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.

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.

Next the researchers examined the ratio of total cholesterol to high-density lipoprotein cholesterol, which is a measure for the heart attack risk. 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 you consume food. It is an irony that in the 1980’s and 1990’s the wrong assumption that a low fat/high carb diet would be heart healthy created the obesity wave. 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.

Sugar stimulates the food addiction center

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.

Monitor your body mass index

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.

Oct
04
2014

The Problem Are Sugar And Starchy Foods

Fareed Zacharia interviewed Chief Medical Correspondent Sanjay Gupta on CNN on Sept. 10, 2014 regarding why sugar is worse than fat.

I like to explain why it is important to rethink the issues of fat, cholesterol, sugar, starchy foods, longevity, prevention of cardiovascular diseases (strokes, heart attacks) and cancer.

I have blogged about this many times before, but perhaps an overview regarding these issues would be in order.

The Framingham Heart Study indicated first that too much cholesterol in our system was a problem leading to heart attacks and strokes (Ref. 3). As more research was done, the reasons for this have become clearer.

1.Liver metabolism

The liver plays a major role in the metabolism of glucose. Digestion of refined starchy foods starts in the mouth where amylase from the saliva digests the surface of the pasta or white bread you eat. The stomach carries on with this process and the job is finished in the small intestine with the help of pancreatic enzymes (Ref.1). This digestive process is so efficient that within 20 to 30 minutes all of the refined carbs from pasta, donuts and bread appear as sugar in the blood stream. The portal vein system that collects the nutrients from the gut delivers all sugar straight to the liver where it is reassembled into glucagon as the storage form in the liver and skeletal muscles. This would all be good, would we have periods of fasting in between our sugar consumption. Periods of famine are no longer part of modern civilization, but consumerism is. Most of the processed food contains sugar and this leads to excess sugar uptake, which has to be processed by our liver. The end result is production of LDL cholesterol, oxidization of LDL cholesterol by sugar and in the process the production of VLDL (=very low-density lipoproteins) that leads directly to deposits in the arterial walls and clogging of arteries. Triglycerides are also produced, which leads to fat deposits (the cause of the obesity wave all around us).

2. Where does the fat that we see around us come from?

In the past we thought that it was from too much saturated fat and cholesterol in the food that would have caused the accumulation of fat and cholesterol in the body. Now we know that this was an over-simplification. In fact more cholesterol and fat comes from metabolized sugar and with a slight time delay also from starchy foods.

Sugar and starchy foods (like pasta, white rice, white bread, potatoes, grapes, honey etc.) get metabolized by your liver into LDL cholesterol, triglycerides, and fat. This does not mean that you should not pay attention to the total fat content and the quality of fats you eat.

3. The finer points about subfractions of cholesterol

You have heard many times about the good (HDL) and the bad (LDL) cholesterol. Sugar and refined starches do not only lead to the production of LDL cholesterol, but also to oxidized LDL cholesterol, which is very aggressive (VLDL=very low-density lipoproteins) leading directly to deposits in the arterial walls and to clogging of arteries. Your doctor can order a detailed lipid profile test, if you belong into a higher risk group to determine your VLDL level.

It may surprise you to read that many of the foods that were demonized in the past 2 to 3 decades like whole eggs; unprocessed grass-fed red meat, coconut oil etc. are now seen to be good for you.

But there are provisos: supplement with molecularly distilled omega-3 fatty acids, have enough vitamin D3, vitamin K2 and calcium in your diet or supplement with these. This will make sure that calcium will leave the blood stream (not lead to arteriosclerosis) and enter into the bones where it is needed for healthy bone structure. The anti-inflammatory effect of vitamin D3 and of the omega-3 fatty acids will prevent arthritis, strokes, heart attacks and cancer.

The Problem Are Sugar And Starchy Foods

The Problem Are Sugar And Starchy Foods

4. Four major conditions causing heart attacks and strokes

According to Ref. 2 only 4 conditions have been proven over the years to lead to serious hardening of arteries causing strokes and heart attacks: dyslipidemia (high triglycerides, high LDL cholesterol and VLDL), hypertension, cigarette smoking, and/or diabetes (Ref. 3). What has not been appreciated until recently is the fact that sugar and refined starchy foods metabolized by the liver are the culprits in causing plaque in arteries as the oxidized LDL cholesterol is aggressively invading the arterial wall and is inflammatory. A total cholesterol level greater than 5.2 mmol/L (200 mg/dL) has been shown to be associated with increased heart attacks and strokes. Ref. 2 also points out that dietary changes; days of fasting and weight loss have all been shown to stabilize and reduce plaque lesions and reduce heart attacks and strokes. It is the rupture of unstable plaques that lead to attraction of platelets and thrombus formation. It is this localized thrombosis that leads to the closure of coronary arteries or brain vessels causing heart attacks and strokes. According to Ref. 2 there are 9 factors that determine whether we get a stroke or heart attack, the four factors mentioned above (dyslipidemia, hypertension, cigarette smoking, diabetes) and abdominal obesity, lack of physical activity, low daily fruit and vegetable consumption, alcohol overconsumption, and a psychosocial risk. This latter factor includes any kind of chronic stress like interpersonal stress at work or home, depression, financial stress, major life events like marriage, death, divorce, and lack of control. Counseling is useful for support regarding psychosocial risk factors. It is significant to note that according to Ref. 2 several studies have shown that 90% of heart attacks and strokes can be prevented by paying attention to these 9 risk factors. Managing stress effectively and seeking professional help for psychosocial difficulties as well as avoiding the  physical health risks will contribute to good allover health.

Conclusion

Where does this leave us? For decades we have been told that saturated fats and cholesterol in our diet were the culprits and we replaced them with sugar that is part of a low-fat diet. We need to pay attention to the glycemic index and cut out high glycemic foods. However, it is OK to eat some carbs from the medium glycemic food list and most of our carbs from the low glycemic food list. With regard to fat it is important to consume only the healthy fats including omega-3 fatty acids. By taking care of the 4 major causes of heart attacks and strokes and also attending to the additional minor contributors mentioned above you will be able to eliminate 90% of the cardiovascular events. As you change these things you will also prevent many cancers as you changed the body metabolism and chronic inflammation has been taken care of as well as I pointed out in several blogs before. Finally, pay attention to stress management. The body and mind work together.

I have discussed all of these items in detail in my book as well (Ref. 3).

More information on high density and low density carbs: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/carbohydrates/

References:

1.Townsend: Sabiston Textbook of Surgery, 19th ed.,Copyright 2012 Saunders.

2.Melmed: Williams Textbook of Endocrinology, 12th ed.,Copyright 2011 Saunders.

3. Dr. R. Schilling: “A Survivor’s Guide to Successful Aging“. Paperback through Amazon.com, 2014.

Last edited Nov. 8, 2014

Sep
14
2013

Food Processing Can Be A Danger To Your Health

Food processing is found everywhere: in pizzas, hamburgers, ready to eat deep frozen dinners, and in the myriad of packages that you see in the center of the grocery store. There are aisles and aisles of ready-made food packages including potato and corn chips, power bars, low fat yoghurt, and on and on it goes.

So, what are the problems with these foods?

Here are the major players that you will find (sometimes not) on the food ingredient lists.

Hidden sugar

With the recommendation for the past few decades that we should use low fat yoghurt a whole industry has sprung up surrounding low fat products. If you study the labels you will see that this has been done at the expenses of adding hidden sugar content. Don’t go for the berry or other fruit yoghurt, because it is over processed, sweetened with sugar or high fructose corn syrup. This is a fast track to becoming a diabetic. Stick to plain yoghurt with 2 to 3 % fat, which has only the original milk sugar in it, but no additives. Also, in the US you ought to avoid any milk and milk products containing bovine growth hormone, which is solely there for increasing the milk farmer’s profit, but will seriously undermine your health (it blocks your growth hormone receptors). Ref. 1 and 3 explain in detail how the metabolism is being changed through added sugar and an overdose of starchy foods, which is the reason for the pancreas over producing insulin. This in turn causes such varied diseases like heart attacks, diabetes, inflammatory conditions like arthritis, MS, Alzheimer’s disease and cancer.

Cut out cookies, excessively starchy foods like potatoes, bread, pasta and rice. Within half an hour of ingesting these your system will be overrun with sugar, the breakdown product of starchy food.

Added salt

Added salt is often used to preserve foods, to lengthen their shelf life and to stimulate your appetite. In restaurants it is added to stimulate your appetite for more liquids. As a result more beverages (alcoholic and nonalcoholic) will be ordered, which is where the profit margin is highest. High amounts of salt will not be beneficial to you, as it will raise your blood pressure and on the long-term will cause high blood pressure, heart attacks and strokes. When you buy organic food, there is no added salt in it, although you get sodium chloride that is contained in the vegetables and fruit. Add very little salt, if any; instead add  herbs and spices, which contain valuable trace minerals.

Food Processing Can Be A Danger To Your Health

Food Processing Can Be A Danger To Your Health

Hidden fat

Whenever you have a food that was deep fried such as potato chips, corn chips or French fries, there is the danger of exposing yourself to trans fats from polyunsaturated fatty acids. This is also true for deep fried chicken or any other ready to eat foods that have been prepared in the deep fryer.This type of oil is often reused after it is filtered and advanced glycosylation end products (AGE’s) are accumulated in it. This ages your cells including your skin much faster. AGE’s also worsen diabetes by causing more complications like heart attacks and kidney failure. For the same reason you should avoid burning meats on the BBQ or food that you cook on a stove.

Hamburgers also have a lot of hidden fat, sometimes as much as 50%. This fat enters your bloodstream and is eventually deposited as fat deposits in your arteries. After decades of eating too many hamburgers and sausages your coronary arteries clog and you require a stent or a bypass surgery. If you do not want to become a statistic prematurely, cut out sausages, hamburgers and other processed meats replacing them with lean turkey breast, organic chicken and lean pork,venison or grass fed lean cuts of beef or bison.

MSG and other food additives

Many foods have artificial sweeteners in them, which includes excitotoxins like MSG and aspartame. MSG is added to stimulate your appetite, but it has devastating effects on your brain cells on the long term. The name may be disguised as yeast extract, sodium caseinate, broth stock, malt extract, natural flavors and others. Soda drinks either have added sugar, in which case your insulin response makes you want to eat more calories in a day leading to obesity and to dementia. Aspartame, which is used by diet conscious people as a low calorie drink, causes insulin resistance making you gain weight. It also damages your brain. I recommend the plant extract stevia, which is a sweetener that does not have the deleterious effects of aspartame. Sucralose (Splenda) was developed through research on insecticides when a student found out that it tasted sweet. Although Big Pharma has succeeded to introduce sucralose into the diet of diabetics, it is a sweetener that in my opinion is not safe. First it kills ants: a few years ago I did an experiment where I took a package of Splenda from Starbucks and sprinkled it on Hawaiian ants. In the beginning they were reluctant to eat it, but after a few hours they came and took it in. One day later there were only shriveled up dead ants left in the area where Splenda had been sprinkled. I refuse to eat insecticide-laced soda! Second, when you read the link about the “sweet deception about Splenda” above you find that it has reduced the growth rate of rats, caused anemia in mice, enlarged the liver and the brain of rats, shrunk ovaries of rats and caused kidney damage with calcifications in rats. We have no official human data, although millions of Splenda doses have been consumed.  Nobody has done clinical safety studies in man.

One of the food additives you may not think much about is gliadin, which is used in baking to bind the ingredients together. It is derived from wheat, which is usually the Clearfield variety of wheat (a dwarf variety). Dr. William Davis (Ref.1) has examined the effects of wheat and wheat products on humans in detail. Suffice it to say that it is safest to avoid wheat and wheat products entirely; otherwise you could develop bowel disease like celiac disease, ulcerative colitis, Crohn’s disease; heart disease, obesity, autoimmune diseases, but also CNS disease like Parkinson’s disease, ataxia, and dementia (including Alzheimer’s disease).

Other health problems associated with marketing and so-called “best practices” of agroindustry

Milk and milk products are not as innocent as in the past when no marketing boards were around. Animals are no longer freely roaming on green pastures, but are kept in high-density facilities and have to be put on antibiotics to prevent infectious illnesses. So we are told. In reality farmers have found out that antibiotics and bovine growth hormone will both increase milk production. The profit principle has been applied and as a result the consumers of milk and milk products have a change of their bowel flora from the antibiotics, which can cause heart attacks. The bovine growth hormone from milk and milk products causes breast cancer and prostate cancer.

Superbugs have emerged as a danger from treating beef animals with antibiotics in feeding lots leading to resistant bacterial strains that can cause human disease like flesh eating disease etc. These superbugs imported from the grocery store and meat market are what can make us sick! Eating only organic meat and organic foods are one way that we can use to protect ourselves. Organic milk or goat milk are alternatives to regular (unhealthy) milk.

Toxins in our foods

Roundup is so rampantly present in agroindustry to protect crops from weeds that traces of it are present in most regular crops. Despite claims that Roundup would be safe for the consumer, newer research has shown that it is not. Genetically modified crops are routinely sprayed with Roundup, as they are resistant to this herbicide, so I recommend to stay away from these crops as well.

Your best protection is to buy organic foods.

Heavy metals can be another source of food toxicity. Red wine was found to contain heavy metals, which could undermine that heart healthy effect of a glass of red wine per day.

Mercury is toxic to the central nervous system. It comes from the effluent of gold mines, the smog from coal burning and volcanic activity, which finds its way into the ocean. Fish is the main source of exposure to humans as explained in this link.

Conclusion

We need to be vigilant about the food we eat. The more it has gone through food processing, the more ingredients get mixed in. We need to ask questions about how the food that we eat was raised. Were food additives mixed in? Are they harmless or bad for our health? Beware of sugar as this causes insulin levels to raise causing obesity, diabetes, heart attacks, strokes and cancer. Watch the addition of salt, which causes high blood pressure, heart attacks and strokes. Avoid polyunsaturated fats, cook with olive oil instead. It’s the Mediterranean way of preventing heart attacks. No butter, no margarine, because this fat ends up in your arteries. Avoid wheat and wheat products that are often mixed into foods. Cook your own food whenever possible. Eat lots of vegetables and salads. Watch the glycemic index and avoid high glycemic index foods. Sweeten with stevia, but avoid all other sweeteners. This way you avoid the insulin response discussed above.

The dietitians of the US have summarized the problems the American public faces in Ref. 2. Essentially we need to take back the responsibility for our own food preparation and become less dependent on manufactured foods. A good collection of wheat-free recipes can be found under Ref. 3.

References

1. William Davis, MD: “Wheat Belly. Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2011.

2. The Profession of Dietetics at a Critical Juncture: A Report on the 2006 Environmental Scan for the American Dietetic Association; Journal of the American Dietetic Association – Volume 107, Issue 7 (July 2007)

3.  William Davis, MD: “Wheat Belly Cookbook. 150 Recipes to Help You Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2012.

Last edited Oct. 4, 2014

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