENESS FOR ANY PURPOSE.

 

WITH REGARDS TO CONTENT RELATING TO HEALTH & WELLNESS ON THE SITE:

THIS SITE OFFERS HEALTH, WELLNESS, FITNESS AND NUTRITIONAL INFORMATION AND IS DESIGNED FOR EDUCATIONAL PURPOSES ONLY. YOU SHOULD NOT RELY ON THIS INFORMATION AS A SUBSTITUTE FOR, NOR DOES IT REPLACE, PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. IF YOU HAVE ANY CONCERNS OR QUESTIONS ABOUT YOUR HEALTH, YOU SHOULD ALWAYS CONSULT WITH A PHYSICIAN OR OTHER HEALTH-CARE PROFESSIONAL. DO NOT DISREGARD, AVOID OR DELAY OBTAINING MEDICAL OR HEALTH RELATED ADVICE FROM YOUR HEALTH-CARE PROFESSIONAL BECAUSE OF SOMETHING YOU MAY HAVE READ ON THIS SITE. THE USE OF ANY INFORMATION PROVIDED ON THIS SITE IS SOLELY AT YOUR OWN RISK.

 

NOTHING STATED OR POSTED ON THIS SITE OR AVAILABLE THROUGH ANY SERVICES ARE INTENDED TO BE, AND MUST NOT BE TAKEN TO BE, THE PRACTICE OF MEDICAL OR COUNSELING CARE. FOR PURPOSES OF THIS AGREEMENT, THE PRACTICE OF MEDICINE AND COUNSELING INCLUDES, WITHOUT LIMITATION, PSYCHIATRY, PSYCHOLOGY, PSYCHOTHERAPY, OR PROVIDING HEALTH CARE TREATMENT, INSTRUCTIONS, DIAGNOSIS, PROGNOSIS OR ADVICE.

 

Termination

 

We may cancel or terminate your right to use the Site or any part of the Site at any time without notice. In the event of cancellation or termination, you are no longer authorized to access the part of the Site affected by such cancellation or termination. The restrictions imposed on you with respect to material downloaded from the Site, and the disclaimers and limitations of liabilities set forth in these Terms of Service, shall survive.

 

Refund Policy

 

Your purchase of a product or service or ticket to an event may or may not provide for any refund.  Each specific product, service, event or course will specify its own refund policy.

 

Digital Millennium Copyright Act

 

The Digital Millennium Copyright Act of 1998 (the “DMCA”) provides recourse for copyright owners who believe that material appearing on the Internet infringes their rights under the U.S. copyright law. If you believe in good faith that materials hosted by COMPANY infringe your copyright, you, or your agent may send to COMPANY a notice requesting that the material be removed or access to it be blocked. Any notification by a copyright owner or a person authorized to act on its behalf that fails to comply with requirements of the DMCA shall not be considered sufficient notice and shall not be deemed to confer upon COMPANY actual knowledge of facts or circumstances from which infringing material or acts are evident. If you believe in good faith that a notice of copyright infringement has been wrongly filed against you, the DMCA permits you to send to COMPANY a counter-notice. All notices and counter notices must meet the then current statutory requirements imposed by the DMCA; see http://www.loc.gov/copyright for details. COMPANY’s Copyright Agent for notice shall be annettegiarde@pro.bigboldhealth.com.

 

Assignment

 

This Agreement shall be binding upon and inure to the benefit of COMPANY and our respective assigns, successors, heirs, and legal representatives. Neither this Agreement nor any rights hereunder may be assigned without the prior written consent of COMPANY Notwithstanding the foregoing, all rights and obligations under this Agreement may be freely assigned by COMPANY to any affiliated entity or any of its wholly owned subsidiaries.

 

Dispute Resolution

These Terms of Use shall be governed by and construed in accordance with the laws of the State of Washington and any dispute shall be subject to binding arbitration in Bainbridge Island, Washington. If any provision of this agreement shall be unlawful, void or for any reason unenforceable, then that provision shall be deemed severable from this agreement and shall not affect the validity and enforceability of any remaining provisions.

 

Class Action Waiver

 

You may only resolve disputes with us on an individual basis, and may not bring a claim as a plaintiff or a class member in a class, consolidated, or representative action. Class arbitrations, class actions, private attorney general actions, and consolidation with other arbitrations aren’t allowed.

 

The arbitrator may not consolidate more than one person’s claims, and may not otherwise preside over any form of a class or representative proceeding or claims (such as a class action, consolidated action or private attorney general action) unless all relevant parties specifically agree to do so following initiation of the arbitration.

 

Severability

 

If any clause within these Terms of Service (other than the Class Action Waiver clause above) is found to be illegal or unenforceable, that clause will be severed from these Terms of Service, and the remainder of these Terms of Service will be given full force and effect. If the Class Action Waiver clause is found to be illegal or unenforceable, this entire Provision will be unenforceable and the dispute will be decided by a court.

Privacy Policy

Effective Date: March 2019

 

The following Privacy Policy governs the online information collection practices of BIG BOLD HEALTH LLC (“COMPANY,” “we” or “us”). Specifically, it outlines the types of information that we gather about you while you are using the www.bigboldhealth.com website (the “Site”), and the ways in which we use this information. This Privacy Policy, including our children’s privacy statement, does not apply to any information you may provide to us or that we may collect offline and/or through other means (for example, at a live event, via telephone, or through the mail).

 

Please read this Privacy Policy carefully. By visiting and using the Site, you agree that your use of our Site, and any dispute over privacy, is governed by this Privacy Policy. Because the Web is an evolving medium, we may need to change our Privacy Policy at some point in the future, in which case we’ll post the changes to this Privacy Policy on this website and update the Effective Date of the policy to reflect the date of the changes. By continuing to use the Site after we post any such changes, you accept the Privacy Policy as modified.

 

How We Collect and Use Information

 

We may collect and store personal or other information that you voluntarily supply to us online while using the Site (e.g., while on the Site or in responding via email to a feature provided on the Site). The Site only contacts individuals who specifically request that we do so or in the event that they have signed up to receive our messaging, attended one of our events, or have purchased one of our products. The Site collects personally identifying information from our users during online registration and online purchasing. Generally, this information includes name and e-mail address for registration or opt-in purposes and name, postal address, and credit card information when registering for our events or purchasing our products. All of this information is provided to us by you.

 

We also collect and store information that is generated automatically as you navigate online through the Site. For example, we may collect information about your computer’s connection to the Internet, which allows us, among other things, to improve the delivery of our web pages to you and to measure traffic on the Site. We also may use a standard feature found in browser software called a “cookie” to enhance your experience with the Site. Cookies are small files that your web browser places on your hard drive for record-keeping purposes. By showing how and when visitors use the Site, cookies help us deliver advertisements, identify how many unique users visit us, and track user trends and patterns. They also prevent you from having to re-enter your preferences on certain areas of the Site where you may have entered preference information before. The Site also may use web beacons (single-pixel graphic files also known as “transparent GIFs”) to access cookies and to count users who visit the Site or open HTML-formatted email messages.

 

We use the information we collect from you while you are using the Site in a variety of ways, including using the information to customize features; advertising that appear on the Site; and, making other offers available to you via email, direct mail or otherwise. We also may provide your information to third parties, such as service providers, contractors and third-party publishers and advertisers for a variety of purposes. Unless you inform us in accordance with the process described below, we reserve the right to use, and to disclose to third parties, all of the information collected from and about you while you are using the Site in any way and for any purpose, such as to enable us or a third party to provide you with information about products and services. If you do not wish your information to be used for these purposes, you must send a letter to the Online Privacy Coordinator whose address is listed at the end of this Privacy Policy requesting to be taken off any lists of information that may be used for these purposes or that may be given or sold to third-parties.

 

Please keep in mind that whenever you voluntarily make your personal information available for viewing by third parties online – for example on message boards, web logs, through email, or in chat areas – that information can be seen, collected and used by others besides us. We cannot be responsible for any unauthorized third-party use of such information.

 

Some of our third-party advertisers and ad servers that place and present advertising on the Site also may collect information from you via cookies, web beacons or similar technologies. These third-party advertisers and ad servers may use the information they collect to help present their advertisements, to help measure and research the advertisements’ effectiveness, or for other purposes. The use and collection of your information by these third-party advertisers and ad servers is governed by the relevant third-party’s privacy policy and is not covered by our Privacy Policy. Indeed, the privacy policies of these third-party advertisers and ad servers may be different from ours. If you have any concerns about a third party’s use of cookies or web beacons or use of your information, you should visit that party’s website and review its privacy policy.

The Site also includes links to other websites and provides access to products and services offered by third parties, whose privacy policies we do not control. When you access another website or purchase third-party products or services through the Site, use of any information you provide is governed by the privacy policy of the operator of the site you are visiting or the provider of such products or services.

 

We may also make some content, products and services available through our Site or by emailing messages to you through cooperative relationships with third-party providers, where the brands of our provider partner appear on the Site in connection with such content, products and/or services. We may share with our provider partner any information you provide, or that is collected, in the course of visiting any pages that are made available in cooperation with our provider partner. In some cases, the provider partner may collect information from you directly, in which cases the privacy policy of our provider partner may apply to the provider partner’s use of your information. The privacy policy of our provider partners may differ from ours. If you have any questions regarding the privacy policy of one of our provider partners, you should contact the provider partner directly for more information.

 

Be aware that we may occasionally release information about our visitors when release is appropriate to comply with law or to protect the rights, property or safety of users of the Site or the public.

 

Please also note that as our business grows, we may buy or sell various assets. In the unlikely event that we sell some or all of our assets, or one or more of our websites is acquired by another company, information about our users may be among the transferred assets.

 

Google Analytics

 

We also use Google Analytics Advertiser Features to optimize our business. Advertiser features include:

  • Remarketing with Google Analytics
  • Google Display Network Impression Reporting
  • DoubleClick Platform integrations
  • Google Analytics Demographics and Interest Reporting

By enabling these Google Analytics Display features, we are required to notify our visitors by disclosing the use of these features and that we and third-party vendors use first-party cookies (such as the Google Analytics cookie) or other first-party identifiers, and third-party cookies (such as the DoubleClick cookie) or other third-party identifiers together to gather data about your activities on our Site.  Among other uses, this allows us to contact you if you begin to fill out our check-out form but abandon it before completion with an email reminding you to complete your order.  The “Remarketing” feature allows us to reach people who previously visited our Site, and match the right audience with the right advertising message.

You can opt out of Google’s use of cookies by visiting Google’s ad settings and/or you may opt out of a third-party vendor’s use of cookies by visiting the Network Advertising Initiative opt-out page.

 

Facebook

 

As advertisers on Facebook and through our Facebook page, we, (not Facebook) may collect content or information from a Facebook user and such information may be used in the same manner specified in this Privacy Policy. You consent to our collection of such information.

 

We abide by Facebook’s Data Use Restrictions.

  • Any ad data collected, received or derived from our Facebook ad (“Facebook advertising data”) is only shared with someone acting on our behalf, such as our service provider. We are responsible for ensuring that our service providers protect any Facebook advertising data or any other information obtained from us, limit our use of all of that information, and keep it confidential and secure.
  • We do not use Facebook advertising data for any purpose (including retargeting, commingling data across multiple advertisers’ campaigns, or allowing piggybacking or redirecting with tags), except on an aggregate and anonymous basis (unless authorized by Facebook) and only to assess the performance and effectiveness of our Facebook advertising campaigns.
  • We do not use Facebook advertising data, including the targeting criteria for a Facebook ad, to build, append to, edit, influence, or augment user profiles, including profiles associated with any mobile device identifier or other unique identifier that identifies any particular user, browser, computer or device.
  • We do not transfer any Facebook advertising data (including anonymous, aggregate, or derived data) to any ad network, ad exchange, data broker or other advertising or monetization related service.

 

General Data Privacy Regulation (GDPR)

 

The GDPR took effect on May 25, 2018, and is intended to protect the data of European Union (EU) citizens. 

 

As a company that markets its site, content, products and/or services online we do not specifically target our marketing to the EU or conduct business in or to the EU in any meaningful way. If the data that you provide to us in the course of your use of our site, content, products and/or services is governed by GDPR, we will abide by the relevant portions of the Regulation.

 

If you are a resident of the European Economic Area (EEA), or are accessing this site from within the EEA, you may have the right to request: access to, correction of, deletion of; portability of; and restriction or objection to processing, of your personal data, from us. This includes the “right to be forgotten.”

 

To make any of these requests, please contact our GDPR contact at annettegiarde@pro.bigboldhealth.com

 

Children’s Privacy Statement

 

This children’s privacy statement explains our practices with respect to the online collection and use of personal information from children under the age of thirteen, and provides important information regarding their rights under federal law with respect to such information.

  • This Site is not directed to children under the age of thirteen and we do NOT knowingly collect personally identifiable information from children under the age of thirteen as part of the Site. We screen users who wish to provide personal information in order to prevent users under the age of thirteen from providing such information. If we become aware that we have inadvertently received personally identifiable information from a user under the age of thirteen as part of the Site, we will delete such information from our records. If we change our practices in the future, we will obtain prior, verifiable parental consent before collecting any personally identifiable information from children under the age of thirteen as part of the Site.
  • Because we do not collect any personally identifiable information from children under the age of thirteen as part of the Site, we also do NOT knowingly distribute such information to third parties.
  • We do NOT knowingly allow children under the age of thirteen to publicly post or otherwise distribute personally identifiable contact information through the Site.
  • Because we do not collect any personally identifiable information from children under the age of thirteen as part of the Site, we do NOT condition the participation of a child under thirteen in the Site’s online activities on providing personally identifiable information.

The HIPAA Privacy Rule

 

The US Department of Health and Human Services provides:  “The HIPAA Privacy Rule establishes national standards to protect individuals’ medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically.  The Rule requires appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. The Rule also gives patients rights over their health information, including rights to examine and obtain a copy of their health records, and to request corrections.”

 

You acknowledge that our operation of the Site does not constitute the practice of medicine, and specifically does not create a doctor-patient relationship between you and Dr. Jeffrey Bland, PhD (the “Doctor”).  The information provided on the Site is for educational purposes only. 

 

Notwithstanding the fact that the Site does not create a doctor-patient relationship between you and DOCTOR, our preservation of your personal health information shall be HIPAA compliant.

 

For purposes of this Privacy Policy, “patients” are those individuals who have secured the in-person services DOCTOR.  If you are a patient of DOCTOR, you will be provided with a copy of DOCTOR’s HIPAA Privacy Statement, which governs the information collection practices of patients’ personal information by DOCTOR.

 

How do we store your information?

 

Your information is stored at the list server that delivers the Site content and messaging. Your information can only be accessed by those who help manage those lists in order to deliver e-mail to those who would like to receive the Site material.

 

All of the messaging or emails that are sent to you by the Site include an unsubscribe link in them. You can remove yourself at any time from our mailing list by clicking on the unsubscribe link that can be found in every communicaiton that we send you.

 

Changes to this Policy

 

This policy may be changed at any time at our discretion. If we should update this policy, we will post the updates to this page on our Website.

 

Questions About this Policy

 

If you have any questions or concerns regarding our privacy policy please direct them to:

annettegiarde@pro.bigboldhealth.com