Jul
01
2017

Advanced Glycation End Products (AGEs)

Advanced glycation end products (AGEs) form when food is cooked at high temperatures. Sugar molecules react with proteins crosslinking them and changing how they function. It prevents proteins from doing their job. Glycation also causes inflammation, which damages mitochondria, the power packages inside cells that provide the body with energy. Overall AGEs lead to premature aging, which comes from the toxic protein reactions. Advanced glycation end products accumulate as glycated proteins in the tissues of the body. This leads to mitochondrial dysfunction.

Effect of advanced glycation end products (AGEs) on the body

The following tissues are frequently affected by the toxic effect of AGEs.

  • The accumulation of AGEs can cause kidney disease and kidney failure (renal failure). In this case the kidneys no longer filter the blood to excrete waste. Hemodialysis may be required.
  • Joint cartilage is damaged by AGEs so it can no longer handle stress and joint stiffness sets in. AGEs are now recognized as a major cause of osteoarthritis.
  • Cross-linked proteins from AGEs can cause Alzheimer’s and Parkinson’s disease. Damaged proteins accumulate in brain cells that disable and kill them eventually.
  • Glycation of LDL particles has been well documented as an important cause of increasing the plaque formation in arteries by LDL. Glycated LDL is much more susceptible to oxidation than regular LDL. Oxidized LDL causes damage to the lining of the arteries and destroys endothelial nitric oxide synthase. This is a critical enzyme, which is involved in maintaining vasodilatation and blood flow. Once LDL has become glycated, it is deformed and LDL receptors can no longer recognize it. This means that glycated LDL continues to circulate in the bloodstream where it contributes to the atherosclerotic process. It forms a plaque which becomes a reason for heart attacks and strokes. Glycation of LDL is particularly common in patients with diabetes.
  • Glycation of the skin sensitizes the skin to UV light damage. It triggers oxidative stress that increases the risk of skin cancer.
  • Glycation damages our eyes. It causes clouding of the lens (cataracts) and it damages the retina. Macular degeneration can ultimately cause blindness.
  • When glycation affects the discs in the spinal cord, this can cause disc protrusions and disc herniations. Often the spinal nerves that are nearby get injured causing limping and leg or arm weakness.

Nutrients to counter AGEs

There are nutrients that can slow down the rate of glycation and as a result will halt the aging process.

Benfotiamine

Benfotiamine is a fat-soluble form of the water-soluble vitamin B1 (thiamine). It has been shown to reverse glycation in cell cultures and in humans.

As a result the damage to the cells that are lining arteries is reduced. Benfotiamine also counters diabetic neuropathy, retinopathy and nephropathy.

Pyridoxal 5’-phosphate

Pyridoxal 5’-phosphate is a metabolite of vitamin B6. It is similar to benfotiamine in that it counters glycation and dissolves deposited AGEs. It is particularly useful to stop fat and protein glycation. In diabetic patients lipid glycation is often a problem as these authors have shown. Pyridoxal 5’-phosphate traps glucose breakdown products before they become part of glycation reactions.

Carnosine

Carnosine is a dipeptide, made up of the amino acids histidine and beta-alanine. It is found in higher concentration in muscle and brain tissue. It scavenges for free radicals and prevents AGE formation. It is preventing both lipid glycation and protein glycation. This publication states that carnosine can play a role in preventing Alzheimer’s disease. As protein crosslinking is prevented with carnosine, tangled protein clumps cannot accumulate and cause Alzheimer’s disease.

Carnosine also reduces blood lipid levels and stabilizes atherosclerotic plaques. This reduces the risk of plaque rupture, which can cause a heart attack or stroke.

Carnosine also has a mitochondria stabilizing function resisting the destructive effects of oxidative stresses.

Luteolin

Luteolin is a bioflavonoid, which can be found in many plants. It has anti-inflammatory effects and works by suppressing the master inflammatory complex, called NF-kB.  NF-kB triggers the production of multiple cytokines and is associated with many cancers, chronic diseases, autoimmune diseases and septic shock. Kotanidou et al. did an experiment where they injected mice with Salmonella enteritis toxin, either with or without luteolin protection. Without luteolin only 4.1% of the mice survived on day 7. With luteolin protection 48% were alive on day 7.

Luteolin has been shown to be effective as an anti-inflammatory in the brain, the blood vessel lining, intestines, skin, lungs, bone and gums.

All these four supplements are available in the health food store. They work together and would be recommendable in diabetic patients where glycation is most prominent. But these supplements are also useful for older people who want to slow down the aging process in general.

Nutrients to slow down mitochondrial aging

Glycation is linked to mitochondrial deterioration and dysfunction. It accelerates aging in every aspect. AGEs (advanced glycation end products) crosslink proteins, lipids, but also damage enzymes and DNA. Mitochondrial energy production is slowed down by glycation. The end result is a lack of energy and slower repair processes, which all depend on mitochondrial energy production. The following supplements have shown some merit in reversing this process.

Pyrroloquinoline quinone (PQQ)

PPQ is a supplement that is known to produce new mitochondria in cells. This helps the energy metabolism of aging cells to recover.

Taurine

Taurine is an amino acid that is found abundantly in heart and skeletal muscles cells, brain cells and cells of the retina. These are areas in the body with high metabolic rates that can burn out mitochondria. Taurine regulates enzymes in mitochondria that harvest energy from food substances. In patients who experience accelerated aging, a lack of taurine can produce an energy crisis. But supplementation with taurine can rescue the cells by reducing oxidative stress and restoring the function of mitochondria in cells that are aging. Brain cells were putting out new shoots, called neurites when taurine was given as a supplement. This helps to improve brain connection, and preserves memory and cognition.

R-lipoic acid

R-lipoic acid helps with mitochondrial function by being involved with extracting energy from foods. When R-lipoic acid is given to aging animals, their metabolic function improves, the mitochondria become healthier and there are less oxidative stress-inducing byproducts. It protects their liver, heart and brain cells from oxidative stress in their mitochondria. It is becoming known as an energy-giving supplement.

Advanced Glycation End Products (AGEs)

Advanced Glycation End Products (AGEs)

Conclusion

Sugar overconsumption and overcooking food can cause advanced glycation end products (AGEs) where lipids and proteins get cross-linked. This leads to premature loss of organ function. The mitochondria are also slowed down. This creates prematurely aging. Fortunately there are a few supplements like

benfotiamine, pyridoxal 5’-phosphate, carnosine and luteolin. They protect against glycation. Mitochondria can also be protected by PPQ, taurine and R-lipoic acid. Although we cannot stop the aging process, avoiding sugar and stopping to consume overcooked food, such as barbecued meats and deep fried food is a sensible step in prevention.

With this approach and some supplements a lot can be done to slow down aging.

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Jun
10
2017

Dementia And Strokes From Diet Drinks

You can get dementia and strokes from diet drinks. This is what a recent study published on April 20, 2017 in the American Heart Association Journals has shown. Because of the bad press around sugary drinks more and more people have switched to diet drinks. But the authors of this study have found a correlation of consuming diet soft drinks (with artificial sweeteners), dementia and ischemic strokes.

How was the study done?

A community-based Framingham Heart Study Offspring cohort was followed for 10 years. There were two age groups they followed: mean age of 62 and mean age of 69. There were 2888 participants in the younger age group and 1484 participants in the older age group. The younger age group was followed to monitor for strokes, the older for dementia. During the observation time there were 97 cases of stroke (82 of them ischemic) and 81 cases of dementia (63 due to Alzheimer’s disease). Compared to the control group with no consumption of diet drinks, there was an increase of 296% of ischemic stroke and 289% increase of Alzheimer’s disease. This was the data based on consuming diet soft drinks for 10 years. Another control group had consumed sugar-sweetened beverages. They did not develop strokes or dementia (observation time too short). As can be seen under this link the popular press also reviewed the study.

What do we know about artificial sweeteners?

Here is a brief review of the most common sweeteners.

1. Saccharin

This sweetener’s history goes back to 1879 when the Russian chemist Constantin Fahlberg first noted experimenting with coal tar compounds that one of the end products, benzoic sulfanide, tasted sweet. In fact it was between 200 and 700 times sweeter than granulated sugar! But there were political struggles that accompanied this saccharin throughout the years. There were rumours that in rats saccharin could cause bladder cancer. The health authorities became concerned. This led to Congress passing the Pure Food and Drug Act in June of 1906, to protect the public from “adulterated or misbranded or poisonous or deleterious foods, drugs or medicines.” This was the precursor of the FDA that would examine all of the medical evidence and consider the pros and cons of sweeteners as well. President Roosevelt took saccharin for weight control to replace sugar. In 1908 Roosevelt felt he had to stop the actions of overzealous Dr. Harvey Wiley, chief of the U.S. Department of Agriculture’s chemical division,who was of the opinion that saccharin should be taken off the market. Dr. Wiley did not give up his fight and finally the FDA decided to ban saccharin in processed foods, but to continue to allow private sales of saccharin.

2. Cyclamate 

Cyclamate was detected in 1937. It was marketed first to achieve a better control of diabetes. Because of the reduction in sugar consumption it allowed diabetic patients to cut the amount of insulin required to control diabetes. Cyclamate did not have a bitter aftertaste, so it was mixed with saccharine at a ratio of 10 parts of cyclamate to 1 part of saccharin , which resulted in the creation of “Sweet ‘N Low. In 1958 the FDA gave cyclamate the GRAS designation: “generally recognized as safe”. The good fortunes of cyclamate did not last long: in 1969 damaging animal experiments showed that cyclamate/saccharin had caused chromosomal breaks in sperm of rats. Another study from 1970 showed bladder tumors in rats. Other studies showed lung, stomach and reproductive tumors in animal experiments with cyclamates/saccharin. The FDA wanted to shut down the sale of the Sweet N’ Low sweetener, but public pressure and the food processing industry forced the issue to be brought up in front of Congress. The compromise was to use a warning label: “Use of this product may be hazardous to your health. This product contains saccharin which has been determined to cause cancer in laboratory animals.” In the year 2000 and beyond a series of animal experiments and data from Denmark, Britain, Canada and the United States on humans showed there were no signs of bladder cancer from exposure to Sweet N’ Low. In 2000 Congress removed the warning labels.

3. Aspartame 

Aspartame was detected in 1965. James M. Schlatter, a chemist, was looking for anti-ulcer drugs, but noticed the intensely sweet flavor when he licked his fingers. This led to the newest sweetener by 1973. We know it by the trade names Equal, NutraSweet or Sugar Twin. As this sweetener consisting of the two amino acids phenylalanine and aspartic acid is metabolized in the body, it cannot be taken by people with phenylketonuria, with certain rare liver disorders or by pregnant women with high levels of phenylalanine in their blood, because it is not metabolized properly in those individuals. Any food made with aspartame has to carry that restriction on the label, a requirement by the FDA. In 1996 W. Olney and his associates presented research that implied that Aspartame would have caused brain tumors in rats. But later these experiments were disproven and studies from children with brain tumors showed “little biological or experimental evidence that aspartame is likely to act as a human brain carcinogen.”

4. Sucralose

Sucralose was detected in 1976 by insecticide researchers who looked for new types of insecticides. They found that chlorinated sugar worked as an insecticide. One of the researchers was astounded how sweet the chemical tasted. If you Google “Splenda and insecticide”, you have a hard time finding references regarding the history of sucralose, but 20 years ago I found a detailed description that explained how one of the chemists doing insecticide research accidentally tasted one of the research products, and it was about 600-times sweeter than table sugar. Here is one of the few references that explains that sucralose was discovered while looking for new insecticides. I have repeated the insecticide experiment myself in Hawaii where small ants are ubiquitous. Out of curiosity I took a package of Splenda from a coffee shop and sprinkled the contents in the path of ants. In the beginning the ants were reluctant to eat it, but after a short time they came and took it in. They slowed down, and finally they were all dead. A few hours later there were only shrivelled up dead ants left in the area where Splenda had been sprinkled. Proof enough for me that Splenda was developed as an insecticide and should not be consumed by humans! In the meantime Dr. Axe in the above references lists the side effects in humans: “Migraines, agitation, numbness, dizziness, diarrhea, swelling, muscle aches, stomach and intestinal cramps and bladder problems.” In the Splenda marketing scheme they decided to first introduce Splenda gradually into diabetic foods as a sweetener, then later sell it to the public at large. Don’t fall for it! It was a side product of insecticide research, and insecticides have the undesirable quality of being xenoestrogens, which block estrogen receptors in women. As a result estrogen can no longer access the body cells, including the heart. The final consequence for a woman is a higher risk for cardiovascular disease. This can cause heart attacks, strokes and cancer. In men estrogen-blocking xenoestrogens can cause breast growth and erectile dysfunction. Taken everything together Splenda seems to be too risky for its sweetness.

5. Other sweeteners

Other sweeteners researchers have not stopped looking for newer, better sweeteners. There is a number of sugar alcohols with less calories than sugar such as erythritol. Another common sugar alcohol is xylitol, used in chewing gum. The advantage is that these are natural sweet alcohols that exist in nature. Xylitol originated from birch wood and was touted to help tooth decay when you use chewing gum containing it. Karl Clauss and Harald Jensen in Frankfurt, Germany detected another sweetener, acesulfame potassium, also known by the names acesulfame K, Ace-K, or ACK in 1967 when they experimented with various chemicals. This is known under the brand name “Sweet One”, but is often disguised in processed foods together with other artificial sweeteners to mimic the taste of sugar.

6. Stevia 

Stevia has been used for over 400 years, particularly in South America. It grows like a small bushy herb with leaves that can be taken to sweeten foods.  With modern, reliable extracting procedures (Sephadex column) it is possible to separate the bitter component of stevia and discard it leaving stevia behind without any bitter aftertaste. In Japan stevia has been occupying 40% of the sweetener market. In Europe and North America there is a lot of competition with the above-mentioned sweeteners, mainly because of clever marketing techniques. In 2008 stevia received GRAS status by the FDA.

What does sugar in soft drinks do?

Sugar is an emotional topic that can get people caught up in heated discussions. The sugar industry and the sugar substitute industry have also powerful lobby groups that provide the Internet and the popular press with conflicting stories to convince you to buy their product. There is good data to show that sugary drinks cause heart attacks, strokes and diabetes. Let’s not forget the metabolism behind the various sugars and starchy foods leading to fat deposits, high triglycerides and high LDL cholesterol. Forget the emotions of severing yourself from your favorite fix and stick to a tiny amount of stevia that can replace the familiar sweet taste that you have become accustomed to from childhood onward. (At least this is what I do.) The only alternative would be to take the plunge and cut out any sweet substance altogether, which I am not prepared to do. If you can do it, by all means go ahead. For more details regarding the effects of sugar and starchy foods read the blog under this link.

Dementia And Strokes From Diet Drinks

Dementia And Strokes From Diet Drinks

Conclusion

The reason diet soft drinks have become so popular is that it had been proven in other studies in the past that sugary drinks could cause heart attacks and strokes. Now a new study revealed that diet soft drink consumption is associated with dementia and strokes. These drinks contained saccharin, cyclamate, aspartame or sucralose. They did not contain stevia, a natural sweetener because it is a natural, not a patented sweetener. It seems that companies’ profits are higher with chemical, patented sweeteners.

Looking back in time it seems perfectly legal that a company produces a chemical, patents it and sneaks it through the FDA channels for approval. The company then markets diet soft drinks that later are shown to produce dementia and ischemic strokes in much larger studies than were originally used to get FDA approval.

I have noticed that companies are now quietly introducing stevia, a natural sweetener to avoid potential legal problems down the road. Perhaps it is time to follow the Japanese lead where stevia is already occupying 40% of the sweetener market.

Jun
03
2017

Fish, The Good And The Bad

I am going to review fish, the good and the bad. Fish can be very nutritious, because it contains a lot of healthy omega-3 fatty acids. But because of pollution it also has various degrees of mercury, PBC’s and other impurities.

I will discuss the good about fish oil first. Later we will learn that wild salmon is one of the best fish to eat, while we should avoid tuna due to mercury pollution.

The good about fish

Omega-3 fatty acids, also called marine oil, is an essential fatty acid. It balances omega-6 fatty acids of which we eat too much. Processed foods are full of omega-6 fatty acids, because they keep a long time on the grocery shelves without turning rancid. But when the omega-6 to omega-3 ratio is getting higher than 3:1 we are experiencing a problem. The body stimulates the arachidonic acid pathway, a metabolic pathway that produces inflammatory substances and arthritis. An old home remedy for arthritis is to use fish oil (cod liver oil). It changes the omega-6 to omega-3 ratio back to more normal levels, which can help arthritis patients. Early stage of arthritis can even heal.

Many processed foods contain only omega-6 fatty acids, because this is the cheapest way to produce them (they are based on vegetable oils). Instead of this you want to eat healthy fats like omega-3 fatty acids contained in nuts and fish. You can also add molecularly distilled, high potency omega-3 fatty acids (purified fish oil) as a supplement to help restore the balance between omega-6 and omega-3 in the food you eat. Avoid omega-6 fatty acids that are derived from corn oil, safflower oil, grape seed oil, soybean oil, cottonseed oil, canola oil and peanut oil.

Compare the metabolism of omega-6 fatty acids with that of omega-3 fatty acids.

The linoleic acid of omega-6 fatty acids gets metabolized into arachidonic acid, which causes pro-inflammatory mediators, PGE2 and LTB4 as shown in the metabolism link. On the other hand with omega-3 fatty acids alpha-linolenic acid (ALA) is metabolized into EPA, DHA and the anti-inflammatory mediators PGE3 and LTB5.

It is easily understandable why a surplus of omega-6 fatty acids from processed foods will disbalance the omega-6 to omega-3 ratio. This ratio should be 1:1 to 3:1, but many Americans’ omega-6 to omega-3 ratio is 6:1 to 18:1. Omega-6-fatty acids cause arthritis, heart disease and strokes. Be particularly careful avoiding soybean oil. It has become the most popular oil in the last few decades to foul up the omega-6 to omega-3 ratio. We consume it through processed foods and cooking oils.

Omega-3 supplements

When it comes to balancing omega-3 and omega-6 fatty acids in your diet, be aware that nutritional balancing can help you restore the ideal omega-6 to omega-3 ratio of 1:1 to 3:1. An easy way is to cut out processed foods as much as possible. Supplement with molecularly distilled fish oil capsules to add more omega-3 fatty acids into your food intake. Here is an example of rheumatoid arthritis patients that received omega-3 supplements. After 24 weeks their joint swelling and tenderness decreased significantly.

Rebalancing the omega-6 to omega-3 ratio was able to treat depression as this research showed. This makes you wonder how much depression may be caused by overconsumption of processed food.

Dr. Blatman suggested the following doses of omega-3 supplementation for various purposes:

  • 1 gram/day as supplementation for healthy adults with a good diet
  • 1-3 grams/day for people with cardiovascular disease
  • 5-10 grams/day for patients with an autoimmune disease, with chronic pain or with neuropsychiatric conditions

He mentioned that these doses are empirical, but in his experience this is what really works. Due to quality differences he suggested that you buy fish oil capsules in a health food store. Stay away from discount stores (the quality is the worst) and drug stores.

Other healthy oils are olive oil and coconut oil. They are also useful for cooking.

The bad about fish

1. Mercury and other pollutant

Pollution of the air, soil and rivers is causing accumulation of mercury and other heavy metals in ocean water.

This affects fish that live in the ocean. There is a pecking order of predators with the larger fish feeding on the smaller fish. The bigger the predator fish, the more mercury and other pollutants they accumulate. According to this link the safest seafood is wild salmon, pollock and oysters.

Tuna is too high in mercury, so is swordfish, and shark is even worse. I only consume fish from freshwater lakes or rivers, as well as salmon, oysters and shrimp. This way I get the lowest exposure to mercury. Why is mercury bad for you? It is a neurotoxin. It can harm your brain, heart, kidneys, lungs and the immune system. Specific symptoms can include loss of peripheral vision and lack of coordination with balancing problems. There may be impairment of speech and hearing. The key is to avoid mercury exposure.

2. Rancidity of fish oil

Rancid fish oil contains free radicals that attack the lining of the arteries. There would be no point in taking fish oil, if it is rancid and destroyed what you want to protect. When fish oil is stored, it can interact with oxygen and form lipid peroxides, which are free radicals. The Council for Responsible Nutrition’s quality standards monitors rancidity in fish oil. Get fish oil that meets or exceeds the Council’s standards. If you refrigerate fish oil, it stays fresh longer.

Managing mercury pollution

  1. The first line of defense is to stick to the smaller fish. They are they prey of the large predator fish. The following fish/mussels belong into the low mercury group (alphabetical order): anchovies, catfish, clam, crab, crawfish, flounder, haddock, herring, mackerel, mullet, oyster, perch, pollock, salmon, sardines, scallops, shrimp, sole, squid, trout and whitefish.
  2. You may want to supplement your omega-3 fatty acid intake by fish oil capsules. It is important that you choose the more expensive higher potency products. A molecular distillation process that removes mercury, PCB and other heavy metals creates these higher potency products. This way you only get the enriched omega-3 fatty acids in pure form. EPA and DHA in one capsule should be in the 900 mg to 1000 mg range, not less. I take 2 capsules twice per day as a daily supplement. This helps you as indicated above to balance the omega-6 to omega-3 ratio, which cuts down any inflammatory process in you.

More good news about omega-3 fatty acids

Omega-3 fatty acids have multiple anti-inflammatory effects. This helps for treating arthritis, osteoporosis, preventing heart attacks and brain shrinkage. Even depression can be influenced positively when krill oil and fish oil are both taken at the same time. It is best to think about krill oil and omega-3 fatty acids (fish oil) as complementary marine oils that have multiple beneficial effects on the body.

Studies have shown that arthritis and osteoarthritis are helped by krill oil, but also by fish oil. Similarly, heart attacks and strokes are prevented with both krill oil and omega-3 fatty acids. It appears that both oils reduce inflammation in the arteries that is associated with high blood pressure, diabetes, obesity and the metabolic syndrome in obese people. C-reactive protein measuring inflammation was reduced by krill oil up to 30% compared to placebo within 30 days. Patients with arthritis had 20% and more reduction in stiffness and pain.

Krill oil is well absorbed into the brain and can prevent age-related brain shrinkage, preserve cognitive function and memory, prevent dementia and also possibly depression.

Other health conditions improve on both krill oil and omega-3 fatty acids like osteoporosis (in combination with vitamin K2, vitamin D3 and calcium), a weak immune system, diabetes, high triglyceride levels and cholesterol problems. Both marine oils prevent LDL cholesterol from being oxidized, which helps to prevent atheroma formation and hardening of the arteries. This prevents heart attacks and strokes.

Fish, The Good And The Bad

Fish, The Good And The Bad

Conclusion

In the past cod liver oil was given to children to prevent rickets. In the 1960’s Dale Alexander wrote a book called “Arthritis and Common Sense”. Since then medicine has been revolutionized in the late 1990’s by the idea that inflammation in the body is responsible for high blood pressure, diabetes, heart attacks, strokes, arthritis and even Alzheimer’s disease. It is in this area that omega-3 fatty acids are an important supplement as fish oil capsules and krill oil capsules. These supplements can be bought molecularly distilled to be free of mercury and other pollutants. The anti-inflammatory effect of omega-3 fatty acids is a powerful preventative for all these diseases mentioned. It no longer is a question, whether these supplements work. It has become a fact backed up by large studies including mortality statistics. Even the FDA has included seafood into their food recommendations. The key is to rebalance your omega-6 to omega-3 ratio and incorporate marine oils in your diet. Your body will thank you for it with a longer, healthier life.

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Apr
22
2017

Only Moderate Alcohol Consumption Benefits Your Heart

A new study from England finds that only moderate alcohol consumption benefits your heart. The study was released on March 22, 2017 in Great Britain. 1.937 million people (51% women, 49% men) had participated in this investigation over 6 years. The lead author, Dr. Steven Bell is a genetic epidemiologist. He said that this study was done to clear up some of the confusion from previous studies. He wondered why the control group without alcohol exposure had more cardiac problems than the moderate group. It did make sense though, that the high alcohol group had worse cardiac problems.

But he and researchers from Cambridge University and University College London did this study to get more detail. They wanted to know why the current non-drinking group used as a control was not looked at more carefully. It consisted of a mix of lifelong abstainers; people who drank formerly, but then gave it up. And the other group was those who drink on an occasional basis.

With this in mind the researchers designed their study. They also used also larger numbers to increase the reliability of the study.

Details of English study

The data comes from the Clinical Practice Research Datalink providing anonymous patient records from general practices in England. The patients upon entry into the study had to be older than 30 years, but have no evidence of cardiovascular disease. A total of 1,937,360 patients qualified to be part of the study.

Based on patients’ records and patients recollections people, researchers looked at 5 classes of drinkers:

  • Non-drinkers (14.3%)
  • Former or ex-drinkers (stopped drinking at one point, 3.7%)
  • Occasional drinkers (drinking rarely, 11.9%)
  • Moderate drinkers (drinking within sensible limits, 61.7%)
  • Heavy drinkers (hazardous alcohol use, 8.4%)

The end point of the study researchers concentrated on the frequency of cardiovascular diseases like angina, heart attack, sudden cardiac death, stroke, peripheral arterial disease, abdominal aortic aneurysm and others. I only listed 6 of the 12 cardiovascular diagnoses as otherwise it would get too technical.

More information: Most study participants were non-smokers, their BMI was within normal limits, and they also did not have diabetes.

Findings of the study

There were significant differences among subclasses of alcohol consumption and the development of cardiovascular diseases over 6 years.

  1. The findings were in line with a number of previous similar studies that showed a U-type dose response curve between developing cardiovascular diseases and alcohol consumption. The group of non-drinkers (where former and occasional drinkers were removed) often had a 20% to 56% increased risk of developing cardiovascular disease, while moderate drinkers had no added risk.
  2. On the other hand the heavy drinkers were at risk of developing cardiac arrest (50% increased risk) or heart failure (22% increased risk). A death from a sudden heart attack occurred in heavy drinkers with a risk of 21% increased risk. A former drinker had a 40% increased risk for this, but a non-drinker a risk of 56% increased risk!
  3. A non-drinker had a 32% increased risk of getting a regular heart attack, a former drinker had a 31% increased risk, an occasional drinker 14%, a moderate drinker no added risk, and a heavy drinker had a 12% reduced risk! This seemed to show that drinking alcohol keeps the coronary arteries open and clean. I have had pathology demonstrations with Professor Dr. Adalbert Bohle at Tübingen University during my medical training in 1969. At that time he pointed out how clear and wide open the coronary arteries were in chronic alcoholics. It was not heart disease that killed those patients; they had died from end stage liver cirrhosis, and we saw pathological slides of that.
  4. Heavy drinkers get more ischemic strokes (33% increased risk) and more intracerebral hemorrhages (37% increased risk).
  5. Obstruction of blood vessels in the lower legs (peripheral arterial disease) is common with heavy drinkers (35% increased risk) and even former drinkers (32% increased risk). Non-drinkers have a 22% increased risk while moderate drinkers have a 0% risk (no increased risk).
  6. There was no association between heavy drinking and aortic aneurysm. On the other hand, non-drinkers (32% increased risk) and former drinkers (23% increased risk) showed an increased risk of aortic aneurysm formation.

Other effects of alcohol consumption

The study above did not take into consideration that alcohol consumption has many other consequences beside cardiovascular effects. One for instance is the effect on the brain and the increase of serious car accidents. Another effect is the causation of cancer.

The American Cancer Society clearly states that alcohol consumption has been causatively associated with the following cancers.

  • Cancer of the mouth
  • Cancer of the pharynx (throat)
  • Cancer of the larynx (voice box)
  • Cancer of the esophagus
  • Cancer of the liver
  • Cancer of the breast
  • Cancer of the colon
  • Alcohol also plays a role with cancer of the pancreas

Many studies have shown a dose-response curve between alcohol consumed and the development of these cancers. In other words there is never a safe low dose, below which no cancer would be caused over time.

These authors conducted a metaanalysis of 16 prospective cohort studies including 6,300 patients. It showed that alcohol caused cancer of the colon and rectum. High intake of alcohol showed a 50% increased risk of causing colon cancer. With regard to rectal cancer the risk was 63% higher. In both cases the highest alcohol intake was compared to the lowest category of alcohol intake.

These authors concluded their discussion by pointing out that 6% of the worldwide cancer deaths are attributed to alcohol intake. They also stated that colorectal cancer risk increased by 50% in the heaviest alcohol users. Among the group of heavy drinkers the cancer death rate would likely be 9%. There would a reduction of mortality from cardiovascular disease by one third in middle and old age. The end result would be 6% mortality again; essentially there is no change.

No matter how you try to solve this equation, there is a risk of cancer deaths from exposure to alcohol. There is also a risk that heavy drinking can cause significant cardiovascular diseases mentioned.

Only moderate alcohol consumption benefits your heart

Only moderate alcohol consumption benefits your heart

Conclusion

Everything we do in life has consequences. With regard to drinking you know that accidents are more common in drinkers; with prolonged exposure to higher alcohol consumption you can get dementia. Moderate amounts appear to have significant protection from heart disease, but the risk for several cancers is not negligible. This point was not mentioned in the study I discussed in the beginning of my blog. In the latter part I included some data about cancer risks from alcohol consumption.

The paradox remains that non-consumption of alcohol is associated with a significant cardiovascular risk because of a U-shape dose response curve. Moderate alcohol use is associated with the lowest cardiovascular risk. The question is whether we can balance moderate drinking with staying in the low cancer risk area. The recommendation of 1 glass of wine for women and 2 glasses of wine for men has been confirmed by the above study. This is considered a healthy preventative dose with respect to cardiovascular risk. It is the official recommendation for cardiovascular disease prevention. The cancer literature clearly states that there is a small cancer risk from moderate alcohol intake. This is particularly true for the 8 cancers discussed.

Dr James Nicholls, the director of research and policy development at Alcohol Research UK had this to say. He pointed to the fact that there are other ways to prevent cardiovascular disease. For those who do not drink at present it would not make sense to take up drinking. You can strengthen your heart by starting a Mediterranean diet and starting to exercise regularly. The beneficial substance for your heart in red wine is known as resveratrol that can be taken as a supplement. Resveratrol has no side effects and does not have the cancer risk of an alcoholic drink. Dr. Nicholls added, “If you drink within the existing guidelines it is unlikely that alcohol will either lengthen or shorten your life.” It is really up to every individual to balance the wine glass with personal health!

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Apr
15
2017

What Foods Lower Insulin Resistance?

When people get diabetes or prediabetes, what foods lower insulin resistance? You may have heard that eating too many carbs and gaining weight can cause high insulin values. This causes the body’s insulin receptors to become sluggish, a condition called insulin resistance. Continuing to eat too many refined carbs leads to a critical point. You can suddenly run out of enough insulin and would develop type 2 diabetes at this time.

So, what foods lower insulin resistance?

Low glycemic food

Insulin resistance and type 2 diabetes occur because people do not pay attention to the glycemic load of the food they choose. Many people eat bread, pasta and starchy vegetables like potatoes. They also eat excessive sugary sweets, such as cupcakes, ice cream, or chocolate bars. All the pancreas can do is keeping blood sugar stable by overproducing insulin. But you can assist your pancreas to not overwork itself.

Leave the high glycemic index foods alone. Instead eat low glycemic foods like non-starchy vegetables (peppers, broccoli), lean meats, fish and nuts. Add high-fiber foods like beans and some whole grains. Eat foods rich in omega-3 fatty acids like salmon. Have a dessert with berries that are rich in antioxidants. Blueberries, strawberries, raspberries and black berries are all low glycemic foods, rich in vitamin C and antioxidants. They are “nature’s candy”.

Research on insulin resistance

In a study from Singapore differences of insulin sensitivity were found between lean Asian Indians and Chinese and Malays, living in Singapore. The Asian Indians had less insulin sensitivity, which means they had higher insulin resistance. This is presumed to be due to a genetic variant of insulin sensitivity.

Another lengthy publication investigated the connection between metabolic syndrome and insulin resistance. In addition it examined the connection of heart attacks and strokes to wrong diets. It also pointed out that diabetes and cardiovascular disease could be reduced significantly. How can this be achieved? By adopting a healthy diet that also leads to weight loss.

Diets in the US and in the Western world have major shortfalls, due to the fact that people consume not enough vegetables, fruit and whole grains. Instead we see a higher intake of red and processed meat. In addition there was higher intake of sugar-sweetened foods and beverages. Refined grains and flour products are another unhealthy food source. In the US and other westernized countries we see an overconsumption of sodium and saturated fat.The key to a healthy diet was adopting a Mediterranean diet. A study was described where a group of patients with metabolic syndrome were encourage to consume whole grains, vegetables, fruits, nuts, and olive oil. The control group simply followed a “prudent” diet. Two years later the group on the Mediterranean diet was found to have the following results: they had a higher intake of monounsaturated fat (olive oil) and polyunsaturated fat (fish oil) and fiber. Their omega-6 to omega-3 ratio had decreased. The high-sensitivity C-reactive protein, a general measure for inflammation, had decreased. Other inflammatory kinins like interleukins had also decreased. The insulin sensitivity endothelial function score showed improvement. The important part overall was that the Mediterranean diet prevented the metabolic syndrome compared to the “prudent” control diet.

In 2013 a study from Spain was looking for positive effects when supplementing with olive oil or nuts. A Mediterranean diet with extra olive oil or extra nuts reduced the risk of heart attacks in a high-risk group compared to controls. The study included 7447 persons and these were the results after 4.8 years: the Mediterranean diet group that used more olive oil had 28% fewer cardiovascular events compared to the control group. The Mediterranean diet group with nuts had 30% less events. Heart attacks, strokes or death from cardiovascular disease were these “events”!

What foods are unhealthy?

In order to be able to avoid unhealthy foods it is important to identify what harms us. Foods to avoid are listed in this link. Sweetened beverages, fountain drinks, sodas and fruit juices are loaded with sugar. They will cause an insulin response and on the long-term insulin resistance. Avoid starchy vegetables, such as potatoes, pumpkin, corn, and yams. Also avoid processed snacks and boxed foods. Starchy foods are broken down into sugar, which stimulates insulin release again. Your no-food list continues with excessive sugary sweets, such as cupcakes, ice cream and chocolate bars. White bread, rice, pasta, and flour are also starchy, and the body breaks down starch into sugar and stimulates insulin production.

Some saturated fats are acceptable, but hydrogenated fat must be avoided altogether.

Epigenetic factors regarding insulin resistance

A recent publication on March 14, 2017 investigated the effect of exercise on insulin sensitivity in a mouse model where the mother mouse was obese.

Pregnant, obese mice were insulin resistant and the offspring came down with diabetes. But when the pregnant mice were exercised, the insulin sensitivity came back to normal. In addition the offspring were not diabetic. This effect was not due to genetic factors. Instead the authors believe it was due to epigenetic factors, in this case treating insulin resistance with exercise. When the pregnant mother turns insulin sensitive, the offspring is programmed to regulate their blood sugar metabolism normally.

An April 2017 study from Korea investigated the effects of healthy nutrition on patients with metabolic syndrome and insulin resistance. They noted that avoiding unhealthy foods could normalize markers of disease.

The authors discuss how nutritional factors can contribute to inheritance of epigenetic markers in the next generation. They also showed how dietary bioactive compounds could modify epigenetic factors. Taking dietary components that regulate epigenetic factors contribute significantly to health. The authors concluded that a healthy diet could prevent pathological processes that otherwise would cause metabolic disease.

What Foods Lower Insulin Resistance?

What Foods Lower Insulin Resistance?

Conclusion

It is interesting to note that insulin resistance can be reversed into insulin sensitivity by eating healthy foods. Research papers are now describing how a healthy diet of the mother can affect her offspring positively. These effects are due to epigenetic factors, as genetic factors have not changed.

We are already hearing that diseases like heart attacks, high blood pressure, strokes, diabetes and others can largely be prevented by a proper diet. The key is to avoid high glycemic foods and eat low glycemic foods instead. It is not complicated. Eat non-starchy vegetables (leafy greens, peppers, broccoli), lean meats, fish and nuts. Add high-fiber foods like beans and some whole grains. Eat foods rich in omega-3 fatty acids like salmon. The end result is that insulin resistance disappears and metabolic processes return to normal. This was what Hippocrates had in mind when he stated “Let food be thy medicine and medicine be thy food.”

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Feb
25
2017

Heart Health Improves With Hormone Replacement

Dr. Pamela Smith gave a lecture in December 2016 showing that heart health improves with hormone replacement. Her talk was part of the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9 to Dec. 11, 2016) in Las Vegas, which I attended. The title of the talk was: “Heart health: The Importance of Hormonal Balance for Men and Women”. Her keynote lecture contained 255 slides. I am only presenting a factual summary of the pertinent points here.

1. Estrogen

Observations regarding risk of heart attacks

  1. Women have a lower risk of heart attacks before menopause compared to men of the same age.
  2. Heart attack rates go up significantly after menopause.
  3. Estrogen replacement therapy may reduce the risk of heart attacks by 50% for postmenopausal women.

Lipid profile after menopause

There is an elevation of LDL cholesterol, total cholesterol and triglycerides as well as lower HDL cholesterol levels. All of this causes a higher risk of heart attacks for postmenopausal women. Estrogen replacement therapy increases the large VLDL particles, decreases LDL levels and raises HDL-2. These changes are thought to be responsible for helping reduce heart attack rates in postmenopausal women who do estrogen replacement therapy (ERT).

Difference between oral and transdermal estrogen replacement

When estrogen is taken by mouth, it is metabolically changed in the liver. This reduces the protective effect on the cardiovascular system. In contrast, transdermal estrogen (from commercial estrogen patches or from bioidentical estrogen creams) has a higher cardioprotective effect. The liver does not metabolize transdermal estrogen. Dr. Smith explained in great detail using many slides how estrogen prevents heart attacks. Details about this would be too technical for this review. Apart from lipid lowering effects there are protective effects to the lining of the arteries. In addition there are metabolic processes in heart cells and mitochondria that benefit from estrogens. The end result is that postmenopausal women who replace estrogen will outlive men by about 10 years. Stay away from Premarin, which is not human estrogen, but is derived from pregnant mares. Also the tablet form is metabolized by the liver, which loses a lot of the beneficial effects that you get from transdermal estrogen. 

How can you document the beneficial effects of estrogen replacement?

  1. Carotid intima measurements in postmenopausal women on ERT show a consistent reduction in thickness compared to controls.
  2. The physical and emotional stress response is reduced compared to postmenopausal women without ERT.
  3. Hormone replacement therapy in postmenopausal women reduces blood pressure. Measurements showed this effect to be due to a reduction of angiotensin converting enzyme (ACE) by 20%. This is the equivalent of treating a woman with an ACE inhibitor without the side effects of these pills.
  4. Coronary calcification scores were lower in postmenopausal women on ERT than a control group without ERT. These calcification scores correlate with the risk for heart attacks.
  5. Oral estrogen replacement leads to proinflammatory metabolites from the liver metabolism of estrogen. This is not found in the blood of women using transdermal estrogen. The anti-inflammatory effect of transdermal estrogen is another mechanism that prevents heart attacks.
  6. Postmenopausal women on ERT had no increased risk of heart attacks or venous thromboembolism (clots in veins). Menopausal women without ERT have a risk of 40% of dying from a heart attack. Their risk of developing breast cancer is 5.5%, the risk of dying from breast cancer is about 1%. Oral estrogen use was associated with venous thromboembolism.
  7. Estrogen has antiarrhythmic effects stabilizing the heart rhythm. Dr. Smith said that in the future intravenous estrogen might be used to prevent serious arrhythmias following heart attacks.

Estrogen levels in males

Males require a small amount of estrogens to maintain their memory, for bone maturation and regulation of bone resorption. But they also need small amounts of estrogen for their normal lipid metabolism.

However, if the estrogen levels are too high as is the case in an obese, elderly man, there is an increased risk of heart disease. Factors that lead to increased estrogen levels in an older man are: increased aromatase activity in fatty tissue, overuse of alcohol and a change in liver metabolism, zinc deficiency, ingestion of estrogen-containing foods and environmental estrogens (also called xenoestrogens).

2. Progesterone

Progesterone is significantly different from the progestin medroxyprogesterone (MPA). MPA was the oral progestin that was responsible for heart attacks and blood clots in the Women’s Health Initiative. MPA increases smooth muscle cell proliferation. This in turn causes hardening of the coronary arteries. In contrast, progesterone inhibits smooth muscle cell proliferation, which prevents heart attacks. Progesterone also lowers blood pressure and elevates HDL cholesterol, but MPA does not.

Progesterone in males

In a small study Depo-Provera was given to males for 17 days. Blood tests showed a lowering of triglycerides, LDL cholesterol and Apo A-1.

3. Testosterone

Testosterone replacement in women

Testosterone in women does not only increase their sex drive, but also relaxes the coronary arteries in women who were testosterone deficient. This allows more blood flow to the heart. In postmenopausal women testosterone replacement lowered lipoprotein (a) levels up to 65%. The physician will only replace testosterone in women who have either enough of their own estrogen production or else have been replaced first with bioidentical estrogen. Otherwise testosterone alone can cause heart attacks in women.

Elevated testosterone in women with PCOS

Women with polycystic ovary syndrome (PCOS) can have increased testosterone levels when they go through premenopause or menopause.

Women with PCOS are at a higher risk to develop diabetes, heart disease and high blood pressure. 50% of women with PCOS have insulin resistance. 70% of women with PCOS in the US have lipid abnormalities in their blood.

Elevated testosterone levels in the blood can lower the protective HDL cholesterol and increase homocysteine levels. Both can cause heart attacks.

Women with PCOS have a 4-fold risk of developing high blood pressure.

Testosterone replacement in males

A 2010 study showed that low testosterone levels in males were predictive of higher mortality due to heart attacks and cancer. Low testosterone is also associated with high blood pressure, heart failure and increased risk of cardiovascular deaths. There was a higher incidence of deaths from heart attacks when testosterone levels were low compared to men with normal testosterone levels.

Low testosterone is also associated with the development of diabetes and metabolic syndrome, which can cause heart attacks.

It is important that men with low testosterone get testosterone replacement therapy.

DHT (Dihydrotestosterone)

DHT is much more potent than testosterone. Conversion of testosterone leads to DHT via the enzyme 5-alpha-reductase. While testosterone can be aromatized into estrogen, DHT cannot. Some men have elevated levels of DHT. This leads to a risk of heart attacks, prostate enlargement and hair loss of the scalp.

Andropause treatment

Only about 5% of men in andropause with low testosterone levels receive testosterone replacement in the US. Part of this is explained by rumors that testosterone may cause prostate cancer or liver cancer. The patient or the physician may be reluctant to treat with testosterone. Bioidentical testosterone has been shown to not cause any harm. It is safe to use testosterone cream transdermally. It does not cause prostate cancer or benign prostatic hypertrophy.

An increase of 6-nmol/L-serum testosterone was associated with a 19% drop in all-cause mortality.

Testosterone helps build up new blood vessels after a heart attack. Testosterone replacement increases coronary blood flow in patients with coronary artery disease. Another effect of testosterone is the decrease of inflammation. Inflammation is an important component of cardiovascular disease.

Testosterone replacement improves exercise capacity, insulin resistance and muscle performance (including the heart muscle).

Apart from the beneficial effect of testosterone on the heart it is also beneficial for the brain. Testosterone treatment prevents Alzheimer’s disease in older men by preventing beta amyloid precursor protein production.

4. DHEA

Dehydroepiandrosterone (DHEA) is a hormone produced in the adrenal glands. It is a precursor for male and female sex hormones, but has actions on its own. It supports muscle strength. Postmenopausal women had a higher mortality from heart disease when their DHEA blood levels were low.

Similar studies in men showed the same results. Congestive heart failure patients of both sexes had more severe disease the lower the DHEA levels were. Other studies have used DHEA supplementation in heart patients, congestive heart failure patients and patients with diabetes to show that clinical symptoms improved.

5. Melatonin

Low levels of melatonin have been demonstrated in patients with heart disease. Melatonin inhibits platelet aggregation and suppresses nighttime sympathetic activity (epinephrine and norepinephrine). Sympathetic activity damages the lining of coronary arteries. Melatonin reduces hypoxia in patients with ischemic stroke or ischemic heart disease. Lower nocturnal melatonin levels are associated with higher adverse effects following a heart attack. Among these are recurrent heart attacks, congestive heart failure or death. Melatonin widens blood vessels, is a free radical scavenger and inhibits oxidation of LDL cholesterol. Melatonin reduces inflammation following a heart attack. This can be measured using the C-reactive protein.

In patients who had angioplasties done for blocked coronary arteries intravenous melatonin decreased CRP, reduced tissue damage, decreased various irregular heart beat patterns and allowed damaged heart tissue to recover.

6. Thyroid hormones

It has been known for more than 100 years that dysfunction of the thyroid leads to heart disease. Hypothyroidism can cause heart attacks, hardening of the coronary arteries and congestive heart failure. Lesser-known connections to hypothyroidism are congestive heart failure, depression, fibromyalgia, ankylosing spondylitis and insulin resistance. Some cases of attention deficit hyperactivity disorder (ADHD) with low thyroid levels may successfully respond to thyroid replacement.

Thyroid hormones improve lipids in the blood, improve arterial stiffness and improve cardiac remodeling following a heart attack. Thyroid hormones help with the repair of the injured heart muscle. They also work directly on the heart muscle helping it to contract more efficiently. Lower thyroid stimulating hormone (TSH) values and higher T3 and T4 thyroid hormone levels lead to improved insulin sensitivity, higher HDL values (= protective cholesterol) and overall better functioning of the lining of the arteries.

Dr. Smith said that thyroid replacement should achieve that

  • TSH is below 2.0, but above the lower limit of normal
  • Free T3 should be dead center of normal or slightly above
  • Free T4 should be dead center of normal or slightly above

Most patients with hypothyroidism require replacement of both T3 and T4 (like with the use of Armour thyroid pills).

7. Cortisol

Cortisol is the only human hormone that increases with age. All other hormones drop off to lower values with age. The adrenal glands manufacture cortisol. With stress cortisol is rising, but when stress is over, it is supposed to come down to normal levels. Many people today are constantly overstressed, so their adrenal glands are often chronically over stimulated. This can lead to a lack of progesterone. It also causes a lack of functional thyroid hormones as they get bound and are less active. When women have decreased estradiol in menopause there is a decline in norepinephrine production, production of serotonin, dopamine and acetylcholine. Women with this experience depression, lack of drive and slower thought processes.

Heart Health Improves With Hormone Replacement

Heart Health Improves With Hormone Replacement

Conclusion

Seven major hormones have been reviewed here that all have a bearing on the risk of developing a heart attack. It is important that these hormones are balanced, so they can work with each other. Hormones can be compared to a team that works together and is responsible for our health. If one or several of the team players are ineffective, our health will suffer. For this reason hormone replacement is crucial. Hormones have effects on mitochondria of the heart muscles cells. They stabilize the heart rhythm as in the case of estradiol. But they can also strengthen the heart muscle directly through DHEA and estrogens in women and DHEA and testosterone in men. Thyroid hormones are another supportive force for the heart and can even be used therapeutically in chronic heart failure patients. When people age, many hormones are produced less, but blood tests will show this. Replacing hormones that are missing can add years of active life.

Taking care of the symphony of hormones means you are taking care of your most important organ, the heart!

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Feb
11
2017

Genetic Switches To Treat Obesity And Diabetes

Dr. Michael Nova gave a talk recently about the role of genetic switches to treat obesity and diabetes. The talk was given as part of the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The full title of the talk was “Nutritional Genetics and Epigenetics in Diabetes and Obesity Management”. Dr. Michael Nova is the Chief Innovation Officer at Pathway Genomics, San Diego, CA 92121.

Twin studies are a powerful tool to show that longevity is both genetically caused as well as environmentally.

These types of studies have shown that a long life (longevity) has been caused by about 20% from genetics. 80% was contributed by a healthy lifestyle. There are powerful epigenetic factors that can slow down aging and that can interfere with the inflammatory process that causes heart disease, obesity and diabetes. There are specific inflammatory markers done with blood tests that detect inflammation. One of the first inflammatory markers detected was the C-reactive protein.

What diseases are caused from inflammation?

Dr. Nova showed a slide depicting MS and Alzheimer’s disease in the head. In the heart area atherosclerosis was shown to cause heart attacks and strokes. Next diabetes, lupus, obesity and irritable bowel disease were depicted. Finally there is arthritis that interferes with joint movements. All of these conditions have inflammation at the core, which leads to worsening of the conditions, if the inflammation is not stopped through nutritional or medical means.

Age-related diseases also due to inflammation

Inflammation is not only confined to these conditions. Research has shown that the following age-related diseases belong into the inflammatory category. These are: osteoporosis, depression, diabetes, cancer, neurodegenerative diseases (Parkinson’s disease, Alzheimer’s), asthma, central obesity, metabolic syndrome and cardiovascular disease. In these diseases the C-reactive protein is often up, so is the fasting insulin level. The rest of the talk concentrated on how various changes in food intake and supplements could lead to epigenetic changes that improve the patients’ conditions.

Human genetics are complicated

The speaker mentioned how complex the human genetics are, and he showed a number of slides that are too complicated to discuss here. There are unstable genes, which can become important in the development of illnesses, particularly when you don’t exercise and you eat a Standard North American diet. There are genes involved that cause diabetes, but they need environmental triggering to get expressed. Dr. Nova showed one slide that listed two genetic variants, which when activated by inflammation rendered the person positive for diabetes or heart disease. If inflammation is vigorously treated with a Mediterranean diet and Metformin, the hemoglobin A1C will decrease to less than 6.0% and diabetes will disappear.

Obesity and genetic factors

Obesity has a 40% to 60% hereditary rate. The fat mass and obesity-associated gene, FTO gene for short is the reason some people gain weight. When this gene is not present the person has no problem maintaining a normal weight. The FTO gene is located on chromosome 16. There are other genes with complicated names that can also increase weight.

It is important that there are many factors that work together in developing obesity. Dr. Nova called this the “epigenetic modulation”. He explained further that there are at least 12 factors working together that can reduce obesity. These are:

  1. Diet
  2. Diurnal/seasonal correlations
  3. Smoking and other toxic chemicals
  4. Street drug use
  5. Disease exposure
  6. Financial status
  7. Exercise status
  8. Microbiome healthy?
  9. Therapeutic drugs
  10. Alternative medicine
  11. Social interactions
  12. Psychological state

Low carbohydrate diets and the ketogenic diet are helping to reduce weight. Financial stress leads to more cortisol production, which leads to weight gain. An unhealthy bacteria composition in your gut causes you to gain weight, while a good composition of bacteria helps you lose weight. Overcoming depression with cognitive therapy can help reduce your weight. Those are just a few examples in more detail from the list of 12 factors.

Extensive research has shown that genetic factors and environmental factors interact to lead to epigenetic marks or imprinting. These epigenetic factors have an influence on gene expression, but they don’t change the underlying DNA sequencing.

There are still gaps of knowledge how obesity develops, what percentage is due to genetic factors and how much is due to other factors including diets.

Diabetes and genetic factors

Major metabolic processes in our body cells like phosphorylation, acetylation and methylation can be influenced by nutrition. This allows epigenetic mechanism of actions to interfere with the expression of inherited health problems like diabetes and other diseases. This has the potential to improve quality of life.

Useful supplements

Dr. Nora showed a slide with a number of useful supplements.

  • EGCG is the effective component of green tea. It supports the viability of the beta-islets of the pancreas that produce insulin. It leads to more secretion of insulin.
  • Naringin and Hesperidin decrease high blood sugar levels.
  • Anthocyanin decreases high blood sugar levels.
  • Quercetin increases cell proliferation in the liver and the pancreas.
  • Vitamin D3 reduces diabetes incidence and inflammation of the insulin-producing cells.
  • Biotin in combination with chromium increases insulin secretion and lowers blood sugars.
  • Vitamin B2, also known as riboflavin has anti-inflammatory effects.
  • Alpha-lipoic acid protects against diabetes by reducing blood sugar levels.

There are several genes involved in the development of type 2 diabetes, one of them is the FTO gene that is also involved in the development of obesity. But Dr. Nora projected a slide that showed 14 other genes that can be involved in the development of diabetes. I have elected to not get into all of those details.

What Dr. Nora concluded is the fact that nutrition could play a vital role in preventing these genes from being expressed. He talked about silencing genes, which good nutrition and supplements can do.

Silencing diabetes genes

A Mediterranean diet can stabilize the metabolism and fight inflammation. Zinc and magnesium are important cofactors in enzymes necessary to prevent diabetes. Vitamin D3 and omega-3 intake are helping to control inflammation and preserve beta cells in the pancreas in diabetes patients.

Nutritional genetic modifiers are

Foods that methylate DNA and silence genes are: citrus (hesperidin), apples (phloretin) and tomatoes (lycopene). The following foods do both DNA methylation and histone modifications: turmeric (curcumin), cinnamon (coumaric acid), green tea (EGCG), soybean (genistein), coffee (caffeic acid) and broccoli (isothiocyanates). These three foods only do histone modifications: garlic (allyl mercaptan), grapes, (resveratrol) and cashew nuts (anacardic acid).

Functional foods with regard to obesity and diabetes

Here are a few food items and their effects on your health.

  • The lignans of flaxseed lower LDL cholesterol and total cholesterol.
  • The catechins of green tea prevent obesity, but also obesity-induced type 2 diabetes.
  • Saponins of fenugreek lower lipid peroxidation and increase the antioxidant level.
  • Soy proteins contain phytoestrogen, genistein and daidzein; this lowers cholesterol levels in the blood, prevents lipid peroxidation and has antioxidant activity.
  • Banaba leaves extract contains corosolic acid and ellagitannins. These substances are able to lower glucose levels in the blood. It also has an anti-obesity effect.
  • Grapes and related products contain anthocyanin, flavan-3-ols and flavonols. They have blood pressure lowering qualities, lower blood fat levels and prevent hardening of the arteries.
  • Dark chocolate contains flavanols that are the main type of flavonoid found in it. Flavanols decrease blood pressure and make platelets in the blood less sticky. This prevents heart attacks and strokes. In addition LDL cholesterol is decreased.
  • Red wine, berries, pears, and apples: proanthocyanidins are the active polyphenols that make all of these fruit valuable. The antioxidant effects of proanthocyanidins prevent LDL to get oxidized, which in turn slows down hardening of the arteries. It reduces the inflammation associated with narrowing of blood vessels and normalizes the lining of arteries.
  • Onions contain two active ingredients, allyl propyl disulfide (which makes you cry when you cut onions) and S-methyl-cysteine sulfoxide. These substances have anti-diabetic effects and lower blood fatty substances.
  • Turmeric contains curcumin, which possesses antidiabetic properties.
  • Fruit and vegetables contain fiber, which lowers blood sugars and hemoglobin A1C.
  • Stevia from the stevia plant reduces blood sugars following a meal in patients with type 2 diabetes.

In summary, all these substances are examples of triggering epigenetic mechanisms to interfere with the expression of negative inherited health problems.

Genetic Switches To Treat Obesity And Diabetes

Genetic Switches To Treat Obesity And Diabetes

Conclusion

This was a whirlwind review of how genetic and epigenetic traits can be overcome by a healthy diet, by supplements, fruit and vegetables, exercise and other healthy lifestyles. After reading about this huge line-up of substances that can contribute to your health, you may feel slightly overwhelmed. Are you going to get all these wonderful items from the health food store and live on a bunch of supplements? Of course this is not the fact! Some herbals can be extremely helpful to combat inflammation, such as curcumin. But the most essential fact remains very simple: to cut down sugar and too many starchy foods, as they will trigger suppressed genes to cause diabetes, obesity, heart attacks and strokes. We need to inform ourselves and stay vigilant to the fact how toxic processed foods are, and we have to cut them out in order to stay healthy. We can become much more resilient to health challenges than we may have thought possible.

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Feb
04
2017

Benefits Of The Ketogenic Diet

Dr. Jeff Volek, PhD, RD gave a talk that clarified the benefits of the ketogenic diet. He is a professor at the Department of Human Sciences at The Ohio State University, Columbus, OH, and teaches in the Kinesiology Program. His lecture was part of the 24th Annual World Conference on Anti-Aging Medicine in Las Vegas, Dec. 9 to 11, 2016.

There were 58 slides, some of them very detailed. I will summarize as best as I can what the presentation was all about.

History of diets

Dr. Volek stated that there were unintended consequences when the low fat/ high carb diet was introduced in the 1970’s and 1980’s. Ancel Keys, a physiologist had proposed in his diet heart hypothesis that saturated fat was the culprit that caused heart attacks.

As a result all major health agencies recommended the low fat/high carb diet. Obesity, diabetes, heart attacks, and strokes were the consequences. Another offshoot later from this was the statin craze where everybody was put on statins as high cholesterol was symptomatically treated. Nothing changed the diabetes and obesity wave and heart attacks and strokes continued to kill the affected persons. Among performance athletes the hypothesis was formed that carb loading would increase muscle performance. Researchers showed evidence that carb loading would improve performance. But athletes were dissatisfied with prediabetes and metabolic problems. Both the average consumer as well as the performance athlete noted that they felt better on a low carb/high fat diet. This is what the ketogenic diet is all about.

Diet heart hypothesis

With the diet heart hypothesis the saturated fat was removed from the diet and replaced by vegetable oils rich in linoleic acid. Dr. Volek explained that blood tests and other investigations were done on people who ingested the low saturated fat/high carb diet. The question was whether this would reduce heart attack rates and deaths by lowering serum cholesterol.

The Minnesota Coronary Experiment was a double blind study, which answered this question.

Cholesterol was reduced in the experimental group. But there was no reduction of heart attacks or strokes compared to a control group. Of concern was the large amount of refined carbohydrate content with the low fat diet. This essentially was responsible for the obesity and diabetes wave. The excess sugar turned into fat deposits and to insulin resistance, which caused diabetes. The low saturated fat/high carb diet of the 1960’s to 1990’s did not reduce heart attacks and strokes. To the contrary: the obesity/type 2 diabetes wave it had caused increased mortality from strokes and heart attacks further.

Laboratory tests on low fat/high carb diet versus the ketogenic diet

Forget hypotheses for a moment. Let us review what the different diets do in terms of lab tests. In a study where 40 overweight people with metabolic syndrome were put on a low fat diet or a low carb/ketogenic diet, the following blood test results were found. There were 20 patients in each group.

  1. Low fat/high carb diet

Triglycerides in the blood went down by 20%, saturated fatty acids by 22%. LDL (the bad cholesterol) rose by 4%. Insulin levels went down by 17% and leptin levels also down by 17%. Glucose levels were down by 1%.

  1. Low carb/ketogenic diet

Triglycerides went down by 52%, saturated fatty acids by 57%. LDL (the bad cholesterol) went down by 18%. Insulin levels went down by 49% and leptin levels by 42%. Glucose levels were down by 11%.

In this group of 20 subjects for each group the body mass index went down by 5% for the low fat diet and by 10% for the ketogenic diet after 3 months. The abdominal fat went down in that time by 12% for the low fat diet and by 20% for the ketogenic diet. The conclusion from these laboratory results and from the body measurements is that the low fat diet is showing some results of weight loss, but the ketogenic diet has superior results. The same is true for the blood tests. Only the ketogenic diet showed reduction of 7 key anti-inflammatory markers. In contrast, the low fat diet did not trigger the production of a single anti-inflammatory marker.

Anti-inflammatory benefits of the ketogenic diet

A 2008 study showed that several anti-inflammatory markers were greatly reduced from the ketogenic diet while a low fat diet did not show such a reduction.

As this 2009 study showed the LDL particles were getting bigger under the influence of a ketogenic diet, but they were getting smaller with a low fat diet.

Large LDL particles are also called pattern A particles, while small LDL particles are also called pattern B particles.

As this link shows there is good evidence that small LDL particles oxidize easier and are more atherogenic (causing hardening of the arteries). This means they lead to hardening of the arteries easier translating into heart attacks and strokes down the road. It is one thing that a ketogenic diet leads to larger LDL particles, which are more resistant to oxygenation. But it is another good thing that this diet is also anti-inflammatory. Overall this means that a ketogenic diet is counteracting the development of heart attacks and strokes.

Are saturated fatty acids in the diet causing heart attacks or strokes?

Dr. Volek discussed several large studies that have investigated this question. One of these studies discussed was a metaanalysis from 2010. Like all the other studies it showed that saturated fatty acids do not cause heart attacks and strokes. This is the secret behind the Inuit and the Eskimo diet. It is a high fat and meat diet. Lots of seafood is consumed as well, which provides omega-3 fatty acids.

Dr. Volek pointed out that if you replace a certain percentage, let’s say 5% of saturated fatty acids with carbohydrates, this would cause 7% more heart attacks. He showed literature evidence to back this up. What causes increased heart attacks and strokes is more refined carbs in your diet (sugar and starchy foods!).

Do saturated fatty acids in your blood increase the risk for disease?

Dr. Volek showed several slides with references to various publications. Elevated saturated fatty acids in the blood cause a higher risk of getting a heart attack, heart failure, metabolic syndrome and diabetes. But this does not happen with a ketogenic diet. The values of the saturated fatty acids in the blood are 4% lower when a ketogenic diet is started. With a low carb diet the calories derived from carbs are 12%. In comparison a low fat diet has 56% of carbs. Protein content in the low fat diet is 20%, in the ketogenic diet 28%. Saturated fat content in the low fat diet is 24%, in the ketogenic diet it is 59%. Let’s assume that both diets are kept at 1500 Cal. per day. Then the saturated fat content for the low fat diet is 12 grams and the carbohydrate content is 208 grams. For the ketogenic diet these values are as follows: 36 grams of saturated fat and 45 grams of carbohydrates. Despite a threefold higher saturated fatty acid intake the circulating level of saturated fatty acids in the blood were decreased by 4%.

You are what you eat, but go easy on carbs

Dr. Volek pointed out that what makes you healthy or sick is how many carbs you include in your diet. If you follow a ketogenic diet with only 12% carbs you are much better off than when you follow a diet like the low fat diet with 56% of carbs. The higher the carb percentage in your food, the higher the production of saturated fatty acids in your system and the higher the storage of saturated fatty acids in your body fat. Conversely, the lower the carb percentage in your food is the higher the oxidation of saturated fatty acids will be. In other words the saturated fatty acids disappear from your blood. Also, with a ketogenic diet the storage of saturated fatty acids is lower in your body fat. With a low fat diet your insulin resistance increases, while with a ketogenic diet insulin resistance decreases. The difference in calories in these two diets (56% derived from carbs in a low fat diet versus 12% derived from carbs in a ketogenic diet) explains why the obesity/type 2 diabetes wave has developed and why heart attacks and strokes still top the mortality figures today.

Endurance athletes win medals on a ketogenic diet

Dr. Volek shared a few cases of world-class athletes that are on a ketogenic diet. They did well for themselves winning medals. Tim Olsen won the Western States 100-mile endurance run from Squaw Valley to Auburn, CA in 2012. Zach Bitter was the 100-mile track record holder in 2015. Mike Morton won the American 24-hour distance running record for 172 miles. Two Tour De France bicyclists made first and second place, Chris Froome (first place) and Romain Bardet (second place).

Sports teams also have been successful on a ketogenic diet: the Columbus Crew soccer team; New Zealand national rugby union team, commonly called the All Blacks; the Los Angeles Lakers basketball team are all on ketogenic diets.

Dr. Volek also pointed out that the ketogenic diet has even been tested for the military. A ketogenic diet restores metabolic health, gives the soldiers more endurance, more stress resistance and decreased fatigue.

Benefits Of The Ketogenic Diet

Benefits Of The Ketogenic Diet

Conclusion

A ketogenic diet is on the one end of the carb spectrum with only 10 to 12% of calories derived from carbs. At the other end is the low fat/high carb diet that caused the obesity/diabetes wave. The Mediterranean diet is in the center. The more you are able to cut down the carb percentage in your diet by cutting out sugar and starchy foods, the more your metabolism gets stabilized and this can be measured with blood tests. The ketogenic diet makes you lose weight down to your ideal weight and makes you gain more muscle strength and physical endurance. Sophisticated blood tests have shown that inflammatory markers go down on a ketogenic diet and factors that lead to hardening of arteries also go down. The end result on the ketogenic diet is that the rate of heart attacks and strokes goes down, something which was the original goal of Ancel Keys. It did not work, but it promoted a wave of diabetes and heart disease! Ironically adding saturated fat and other healthy fats while cutting down carbs will achieve disease prevention. This is the opposite of what Ancel Keys had recommended to do and what the processed food industry has mimicked. The ketogenic diet lowers mortality by cutting down heart attacks and strokes. With this knowledge it will finally be possible to get people on a path to better health.

More information about ketogenic diet: https://www.dietdoctor.com/low-carb/keto

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Jan
21
2017

Effects Of Metformin On The Gut Microbiome

Matthew Andry, MD talked about the effects of metformin on the gut microbiome. This talk was delivered at the 24th Annual World Congress on Anti-Aging Medicine. The congress took place from Dec. 9 to Dec. 11, 2016 in Las Vegas. A lot of the sessions that I attended dealt with the gut flora and how it affects our health. This talk belongs to the theme of what a healthy gut microbiome can do for us.

History of metformin

Dr. Andry is a clinical associate professor of the Indiana School Of Medicine.

He pointed out that metformin has been used for a long time for type 2 diabetes, particularly, if fasting insulin levels are high. Metformin is a biguanide, which was isolated from French lilac (also known as Goats Rue). In the middle ages this herb was used to treat “thirst and urination”. In retrospect we recognize these as symptoms of diabetes. Chemists were able to synthesize the active ingredient in this herb in the 1920’s. Since then it is known as metformin. Dr. Jean Stern was able to show in the 1950’s in clinical studies that Glucophage, the brand name of metformin was able to reduce blood sugar without raising insulin levels. Between 1977 and 1997 metformin enjoyed wide spread acceptance for treating diabetics. Several clinical investigators demonstrated that diabetic patients on metformin lived longer and had less heart attacks than patients who were treated otherwise.

Metformin is the first-line drug in the treatment of type 2 diabetes in children and adults. It is one of the most widely prescribed drugs throughout the world with 120 million prescriptions per year.

Off-label use of metformin

There are many other clinical conditions for which metformin have been found to be beneficial. Polycystic ovary syndrome (PCOS), obesity, prediabetes, metabolic syndrome and nonalcoholic steatohepatitis are a few examples of off-label use of metformin. Metformin is also used as an anti-aging agent as it was found to elongate telomeres, which helps people to live longer. Metformin has been identified as a possible cancer prevention agent. In prostate cancer it was found to have an effect against prostate cancer stem cells. Without these cells prostate cancer does not recur after surgical removal.

Action of metformin

Metformin increases the action of an enzyme, AMPK, which leads to lipid oxidation and breakdown of fatty tissue (catabolism). In the liver the metabolic pathway of making sugar from fatty acids, called gluconeogenesis is inhibited. Metformin causes increased uptake of sugar into skeletal muscle tissue. This is the reason for the previously mentioned stabilization of blood sugar. Metformin has two beneficial effects on the liver. First it stabilizes insulin sensitivity. This means that a given amount of insulin has a larger effect on the liver. Secondly metformin decreases the toxic effect of fatty acids on the liver tissue. In other words metformin has a healing effect on non-alcoholic steatohepatitis, a precursor to fatty liver and liver cirrhosis. Metformin also has an effect on the appetite center in the brain. It helps many obese and overweight people, but not all to lose weight. The mechanism for that effect is in the hypothalamus, where the appetite center is located. The neuropeptide Y gene expression in the hypothalamus is inhibited by metformin leading to reduced appetite.

Finally, metformin also normalizes the gut flora. This last point was the main focus of Dr. Andry’s talk.

Metformin and the gut

An animal experiment on mice showed in a study published in 2014 that metformin was stimulating the growth of a beneficial gut bacterium, Akkermansia. This is a mucin-degrading bacterium. But it also affects the metabolism of the host. The authors found that metformin increased the mucin-producing goblet cells.

Akkermansia muciniphila bacteria were fed to one group of mice. This group was on a high fat diet, but not on metformin. The mice showed control of their blood sugars, as did the metformin group. In other words manipulation of the gut flora composition could achieve control of the diabetic metabolism. The authors concluded that pharmacological manipulation of the gut microbiota using metformin in favor of Akkermansia might be a potential treatment for type 2 diabetes.

Effect of metformin on the gut flora

Akkermansia muciniphila bacteria comprise 3%-5% of the gut flora. It does not form spores and is strictly anaerobe, in other words oxygen destroys it. This is the reason why it is difficult to take it as a supplement. It is mostly growing in the mucous of the epithelium layer of the gut. The highest number of Akkermansia bacteria is found in the colon, lesser amounts in the small intestine of all mammalian species including the human race.

Here are the effects of metformin on Akkermansia:

  • Metformin increases the Akkermansia bacteria count both in a Petri dish as well as in the gut of experimental mice. This suggests that metformin acts like a growth factor for Akkermansia.
  • Metformin increased the count of Akkermansia bacteria by 18-fold up to a maximum of 12.44% (up from the normal 3-5%) of all of the gut bacteria.
  • Researchers observed that the mucin layer of the lining of the gut in metformin treated mice was thicker. This suggests that the thickness of the mucin layer plays a role in increasing the Akkermansia count.

Effect of the gut on the body’s metabolism

Other researchers have investigated how a high fat diet can change the composition of the gut bacteria, which in turn are altering the body’s metabolism. Essentially a shift in the bowel flora can increase the gut’s permeability. This is called leaky gut syndrome. It leads to absorption of lipopolysaccharides (LPS) from bad bacteria in the gut. The end result is endotoxemia in the blood. This causes systemic inflammation in the body. Insulin resistance and obesity develop and this can be followed by type 2 diabetes. It is interesting to note that the effects of a high fat diet that led to these changes can be reversed by increasing Akkermansia bacteria in the gut or by treating with metformin.

An interesting mouse experiment showed that the changes that take place in the gut bacteria with cold exposure could be transferred to germ-free mice with no gut flora. This changed their metabolism proving that gut bacteria have profound influences on the metabolism. The fact that the gut bacteria have a profound influence on the metabolism is not only true for animals, but also for humans.

Akkermansia Facts

Here are a few facts about the Akkermansia bacteria.

  • The amounts of Akkermansia bacteria in the gut are inversely related to how fat we are. This is measured by the body mass index (BMI). Fat people have less Akkermansia in their guts.
  • A high fat diet lowers the amount of Akkermansia in the gut
  • Systemic inflammation is present with low Akkermansia counts
  • A high fat diet causes gut permeability (leaky gut syndrome).
  • Low levels of Akkermansia causes worsened severity of appendicitis and inflammatory bowel disease.
  • Low levels of Akkermansia causes fat storage (both in subcutaneous fat and visceral fat).
  • Low levels of Akkermansia cause insulin resistance (associated with diabetes) and high blood sugars.
  • Increased Akkermansia counts increase brown fat’s ability to burn calories, which leads to weight loss. Decreased Akkermansia counts lead to fat storage (weight gain).
  • Increased Akkermansia improves gut-barrier integrity
  • Increased Akkermansia reduces visceral and total body fat
  • Increased Akkermansia reduces synthesis of sugar in the liver (gluconeogenesis)

We have 10 times more bacteria in the gut than we have cells in our body. The Akkermansia percentage of the gut flora can be decreased from antibiotics or food that contains traces of antibiotics. If there is a lack of Akkermansia species, there is more gut permeability, causing LPS increase and causing increase of inflammation in the body. This translates into high blood pressure, heart attacks, strokes, and degenerative neurological diseases like Parkinson’s disease, Alzheimer’s disease or MS. But it can also cause inflammatory bowel disease and autoimmune diseases.

What increases Akkermansia?

We can increase Akkermansia bacteria in the gut by eating Oligofructose-enriched prebiotics. Oligofructose belongs into the inulin type soluble fibers. It is found in a variety of vegetables and plants. This includes onions, garlic, chicory, bananas, Jerusalem artichokes, navy beans and wheat. But wheat can be problematic. Clearfield wheat is the modern wheat variety which is now grown worldwide. It is much richer in gluten and can cause problems with gut permeability.

Eating lots of vegetables and fruit will give you enough of oligofructose to maintain a healthy percentage of Akkermansia in your gut bacteria.

Metformin as pointed out earlier can be used as pharmacotherapy. But it must be stressed that the use of metformin for dysmetabolic syndrome is off-label. There are real side effects of metformin. Lactic acidosis with an unusual tiredness, dizziness and severe drowsiness can develop. Also chills, muscle pain, blue/cold skin and fast/difficult breathing has been described. Slow/irregular heartbeat, vomiting, or diarrhea, stomach pains with nausea are also listed under side effects.

Effects Of Metformin On The Gut Microbiome

Effects Of Metformin On The Gut Microbiome

Conclusion

Our gut bacteria are important for us, more so than you may be aware of. An anaerobe bacterium, Akkermansia makes up 3%-5% of the gut flora. This bacterium lives in the mucous layer of the lining of the gut and ensures that the gut wall is tight. When these bacteria are lacking (due to consumption of junk foods) the gut wall becomes leaky, which is why this condition is called “leaky gut syndrome”. Irritating toxic substances can now leak into the blood stream and lipopolysaccharides are among them. This causes inflammation in the gut wall, but can go over into the blood vessels and the rest of the body including the brain. High blood pressure, obesity, diabetes, heart attacks, strokes, and degenerative neurological diseases like Parkinson’s disease, Alzheimer’s disease or MS can develop from the inflammation. But it may also cause inflammatory bowel disease and autoimmune diseases.

Eating lots of vegetables and fruit will give you enough of oligofructose to maintain a healthy percentage of Akkermansia in your gut bacteria. In particular, onions, garlic, chicory, bananas, Jerusalem artichokes and navy beans provide lots of oligofructose to support Akkermansia in your gut bacteria.

As pointed out earlier metformin can be used as pharmacotherapy of dysmetabolic syndrome. But it must be stressed that the use of metformin is off-label. It is also important to remember, that with effects there are side effects of metformin.

It may be news to you, how close the health of the gut is connected to our overall health. With the knowledge that food can be your medicine, choose your foods wisely. Add some or all of the above named foods that help you support beneficial gut bacteria, and take care of your health!

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Jan
14
2017

How To Avoid Being Hungry

Dr. Ludwig gave a lecture about how to avoid being hungry at a conference in Las Vegas. The actual topic was “Always Hungry?” I attended the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas where this lecture was given. Dr. Ludwig is a Harvard-based endocrinologist who has been researching weight loss methods and obesity for over 20 years. Here is a list of his major publications.

Dr. Ludwig stated that the low fat/high carb diet popular in the1980’s until the early 2000’s was misguided and probably even harmful. The theory at that time was that obesity was caused by too much saturated fat. This has since been proven to be wrong. Instead it has been proven that increased sugar intake is responsible for the obesity wave.

General information about weight gain

The carbohydrate-insulin model states that without insulin you cannot gain weight, because in order to store fat in fatty tissue you need insulin to transport fatty acids across the cell membrane of fat cells.

In this context it is important to note that high glycemic index food increases the blood sugar. This leads to stimulated insulin production, and the liver converts the extra sugar into fatty acids that get deposited as fat in fatty tissue.

The glycemic load from a person’s diet is the single best predictor for a rising blood sugar level. After food intake the blood sugar goes up, glucagon goes up, epinephrine goes up within 4 hours. It is the epinephrine, which after 4 hours makes you hungry again.

The nucleus accumbens is the addiction center. At 4 hours after a high glycemic index milk shake the nucleus accumbens was stimulated in 12 subjects of a double blind trial.

The nucleus accumbens does not work in isolation. It is not only involved in food satisfaction, but also in sexual satisfaction and even plays a role in satisfaction that some people get from playing video games.

Low-carbohydrate, Mediterranean or low-fat diet

In an Israeli study from the New England Journal of Medicine in 2008 investigators were interested to find out which diet was helping people to lose most weight. h

322 moderately obese subjects that were aged 52 years on average were randomized to one of the following diet groups.

They compared

  1. a low fat diet (Atkins type, restricted calorie) with a
  2. Mediterranean diet (low carb, restricted-calorie) and a
  3. Low fat/high carb diet (low fat, non-restricted-calorie)

What was the result? The mean weight losses were: 2.9 kg (low fat group), 4.4 kg (Mediterranean diet group), and 4.7 kg (low fat/high carb group). Of the 272 participants who had completed the intervention after two years of the study the weight loss was 3.3 kg, 4.6 kg, and 5.5 kg in the same sequence as above.

The ratio of total cholesterol to high-density lipoprotein cholesterol, which is a measure for the heart attack risk, was examined next. It was 20% lower from the baseline in group 2 (Mediterranean diet group). The low fat groups (group 1 and 3) were 12% lower from the baseline.

36 subjects had diabetes. There was a clear winner with respect to lower fasting blood sugar and insulin levels, namely the Mediterranean diet (group 2).

The authors concluded that the Mediterranean diet is preferable to low fat diets as they have shown an improvement in lipid profiles and in control of diabetes.

The “POUNDS LOST” study

This was a 2-year study that investigated 4 different lower calorie diets to help people lose weight. Despite the significant difference in diet composition, these 811 free-living overweight or obese adults ages 30-70 from Boston, MA and Baton Rouge, LA lost 16 pounds at 6 months and 9 pounds at the end of two years. The diets were 1) low fat (20%) or 2) high fat (40%) 3) average protein (15%) or 4) high protein (25% of total calories).

The authors concluded that any reduced, calorie-controlled diet would help obese or overweight people to achieve weight loss that lasts. It is interesting that it did not matter whether the diet was low or high in fat, or had low or high protein content. What did matter was that all diets were low in sugar.

Sugar is the driving force

Dr. Ludwig pointed out that without insulin you couldn’t gain weight. High glycemic index food increases blood sugar. The glycemic load is the single best predictor to indicate whether a person will gain weight or lose weight when this food is consumed. It is an irony that in the 1980’s and 1990’s the obesity wave was created by the wrong assumption that a low fat/high carb diet would be heart healthy. We have abundant data available that show otherwise: high sugar content of food brings the calorie count up as everybody can read on the food labels.This will lead to weight increase, which has been abundantly proven. Sugar also stimulates your nucleus accumbens, the food addiction center. As you probably know it is extremely difficult to get out of this food addiction cycle unless you cut out sugar. You even need to go one step further and include many starchy foods that will within 30 minutes of digesting them turn into sugar. Your system makes no difference whether you eat a few teaspoons of sugar or two slices of white bread. The response of your pancreas is insulin, which gladly stores the fatty substances your liver made as fat.

How to get out of the vicious food cycle

As the quoted publications and many other ones have shown, it only matters that you limit your refined carb intake. You can vary the fat content and you can vary the protein content and still lose weight provided you watch the low carb intake. You also need portion control, which is a given! Study glycemic index and glycemic load sites on the Internet. The links I provided are just some examples. The more you educate yourself about carbs, the better for you. Note that many fruit and vegetables belong to the low-glycemic load/index foods. Avoid the high glycemic index foods like dates and cornflakes. Stick to low-glycemic index foods, which are less than 55. With regard to low-glycemic load food the values should be below 10.

The Mediterranean diet is a very desirable diet, which has been proven to be anti-inflammatory.

The zone diet of Barry Sears is also an anti-inflammatory diet and he summarizes this in this link.

How To Avoid Being Hungry

How To Avoid Being Hungry

Conclusion

I have summarized the content of a talk given by Dr. Ludwig. We learnt from this that sugar and refined carbs are the driving force that leads to “feeling hungry”. This stimulates your nucleus accumbens, the food addiction center. Let’s assume that a person is obese or overweight and wants to lose some weight. You need to start by being strict with yourself. Cut out sugar and high-glycemic foods. This will remove the food addiction factor that keeps you going back to the wrong, high calorie foods. You will also consume more low calorie vegetables and fruit, which have more fiber that fills you up. Once you are used to the new way of eating, there is no need to count calories. I recommend that you weigh yourself daily on body composition scales and record the results. This allows you to monitor your body mass index (BMI), your weight, your fat percentage, and your muscle percentage. Typically you will lose 2 to 3 pounds per week on such a low-calorie diet. Later the weight loss will slow down to 1 to 2 weeks per week until you reach your goal. Don’t go lower than a BMI of 21.0 to 22.0 and discuss your goal with your doctor.

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