Apr
14
2018

Where Does Fat Go With Weight loss?

People often wonder where does fat go with weight loss? This question recently came up in a CNN conversation.  The answer was originally researched by Dr. Ruben Meerman and Professor Andrew Brown.

Dr. Meerman is an assistant scientist at the University of New South Wales and author of “Big Fat Myths: When You Lose Weight, Where Does the Fat Go?” Professor Brown is the head of the School of Biotechnology and Biomolecular Sciences at the same university.

When you lose 1 kilogram of fat, where does fat go with weight loss?

The interesting answer to this question is that fat gets metabolized. Dr, Meerman and Prof. Brown pointed out that originally Leifson et al. answered this question who used heavy oxygen and found out that this was metabolized into heavy water.

Technically these experiments are fairly complex, but they allow the researchers to see exactly where the body incorporates these chemicals and where they end up with breakdown of fat. The BMJ paper describes that the breakdown of 1 kg of fat follows the following pattern: It breaks down into 0.84 kg of CO2 (carbon dioxide) and 0.16 kg of H2O (water). In other words, the lungs are the primary organs that get rid of fat and the kidneys excrete the water. There is a bit of extra energy in this chemical reaction as well, which dissipates through the skin and through exhaled air.

What did health professionals think where the fat would go?

The health professionals were doctors, dieticians and personal trainers. About 65% of them thought fat would evaporate into energy/heat. About 10% thought fat would end up in the feces. 5% thought fat would turn into muscle. Another 5% thought fat would turn into sweat or urine. 8% were correct that fat would become CO2 and H2O. 7% said they did not know.

The chemistry of fat deposits and metabolizing fat

The body deposited triglycerides from the liver metabolism of sugar and fatty acids into fat cells and stored them as oleate (C18H34O2), palmitate (C16H32O2), and linoleate (C18H32O2). Part of this are many chemical reactions, including a number of enzymes. These fatty acids form esters and turn into gigantic molecules with this chemical formula: C55H104O6. The BMJ paper further says that an overall chemical description of metabolized fat would look like this:

C55H104O6+78O2→55CO2+52H2O+energy. In plain English it means that 1 molecule of fat ester (from fat storage) is metabolized together with 78 molecules of oxygen. This results in 55 molecules of carbon dioxide, 52 molecules of water and energy.

Fat turns into carbon dioxide and water

Based on this chemical reaction a calculation of the breakdown of fat into carbon dioxide and water was possible. The surprising result is that 84% of fat becomes carbon dioxide and only 16% of fat becomes water. We exhale the carbon dioxide from our lungs and it is mostly the kidneys that excrete the water. People who lose weight are aware that they have to urinate more often. But they do not notice that they get rid of a lot of carbon dioxide, as this is a subtle process.

Some observations from the fasting mimicking diet

The fasting mimicking diet (FMD) was at the center of the most recent anti-aging conference in Las Vegas I attended. This was the 25th Annual World Congress on Anti-Aging Medicine in Las Vegas, Dec. 14-16, 2017. Late in December 2017 I started 5 days of FMD and have just completed my 4th round of it (FMD is done 5 days out of each month). My main interest in doing this is to prevent heart attacks and strokes and I like the idea of stimulating telomeres for anti-aging and increasing stem cell production. See more details under this link.

Personal experience of fasting mimicking diet

I keep meticulous records of my body measurements using daily body composition scales, which I record in a booklet. Between March 23, 2018 and March 28 I lost 1.5 kg from 64.8 kg to 63.3 kg. Fat composition was reduced from 14.1% to 12.2%. Visceral fat was reduced from 6% to 5%. My muscle percentage rose from 38.1% to 39.1%. The basic metabolic rate was 1471 Calories on March 23 and went down to 1449 Calories on March 28. My body mass index went from 22.0 to 21.5.

I definitely noticed the frequent urination, something I had noticed in the past in 2001 when I lost 50 pounds over 3 months. Of course it is understandable when you reduce your daily calorie intake to 600 Calories per day that you will lose this amount of weight. People have different metabolisms. It may be that you won’t lose as much as I did.

What causes mainly weight loss?

There are many people who think that extra exercise would help you lose weight. But a publication has established that only about 8% of weight loss is due to exercising. 92% of weight loss is due to dieting.

Regular exercise is important for conditioning of your lungs, heart, muscles and joints. But to keep things in balance a reasonable diet, like a Mediterranean diet, should also be part of the regimen.

Sugar overconsumption

The obesity wave in the US started to take off between 1976 and 1980. 40 years later it is still rising. It is interesting to note that both wheat flour and sugar consumption in the US were increasing parallel to the rising obesity figures. In the 70’s the old-fashioned wheat has changed into the force hybridized Clearfield wheat, which is now 100% of the commercially available wheat. Clearfield wheat contains 7-fold higher gluten amounts than the old-fashioned wheat that your grandparents consumed. Gluten stimulates your appetite, so you crave more wheat and you crave more sugar. This becomes a vicious cycle.

Excess calories are stored as fat

The liver metabolizes sugar from regular food and from processed food into triglycerides and LDL cholesterol (the bad cholesterol that plugs up arteries). As I mentioned above, the body stores any excess triglycerides as fat and deposits the excess into fatty cells. You see from this that essentially sugar and wheat end up as fat deposits. I suggest you change your food intake into eating sensible food with fewer calories. Start by eliminating most of your sugar, wheat and processed food intake. This will help you to melt fat away as I showed with an example of my 5 day FMD.

Where Does Fat Go With Weight loss?

Where Does Fat Go With Weight loss?

Conclusion

I reviewed facts about the chemistry of melting fat away. The question is where does fat go with weight loss? In the process of weight loss fat breaks down into carbon dioxide and water. I also documented how you can lose fat in just 5 days (1.1 kilogram) on a 600-calorie diet and reduce the body mass index from 22.0 to 21.5.

Most people do not recognize the importance of watching their diet to achieve weight loss. 92% of weight loss occurs as a result of dieting. Wheat and sugar consumption have a direct connection to the obesity wave that started between 1976 and 1980. I have cut out all wheat, all sugar and all processed food in 2001. This allowed me to lose 50 pounds then and my body mass index today is 21.5. It can be done, even if you are 73 years old.

Jul
16
2016

Mediterranean With Healthy Fat

If you want to lose weight, have you considered eating Mediterranean with healthy fat? A lot has changed in recent years regarding recommendations for healthy food intake. In the eighties and nineties there was a recommendation for a  low fat diet, which unfortunately was high in carbs and led to obesity. We learnt from this that carbohydrates break down in the gut into sugar. This converts into fatty acids, which go in storage as fat.

Studies regarding diets with unhealthy and healthy fats

Prospective study in the US

Here is a prospective study that followed 120,877 U.S. women and men over a longer time. Every 4 years there was weight gain of 1.69 lbs. for potato chips, 1.28 lbs. for potatoes, 1.00 lb. for sugar-sweetened beverages, 0.95 lb. for unprocessed red meats and 0.93 lb for processed meats. On the other hand from vegetables there was a weight loss of −0.22 lb., for whole grains −0.37 lb., for fruits −0.49 lb., for nuts −0.57 lb. and for yogurt −0.82 lb. The researchers checked cheese out and found it mostly neutral in terms of weight gain, while butter did cause weight gain.

Lancet study from Spain

In a study from Spain that was published in the Lancet in June 2016. The researchers followed 7447 asymptomatic men (aged 55–80 years) and women (aged 60–80 years) for about 5 years. They all had type 2 diabetes and three or more cardiovascular risk factors. They were randomly assigned to three Mediterranean diet types: a Mediterranean diet with olive oil, a Mediterranean diet with nuts and a control group on a low fat Mediterranean diet.

Weight loss when on Mediterranean diet

The interesting finding after 5 years was that there was weight loss around the waist in both the patients on the Mediterranean diet with nuts and with olive oil. Their weight loss was 0.95 lbs. for the olive oil group and 2.82 oz. in the Mediterranean diet group with nuts. The Mediterranean diet group with olive oil had lost 0.22 inches in the waistline, the other group on nuts lost 0.38 inches. These are hardly impressive losses! The researchers concluded that fat restriction is not necessary on the Mediterranean diet, as there was no weight gain with unrestricted healthy fats after 5 years.

Summary from a cardiologist

Dr. Dariush Mozaffarian, a cardiologist and epidemiologist of the Tufts Friedman School of Nutrition Science & Policy wrote an editorial regarding this Spanish study: ”A handful of nuts may be 160 calories, which is more calories than a can of Coke, but that doesn’t mean the can of Coke is a better choice”. He added: “Salt, sugar, starch, processed food and trans fats should be off the menu, not fat. Healthy foods are healthy foods, and bad foods are bad. It doesn’t matter, if the food is low fat or high fat. This is a separate issue.”

Mediterranean With Healthy Fat

Mediterranean With Healthy Fat

Conclusion

When wanting to lose weight, the key is to pay attention to your carb intake. Make sure it consists of unrefined carbs. You will do this if you eat vegetables and fruit. Cut out sugar and starchy foods as much as you can. Have lean, clean meats, but avoid red meat except perhaps for every two weeks some grass fed beef. Eat fish (important for its content of omega-3 fatty acids), also enjoy yogurt, nuts, olive oil and avocados. It is an extra benefit if you add regular exercise to this as well. You will notice that you gradually shed the unnecessary pounds. This is not a program for just a month or two. To stay well, make it a new lifestyle!

Aug
29
2015

Problems With The Western Diet

Lately there have been various news reports cautioning us about the Western diet. We eat too much processed food, we eat too much sugar and we have to be careful with how much fat and what kind of fat we eat. Take this story from the CNN. Half the world lives in big cities. And this number will reach 70% in the year 2050, if the urbanization trend continues at the same rate. With it comes the consumption of fast food. The wealthier people are, the more meat they eat. This is exactly what is bad for us. Too much meat can cause gout, particularly when paired with alcohol. First it is time to explain some more about the Western diet. “The biggest features of a Western diet are overconsumption of over-refined sugars, highly refined and saturated fats, animal protein and a reduced intake of plant-based fibers,” says Ian Myles. He is located at the U.S. National Institute of Allergy and Infectious Diseases. This statement is specific enough: we are eating too much fat, red meat, salt and sugar, and too little fiber.

Too much fat

In processed foods we get too many omega-6 fatty acids, which have been shown to cause clogging of arteries and causing heart attacks and strokes, if not balanced with enough omega-3 fatty acids. But many processed foods still have hidden trans fats, which distribute free radicals in your system; this in turn causes hardening of the arteries again. Free radicals also age you faster. A candy bar with palmitic acid and fructose for instance, leads to a slow grade inflammation. The immune system mistakenly takes palmitic acid for the gut bacterium E.coli and mounts an immune reaction. This low-grade inflammation causes inflammation in the blood vessels, but also weakens the immune system. The sugar part of the candy bar oxidizes LDL cholesterol leading to clogging of arteries, which causes heart attacks and strokes.

Too much red meat

Grain fed and antibiotic treated regular beef changes the gut bacteria and can cause super bugs. The change of the gut flora can lead to inflammation in the gut lining and something called “leaky gut syndrome”. We carry almost 2 pounds of gut bacteria in us at any given time. But residual antibiotics from regular beef and chicken reduces that amount and changes the composition of our gut flora.

You can read in this blog that the changes taking place from consuming regular beef changes your liver metabolism and leads to accelerated hardening of the arteries, which in turn causes deadly heart attacks and strokes. On the other hand, grass fed beef or organic beef do not do this. To prevent leaky gut syndrome, heart attacks and strokes from developing you can take probiotics every day, which should include these two species: Lactobacillus acidophilus and Bifidobacterium bifidus. This keeps your gut flora stable and does not allow your food to undermine your health.

To much salt and sugar

Too much salt is often in processed food to prolong the shelf life. But we humans are very sensitive to overdoses of salt. Our kidneys have to work overtime to get rid of the excess salt. We need to drink enough water to allow the kidneys to produce urine, which will eliminate the excess salt. Persistent excessive salt intake will also cause high blood pressure. High blood pressure can cause heart problems, strokes and aortic aneurysms. Restaurant food often contains too much salt and sugar.

Too little fiber

The more food is processed, the less fiber it will contain. If you go for the pizza, it may taste good, but where is the fiber? If you eat bread and butter, where is the fiber? You may say that you like a donut. I ask you again: where is the fiber? The end result is that toxins that normally would have been bound to fiber in the colon and were eliminated in the stool are now interacting with the wall of the colon causing colonic polyps and colon cancer. It may not only be fiber as plant-based diets rich in fruits, non-starchy vegetables, legumes, and whole grains were shown to be associated with a lower risk of the most common cancers. That’s the reason why people who consume a Western diet have higher rates of cancer in general. They lack fruits and vegetables.

Polyunsaturated fatty acids

The recommendation in the 1980’s until about 2010 of a low fat diet to prevent heart attacks and strokes has failed miserably. It turned out that polyunsaturated fatty acids are of the omega-6 type, which gets metabolized into arachidonic acid and causes inflammation. The immune system gets suppressed from the chronic inflammation and the person becomes more prone to infections. As low fat diets are typically high in carbohydrates, there is a calorie surplus causing weight gain. Dr. Fife explains in his book that polyunsaturated acids interfere with the insulin receptor feeding into insulin resistance, which makes it even more difficult to control the metabolism and leads to more weight gain (Ref.1). The end result is what we have observed over the last few decades, a relentless obesity wave in the civilized world. It is a direct result of the Western diet.

Cancer caused by the Western diet

Breast cancer, colon cancer and prostate cancer are cancers that are related to the Western diet. But there are likely many other cancers that are also caused by it.

We know that free radicals cause cancer, such as from trans fats and rancid polyunsaturated fatty acids found in processed foods. Cancer is more common in obese people and people with diabetes.

Habits that make us eat more

There are habits that make us eat more like snacking and falling for so-called “fitness food” which contains dubious ingredients. It may come as a surprise, but married people can also fall prey to unhealthy habits together, forgetting about working out and sneaking in “skinny cocktails”. Read what Cynthia Sass, registered dietician had to say about this on CNN.

Solution to the Western diet

You may expect me to say that you should modify this or that in the Western diet. Modification does not work. You have to get radical here! The real solution is to abandon the Western diet altogether. Replace it with the Mediterranean diet without sugar and starchy foods. It is not that as bad as you can see from 1 week of recipes that my wife included in my book: “A survivor’s Guide To Successful Aging”.

You can eat cooked organic spinach, a piece of meat with slices of Avocado for breakfast. Cooking is done mostly with coconut oil or olive oil. Alternatively you may enjoy an egg or egg white vegetable omelette with lots of greens, mushrooms, onions and salsa and avocado on the side. Add to this caffeinated or decaffeinated coffee with stevia. Alternatively, a bowl of rolled oats, flaxseed and nuts with fresh fruit and organic milk, goat milk or yoghurt would make an excellent, sustaining breakfast. I am mentioning all of this to show you that you can get away from your familiar pancakes with maple syrup, sausages, waffles, toasts and muffins etc.

Food needs to be prepared form scratch with organic ingredients. GMO foods need to be avoided as the final judgment on these is decades away, and you do not want to become a human guinea pig.

Problems With The Western Diet

Problems With The Western Diet

Conclusion

The only way to “improve” a Western diet is to eliminate it and replace it by the Mediterranean diet. Throw all the processed food into the trash where it belongs! Avoid omega-6 fatty acids (polyunsaturated fatty acids), which have been shown to weaken the immune system and cause insulin resistance. The best fats are omega-3-fatty acids from marine oils (fish oil), coconut oil and olive oil. Forget all the other oils that are heavily advertised. They are not healthy.

I stick to organic foods although they are more expensive. Don’t forget that apart from a good diet you need to engage in a regular exercise program in order to prevent heart disease and cancer. And don’t stress out over the changes that you are about to make. Remember to manage your stress and relax!

References:

  1. Bruce Fife, C.N., N.D.: “The Coconut Oil Miracle”, 5th edition,2013, Penguin Books, NY 10014

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Jan
04
2015

Lifestyle Has Profound Changes On Our System

Dr. David Katz delivered a keynote address where he said that lifestyle has profound changes on our system. This took place at the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas Dec. 10-14, 2014. His talk was entitled “Integrative Medicine: A Bridge Over Healthcare’s Troubled Waters”.

He started the 1 hour talk with showing a slide of six blind men and the elephant. The conclusion was that each of the blind men saw only one aspect of the elephant, but no one saw the true elephant. With healthcare it is a bit like that.

Causes of death

Dr. McGinnis et al. in 1993 published the “Actual causes of death in the United States”.

Ten factors were responsible for chronic disease, but the first three things on McGinnis list were the most important ones: tobacco use, diet and lack of exercise.

Mokdad in 2004 noted that the revised list of “Actual causes of death in the United States”: tobacco was no longer number one.

Effect of healthy lifestyle

Ford et al. in 2009 stated: “Healthy living is the best revenge…Nutrition-Potsdam study

Although there is no magic pill for reducing disease, lifestyle is exactly “the magic pill” that reduces mortality by almost 80%.

Fastforward to 2014: Akkeson et al. came to the same conclusion when examining what would be able to prevent heart attacks. They stated that LIFESTYLE is what matters.

We live in the “epigenetic age: dinner is destiny!” With this Dr. Katz meant to say that our genes get switched on and off depending on what we put into our mouths. This determines whether we live shorter or longer lives.

He went on to say: “Feet (exercise), forks (diet), fingers (cigarettes) are what matters.” Oncogenes can get turned off in prostate cancer with the help of exercise, the right food intake and quitting to smoke.

Food addiction and obesity

Dr. Katz mentioned the book by Michael Moss “Salt, sugar, fat”, which made it to the cover story of Time Magazine in 2013. In it is described how the food industry employs PhD’s to include agents in processed foods to ensure that consumers get addicted to the food products. Food addiction leads to obesity; the CDC statistics show that it is effective! We have put up with this for far too long. There are differences of obesity rates between countries, here Canadian and US statistics shown.

Dr. Katz asked the audience to raise up their hands, if they had a person close to them die of cancer, a heart attack or a stroke. Almost all of the more than 500 participants in the Hall raised their hands.

Lifestyle Has Profound Changes On Our System

Lifestyle Has Profound Changes On Our System

Children education programs

So what is the ONE thing that can fix everything? He answered this rhetoric question by saying that there is no one thing that fixes everything. But we can start at a young age by educating our children. Dr. Katz has started a program for school kids called “ABC for fitness for kids” to prevent obesity. The program teaches children healthful food choices. Dr. Katz commented that a website, NuVal uses a nutritional value rating system to monitor food quality and manufacturers have improved the content of their products because the composition of their products were displayed on that website. We need to be vigilant and read labels.

Change one thing at a time

But we can only change one thing at a time, like we walk one step at a time on a spiral staircase to get to the next floor. We ask ourselves about our lifestyle: what is the first thing to fix? We fix this point (like exercise more), then we fix the second (adopt a Mediterranean diet), the third (take specific vitamins and supplements) and so on; in other words we approach one thing at a time. Integrative medicine, the fusion of conventional and non-conventional medicine, can help to solve problems one step at a time.

Effect of CoQ10

Despite a bias in the North American medical literature saying that CoQ10 was “useless”, the European Heart Journal reported in 2013 that CoQ10 decreases all-cause-mortality in patients with heart disease. Here is a link to a more recent article (Dec. 2014) regarding a two year trial with congestive heart failure patients taking only 100 mg of CoQ-10 three times daily that found that all-cause-mortality was reduced significantly.

Blue zones

There is a new wave going around the United States: It is the idea to copy the lifestyle of the blue zones around the world. Blue zones are areas in the world where the life expectancy is 100 years or more. This link leads you to a information about blue zones that is worth watching.

It explains how Blue Zones are being established all around America. Dr. Katz explained that lifestyle is the medicine and the environment is the spoon. In Blue Zones the environment is such that people who live long, healthy lives influence you positively. They spoon it to you non-verbally by their example. Organic vegetables in stores are cheaper in Blue Zones, so it is easier to eat more of them; people socialize more with each other, they exercise more and dance. This is what people do who live longer than 100 years. In other words, you change the culture, you change your lifestyle, you exercise more, you stop smoking, you eat healthy and you live longer.

You must decide on which pathway to go

Dr. Katz ended his lecture with the image of you walking along and coming to a fork. To go further you must decide to go on the pathway to your right or on the pathway to the left. You turn on the right pathway by deciding to adopt the principles of the Blue Zones; you make the decision to want to turn older than 100 years and keep your vitality until it is time for you to pass on. In the meantime you enjoy every day, you are not disabled and your mind and body stay healthy. The other pathway was the one that the majority of the industrialized Western nations has taken in the last few decades. Which path will it be that you decide to take?

Conclusion

At the conference Dr Katz and a number of other speakers pointed out how powerful lifestyle is for our body functions. Other speakers stressed the importance of telomeres, the caps of the chromosomes, which comprise the end of the double stranded DNA. With every cell division our telomeres shorten. Stem cells also have telomeres, but they are on average longer than the somatic dells. It probably is like this to be able for stem cells to replace the aging somatic cells.

There is a new logic of a healthy lifestyle is. It says that a healthy lifestyle causes healthy telomeres of somatic cells and of stem cells. This causes health until a ripe old age. I will be blogging about some of the other key talks of the conference in the near future to clarify this point further.

May
21
2014

Forty Percent Of Premature Deaths Can Be Prevented

A new report from the CDC (Center of Disease Control) in the US has revealed that up to 40% of premature deaths could be prevented by simple lifestyle changes. As this link shows every year about 900,000 premature deaths occur in the US, which are due to 5 major diseases that in the opinion of the CDC can be prevented by 20 to 40%. Here are the diseases that kill: cancer, heart disease, COPD/emphysema, stroke and accidents/injuries. These conditions were responsible for 63% of all deaths in the US in 2010.

Let’s discuss each of these conditions and how one could lower the risk of dying from them.

1. Cancer:

The Framingham Heart Study has shown that smoking and cancer are closely related. Smokers who quit can significantly reduce their risk of getting cancer. We also know that exercise and prophylactic supplements like fish oil and vitamin D3 have cancer preventative effects.

Antioxidant supplementation that included beta-carotene, vitamin A, vitamin C, and vitamin E daily or on alternate days for 1 to 12 years, along with selenium supplementation reduced the incidence of cancer of the esophagus, colon, pancreas, stomach or the liver. Insulin resistance due to sugar and starch overconsumption is causing cancer, particularly breast cancer, colorectal cancer and endometrial cancer. I have discussed this in a recent blog.

Pollution has been linked to increased lung cancer risks as discussed here.

2. Heart disease:

Heart disease can be caused by several factors in combination. Lifestyle issues are important: Smokers need to quit smoking as the Framingham Heart Study has shown more than fifty years ago that smoking causes heart attacks. Obesity and diabetes also contribute significantly to the risk of heart disease. Often these are connected to faulty nutrition, which is another lifestyle issue that comes to mind when too much sugar and starchy foods are taken in; your liver will convert these into fatty acids, triglycerides and elevated, oxidized LDL cholesterol, which gets deposited under the lining of the arteries. A lack of exercise adds to this problem as a lack of exercise lowers the protective HDL cholesterol and fat is deposited under the lining of the arteries. Start exercising and your protective HDL cholesterol will rise, your total cholesterol to HDL ratio will lower to healthier levels and your risk for hardening of the arteries and for getting a heart attack will fall. If you have diabetes, it is important that you manage your blood sugars well; this means that if you inject insulin, you want the blood sugar tests to be within the normal range and the hemoglobin A1C values to be below 5.5%. Poorly controlled diabetes is an important cause of heart attacks and strokes. High blood pressure is also an important cause of developing heart attacks and strokes. It is important to control your blood pressure by taking blood pressure lowering pills and also by exercising regularly. Exercise seems to send a signal to relax the blood vessels thus lowering the blood pressure, which in turn prevents heart attacks.

Forty Percent Of Premature Deaths Can Be Prevented

Forty Percent Of Premature Deaths Can Be Prevented

 

3. COPD/emphysema:

Chronic obstructive pulmonary disease (COPD) or emphysema is mostly caused by chronic exposure to cigarette smoke from smoking. The earlier you can quit, the better your chances that your breathing will not be the limiting factor when you age. But it is also important to avoid exposure to other noxious gases, such as from welding and from exposure to pollution. This may involve a decision to move to a less polluted area. Or it might involve a job retraining. Those who are suffering from COPD can be helped to a certain extent by a portable oxygen tank with nasal prongs.

4. Stroke:

As mentioned before, quitting smoking, controlling high blood pressure and controlling blood sugar, if you suffer from diabetes have been shown to stabilize your blood vessels including the ones that supply your brain. The key is to prevent hardening of the arteries by a healthy lifestyle. Exercising and keeping your weight under a body mass index of 25.0 have been shown to be effective stroke prevention. Healthy nutrition as indicated above under “heart disease” is equally important for stroke prevention. Go green (eat more vegetables, consume more green smoothies), cut down grains, sugar and starchy foods and you will live longer without strokes and heart attacks. Remember, what’s good for your heart is good for your brain!

5. Unintentional accidents/injuries:

Wearing helmets when bicycling, wearing seat belts when driving in a car, avoiding risky behaviors are all measures that save lives. One factor stands out in all of this: if you drink too much, you run the risk of being involved in unintentional accidents or injuries. People may not like to hear this, but your brain lacks the natural inhibitory impulses when you are under the influence of alcohol, so you become more daring and you may not pay attention for the split second that could have prevented an injury or accident. People react very differently to alcohol. Some people feel inebriated after only ½ a glass of wine or beer whereas others can drink more before they make mistakes. The best is to be sober when you drive, ski, use power tools or walk in traffic. Even climbing ladders requires a clear mind!

Conclusion:

As the CDC said 20 to 40% of premature deaths (deaths that occurred before the age of 80) could have been prevented, if the above-mentioned recommendations were followed. Let me rephrase this: 180,000 to 360,000 premature deaths every year in the US before the age of 80 could have been prevented! Curative medicine cannot help with these statistics as a heart attack or stroke has happened when it has struck you. Cancer and end stage lung disease are similar conditions that you are suddenly faced with when they occur and unintentional accidents just seem to happen. This is where the importance of prevention can be seen, because these little baby steps every day are adding up to something formidable, a force to be reckoned with. Be part of the solution, think prevention!

More information on:

1. Cancer mortality: http://nethealthbook.com/cancer-overview/overview/cancer-mortality-rate/

2. Higher vitamin D3 intake lowers mortality from heart attacks, strokes, cancer, fractures due to osteoporosis: http://nethealthbook.com/news/higher-vitamin-d-levels-associated-lower-risk-mortality/

Last edited Nov. 8, 2014

Nov
30
2013

Statins Can Hurt The Consumer

Lovastatin (Mevacor, from Merck) was the first statin drug approved by the FDA in 1987 as a cholesterol-lowering drug in the US. It made history in helping high-risk heart attack patients reduce their cholesterol levels and has helped safe many lives. But with the detection around 2002 that heart disease is an inflammatory disease, and that measuring the C-reactive protein with a blood test was a better than measuring cholesterol levels in predicting who would be at risk for developing a heart attack, the landscape has changed. Lifestyle changes have also been shown to be very effective in reducing cholesterol, C-reactive protein and triglyceride levels. In fact, lifestyle changes will reduce the risk for heart attacks and strokes. The newest flurry of activity with calls for putting more people on statins makes me suspicious that there could be a misrepresentation of the facts.

In this blog I am analyzing the literature to get to the bottom of the facts on reducing risk for heart attacks and strokes. I also come to my own conclusion.

Facts about cholesterol

Cholesterol is a waxy substance that is part of the cell walls and plays a vital role in our metabolism. Liver cell membranes, for instance contain about 30% cholesterol. However, most of the cholesterol in our body comes from metabolism, 20 to 25% from the liver, the rest in the gut, adrenal glands and the reproductive organs, and also from the brain (the myelin sheaths contain a lot of cholesterol). 50% of the body’s cholesterol is recycled through bile salts and reabsorption of cholesterol in the gut (called the enterohepatic pathway).

Cholesterol is vital for cell function, for insulation of nerve fibers (myelin sheaths) and for synthesis of our steroid hormones (sex hormones and vitamin D3, which  is now considered to be a hormone). The medical establishment took most of the information regarding heart attack and stroke prevention from the ongoing Framingham study. This clearly pointed to the importance of lowering the LDL cholesterol fraction (the “bad” cholesterol) and maintaining or increasing the HDL fraction (the “good” cholesterol). When it was realized that concentrating only on lowering cholesterol missed 50% of all heart attacks that researchers refocused and found the missing link, namely inflammation. Inflammation is at the cause of heart attacks and strokes, high cholesterol and lipids were only secondary phenomena. Ref. 2 points out that a comprehensive approach to treating a patient with high cholesterol should involve a combination of treatments aimed at the underlying risk factors for heart disease or stroke in a particular patient. This involves sophisticated blood tests where a metabolic derangement can be pinpointed. It should include measuring cholesterol fractions, lipids, the C-reactive protein, hormone levels and more.

Statins Can Hurt The Consumer

Statins Can Hurt The Consumer

How the traditional thinking about cholesterol has changed

The Framingham study has provided the basis for the drug industry to produce statins until about 2002 when our thinking about cholesterol being the culprit for causing heart attacks has forever changed. Subsequently further research showed that other factors like inflammation of the blood vessels, the metabolic syndrome associated with obesity and lack of exercise were also to blame for causing heart attacks and strokes. Recently more details have come to light, which point to multiple causes like the consumption of too much sugar, too much trans fats, too much salt and eating too much over processed convenience food.  We end up gaining weight, develop the metabolic syndrome and inflammation of arteries (including the coronary arteries of the heart and the brain vessels). It is the lack of nitric oxide in the lining of the arteries, which combined with inflammatory substances from visceral fat are responsible for hardening of the arteries as the ultimate consequence of faulty nutrition and lack of exercise. We also know that oxidized LDL, particularly the very low-density lipoproteins (VLDL), will release free radicals and damage the arterial walls. CoQ-10 is a supplement, which is known to counteract this. One important test that had developed out of the Framingham study is the “ratio of total cholesterol to HDL cholesterol”, which is used by cardiologists to determine the risk of coronary artery disease. The average risk of this ratio for Americans is 5.0 for males and 4.4 for females. The ideal ratio to strive for is  the “1/2 average risk” ratio of 3.4 for males and 3.3 for women (Ref.2). A fit, slim person who eats a low carb, normal fat diet (modified Mediterranean diet) will often have a ratio of only 3.0, well below the 1/2 average risk. The moment you introduce grains in your diet (cereals, bread, pasta) your liver will convert carbs into LDL cholesterol, while HDL cholesterol will drop resulting in a high risk ratio of above 5.0 (often 7 or 8 or more). The LDL will get oxidized and is deposited into your arteries setting you up for coming down with a heart attack or stroke down the road.

How do statins work?

The statins are a group of drugs that inhibit an enzyme, called the hydroxymethylglutaryl–Coenzyme A (HMG-CoA), which leads to a lowering of cholesterol, specifically a fraction known as the LDL cholesterol. The success story of lovastatin (Mevacor) led to a flurry of new HMG-CoA reductase inhibitors (cholesterol lowering drugs) such as fluvastatin (Lescol), pravastatin (Pravachol), simvastatin (Zocor), atorvastatin (Lipitor), and rosuvastatin (Crestor) in the late 1980’s and the 1990’s. Collectively it is now a 26 billion industry in annual sales.

Later investigations showed that there were other mechanisms by which statins helped, namely they were found to decrease the inflammatory reaction, which can be measured by lowering of the C-reactive protein. However, there are significant side effects in about 1 to 3% of people who take this medication, particularly an inflammation of liver cells (evident from elevation of liver enzymes) and a myopathy, which is a painful muscle condition (Ref. 1). This latter fact, which can occur in as many as 33% of the population at large (particularly the exercise minded) has limited the use of statins in competitive athletes where myopathies can occur in as many as 75% of athletes treated with statins (Ref.2). The reason for that is that the muscles of athletes cannot keep up with the demands put on them when they are kept in check by the HMG-CoA reductase inhibitors. On the other hand statins have prevented heart attacks and deaths from heart attacks and strokes in about 25% to 35% of patients treated with them as many clinical trials have shown (Ref.1), but simple supplements that have no side effects can do the same or do even better (see below).

The lack of cholesterol synthesis by the body’s cells when statins are given, leads to an expression of more LDL receptors on the cell surfaces. LDL binds to these receptors and enters the cells, which removes the circulating high risk LDL fraction of cholesterol from the blood thus causing a drop in LDL cholesterol. All of the side effects of statins (pull down to side effects in this link) can be explained as a result of the slow-down of organ functions (brain, muscles, gut, adrenal glands, etc.) as cholesterol synthesis is reduced.

New information from the Framingham Heart Study

So far everything I said made sense. But when I came across Ref. 4 I noticed that there was a bombshell of new information from another follow-up study of the Framingham Heart Study (Ref. 5) that did not fit in with the latest marketing drive of the statin manufacturers. In this study from 2005 Boston researchers had studied the outcomes of 789 men and 1105 women over a period of 16 to 18 years with respect to cognitive function. Participants were divided into total cholesterol groups that showed levels that were desirable (less than 200), borderline (200 to 239) or high (above 240). The astounding results were that higher cognitive functioning as documented in multiple cognitive tests in these three groups showed the best performance in the group with the highest cholesterol and the worst cognitive test outcomes in the lowest cholesterol group, quite opposite of what was expected.

Another important piece of research (April 2013) comes from Spain where doctors followed a group of 7447 patients with a high cardiovascular risk who were put on a Mediterranean diet with olive oil, a Mediterranean diet with nuts or a regular diet. The end point was death from heart attack or stroke. After 4.8 years the study had to be interrupted as the Mediterranean groups showed a significant survival advantage over the group on a regular diet.

Ref. 4 cited literature evidence that statins cause a 48% increased risk in postmenopausal women who take statins to develop diabetes. It also cites compelling evidence that diabetes patients are twice as likely to develop Alzheimer’s disease within 15 years and are 1.75 times more likely to develop any kind of dementia in the same time period.

Dr. Seneff from the Computer Science and Artificial Intelligence Laboratory at MIT explains in great detail that statins effectively reduce cholesterol synthesis in the liver, which in turn starves the brain of one of its main nutrients explaining why patient develop Alzheimer’s disease and dementia as a result of statin treatment.

So, the lessons to be learnt from these clinical trials are that you want to offer your brain enough cholesterol and healthy fat to have a normal metabolism. Fortunately, what’s good for your heart is also good for your brain. Conversely avoid statins, if you can and try alternatives first. Ref. 4 explains that for years the experts had the wrong theory that low fat/high carb was what would be good for your heart and brain, but the opposite is true: what is good for your heart and brain is a high healthy fats/low refined carb diet.

Make sure that with your blood tests that fasting insulin is low (no insulin resistance), that the ratio of total cholesterol to HDL cholesterol is less than 3.4 (low risk for heart attacks or strokes) and that the hemoglobin A1C level is low (4.8 to 5.6%, ideally less than 4.5%), which means you are not diabetic.

How alternative treatment can save you from heart attacks

Lifestyle treatment through dietary intervention, moderate exercise, and weight loss has been somewhat neglected by mainstream medicine, but is now recognized in regular textbooks of medicine as first-line treatment (Ref. 3). Most patients can lower LDL cholesterol by 10 to 15% through a change in diet. High-risk patients with established heart disease (narrowing of coronary arteries) require a drop of 30 to 60% of LDL cholesterol; this high-risk patient group may need an addition of a statin. In patients with metabolic syndrome or diabetes high triglycerides are often present and will respond to decreased intake of simple sugars, alcohol, and calories (Ref.3). Total calorie intake should be adjusted according to what the weight is when weighed every day with the goal of reducing the weight when overweight or obese, but maintaining the weight when it is in the normal body mass index range (BMI of 20 to 25). The total fat intake should be around 25%-35% of the total calorie intake. Specifically, saturated fat needs to be less than 7% of total calories, polyunsaturated fat up to 10% of total calories and monounsaturated fat up to 20% of total calories. Healthy fats according to Ref. 4 are extra-virgin olive oil, organic butter, almond milk, avocados, olives, nuts, nut butters and cheese ( except for blue cheeses). Other healthy fats are sesame oil, coconut oil, and the oils found in seeds like flaxseed, sunflower seeds, pumpkin seeds and chia seeds. Note that trans-fats (such as in margarine and baked goods) are a “no-no” as it causes free radicals in your body, which would accelerate the hardening of your arteries. Complex carbohydrates from vegetables and fruit are the main source of total calories providing 50%-60% of the total calories. Fiber intake needs to be 20-30 grams per day. Protein intake should be about 15% of total calories. Fat should provide 25% to 35% of the total calories per day. Cholesterol intake should be less than 200 mg per day. You may want to consider the use of plant sterols (2 grams per day) to enhance LDL cholesterol lowering. Physical activity from moderate exercise should expend at least 200 kcal per day (better 300 kcal).

Which supplements prevent heart attacks and strokes?

There are several nutrients that have been shown to be powerful preventers of heart attacks and strokes. I will review them briefly here (based on Ref. 2):

1. Coenzyme Q10 (CoQ10): The cells lining the arteries are only working well when their mitochondria are working properly producing chemical energy in form of ATP. CoQ10 is an important component of the mitochondrial metabolism; it is also the only fat soluble antioxidant that gets absorbed into the LDL particles where it protects these from oxidation. Statins suppress CoQ10 synthesis, so patients on statins need to take CoQ10 supplements daily to counteract this. However, anybody who is healthy now should take CoQ10 as a daily supplement for prevention. I take 400 mg per day.

2. Vitamin E (tocopherols): this fat soluble vitamin is an antioxidant and has been praised in the past as being heart supportive, was subsequently bad-mouthed by some conservative physicians, but lately has been resurrected. It turns out that there are 8 different types of tocopherols, with the alpha tocopherol being the most known, but gamma tocopherol is the one you want to make sure you are also getting with your balanced vitamin E supplement every day as this is the one that is a powerful anti-inflammatory. Simply ask staff at your health food store for a vitamin E supplement with gamma tocopherol in it. Take 400 IU per day (of the mix).

3. Curcumin: This is a powerful heart and brain protector combining three different mechanisms in one; it is reducing oxidative stress, is an anti-inflammatory and counters the process that threatens to destroy the lining of the arteries. One study on healthy volunteers showed a reduction of 33% in lipid oxidation, a 12% reduction of total cholesterol and an increase of 29% of the protective HDL cholesterol when 500 mg of curcumin was taken only for 7 days (Ref.2). This is the daily dose I would recommend for prevention of heart attacks and strokes.

4. Polyphenols: Flavonoids are the largest group among the polyphenols contained in such common foods as vegetables, fruits, tea, coffee, chocolate and wine.  Over 130 studies have been done on humans showing improvement of the lining of the arteries (endothelial functioning) and lowering of blood pressure. Polyphenol consumption has been associated with a lower risk of mortality from heart attacks. Eat a Mediterranean type diet or a DASH diet and you will automatically get enough polyphenols with your food. However, resveratrol, the powerful red wine polyphenol warrants a separate daily supplementation as it prevents LDL oxidation in humans (Ref.2). Take about 250 mg of it daily.

5. Niacin/nicotinic acid: This supplement comes as “flush-free niacin” and also as extended release niacin; it can raise the beneficial HDL cholesterol by 30 to 35% when higher doses of 2.25 grams per day are used. In a metaanalysis of 7 studies it has been shown to significantly reduce heart attacks and transient ischemic attacks (precursor syndrome before developing a stroke). Niacin can change the small particle LDL into a large particle size LDL, which is less dangerous. Niacin has also been shown to reduce oxidation of LDL, which stops the atherosclerotic process. For a healthy person 500 mg per day of flush-free niacin is adequate.

6. Fish oil (omega-3-fatty acids): Because heart attacks are due to an inflammatory process and high LDL cholesterol is thought to be only a secondary phenomenon, it is very important to have this additional tool of an important anti-inflammatory supplement. In the past it was still safe to eat fish fairly frequently per week. But with mercury, radioactive iodine from Japan’s leaking reactor and carcinogenic PBC’s all congregating in the ocean waters, it is no longer safe to consume fish in large quantities. The remedy to this situation is molecularly distilled (or pharmaceutically pure) EPA/DHA supplements. EPA stands for eicosapentaenoic acid or omega-3 fatty acid. DHA is the acronym for docosahexaenoic acid. Fish oil supplements at a dosage of 3.35 grams per day of EPA plus DHA were shown to reduce triglycerides by up to 40%, equally to Lipitor or even more effective, but without the statin side effects. The amount of the dangerous small dense LDL is also being reduced with fish oil. Fish oil supplements have reduced the mortality from heart attacks and strokes and led to a higher survival from non-fatal heart attacks. At the same time these preventative fish oil doses will also treat and prevent arthritis.

7. Other useful supplements: Soluble fiber from psyllium, pectin, beta-glucans and others have been shown in clinical trials to reduce LDL cholesterol by binding bile salts in the gut (interrupting the enterohepatic pathway). Plant sterols (usually sold as sterol esters) are recognized by the FDA as reducing the risk of coronary heart disease, if taken in high enough amounts (2.4 grams of sterol esters per day). There are other useful supplements like artichoke extract, pomegranate, soy protein, Indian gooseberry (amla), garlic and pantethine (vitamin B5) that have been proven to be of benefit in terms of prevention of heart attacks and strokes. It would be too lengthy to get into more details here.

Conclusion

Recently there was a review in a medical journal that demonstrated that clinical guidelines (in this case for clinical guidelines for lowering cholesterol) erred 40% of the times when measured against scientific tests as this link explains. When it comes to saving lives by preventing heart attacks and strokes, what is needed is a multifactorial approach that treats the multifactorial causes of cardiovascular disease. Just pushing for treating more people with statins as Big Pharma is attempting to do is not addressing the fact that cholesterol is needed for our metabolism and the synthesis of our hormones. It is much superior to use a combination of different approaches that overlap and thus potentiate each other in their effects excluding statins first. Exercise creates more nitric oxide production by the lining of the arteries, which opens up arteries and prevents spasms. A proper diet with as many of the proven vitamins and other support factors will control inflammation and oxidation of LDL cholesterol particles as explained. This will prevent heart attacks and strokes as has been shown in many clinical trials. Only patients who come from families with genetically high cholesterol or high triglycerides and those patients who had heart attacks and strokes should be exposed to statins as they are at a higher risk of developing a heart attack or stroke. They need all of the help they can get in addition to the lifestyle factors mentioned. Most other patients and the public at large will do quite well without statins (no side effects of diabetes, Alzheimer’s and muscle pains). And, yes, a diet high in healthy fats, but low in refined carbs is what your brain and heart need (the opposite of what you have thought, see Ref. 4).

More information about side-effects of statins (acute pancreatitis): https://www.askdrray.com/pancreatitis-can-occur-with-statin-use/

Lower cholesterol with Mediterranean diet: http://nethealthbook.com/news/mediterranean-diet-benefits-us-workers/

 

References

1. Bonow: Braunwald’s Heart Disease – A Textbook of Cardiovascular Medicine, 9th ed. © 2011 Saunders.

2. Life Extension: Disease Prevention and Treatment, Fifth edition. 130 Evidence-Based Protocols to Combat the Diseases of Aging. © 2013

3. Melmed: Williams Textbook of Endocrinology, 12th ed. © 2011 Saunders.

4. David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

5. http://www.psychosomaticmedicine.org/content/67/1/24.full.pdf

Last edited Nov. 7, 2014

Aug
10
2013

Bioidentical Hormone Replacement

In many previous blogs I have mentioned that bioidentical hormone replacement prolongs life. Here is a more detailed look at what such hormone replacement looks like for both women and men. Before I get into details I want to stress that I am talking about replacing what is missing and replacing only with natural hormones, not some artificial hormone derivative produced by a drug company. The reason this is immensely important is that hormone receptors in the body are distributed all over our vital organs including bones, blood vessels and the nervous system. If there is no lock and key fit (bio-identical hormone fitting the hormone receptor), there is trouble as the Women’s Health Initiative in 2002 has shown. Unfortunately they had used synthetic hormones for HRT that were not fitting the hormone receptors, and this caused many problems (heart attacks, strokes, osteoporosis, cancer).

Physiology of aging

As we age, we gradually produce fewer hormones in our hormone glands, but the various hormone glands deteriorate in their functions at different rates. Beyond the age of 30 we produce less melatonin and less growth hormone. As a result our sleep pattern may change, as melatonin is necessary for a deep sleep. The decreasing growth hormone production means that we are losing some of our muscle mass and accumulate more fat in the subcutaneous tissues. Our adrenal glands produce less DHEA at the age of 35 to 40, a hormone that is a precursor to our sex hormones in males and females. The gonads (testicles and ovaries) also produce fewer hormones, a process which already starts 5 years before menopause and about 5 years before andropause (the male menopause equivalent).

Typically a woman will get into menopause at the age of 45 to 55 at which time the periods stop and postmenopausal symptoms are interfering with her well-being.  Men get into andropause (the male equivalent of menopause) at the age of 55 to 65 at which time erectile dysfunction occurs and often the individual will become the “grumpy old man”.

Other hormones such as thyroid hormones are also affected by the slow down. Hypothyroidism is common in people above the age of 50.

Bioidentical Hormone Replacement

Bioidentical Hormone Replacement

Baseline laboratory tests

In order to know what is going on, the physician or naturopath needs to order a number of tests to assess whether there is inflammation, how your key hormone levels are; the cardiovascular system markers should also be checked, the liver enzymes and vitamin D3 level. Inflammatory markers are fasting insulin levels and C-reactive protein (CRP). Fasting cholesterol and subfractions (HDL, LDL, VDLP, small LDL) and fasting triglycerides are also measured. Thyroid hormones (T3 and T4, TSH) are measured to rule out over or under function. Typically hypothyroidism is found, which would have to be rectified by taking Armour (a mix of T3 and T4 thyroid hormones).

At this point I need to explain that long time ago the research by Dr. Lee has shown that progesterone hormone levels are notoriously unreliable when blood tests are done. All of the other sex hormones, and cortisol are also not that reliable with blood tests. For this reason the saliva hormone tests have been invented that conveniently report a panel of 5 hormones from one saliva sample: DHEAS (which is the storage form of DHEA), estradiol (the major estrogen in a woman), progesterone, testosterone and cortisol. The saliva hormone tests correlate very well with the actual tissue hormone levels. You can order the saliva tests through Dr. Lee’s website. Another longstanding lab in the US is Dr. David Zava’s lab. In Canada the Rocky Mountain Analytical Lab can process your saliva tests.

Women’s hormone replacement

Let us assume that a woman is getting postmenopausal symptoms and bioidentical hormone replacement is being discussed. The physician will want to first rule out that insulin resistance is not present by ordering a fasting insulin level. If this is normal and the other baseline tests are normal as well except for missing estrogen and progesterone, the physician will usually start to replace progesterone first using a bioidentical hormone cream to be applied once or twice per day. If estrogen levels were also low, the next step in 4 weeks or so is to add Bi-Est, a bioidentical estrogen replacement cream. After 8 weeks of hormone replacement the saliva hormone test is repeated to see whether the estrogen and progesterone levels have come up and also, whether the ratio of progesterone to estrogen is at least 200 or more. Dr. Lee has extensively researched this and found that women with a ratio of less than 200 to 1 (progesterone/estrogen ratio) were more prone to breast cancer. He also stated in this link that there are 3 basic rules with regard to bioidentical hormone replacement:

1. only replace hormones, when they were measured to be low.

2. use only bioidentical hormones (never synthetic hormones) and

3. only replace with low doses of bioidentical hormones to bring hormone levels to physiological levels (body levels that were experienced to be normal before).

Many women who are not replaced in menopause have estrogen dominance meaning that the progesterone/estrogen ratio is less than 200:1, which puts these women at risk of developing breast cancer. Women who are overweight or obese also are estrogen dominant (from estrogen produced in excess through aromatase in the fatty tissue, explained further below), which makes them more prone to breast cancer, uterine cancer and colon cancer. Without bioidentical hormone replacement inflammatory processes take place in the joints (causing arthritis), in the nervous system (causing Alzheimer’s and dementia) and in the blood vessels (causing heart attacks and strokes). Rebalancing your hormones to a youthful state by paying attention to the hormone levels and the hormone ratios mentioned will remove the inflammatory reactions and reduce the risk for cancer.

Men’s hormone replacement

Males enter andropause 10 to 15 years later than women are entering menopause. Typically testosterone production slows down leading to hair loss, erectile dysfunction, loss of muscle mass, osteoporosis and Alzheimer’s/dementia. Blood tests (bioavailable testosterone) or saliva tests are both reliable in determining a deficiency. Replacement with bioidentical hormone creams once per day is the preferred method of treatment. Overweight and obese men produce significant amounts of estrogen through an enzyme localized in fatty tissue, called aromatase.

Aromatase converts testosterone and other male type hormones, called androgens, into estrogen. Estrogen causes breast growth, weakens muscles, and leads to abdominal fat accumulation, heart disease and strokes.

Similar to women, where the progesterone/estrogen ratio is important, there is another ratio for men, called testosterone/estrogen ratio. This should be in the 20 to 40 range for a man to feel good and energetic. Unfortunately many men above the age of 55 have testosterone/estrogen ratios much smaller than 20. This makes them more prone to heart disease and prostate cancer (Ref.1).

However, a male also does need a small amount of estrogen and normal thyroid hormones as well as all of the other hormones for his “hormonal symphony” (mentioned in Ref. 2) to function at his best.

Safety of hormone replacement

There are still otherwise reputable websites that state that bioidentical hormones are not safer than standard synthetic hormones. This confuses the consumer and does not serve the public well. I much prefer the text of the Wikipedia, which is a more thorough review regarding safety of hormone replacement and explains what the issues are.

In the US there is a collective experience of about 25 years on thousands of patients, but there have not been any randomized studies, as Big Pharma that would have the money to finance such studies is not interested in proving that bioidentical drugs would be safer than their distorted synthetic hormone copies that will not fit the body’s hormone receptors. There are some noble exceptions as Big Pharma is producing bioidentical insulin and human growth hormone that had toxicity studies done and showed safety. In Europe bioidentical hormones have been used since the 1960’s, on a larger scale since the 1970’s. So the European experience of safety of bioidentical hormones is presently about 40 to 50 years.

The FDA is contributing to the confusion of the public as can be seen from this publication. One example where the FDA is confusing the consumer, is the progesterone product Prometrium, a bioidentical micronized progesterone capsule that can be taken by mouth. By law the manufacturer had to put a warning label on the package identical to progestin, which is the synthetic, non-bioidentical hormone having been shown to have severe side effects. As is explained in this last publication Prometrium should not have been required to have a warning label in it ; the paper explains what I have already stated above, namely that bioidentical hormones are the safest form of hormone replacement and administered in the right ratios will actually prevent cancer and prevent premature cardiovascular and joint deterioration. In other words, bioidentical hormone replacement can add many years of useful life when started early enough before permanent organ damage sets in from the aging process (which would be due to missing hormones).

Why bother about hormone replacement?

Nature has a plan of “knocking us off” to make room for the next generation. The only way that you can change nature’s plan of killing us prematurely through cardiovascular disease, arthritis, dementia and loss of your sexual life is by bioidentical hormone replacement. Of course you also need the other ingredients of known life prolongers such as healthy (preferably organic) foods, exercise and detoxification. Many women are scared to treat the hormone deficiencies that cause their menopausal symptoms because of the Women’s health Initiative results with synthetic hormones. Men who would benefit from testosterone are often anxious that they may get prostate cancer, when in reality it is the exact opposite: testosterone prevents prostate cancer (Ref.3).

Conclusion

I wrote this blog about bioidentical hormone replacement in order to clarify this often-misunderstood topic. Don’t get confused by the FDA, by highbrow medical websites (such as the likes I mentioned). Big Pharma has a powerful lobby that attempts to keep the medical profession in the belief that their products are better than those that nature has provided (I call it “defend your patent rights”). We are still in a flux state where anybody who tells the truth about hormones gets much criticism. In another few decades it will be an accepted fact and people will wonder why the Women’s Health Initiative was done without a control with bioidentical hormones. With bioidentical hormone replacement you can add about 20 years of youthful life without disabilities to the normal life expectancy. Exercise, detoxification and organic food with avoidance of wheat, starch and sugar can add another 5 to 10 years to your life. The baby boomers are lucky that they have this new tool to prolong life. I wonder whether they will put it to good use.

More information about bioidentical hormone replacement: http://nethealthbook.com/hormones/anti-aging-medicine-women-men/

References:

1. John R. Lee: “Hormone Balance for Men – What your Doctor May Not Tell You About Prostate Health and Natural Hormone Supplementation”, © 2003 by Hormones Etc.

2. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008

3. Abraham Morgentaler, MD “Testosterone for Life – Recharge your vitality, sex drive, muscle mass and overall health”, McGraw-Hill, 2008

Last edited Nov. 7, 2014

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Jul
06
2013

The Inconvenient Truth About Convenience Foods

When your grandmother grew up there was very little convenience food, maybe ketchup and yes, there was processed cheese and coke. There were also bread and butter.

Now we go through a large grocery store and the center of the whole store is occupied by convenience food, row after row.

What is convenience food? It is pre-cooked or processed food that sits on a shelf waiting to be bought and consumed. You may be able to just eat it the way it is (power bars, fruit yoghurt snacks, ice cream, breakfast cereals etc.) or you just have to microwave it for a minute or two (ready made meals, pizzas). Even, if you make a fresh salad, you top it with a salad dressing that has been processed and may contain chemicals that are not necessarily healthy for you.

This blog is meant to make you think and get educated as a consumer. As a physician I am guided by what is healthy for you, but at the same time food needs to be interesting and taste good and be affordable.

As fat, carbohydrates and protein are the main food groups that we eat, I will deal with each of these categories first followed by vitamins and minerals, which we also need.

Fats and oils

Many convenience foods are full of saturated fatty acids, which contribute to the overall calorie count of the package and are one of the main reasons why we gain weight and deposit fat into our arteries in preparation for a heart attack or stroke down the road. As you may know the worst form of fat is hydrogenated fat, also known as “trans fat”.

It contains free radicals from the hydrogenation process, which damage your cells and interfere with normal body metabolism. Read labels and avoid any foods that have a long shelf life as this is due to hydrogenated fats and chemicals known as food preservatives.

This food group also contains sausages and other processed meat; I wrote a separate blog about this recently.

If you eat cheese, reduce your saturated fat intake by buying cheese with only 18% fat (such as Cantenaar cheese, Jarlsberg light, skim milk mozzarella and goat cheese). Avoid the rich 45% type cheeses. The best oil in your kitchen would be an organic cold pressed olive oil. It figures prominently in Mediterranean cooking.

The Inconvenient Truth About Convenience Foods

The Inconvenient Truth About Convenience Foods

Sugar, starch and other carbohydrates

A large portion of snacks from the mid section of the grocery store contains all forms of sugar: high fructose corn syrup, sugar, honey, agave syrup, maple syrup etc.  You may think that a harmless fruit juice would be healthy until you see from the ingredient list on the label that it contains 5 to 6 teaspoons of sugar per cup (250 ml) of juice.

Unfortunately our body is not equipped to process all the sugar that the food industry wants us to consume and we develop insulin resistance; the liver converts the excess sugars into fat and deposits it into our arteries and as fat deposits between our guts (visceral fat) and as subcutaneous fat in the thighs, around the hips and the waist. It is no secret that a lot of obesity is related to overconsumption of sugar containing convenience foods (snacks and sugar-laden drinks).

Often low calorie alternatives contain aspartame or sucralose (Splenda). Aspartame is an excitotoxin damaging your brain cells and sucralose was developed in the 1950’s as an insecticide. We do not want to replace disease-promoting sugar with toxins as sweeteners. Safe alternatives for sugar are xylitol, mannitol, and stevia.

What is sometimes overlooked is the fact that your body digests bread, starchy foods such as potatoes, and pasta, rice and flour products like pizza or cookies within 30 minutes into sugar that is as harmful to your pancreas as plain sugar or high fructose corn syrup. The body reacts with the same overproduction of insulin converting the excess sugar into fat and depositing it in your body as described above. Much of the obesity wave we see in the past 3 decades is due to baked goods like bagels, bread, pasta and pizza. It is much better to enjoy your stevia-sweetened coffee without any bakery pieces to go along with it.

Protein in meats, dairy products and sausages

You would think that a healthy cut of meat from the grocery store would be a good source of protein for you. You probably did not think that it could be contaminated with a superbug when you bought it. This is especially true for ground meats like hamburger meat. If you bought a portion of organic meat you can be more certain that you are buying a qualitatively superior product. I discussed this whole issue of superbugs in meat and meat products in this blog recently.

We need to be aware of the agroindustry, the feedlots and what they fed the animals. I only buy organic meat and organic dairy products as my source of protein. I avoid sausages altogether because of the food additives that they contain, which are cancer causing.

The problem with prepared meats like chicken nuggets and others is that they contain breading and food preservatives and they have been deep fried, which makes these items an unhealthy choice.

What are some of the problems with dairy products? Despite the allegations that bovine growth hormone would be harmless to your health, your body thinks otherwise. Your body has hormone receptors that are very specific and bovine growth hormone can block them so your own human growth hormone from the pituitary gland cannot function properly. This is why I would recommend only organic milk products. You may have heard that in many European countries bovine growth hormone is banned for that reason.

Next the fat content of dairy products needs to be monitored: go for low-fat milk, cheese and yoghurt. While we are talking about yoghurt, stay away from fruit yoghurts that have all kinds of sugar and food additives mixed in. Add fruit of your choice and stevia, if you need a sweet taste.

Vitamins and minerals

The more foods are processed, the less natural vitamins and minerals stay behind. Particularly vitamin C and the B complex group are affected, but also magnesium, which is an important co-factor to enzymatic reactions within our cells. Often processed foods contain too much salt with sodium displacing potassium from the cells resulting in a lack of energy and high blood pressure.

Your best prevention is to stick to as little processed food as possible and to eat organic. If you eat enough organic greens and vegetables, there is an ample supply of vitamins and minerals. Prepare your own soups as canned products are high in sodium; another unwanted additive is often sodium glutamate (MSG), which comes under many disguised names. It belongs to the group of excitotoxins like aspartame and is not welcomed by your brain cells.

Public Awareness

Lately there has been more of public interest and awareness to the detrimental effects of convenience foods. Alarming reports about the increase in the obesity rates, the rise in diabetes type 2 even in children have been in the media for some time. The publications are not only North American, but also European, as can bee seen in this link.

New legislation is being introduced in many states of the US regarding school snacks and vending machines in schools.

Not all food news is bad. Recently it was reported that fish oil could protect against the effects of junk food. Omega-3-fatty acids contained in fish oil are helping to rebalance the ratio between omega 3 and omega 6-fatty acids in food, which often is disbalanced towards an overabundance of omega-6 fatty aids in processed foods. Rebalancing the omega3/omega6 ratio in food helps to normalize the metabolism of the brain and prevents hardening of arteries.

What you can do to get healthy food

It starts when you buy food. Read labels and look for calories, sugar, fat and sodium content. You may be surprised how many stores carry organic foods now. The price may not be that much more. There is a useful app for your cell phone, Buycott, that you may want to download. This way you can scan items in the store and find out what ingredients are contained in a particular food item and which company produces it.

With meats it is particularly important to buy organic (because of superbugs and also because of the aspect that feed lot animals often receive antibiotics and hormones). Stick to organics also with vegetables and greens (xenoestrogens in non-organic greens that block hormone receptors). Milk products also need to be organic because of the bovine growth hormone facts mentioned above.

When you eat out, things become more difficult unless you find an organic food restaurant. You can always prepare your own salad for lunch with organic greens and a lean protein food, which you keep refrigerated until you are ready to consume it. On weekends a portable picnic in a park can be a great way to relax and socialize, especially in summer.

More information about nutrition: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/

Last edited Nov. 6, 2014

May
11
2013

Changes Of Gut Bacteria Can Cause Heart Attacks

The recent news of gut bacteria possibly being involved in causing heart attacks (see details below) sounds pretty outrageous. In order to make this more understandable, we need to start backtracking how bacteria end up in our gut and what they are doing there.

Gut bacteria in our bowels at various stages in life

Even among infants there is a huge difference in the composition of the gut flora depending on whether the baby was vaginally delivered, born by Cesarean section or prematurely born and nursed in an intensive care unit for a prolonged period of time.

When we are grown up, it depends on where we live on our planet as to what type of gut flora we have. A 2011 study of the bacterial composition of stool samples in Europe versus Africa showed that the European microbiome in the colon was typical of the Bacteroides enterotype, whereas the African microbiome was dominated by the Prevotella enterotype. Other studies have shown that the type of diet we eat causes us to harbor different types of gut flora. A person eating a more vegetarian diet will have a Prevotella enterotype gut flora, while another person eating a Western style fat and protein dominated diet will have a Bacteroides enterotype gut flora. What is the gut flora doing? It lives within our gut for our mutual benefit. We provide the gut bacteria a comfortable home at body temperature where they grow best. They in turn ferment undigested foods, protect us from the growth of harmful bacteria, produce vitamins like vitamin K and biotin, and produce hormones that direct the body to store excess food as fat.

Changes Of Gut Bacteria Can Cause Heart Attacks

Changes Of Gut Bacteria Can Cause Heart Attacks

Cleveland Clinic’s gut flora research linked to heart attacks

In April 2013 reports that heart attacks may be related to the composition of your gut flora hit the popular press, articles like this. Two years earlier, in April of 2011, the same Cleveland research group under Dr. Stanley Hazen found that the gut flora composition has an impact on heart disease. They stated that a “byproduct called trimethylamine N-oxide (TMAO) is produced when intestinal bacteria digest the nutrient phosphatidylcholine, commonly known as lecithin”. It was determined that the liver was responsible for producing TMAO out of absorbed materials from gut bacteria and that this was responsible for accelerating hardening of the arteries, which in turn caused deadly heart attacks and strokes.

As can be seen from this link the Cleveland research group is suggesting that TMAO could become a valuable screening tool when measured in patients’ blood to screen for their risk to develop a heart attack or stroke in the future. Furthermore, once these patients are identified, they can be sent to a dietitian and be put on a different diet that prevents heart attacks and strokes; also, the progress could again be monitored through repeat TMAO blood tests down the road.

Criticism of research from the Cleveland Clinic

Not every one has welcomed the study as clear-cut proof for a link between the gut flora and heart attacks, strokes and deaths. This link shows that it is questioned whether perhaps low antibiotic residues in red meat would explain the findings of the study. It rightly points out that there was no control for whether the more than 4000 patients were eating organic foods or a regular American diet. The comment goes on to say that the regular American diet contains residual antibiotics from milk, milk products, beef, chicken and turkey. These traces of antibiotics are powerful enough to have an effect on the gut flora, which likely is the reason for the differences between the vegetarian diet versus a Western style fat and protein dominated diet. It is entirely possible that grass fed beef would not lead to TMAO levels in the blood whereas regular beef or hamburger meat will raise the TMAO levels. The same could be true for egg consumption, which was also accused of raising TMAO levels. However, we do not know whether organic eggs that do not contain antibiotics would have done the same as regular eggs that contain traces of antibiotics.

Cancer caused by gut flora

This 2008 review article explains how lactobacillus and bifidobacteria (probiotics) prevent colon cancer, while bacteria of the Bacteroides and Clostridium variety increase the incidence of colon cancer and the growth rate of colonic tumors. So, the composition of your gut flora does not only matter with regard to prevention of heart attacks and strokes, but is also important in preventing colon cancer.

Change your gut flora to boost your health

Here is where the “rubber hits the road”. What I mean is that you can benefit from all of this research with regard to your health by paying attention to a few facts and possibly making a few changes as follows.

  1. I think that the argument of the bulletproofexec.com website holds true and we should all eat organic meats whenever possible. The Cleveland study has already shown that the gut flora in vegetarians stayed healthy even when they occasionally slipped and ate a regular steak.
  2. Take supplemental probiotics from the health food store. It will improve your gut flora within a day or two.
  3. Higher intake of fruit and vegetables make a measurable difference in the body decreasing the risk for heart attacks and strokes as this British research group has shown. Another research group from Italy has confirmed that an increased intake of fruit and vegetables mobilizes genetic switches that will stabilize the metabolism of the gut wall and prevent cancer of the colon.

So, the verdict for boosting your health is out: eat organic foods, use probiotics as supplements and eat more fruit and vegetables!

More information on nutrition: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/

References

  1. http://www.nature.com/nm/journal/v19/n5/full/nm.3145.html
  2. http://www.ncbi.nlm.nih.gov/pubmed/23614584

Last edited Nov. 7, 2014

Apr
07
2013

Caution, Processed Food Ahead

Introduction

The title of this review is: caution, processed food ahead. During the last month there have been three large studies that drew media attention regarding healthy food intake. The first study dealt with processed meats (sausages, ham, bacon). Over 12.7 years those consuming 160 Gm per day (=5.64 oz.) were 44% more likely to die prematurely than those who ate only 20 Gm (=0.7 oz.) of processed meat per day. The study included 10 European countries including about 500,000 people over almost 13 years; nearly 10,000 people died from cancer and 5,500 from heart problems.

Harvard study 

Then there was the Harvard study that analyzed 114 national dietary surveys around the globe and came to the conclusion that every year there are 180,000 obesity related deaths from overuse of sugary drinks. The US stands third highest on the ranking list regarding deaths from drinking sugary soda pops. The deaths are due to heart attacks, strokes and diabetes, which associate with obesity.

15% of all death around the world from salt overuse

As if this was not enough the third bad news story came shortly after story about salt overuse: At a cardiology conference in New Orleans Dr. Dariush Mozaffarian, the main author regarding the sugar study mentioned above, revealed a long-term study regarding salt intake between 1990 and 2010 .  He determined that 15% of all deaths that occur around the world every year (which translated into 2.3 million people) are the result of salt overuse. The recommended salt limit is 1500 mg per day. But many people in the study consumed 4000 to 6000 mg of salt per day or more. This led to hypertension, heart attacks and strokes with the yearly mortality rates indicated.

Caution, Processed Food Ahead

Caution, Processed Food Ahead

What do these studies have in common and why is processed food so devastating?

All these studies pointed out that processed foods are dangerous to your health. Sausages, ham and bacon contain a lot of fat and salt; they are full of extra calories and they elevate your fatty substances in your blood (triglycerides, cholesterol). The extra salt raises your blood pressure. Processed meat is also poor in omega-3-fatty acids. No wonder that they can cause heart problems and cancer.

Sugar and processed food

Next, we have the sugary soda drinks, but also the hidden sugar in starchy processed foods like cookies, bagels, bread and cakes. Dough and pasta digests within 30 minutes into sugar, which your gut absorbs and your liver processes as extra calories to be stored as fat. Where? As visceral fat and subcutaneous fat, and the end result is obesity. At the same time the sugar from soft drinks and the sugar from starches stimulate the pancreas to produce extra insulin, which leads to hyperinsulinemia and insulin resistance. This is known as metabolic syndrome and was found to be an independent risk factor for heart attacks apart from high LDL cholesterol and high triglycerides. We know for quite some time that obesity, diabetes, insulin resistance and metabolic syndrome are all associated with a higher rate of deaths from heart attacks and strokes.

Salt overuse

Finally, there is the salt overuse story. In 2009 the same Harvard group that gave us the world data on salt mortality now, stated that 102,000 Americans die every year from salt overconsumption. The same study cited that 82,000 Americans die needlessly every year due to their love affair with deep fried foods (due to high trans fatty acids) , and 84,000 die from a lack of omega-3-fatty acids in their diet, which when present in the diet protects from heart attacks and strokes.

Food processing

What does food processing do? It reduces or eliminates dietary omega-3-fatty acids, adds cheap oils containing omega-6-fatty acids (the fatty acids that lead to inflammation), adds salt, sugar and starch. It is the perfect recipe to die from strokes and heart attacks. The same research group from Harvard University did a study in India, published in 2010, where they established that salt over consumption caused insulin resistance and this was the cause of higher mortality from heart attacks and strokes.

Other studies pointing to the dangers of processed food

Deficits in cognitive function (dementia or Alzheimer’s disease) are associated to dietary habits, particularly sugar and starch overconsumption. Research has established that hyperinsulinemia or insulin resistance is responsible for the degenerative changes in the brain of Alzheimer patients. This study also pointed out that these diets are typically very low or deficient in omega-3-fatty acids, which is necessary for normal nerve cell metabolism in the brain. The lack of it leads to brain cell disease like Alzheimer’s and a lack of omega-3 fatty acids in nerves leads to damaged nerves which in turn cause excruciating pain.This condition is also known as neuropathy.

Gout was around in the Middle Ages

In the Middle Ages it was first observed that overindulging in red meat and sausages caused gout attacks. A nickname for gout was “a disease of the rich”. Higher uric acid levels, which are found in gout have been linked to higher mortality rates from heart attacks and stokes. A low purine diet can lower the risk for gout and also the risk for heart attacks and strokes. It is interesting that this type of a diet is also devoid of processed food at the same time.

What can we do to reduce dangers to our health?

We have identified the suspects; it is sugar, starchy foods, salt and processed meats. Instead of just buying precooked meals, boxed foods and other processed foods from the center of the grocery store or from a fast food place, look for original ingredients more at the periphery of the grocery store.  Read food labels and look for sugar, fat and salt content. Start buying organic food and buy the ingredients you need to prepare a meal by yourself. When you start preparing your own meals with organic ingredients, you may as well avoid the toxins that I described in a recent blog.

Buy organic foods

By buying organic foods, you largely avoid these toxins. Don’t exceed your daily limit of 1500 mg of salt, as your kidneys are not able to process this and would cause you to get high blood pressure. Personally, I cut out all sugar and starch from my diet since 2001. This includes potatoes, pasta, bread, bagels, French fries, toast etc. However, you will get enough complex carbohydrates (from vegetables and greens). The body absorbs them much slower and does not cause the insulin surge by the pancreas. In contrast, highly processed carbs lead to an insulin surge.

Omega-3 fatty acids important for health

You want to eat foods rich in omega-3-fatty acids, but seafood (even salmon) has a contamination with mercury. You can circumvent this by taking 3 or 4 capsules of high potency, molecularly distilled omega-3 per day. This is free of toxins and protects your brain and nerves from the dangers mentioned above. Your organic vegetables/greens have enough natural minerals that you will seldomly want to add salt to your food. Do not add extra salt when you cook or when you eat your prepared meals. Use spices instead. Also avoid eating out too often. Restaurants are notorious for overusing salt.

More information

More information on nutrition: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/

Other links:

1. Processed meat: http://www.huffingtonpost.com/2013/03/07/processed-meat-cancer-heart-disease-death-risk_n_2829092.html

2. Sugary drinks: http://www.cnn.com/2013/03/19/health/sugary-drinks-deaths/index.html?hpt=he_c2

3. Alzheimer’s and pre-diabetes with insulin resistance: http://www.usatoday.com/story/news/nation/2012/10/17/carb-diet-alzheimers/1637481/