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Soda and Obesity

type 2 diabetes, obesityWhile a major study relating soda and obesity was done in California, the hypothesis, observations and outcomes are applicable to all the states of the Union.  More than half the adolescents in that state and almost a fourth of the adults treat themselves to at least one sweetened beverage every day.  One of the concerns expressed by UCLA researchers is that the serving size has grown from an average of 6.5 ounces and eighty-eight calories in the 1950’s to 20 ounces and two hundred sixty-six calories by the 2000’s.  In fast food restaurants in 2003, the average serving was 23 ounces (almost 300 calories).  These added caloric sweeteners, including high fructose corn syrup, are not only markers of a poor diet, but also are associated with overweight and obesity in all age groups.

CITATIONS FROM REPORT / ARTICLE
The UCLA Health Policy Research Brief from September, 2009, reports from its data that, “Adults who drink soda occasionally (not every day) are 15% more likely to be overweight or obese, and adults who drink one or more sodas per day are 27% more likely to be overweight or obese than adults who do not drink soda, even when adjusting for poverty status and race/ethnicity.”  Even though the prevalence of overweight in children is lower than in adults, the rates among children have increased more.  In fact, overweight has tripled in teenagers and quadrupled in those from six to eleven years old in the last three decades.  In California the cost of obesity approaches twenty-one billion dollars a year, burdening families, employers and the health care industry.  The study comments that, “California spends more public and private money on the health consequences of obesity than any other state.”  To compound the matter, the article admits that “…drinking soda is also associated with increased risk for type 2 diabetes.”

COMMENTARY
One third of American adults are obese. Their health care costs $1500 more a year than it does for an average-weight person.  The Center for Disease Control announced in July, 2011, that obesity in the entire United States costs $147 billion a year in direct medical costs.  Dr. Thomas R. Frieden, director of the CDC, said the problem is “getting worse rapidly.  The average American is now 23 pounds overweight.”  For Medicare, the cost of obesity is 72% greater just for prescription drugs.  The CDC says that one in three children born in 2000 will develop diabetes.  How did we get there?  Diet.  Does the rest of the world share the problem?  Yes.  Where does the blame go?  White flour, white sugar, high fructose corn syrup, soft drinks and fast food.

Whether it gets marketed as corn sugar or as high fructose corn syrup, which is what it is, this commodity is not equal to other sweeteners when it comes to weight gain.  HFCS costs less than table sugar because, being liquid, it’s easier to transport and blend.  It’s sweeter than sucrose (table sugar), so less is needed, and it’s cheaper because of a combination of corn subsidies and sugar tariffs and quotas.  Cheap corn, in fact, is the building block of the fast-food nation.  Cheap corn created the chubby 20-ounce bottle of soda we have today.

High fructose corn syrup commonly is 55% fructose and 45% glucose, somewhat different from the 50-50 mix in table sugar, where one fructose molecule is attached to one glucose molecule.  Some HFCS may be as high as 80% fructose.  Since all sugars contain four calories per gram, there must be something else about fructose that matters.  Fructose is metabolized more rapidly that glucose, flooding metabolic pathways and increasing triglyceride storage.   It doesn’t spur the production of insulin or leptin, the hormone that sequesters appetite.  The body then lacks satiety.  This elevates serum triglycerides and increases fat storage.  Since it may have less impact on appetite than glucose, fructose contributes to weight gain.  Ingesting lots of fructose may also reduce insulin sensitivity.  (Beck-Nielsen, 1980)

Soft drink consumption has more than doubled in the twenty years from 1977 to 1997.  Not surprisingly, obesity followed the same trend. Cause and effect? It’s been estimated that for each additional sweet drink consumed per day, the odds of obesity increase by sixty percent.  A study of more than fifty thousand nurses by Harvard compared time periods from 1991-1995 and 1995-1999, and found that women whose soda consumption increased had bigger rises in body-mass index than those who drank less or the same amounts of soda. Fast food seems to go well with it.  Unhealthy foods get along nicely with each other.

The debate between the soft drink industry and the health nuts is ongoing.  People who consume lots of fresh-squeezed juices, vegetables and fruits are not the same group that consumes soda and cold cut sandwiches.  The daily calories from soft drinks account for almost a fourth of the recommended daily intake for many Americans, who drink almost fifty-six gallons of soda a year.

In case you’re interested, more than 30% of Americans are obese. More than 24% of Mexicans, 23% of British, 22% of Slovakians, 22% of Greeks and Australians, 21% of New Zealanders, and 15% of Czechs, but only 3% of Japanese and Koreans. Go figure. Obesity, by the way, means being more than 20% above ideal weight for height.

References

UCLA Health Policy Research Brief
September 2009
Bubbling Over: Soda Consumption and Its Link to Obesity in California
Susan H. Babey, Malia Jones, Hongjian Yu and Harold Goldstein

In California, 62% of adolescents ages 12-17 and 41% of children ages 2-11 drink at least
one soda or other sweetened beverage every day. In addition, 24% of adults drink at least
one soda or other sweetened beverage on an average day. Adults who drink soda occasionally
(not every day) are 15% more likely to be overweight or obese, and adults who drink one or
more sodas per day are 27% more likely to be overweight or obese than adults who do not
drink soda, even when adjusting for poverty status and race/ethnicity.

The prevalence of overweight and obesity has increased dramatically in both adults
and children in the last three decades in the United States. In the 1970s, about 15% of
adults were obese and by 2004 the rate had climbed to 32%.1 Although the prevalence of
overweight among children is lower than among adults, the rates among children and
adolescents have increased considerably more. The prevalence of overweight and obesity
nearly tripled among 12-19 year olds and more than quadrupled among 6-11 year olds
in the last three decades.

In California, 21% of adults are currently obese and an additional 35% are overweight. Among adolescents, 14% are obese and another 16% are overweight.2 Similar to national trends, the trend in California is toward increasing weight in both adults and adolescents.3 Each year in California, overweight and obesity cost families, employers, the health care industry and the government $21 billion.4 California spends more public and private money on the health consequences of obesity than any other state.5

Overweight and obesity are associated with serious health risks. In children and adolescents, overweight and obesity are associated with increased risk for cardiovascular disease indicators including high total cholesterol, high blood pressure, and high fasting insulin, an early indicator of diabetes risk.6 In addition, overweight children and adolescents are more likely to be overweight or obese as adults.7 In adults, overweight and obesity are associated with increased risk for diabetes, heart disease, stroke, some types of cancer and premature death.1, 8, 9

Drinking sweetened beverages such as soda and fruit drinks that have added caloric sweeteners (e.g., sucrose, high fructose corn syrup) is one marker of a poor diet, and is
associated with overweight and obesity in people of all ages.10-13 A number of studies have found that greater consumption of sweetened beverages is associated with overweight and obesity among both adults and children.12-19 In addition, randomized controlled trials that examine the impact of reducing intake of sweetened beverages on weight indicate
that reducing consumption of soda and other sweetened drinks leads to reductions in
overweight and obesity.20, 21 Among adults, drinking soda is also associated with increased risk for type 2 diabetes.13 Moreover, drinking sweetened beverages has
increased, and it is now more common than ever, particularly among adolescents.22
Between 1977 and 2002 Americans increased their calorie intake from soft drinks by
228%.23 Portion sizes have also increased from an average serving size of 6.5 fl oz (88 calories) in the 1950s, to 12 fl oz (150 calories), 20 fl oz (266 calories), and even larger portion sizes common today.24-26 The average serving size of soft drinks in fast food restaurants in 2002 was 23 fl oz (299 calories), with some chains now commonly selling soft drinks in 32 to 64 fl oz portions (416 to 832 calories, respectively).27 Sweetened beverages are a significant contributor to total caloric intake, especially for children and adolescents, and they lack the nutrients our bodies need.24, 26, 28

Additionally, eating habits established in childhood are important determinants of
eating habits as adults.29, 30
http://www.healthpolicy.ucla.edu/pubs/files/Soda%20PB%20FINAL%203-23-09.pdf

SUPPORTING ABSTRACTS
Am J Clin Nutr February 1980 vol. 33 no. 2 273-278
Impaired cellular insulin binding and insulin sensitivity induced by high-fructose feeding in normal subjects
H Beck-Nielsen, O Pedersen and HO Lindskov

We have studied whether the sucrose-induced reduction of insulin sensitivity and cellular insulin binding in normal man is related to the fructose or the glucose moiety. Seven young healthy subjects were fed their usual diets plus 1000 kcal extra glucose per day and eight young healthy subjects were fed their usual diets with addition of 1000 kcal extra fructose per day. The dietary regimens continued for 1 week. Before change of diet there were no statistically significant differences between body weight and fasting plasma concentrations of glucose, insulin, and ketone bodies in the two groups studied. High- glucose feeding caused no significant changes in insulin binding or insulin sensitivity whereas high-fructose feeding was accompanied by a significant reduction both of insulin binding (P less than 0.05) and insulin sensitivity (P less than 0.05). The changes in insulin binding and insulin sensitivity correlated linearly (r = 0.52, P less than 0.01). We conclude that fructose seems to be responsible for the impaired insulin binding and insulin sensitivity induced by sucrose.

Medscape J Med. 2008;10(8):189. Epub 2008 Aug 12.
Soft drinks and weight gain: how strong is the link?
Wolff E, Dansinger ML.
Boston University School of Medicine, Boston, Massachusetts, USA. [email protected]

CONTEXT
Soft drink consumption in the United States has tripled in recent decades, paralleling the dramatic increases in obesity prevalence. The purpose of this clinical review is to evaluate the extent to which current scientific evidence supports a causal link between sugar-sweetened soft drink consumption and weight gain.

EVIDENCE ACQUISITION
MEDLINE search of articles published in all languages between 1966 and December 2006 containing key words or medical subheadings, such as “soft drinks” and “weight.” Additional articles were obtained by reviewing references of retrieved articles, including a recent systematic review. All reports with cross-sectional, prospective cohort, or clinical trial data in humans were considered.

EVIDENCE SYNTHESIS
Six of 15 cross-sectional and 6 of 10 prospective cohort studies identified statistically significant associations between soft drink consumption and increased body weight. There were 5 clinical trials; the two that involved adolescents indicated that efforts to reduce sugar-sweetened soft drinks slowed weight gain. In adults, 3 small experimental studies suggested that consumption of sugar-sweetened soft drinks caused weight gain; however, no trial in adults was longer than 10 weeks or included more than 41 participants. No trial reported the effects on lipids.

CONCLUSIONS
Although observational studies support the hypothesis that sugar-sweetened soft drinks cause weight gain, a paucity of hypothesis-confirming clinical trial data has left the issue open to debate. Given the magnitude of the public health concern, larger and longer intervention trials should be considered to clarify the specific effects of sugar-sweetened soft drinks on body weight and other cardiovascular risk factors.  PMID: 18924641

Diabetes Care. 2010 Nov;33(11):2477-83. Epub 2010 Aug 6.
Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis.
Malik VS, Popkin BM, Bray GA, Després JP, Willett WC, Hu FB.

Department of Nutrition, Harvard School of Public Health, and Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA.

OBJECTIVE
Consumption of sugar-sweetened beverages (SSBs), which include soft drinks, fruit drinks, iced tea, and energy and vitamin water drinks has risen across the globe. Regular consumption of SSBs has been associated with weight gain and risk of overweight and obesity, but the role of SSBs in the development of related chronic metabolic diseases, such as metabolic syndrome and type 2 diabetes, has not been quantitatively reviewed.

RESEARCH DESIGN AND METHODS
We searched the MEDLINE database up to May 2010 for prospective cohort studies of SSB intake and risk of metabolic syndrome and type 2 diabetes. We identified 11 studies (three for metabolic syndrome and eight for type 2 diabetes) for inclusion in a random-effects meta-analysis comparing SSB intake in the highest to lowest quantiles in relation to risk of metabolic syndrome and type 2 diabetes.

RESULTS
Based on data from these studies, including 310,819 participants and 15,043 cases of type 2 diabetes, individuals in the highest quantile of SSB intake (most often 1-2 servings/day) had a 26% greater risk of developing type 2 diabetes than those in the lowest quantile (none or <1 serving/month) (relative risk [RR] 1.26 [95% CI 1.12-1.41]). Among studies evaluating metabolic syndrome, including 19,431 participants and 5,803 cases, the pooled RR was 1.20 [1.02-1.42].

CONCLUSIONS
In addition to weight gain, higher consumption of SSBs is associated with development of metabolic syndrome and type 2 diabetes. These data provide empirical evidence that intake of SSBs should be limited to reduce obesity-related risk of chronic metabolic diseases.

J Public Health Policy. 2004;25(3-4):353-66.
The obesity epidemic in the United States.
Morrill AC, Chinn CD.
Capacities Inc., Watertown, Massachusetts 02471, USA. [email protected]

We describe the epidemic of obesity in the United States: escalating rates of obesity in both adults and children, and why these qualify as an epidemic; disparities in overweight and obesity by race/ethnicity and sex, and the staggering health and economic consequences of obesity. Physical activity contributes to the epidemic as explained by new patterns of physical activity in adults and children. Changing patterns of food consumption, such as rising carbohydrate intake–particularly in the form of soda and other foods containing high fructose corn syrup–also contribute to obesity. We present as a central concept, the food environment–the contexts within which food choices are made–and its contribution to food consumption: the abundance and ubiquity of certain types of foods over others; limited food choices available in certain settings, such as schools; the market economy of the United States that exposes individuals to many marketing/advertising strategies. Advertising tailored to children plays an important role.  PMID: 15683071

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Hydration: How much do you need?

waterWe have been counseled to drink eight, 8-ounce glasses of water a day (8 x 8) for such a long time that the advice has become unwritten law…and slavishly followed at that. This chant started so long ago that most people have no idea of its origin. At the same time, we are cautioned not to count alcohol and coffee as hydration elements. The science behind the recommendation is so scant that little support can be given to the exhortation, yet the possession of a water bottle is ubiquitous. It is possible that this idea is the result of misinterpretation or misreading of a notion proposed by the Food and Nutrition Board of the National Research Council that recommended one milliliter of water for every calorie consumed. The neglected fact is that there is water in our food. That would surely separate liquid intake from total dietary intake.

Dr. Heinz Valtin, a medical professor at Dartmouth, examined this mantra earlier in this century, and learned, “No scientific studies were found in support of 8 x 8.”  After reviewing surveys of food and fluid intake on thousands of adults of both genders, Dr. Valtin stated that, “…such large amounts (of water) are not needed because the surveyed persons were presumably healthy and certainly not overtly ill.”  He added that most other kinds of beverages, including soft drinks and coffee, contribute to one’s daily need for hydration, continuing that a considerable body of evidence supports the premise that the human body is fully capable of maintaining proper water balance.  But all this must be tempered with the qualifier, “in healthy persons.”  He leaves us with, “…large intakes of fluid, equal to and greater than 8 x 8, are advisable for the treatment or prevention of some diseases and certainly are called for under special circumstances, such as vigorous work and exercise, especially in hot climates.”  In the spirit of open-mindedness, Dr. Valtin asks that readers submit their own findings to him.

Including the 20% supplied by foods, the Institute of Medicine recommends a fluid intake of about 91 ounces a day for women and 125 ounces for men.  Do you know how much water is in your food?  Few of us do. The puzzling thing about this recommendation is the lack of sufficient data available on water metabolism in adults, especially those who are sedentary and living in a temperate environment.  Most of us take in more than that suggested level, when we account for comestibles, although the geriatric populace is apt to take in less of both food and liquid water, partly because of insensitivity to a thirst stimulus and partly because of a waning ability to taste foods and beverages as well as they did in their early years.  It appears that older men drink less than their younger counterparts, but excrete more urine.  Differences in women have shown to be insignificant, but contribute to the notion that, “water turnover is highly variable among individuals…”  (Raman et al. 2004)

Admittedly, older adults are at greater risk for dehydration, but water balance in this population had not been faithfully studied until Purdue University picked up the reins in 2005, and compared/contrasted water intake/output and total balance of fluids in an older population (63-81 y.o.) and a younger one (23-46 y.o.), finding that, in fat-free mass, there is little difference.  The study noted, though, that fat-free mass was lower in the elderly and that fat-free hydration was significantly higher.  Considering that the elderly have less muscle to begin with, this is simple to follow.  (Bossingham. 2005)

Many people complain that, if they increase water intake, they will spend more time in the lavatory.  While this is the case with many of us, there is a limiting factor—time.  The period of time over which a specific amount of water is consumed makes a difference in when the urge to evacuate that water will arise.  The faster you drink that glass of water, the sooner you will need to excrete it.  The longer the glass lasts, the more time there will be prior to evacuation.  “A water diuresis occurs when a large volume of water is ingested rapidly.”  (Shafiee. 2005)   Also note that water mixed with a poorly absorbed sugar (not glucose) will retard absorption and delay excretion.

The kidneys can process almost four gallons of water a day.  Too much water will make you sick because sodium stores will become depleted and electrolyte activity will be sorely jeopardized.  Drinking over a period of time can thwart this threat.  You need not measure urine output to figure out how much fluid to replace.  That is something you can eyeball.  Thirst should not be the barometer by which fluid need is determined.  While there is no absolute proof that we all need 8 x 8, have a glass of water even when you are not thirsty, working in the heat, or running a marathon.  To prevent electrolyte displacement, we might consider electrolyte replacement in at least a couple of our glasses.

References

MAIN ABSTRACT
Am J Physiol Regul Integr Comp Physiol. November 2002; vol. 283 no. 5: R993-R1004
“Drink at least eight glasses of water a day.” Really? Is there scientific evidence for “8 × 8”? Heinz Valtin and (With the Technical Assistance of Sheila A. Gorman)

SUPPORTING ABSTRACTS
Am J Physiol Renal Physiol. 2004 Feb; 286(2):F394-401. Epub 2003 Nov 4.
Water turnover in 458 American adults 40-79 yr of age. Raman A, Schoeller DA, Subar AF, Troiano RP, Schatzkin A, Harris T, Bauer D, Bingham SA, Everhart JE, Newman AB, Tylavsky FA.
Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA.

Am J Clin Nutr. 2005 Jun; 81(6):1342-50.
Water balance, hydration status, and fat-free mass hydration in younger and older adults. Bossingham MJ, Carnell NS, Campbell WW.
Department of Foods and Nutrition, Purdue University, West Lafayette, IN 47907, USA.

Kidney Int. 2005 Feb;67(2):613-21.
Defining conditions that lead to the retention of water: the importance of the arterial sodium concentration. Shafiee MA, Charest AF, Cheema-Dhadli S, Glick DN, Napolova O, Roozbeh J, Semenova E, Sharman A, Halperin ML.

Renal Division, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada.

Am J Physiol Regul Integr Comp Physiol. 2000 Sep;279(3):R966-73.
Effects of time of day, gender, and menstrual cycle phase on the human response to a water load. Claybaugh JR, Sato AK, Crosswhite LK, Hassell LH.

Department of Clinical Investigation, Tripler Army Medical Center, Tripler Army Medical Center, Hawaii 96859 – 5000. [email protected]

Eur J Clin Nutr. 2010 Feb;64(2):115-23. Epub 2009 Sep 2.
Water as an essential nutrient: the physiological basis of hydration. Jéquier E, Constant F.
Department of Physiology, University of Lausanne, Pully, Switzerland. [email protected]

J Am Soc Nephrol 19: 1041-1043, 2008
Just Add Water
Dan Negoianu and Stanley Goldfarb

Renal, Electrolyte, and Hypertension Division, University of Pennsylvania, Philadelphia, Pennsylvania

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Diet Soda is Not A Free Ride

diet soda & weight gainThere is little doubt that obesity in America is on the upswing. Lots of people think that an artificially-sweetened beverage can offset the poor dietary decisions to which they have become accustomed. There has been established a relationship between non-sugar sweeteners and weight gain based on physiological responses to the message of satiety and the perceived need to consume more calories to achieve it. While the perception of sweet taste is supposed to satisfy appetite, the calculated deception to the body just might boomerang and call off all bets.

In the San Antonio Heart Study that ran from 1979 to 1988, researchers examined the association of artificially sweetened beverages with long-term weight gain, and found that, “A significant positive dose-response relationship emerged between baseline ASB (artificially sweetened beverage) consumption and all outcome measures…”  These outcome measures included overweight / obesity, weight gain, and changes in body mass index (BMI).  As with most nutrition research, considerations were made for demographics and behavioral characteristics.  Drinking more than twenty-one ASB’s a week had the most impact, with “…almost double risk of overweight / obesity among 1,250 baseline normal-weight individuals.”  For those with a body mass index already elevated, the changes were more pronounced.  This report concluded with, “These findings raise the question whether AS (artificial sweetener) use might be fueling—rather than fighting—our escalating obesity epidemic.”

That last sentence from the San Antonio Heart Study is quite the incrimination, would you say?
Diet soft drinks have long been thought to be healthier alternatives to their sugary counterparts, but reports like this one have linked increased incidence of weight gain, metabolic syndrome, and even diabetes to frequent intake of diet soft drinks.  Keep in mind, though, that all studies in all areas of health care are subject to scrutiny and critique.    Regardless of the topic, there are always two—or more—sides.  But here it may have been discovered that fooling the body is the instigator behind the concern.

When the body is told that something sweet has been ingested, it launches the production of insulin to carry the sweet to the cells to be burned for energy.  By the time the body finds out that there really is no sugar to be burned—in the form of glucose—the insulin has already been sent on its way to work.  Now the insulin has to find something to do, so it initiates a signal that says, “Feed me.  I need to carry glucose.”  That arouses hunger.  What do we grab for immediate satisfaction?  Carbohydrates, the simpler, the better.  Most of them spike glucose rapidly, which, if it fails to get burned for energy, is stored as fat.  It now appears that a lack of exercise becomes part of the equation.

There’s another tack to look at.  Some artificial sweeteners are alleged to block the brain’s production of serotonin, the neurotransmitter that controls mood, learning, sleep, and…appetite.  When the body experiences low levels of serotonin—and that can affect depressed mood—it seeks foods that can bring the levels back up.   Those foods happen to be the ones that will also bring the belt size up. Real sugar, of course, provides empty calories that can also cause weight gain as excessive energy intake.  But a weight conscious public does what it thinks is right.

Sweet taste enhances appetite.  Aspartame-sweetened water, for example, increased subjective hunger ratings when compared to glucose-sweetened water.  (Yang. 2010)  Other artificial sweeteners were associated with heightened motivation to eat, with more items selected on a food preference list. (Blundell. 1986)  This suggests that the calories in natural sweeteners trigger a response to keep overall energy intake constant, and that inconsistent coupling between sweet taste and actual caloric content can lead to compensatory overeating and consequential positive energy balance.  (This means that more energy came into the body than went out.)  People associate taste with calorie content.  You can tell that a crème brulee has more calories than the eggs from which it is made, but you’d probably eat more of it if made with artificial sweetener than with cane sugar.

Humans have a hedonic component.  We like those things that appeal to the senses and activate our food reward pathways.  That contributes to appetite increase.  But artificial sweeteners fail to provide completeness.  Unsweetening the American diet over the long haul, a little at a time, might just do the trick.  After all, it seems to work with salt.

References

MAIN ABSTRACT
Obesity (2008) 16(8), 1894–1900.
Fueling the Obesity Epidemic? Artificially Sweetened Beverage Use and Long-term Weight Gain Sharon P. Fowler, Ken Williams, Roy G. Resendez, Kelly J. Hunt, Helen P. Hazuda and Michael P. Stern

SUPPORTING ABSTRACTS
Diabetes Care. 2009 Apr;32(4):688-94. Epub 2009 Jan 16.
Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Nettleton JA, Lutsey PL, Wang Y, Lima JA, Michos ED, Jacobs DR Jr.
SourceDivision of Epidemiology, University of Texas Health Sciences Center, Houston, Texas, USA. [email protected]

Physiol Behav. 2010 Apr 26;100(1):55-62. Epub 2010 Jan 6.
High-intensity sweeteners and energy balance.
Swithers SE, Martin AA, Davidson TL.

SourceDepartment of Psychological Sciences, Purdue University, 703 Third Street, West Lafayette, IN 47907, United States. [email protected]

Yale J Biol Med. 2010 June; 83(2): 101–108.
Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings
Neuroscience 2010
Qing Yang

The Lancet, Volume 327, Issue 8489, 10 May 1986, Pages 1092-1093
PARADOXICAL EFFECTS OF AN INTENSE SWEETENER (ASPARTAME) ON APPETITE J. E. Blundell, A. J. Hill

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Spices Cut the Fat

Antioxident SpicesMany spices are known for their antioxidant potential, that is, they are able to prevent the breakdown of other substances by oxidation.  In this case, we are the other substance.  Eating a diet beautified with spices, such as cinnamon or turmeric, reduces the body’s negative response to eating high-fat meals.  Such dining experiences may have a cumulative toll in elevated triglyceride levels, a marker for increased risk of heart disease.

Penn State University researchers, under the guidance of Professor Sheila West, found that adding spices to a high-fat meal reduced triglyceride (TG) response by thirty percent, compared to a similar meal without spices.  The team was looking for influence on postprandial cardiac markers by adding, “…14 g of a high antioxidant spice blend to a 5060-kJ (1200 kcal) meal…” wondering how and if plasma antioxidant status and metabolism would be affected.  In a cross-over study, healthy overweight men were enlisted to eat either a control meal or a spiced meal.  They swapped diets after a week’s hiatus between testing sessions.  It was learned that, “The…oxygen radical absorbance capacity (ORAC) of plasma…was increased by spices,” and that, “The incorporation of spices into the diet may help normalize postprandial insulin and TG and enhance antioxidant defenses.”  (Skulas-Ray. 2011)

Just because this is welcome news doesn’t mean we should jog to the fast-food joint and fill up on burgers and fries, and then swallow half an ounce of cinnamon candies.  The detriments of high-fat meals are real and absolute.  There’s no way to escape them, but it appears they can be mollified.   And even then, we need to tread carefully.  Prior to this report from Penn State, the U of Maryland was performing its own work on high-fat meals, looking into the ameliorative effects of fruit and vegetable phytonutrients, learning ultimately that the outcomes are favorables if consumed regularly before eating a fatty meal.  This study, performed eight years earlier, concluded that daily use of a fruit/vegetable concentrate is able to reduce the immediate effects of a high-fat meal on the activity and function of blood vessels.  (Plotnick. 2003)  It added that taking a high dose of the antioxidant vitamins C and E immediately prior to a high-fat feast could blunt the effects, as well, although the scientists were more interested in the power of foods than in the power of supplements.

The danger of taking this good news to heart (no pun intended) is the accidental consumption of too many calories, which, themselves, are deleterious in high numbers.  The inner lining of blood vessels, the endothelium, is grossly insulted by a fat attack, and the response happens so fast that it can be documented a couple of hours after eating.  Blood vessels act abnormally after high-fat meals and fail to dilate in response to blood flow.  This activity is attributed to oxidation and the immediate accumulation of triglyceride-rich lipoproteins.  (Plotnick. 1997)

To the culinary purist, the general term, “seasonings,” might be more applicable, since spices come from the harder parts of a plant (seeds, roots, bark) and herbs come from the softer parts (leaves) and may be dried or fresh.  Spices are more common to the Eastern and tropical countries; spices to the whole planet.

Antioxidant herbs were given a hierarchical order in a study parallel to the one at Penn State, where curries (curry chicken), Italian herbs (bread), and cinnamon (biscuits) were used.  Superoxides are pro-oxidants that  need to be attenuated.  Herbs with such capability include, in descending order of efficacy, marjoram, rosemary, oregano, cumin, savory, basil, thyme, fennel, coriander, and ascorbic acid (vitamin C).  (Kim. 2011)    Though vitamin C is not exactly in the category, it is the frame of reference for antioxidant activity.

Since obesity is growing faster than your money market fund, you’ll still want to control calorie intake.  Control portions and balance the meals.  But if the occasion introduces high fat content, now you know how to handle it.

References

J Nutr. 2011 Aug;141(8):1451-7. Epub 2011 Jun 22.
A high antioxidant spice blend attenuates postprandial insulin and triglyceride responses and increases some plasma measures of antioxidant activity in healthy, overweight men.
Skulas-Ray AC, Kris-Etherton PM, Teeter DL, Chen CY, Vanden Heuvel JP, West SG.

J Am Coll Cardiol. 2003 May 21;41(10):1744-9.
Effect of supplemental phytonutrients on impairment of the flow-mediated brachial artery vasoactivity after a single high-fat meal.
Plotnick GD, Corretti MC, Vogel RA, Hesslink R Jr, Wise JA.

JAMA. 1997 Nov 26;278(20):1682-6.
Effect of antioxidant vitamins on the transient impairment of endothelium-dependent brachial artery vasoactivity following a single high-fat meal.
Plotnick GD, Corretti MC, Vogel RA.

Int J Mol Sci. 2011;12(6):4120-31. Epub 2011 Jun 21.
Antioxidant activities of hot water extracts from various spices.
Kim IS, Yang MR, Lee OH, Kang SN.

Crit Rev Food Sci Nutr. 2011 Jan;51(1):13-28.
Spices as functional foods.
Viuda-Martos M, Ruiz-Navajas Y, Fernández-López J, Pérez-Alvarez JA.

Before you eat that burger stop and think…
Just one high-fat meal can alter proper blood vessel functioning, according to a UM cardiologist

Dr. Gary Plotnick

Biological & Pharmaceutical Bulletin. Vol. 24 (2001) , No. 10 1202
DPPH (1,1-Diphenyl-2-Picrylhydrazyl) Radical Scavenging Activity of Flavonoids Obtained from Some Medicinal Plants
Masafumi OKAWA, Junei KINJO, Toshihiro NOHARA and Masateru ONO

Crit Rev Food Sci Nutr. 2010 Oct;50(9):822-34.
Cinnamon and health.
Gruenwald J, Freder J, Armbruester N.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Plate and Weight

portion controlPortion control and super-sized everything have taken their toll on the waists of the world, especially in the United States. In every town and city you’ll find an all-you-can-eat buffet within easy driving distance. If not that, how about a diner / restaurant that piles the food so high you can’t see the person across the table? The dining establishments may be feeding the frenzy, but it is the consumers who are getting out of control. And not just when eating out. Dinner plates are larger than ever, and, being good Americans, we feel obligated to empty them.

An article in the July, 2007, edition of the Journal of the American Dietetic Association defines at least one cause of the expanding American waistline:  overeating.  The indictment that, “…portion distortion begins as early as 3 years of age” is quite the slap.  Regardless of gender or hemisphere of residence, education or employment, portion size has the same impact.  “People tend to eat more from larger-sized restaurant portions (in the general range of 30% to 50% more) and they tend to serve themselves and eat more from larger-sized packages (in the general range of 20% to 40% more).”  It really is easy to “make room for more” when your plate is filled, when, all along, you’d have been satisfied with six ounces of spaghetti instead of the ten sitting in front of you.  All of us are unable to estimate the number of calories we’ve just eaten, and it gets harder to do as the pile of food gets taller and wider.   “…even registered nurses and dietitians—are inaccurate at estimating the calories from large portions.”  (Wansink. 2007)

Bigger is better when it comes to the size of the guardian angel that accompanies you through that dark alley downtown on your way home from the late shift.  Besides that, a pile of fifties is better when bigger.  When it comes to food, though, we need to be more aware of bigger.  Early in 2001, the Centers for Disease Control noticed that 61% of Americans are overweight, an increase from the 55% of only a few years earlier.  (Peregrin. 2001)  That can’t be blamed on the food industry, whose job is to sell food, not good nutrition.

Lots of us were taught by Mom to clean our plates.  That wasn’t too much of a concern when the dinner plate was 9 inches in diameter.  Somewhere along the line, though, it grew to ten inches, then to twelve, and, in some venues, fourteen.  We have a friend who bought a farmhouse built in the 1940’s—a real beauty, too.  When his wife tried to put the dinnerware into the built-in cabinets, the plates wouldn’t fit.  They were too big.  A little nosing around found that dinner plates were less than 9 inches in diameter back then.

Since we’re unlikely to change plates at home, we can settle for smaller servings.  But the psychological factor might make us feel deprived.  Using a 10-inch plate instead of a 12-incher will save between 100 and 500 calories a day.  A pound equates to about 3500 calories, so the  math is easy.  By swapping out plates, you can lose between 0.2 and 1.0 pounds a week.  Losing weight slowly gives you ample time to get accustomed to the new regimen…and you likely will not regain what you’ve lost.

Many Americans view eating out as a treat, meant to be a full, rewarding experience.  In a group, it’s difficult to spoil it for others by ordering an appetizer as an entrée.  On the other hand, many restaurateurs disagree, saying an appetizer is perfectly acceptable as a main meal.  Although you can’t order half a meal and expect to pay half the price, you can take it home.  With home cooked meals, in lieu of buying new dinnerware, try using a salad plate.  In a little while your appetite will shrink to fit the size of the dish… and so will your belt.

References

Journal of the American Dietetic Association. Vol 107, Is 7 , Pp 1103-1106, July 2007
Portion Size Me: Downsizing Our Consumption Norms
Brian Wansink, PhD, Koert van Ittersum, PhD

Journal of the American Dietetic Association. 101(6); Jun 2001: 620
A Super-sized Problem:  Restaurant Chains Piling on the Food
Tony Peregrin

Journal of the American Dietetic Association. 103(2); Feb 2003: 231-234
Expanding portion sizes in the US marketplace: Implications for nutrition counseling
Lisa R Young, PhD, RD and Marion Nestle, PhD, MPH

Arch Intern Med. 2007 Jun 25;167(12):1277-83.
Portion control plate for weight loss in obese patients with type 2 diabetes mellitus: a controlled clinical trial.
Pedersen SD, Kang J, Kline GA.

Plate Size Might Influence Weight Gain
MELISSA CONRAD STÖPPLER, MD
http://www.medicinenet.com/script/main/art.asp?articlekey=77662

Size of a Diet Plate
Ashley Jacob, RD
http://www.livestrong.com/ARTICLE/469270-SIZE-OF-A-DIET-PLATE/

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Calorie Restriction Extends Lifespan

calorie restrictionCalorie restriction (CR) in animals extends longevity by a considerable margin. Both primary and secondary aging processes are decelerated by limiting foods to those that are high in nutrients and relatively low in calories. Studies on humans are only now in progress, while those in animals have been unfolding for a few years. One of the boons of CR is a lowered core body temperature, which is that at which all physiological activity is most efficient. Not only this, but also fat reduction and consequent cardiac health can defer the foibles and imperfections of old age.

Studies at Washington University (St. Louis, MO) and the U. of California at San Francisco, sponsored in part by the Calorie Restriction Society, have found that” (calorie) restriction in animals seems to be the fountain of youth…” Studies on people may or may not yield the same results, primarily because free-living humans are not accepting of the same externally imposed restrictions as are endured by the animals. Human variables that need to be addressed include alterations in cognitions, behaviors, responses to stressors, and effects on other markers of health. However, humans have shown some of the same “…adaptations that are…involved in slowing primary aging in rats and mice.” Most notable here is a reduction in the inflammatory markers known as C-reactive protein and Tumor Necrosis Factor-alpha.

Primary aging is the gradual and inevitable process of physical deterioration that occurs throughout life.  You know, the aches and pains, the slowed movements, the loss of 20-20 vision, decreased resistance to infections, impaired hearing, and the rest of the baggage.  Secondary aging results from diseases and poor health practices (read lifestyle) that include smoking, torpor, booze and obesity, all of which can contribute to diseases in the first place.

Does CR work in people?  Yes, as long as it is reasonable…and that varies from person to person.  Decreasing calorie intake by only a few hundred can make a significant difference in health and longevity by reducing body fat, lowering blood pressure and cholesterol, and avoiding degenerative diseases, such as diabetes and heart disease.  Don’t forget about lowered body temperature, where the Washington University researchers learned that life expectancy was increased in animals. (Soare, 2011)  Of course, we can’t definitely tell how this affects people because we don’t know when each is programmed to die.  It is such, however, that family history of salubrious long life can be predictive of an individual’s longevity.

You might be interested to know that a nutritional supplement demonstrates an effect that mirrors calorie restriction.  We advise that you not yet jump for joy without the realization that this needs to be approached sensibly, which means being attentive to calorie intake. You can’t go wild on doughnuts, white flour bagels, ice cream and other culinary nonsense. You see, the mechanism behind calorie restriction’s success is not completely understood, but it is presumed that a protein called sirtuin is responsible for control of the aging process, and that CR directs the activity of sirtuin. Part of the aging procedure involves cellular stress, particularly in the mitochondria, the power plants of the cell that make energy. If we can slow down oxidation by ramping up the mitochondria’s defense mechanisms and simultaneously inhibiting the attack of reactive oxygen species, then we might be able to stave off the pangs of aging.  How do we do that without restriction of calories?  What supplement is held in such high regard? Resveratrol, the red wine polyphenol!

Independent of each other, Zoltan Ungvari (2009) and Thimmappa Anekonda (2006) discovered that resveratrol may have therapeutic value in the treatment of metabolic and neuronal diseases, based at least partially on the activity of sirtuin.  What is known about resveratrol’s mechanism of action is that it encourages the sirtuin homologue SIRT1 to ply its trade as a cellular regulator, where it slows down metabolism and any stimulatory reactions to environmental toxins, thus placing an organism into a defensive state so it can survive adverse circumstances.  Tobacco smoke-induced oxidative stress even becomes minimized.

We are individuals with different needs and responses to interventions, whether dietary or medical.  You will differ in your response to calorie restriction from your twin. You will differ in your response to resveratrol, if that is the route you choose.  But it seems more than likely you will experience a strengthened immune system, heightened energy, a healthier reproductive system, increased stamina…and looser trousers.

References

Exp Gerontol. 2007 Aug;42(8):709-12. Epub 2007 Mar 31.
Caloric restriction in humans.
Holloszy JO, Fontana L.

Toxicol Pathol. 2009;37(1):47-51. Epub 2008 Dec 15.
Caloric restriction and aging: studies in mice and monkeys.
Anderson RM, Shanmuganayagam D, Weindruch R.

Aging (Albany NY). 2011 Apr;3(4):374-9.
Long-term calorie restriction, but not endurance exercise, lowers core body temperature in humans.
Soare A, Cangemi R, Omodei D, Holloszy JO, Fontana L.

Free Radic Biol Med. 2011 Apr 22. [Epub ahead of print]
The controversial links among calorie restriction, SIRT1, and resveratrol.
Hu Y, Liu J, Wang J, Liu Q.

Am J Physiol Heart Circ Physiol. 2008 Jun;294(6):H2721-35. Epub 2008 Apr 18.
Vasoprotective effects of resveratrol and SIRT1: attenuation of cigarette smoke-induced oxidative stress and proinflammatory phenotypic alterations.
Csiszar A, Labinskyy N, Podlutsky A, Kaminski PM, Wolin MS, Zhang C, Mukhopadhyay P, Pacher P, Hu F, de Cabo R, Ballabh P, Ungvari Z.

Am J Physiol Heart Circ Physiol. 2009 Nov;297(5):H1876-81. Epub 2009 Sep 11.
Resveratrol attenuates mitochondrial oxidative stress in coronary arterial endothelial cells.
Ungvari Z, Labinskyy N, Mukhopadhyay P, Pinto JT, Bagi Z, Ballabh P, Zhang C, Pacher P, Csiszar A.

Brain Res Rev. 2006 Sep;52(2):316-26.
Resveratrol–a boon for treating Alzheimer’s disease?
Anekonda TS.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

MSG and Weight Gain

No MSGThe Body Mass Index (BMI) is a measure of the relative percentages of fat and muscle mass in the human body, based on a person’s weight and height, used to assess obesity. This barometer was used by researchers to determine the effect of the food additive, monosodium glutamate (MSG), on weight over a period of time. It was learned that those persons who consume MSG regularly experience changes in the part of the brain that controls appetite, thus having an influence on energy balance and consequent weight gain.

When researcher, Ka He, and his colleagues at the University of North Carolina began to look for a relationship between monosodium glutamate and weight gain, they hypothesized that it would be a positive one.  As a design element of the study, “…overweight was defined as a body mass index ≥ 25…based on World Health Organization recommendations for Asian populations.”  With an average MSG intake of 2.2 grams a day, and a five-year follow-up, the study population demonstrated that “MSG consumption was positively, longitudinally associated with overweight development…”

The better it tastes, the more we’ll eat.  That seems logical.  Most Americans eat so fast that their brains don’t have enough time to process the information that says they’re full.  Since that lag time is about twenty minutes, we should take at least that much time to eat.  But the school cafeteria, the incessant phone calls, the pressures of the job, and other lifestyle components disallow that.  Combine any of these facets of life with food additives that enhance flavor, and start looking for a longer belt.

Leptin is a hormone that plays an important role in energy intake and expenditure, and it tells us when to stop eating…if it works the right way.  It’s made by fat cells, oddly enough, but can also come from other parts of the body, such as the bones, stomach, and liver.  It acts on parts of the brain’s hypothalamus, where it inhibits appetite. If leptin is not appropriately received and taken up by the hypothalamus, appetite fails to shut off and food intake is uncontrolled.  Where does MSG fit into this picture?  It seems to be able to induce hypothalamic lesions and ensuing leptin resistance (He, et al. 2008).  The stage is now set for weight gain.

Glutamate is the major excitatory transmitter in the brain, meaning that it makes things happen, especially in cognition, memory and learning.  It also affects brain development, cellular survival and the manufacture of synapses.  Too much glutamate, though, can raise serious concerns because its excitatory nature becomes intensified by virtue of its accumulation, allowing excess calcium to enter a nerve cell and damage it beyond repair.  This is what happens in the hypothalamus.

Glutamate, sometimes as glutamic acid, is responsible for the tantalizing flavors of poultry, some fishes, and eggs, among other foods.  Its salt, MSG, was introduced to the United States after WW II as “Accent” flavor enhancer.  It can be made by the fermentation of beets, sugar cane, or molasses.  People began to experience adverse reactions to MSG after eating Chinese food prepared with it, thereby coining the expression “Chinese Restaurant Syndrome.”  Sensitivity to monosodium glutamate may present with headaches, asthmatic symptoms, hyperactivity (especially in children), and obesity.  Frequency of such responses is low, but if it happens in your family, it’s high enough to merit attention.

We all know that the world revolves around the dollar bill and the ball point pen, the latter often employed to guarantee the former.  As long as clandestine groups can get away with something, they’ll persist.  And so it is with MSG.  It has more disguises than Artemus Gordon and Sherlock Holmes combined.  Here are a couple handfuls of MSG aliases:  glutamic acid, monopotassium glutamate, magnesium, glutamate, monoammonium glutamate, yeast extract, hydrolyzed anything, calcium or sodium caseinate, yeast nutrient, gelatin, textured protein, soy protein isolate, soyprotein concentrate, whey protein, ajinomoto.

These ingredients often contain glutamic acid:  carrageenan, bouillon, stock, maltodextrin, barley malt, protease, malt extract, soy sauce, and any protein that is fortified or fermented.  Additionally, these work with MSG to further enhance flavor:  Disodium 5’-guanylate; Disodium 5’-inositate; and Disodium 5’-ribonucleotides.  Wherever these three abide, it’s almost guaranteed that MSG is a companion.

Individual amino acids are not generally listed on the ingredients labels of food or health care products.  Binders and fillers may or may not contain MSG.  Believe it or not, MSG may also appear in cosmetics, including shampoos, soaps and hair conditioners.  If the words “hydrolyzed,” “amino acids,” or “protein” appear on the label, MSG could be in it.  Live virus vaccines may also have it.  Even though reactions to MSG are dose-dependent, you could react to a very small amount all of a sudden, when you never did so before.  Yes, MSG is natural, but so is arsenic.  To most of us, MSG does not cause problems.  MSG might make you want to eat more.  It might affect the state of your hypothalamus.  On the other hand, it’s not likely to make you wash your hair more often.  Is it?

Referneces

Am J Clin Nutr. 2011 Jun;93(6):1328-36. Epub 2011 Apr 6.
Consumption of monosodium glutamate in relation to incidence of overweight in Chinese adults: China Health and Nutrition Survey (CHNS).
He K, Du S, Xun P, Sharma S, Wang H, Zhai F, Popkin B
Departments of Nutrition and Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Acta Physiol Hung. 2011 Jun;98(2):177-88.
Monosodium glutamate versus diet induced obesity in pregnant rats and their offspring.
Afifi MM, Abbas AM.
Department of Biochemistry, Zagazig University, Zagazig, Egypt.
Abstract

Am J Clin Nutr. 2011 Jun;93(6):1328-36. Epub 2011 Apr 6.
Consumption of monosodium glutamate in relation to incidence of overweight in Chinese adults: China Health and Nutrition Survey (CHNS).
He K, Du S, Xun P, Sharma S, Wang H, Zhai F, Popkin B.

Nutrition. 2005 Jun;21(6):749-55.
Monosodium glutamate in standard and high-fiber diets: metabolic syndrome and oxidative stress in rats.
Diniz YS, Faine LA, Galhardi CM, Rodrigues HG, Ebaid GX, Burneiko RC, Cicogna AC, Novelli EL.
Department of Clinical Cardiology, Faculty of Medicine, University of São Paulo State, Botucatu, Brazil.

Mol Pharmacol. 1989 Jul;36(1):106-12.
Delayed increase of Ca2+ influx elicited by glutamate: role in neuronal death.
Manev H, Favaron M, Guidotti A, Costa E.
Fidia-Georgetown Institute for the Neurosciences, Georgetown 4niversity, Washington, DC 20007.

Cell Calcium. 2003 Feb;33(2):69-81.
Calcium influx constitutes the ionic basis for the maintenance of glutamate-induced extended neuronal depolarization associated with hippocampal neuronal death.
Limbrick DD Jr, Sombati S, DeLorenzo RJ.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Blood Pressure And Body Fat

sphygmomanometerIf you’re in the upper part of your normal weight range or are outright overweight, you might want to do something about it, especially if you’re getting up there in age.  The relationship between being overweight and having high blood pressure is well-established.

The upper part of the normal blood pressure range can be a danger zone for heart attack and stroke.  Investigators at Kaiser Permanente, in Portland, Oregon, looked at almost 600 men and women who were ten to sixty-five percent above their ideal weight, and who had slightly elevated blood pressure.  All were given weight reduction counseling, and later were compared to a like-sized group who received no such guidance.  It was found that a ten-pound weight loss effected a drop in diastolic (bottom number) blood pressure by 2.7 mm of mercury, which doesn’t sound like a lot, but which is significant.  For those who dropped twenty pounds, diastolic pressure dropped by 7 mm of Hg.  During this 3-year study, those who managed to keep the weight off also managed to keep their blood pressure under control, as opposed to the control group.  “Clinically significant long-term reductions in blood pressure and reduced risk for hypertension can be achieved with even modest weight loss” is the conclusion.  (Stevens. 2001)

Though a decade old, the cited study is pertinent.  The dietary habits of Americans are paving a road to dereliction by creating serious health concerns that include obesity, diabetes, CVD, and hypertension.  For every pound of fat above your ideal weight, you might be adding miles of blood vessels.  Although fat doesn’t need the vasculature that muscle does, it needs to be fed nonetheless.  If you were to add another hundred feet to your garden hose, you’d notice the water dripping out the end instead of flowing with purpose.  Unless you have a pump, you’ll not likely increase water pressure.  Your heart, on the other hand, will notice a need for increased pressure to get blood to the other end of the line and will do just that—increase the pressure.  If this goes on for too long, it just might start giving you trouble.

The Dietary Approach to Stop Hypertension (DASH) has been deemed an effective management tool.  Lifestyle modifications and salt reduction, along with a diet filled with fruits and vegetables, nuts and seeds, eliminating / limiting saturated and trans-fats and empty calories, was found to be effective in reducing blood pressure by considerable margins.  Those with the highest blood pressure realized the greatest benefits.  (Kolaska.  1999)  Exercise alone can lower blood pressure, but it’s not going to happen until you do it.  Combined with a behavioral weight loss program, even a modicum of exercise will show an enhanced effect.  (Blumenthal.  2000)  Health of the entire cardiovascular system is at stake, and the rewarded decrease in ventricular mass and wall thickness should be motivation enough to get an overweight hypertensive guy movin’ and shakin’.  The improvements in peripheral vascular health are also measurable, and conditions such as peripheral arterial disease may be forestalled.  (Bacon.  2004)

The development of obesity causes significant changes inside the body, things you can’t see.  Extra blood vessel formation is one such change.  And the accumulation of fat around the middle and the accompanying elevation in blood pressure may change lifestyle in an unwanted direction.

References

Stevens VJ, Obarzanek E, Cook NR, Lee IM, Appel LJ, Smith West D, Milas NC, Mattfeldt-Beman M, Belden L, Bragg C, Millstone M, Raczynski J, Brewer A, Singh B, Cohen J;
Trials for the Hypertension Prevention Research Group.
Long-term weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, phase II.
Ann Intern Med. 2001 Jan 2;134(1):1-11.

Kolasa KM.
Dietary Approaches to Stop Hypertension (DASH) in clinical practice: a primary care experience.
Clin Cardiol. 1999 Jul;22(7 Suppl):III16-22.

Blumenthal JA, Sherwood A, Gullette EC, Babyak M, Waugh R, Georgiades A, et al
Exercise and weight loss reduce blood pressure in men and women with mild hypertension: effects on cardiovascular, metabolic, and hemodynamic functioning.
Arch Intern Med. 2000 Jul 10;160(13):1947-58.

Bacon SL, Sherwood A, Hinderliter A, Blumenthal JA
Effects of exercise, diet and weight loss on high blood pressure.
Sports Med. 2004;34(5):307-16.

Lijnen HR.
Angiogenesis and obesity
Cardiovasc Res (2008 May 1); 78 (2): 286-293.

Blumenthal JA, Babyak MA, Hinderliter A, Watkins LL, Craighead L, et al
Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study
Arch Intern Med. 2010 Jan 25;170(2):126-35.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Medium-Chain Triglycerides Effect Weight Loss

less-weightMedium-chain triglycerides (MCT) are a unique kind of dietary fat that lend a wide range of positive health benefits, weight loss among them. MCT’s have a fatty acid chain length that varies between six and twelve carbon atoms, which is only one characteristic that distinguishes them from the more familiar long-chain fatty acids, such as the highly-celebrated fish oil. MCT’s are transported through the blood by the portal system, which bypasses the usual route of digestion and sends them directly to the liver.

Medium-chain triglycerides do not require the modifications of long-chain and very-long-chain fatty acids.  Neither do they require bile salts for digestion.  These qualities enable them to be less susceptible to hormone-sensitive lipase and to deposition into adipose (fat) tissue storage.  A study from England’s Oxford Brookes University in 2010 announced that, because of their particular character, “MCT’s have been researched for both benefits to exercise performance and health.”  In the former application, MCT’s may be “a means to maximizing an athlete’s ability to maintain their glycogen stores so they can be more competitive.”  From the health angle, these substances “increase fat oxidation and energy expenditure as well as reduce food intake and beneficially alter body composition.”  (Clegg. 2010)

If you watch the lose-weight ads on TV, you might be driven to buy one of the untested, unproven, and maybe even unsafe products that promise the physique of champions.  Read the small print to learn that exercise and diet are part of the program, and your dreams of Roman god-hood (or goddess) are shattered.  Back to the chips and dip, right?  There might be something that’s been tested, and found to be safe and effective for at least a little drop in weight.

Because MCT’s don’t need energy for absorption, utilization or storage, they’ve been used to treat malabsorption conditions.  But weight management has evoked more interest.  The milks from humans, dogs, and guinea pigs contain mostly long-chain fats.  Those from goats, cows, and sheep are primarily short-chain.  Horse milk has lots of medium-chain fatty acids.  Data suggest that the milk of all species depends on a partial resynthesis of pre-formed glycerides. (Breckenridge. 1967)  (Since horses run faster than cows, their milk is hard to bottle, and because they have only two spigots, it takes longer to get it.)

Decades ago, MCT’s had been studied for body fat management in obese persons without diabetes, but more recent work has focused on those with Type 2 diabetes.  The findings showed that a diet containing MCT’s at 18 grams a day (about 2/3 ounce) brought about a reduction in body weight and waist circumference, a decrease in insulin resistance, and a drop in serum cholesterol concentration.  (Han. 2007)  Compared to the subjects ingesting long-chain fatty acids, the results are significant.  The MCT users also enjoyed increased dietary satiety, meaning that they felt full sooner, so they ate less.  Still another welcome benefit was realized by a cohort in 2009, when Chinese investigators noted a significant decline in serum triglycerides and LDL-cholesterol, both markers for cardiovascular complications, in those ingesting 25-30 grams (there are 28 grams in an ounce) of MCT’s a day. (Zhang. 2009).  (Xue. 2009)

The fast rate of oxidation of medium-chain fatty acids leads to greater energy expenditure—almost without doing any hard work.  It’s impressive that such can be the case, especially where weight gain is reduced and the size of body fat deposits diminishes.  Note that fat cells are not normally lost once they appear; they merely shrink in size.  They are, however, prepared to expand again at the drop of a hat.  (Xue. 2009)

Since the 1960’s MCT’s have been advocated for use in weight control.  Back then the research entailed other factors as well, including  the balance of energy intake, the nature of the diet, the ratio of MCT to LCT (long-chain triglycerides), and duration of the protocol.  Nonetheless, the presence of MCT’s as part of the regimen made a difference.  Although the exact mechanism hasn’t been fingered, MCT’s are able to increase energy outgo, hasten satiety at the table, and facilitate weight control when consumed as a replacement for fats containing LCT’s.  ( St-Onge. 2002)  Increased heat production, known as thermogenesis, is one of the activities by which MCT’s burn fat. (Baba. 1982)

Palm oil and coconut oil are major food sources of medium-chain fats.  The fact that these are saturated fats means little because all sat fats are not created equal, displaying differing cholesterolemic effects.  Therefore, when you see them listed on an ingredient label, have no fear.  The less weight you need to lose, the faster you will see results, so it’ll pay to get started now. (St-Onge. 2003)

References

MAIN ABSTRACT
Clegg ME.
Medium-chain triglycerides are advantageous in promoting weight loss although not beneficial to exercise performance.
Int J Food Sci Nutr. 2010 Nov;61(7):653-79.

SUPPORTING ABSTRACTS
W. C. Breckenridge and A. Kuksis
Molecular weight distributions of milk fat triglycerides from seven species
The Journal of Lipid Research. September 1967 (8): 473-478.

Han JR, Deng B, Sun J, Chen CG, Corkey BE, Kirkland JL, Ma J, Guo W.
Effects of dietary medium-chain triglyceride on weight loss and insulin sensitivity in a group of moderately overweight free-living type 2 diabetic Chinese subjects.
Metabolism. 2007 Jul;56(7):985-91.

Zhang YH, Liu YH, Zheng ZX, Wang J, Zhang Y, Zhang RX, Yu XM, Jing HJ, Xue CY, Wu J.
[Medium- and long-chain fatty acid triacylglycerol reduce body fat and serum triglyceride in overweight and hypertriglyceridemic subjects].    [Article in Chinese]
Zhonghua Yu Fang Yi Xue Za Zhi. 2009 Sep;43(9):765-71.

Xue C, Liu Y, Wang J, Zhang R, Zhang Y, Zhang J, Zhang Y, Zheng Z, Yu X, Jing H, Nosaka N, Arai C, Kasai M, Aoyama T, Wu J.
Consumption of medium- and long-chain triacylglycerols decreases body fat and blood triglyceride in Chinese hypertriglyceridemic subjects.
Eur J Clin Nutr. 2009 Jul;63(7):879-86.

Marie-Pierre St-Onge and Peter J. H. Jones
Physiological Effects of Medium-Chain Triglycerides: Potential Agents in the Prevention of Obesity1
J. Nutr. March 1, 2002; 132(3): 329-332

Baba N, Bracco EF, Hashim SA.
Enhanced thermogenesis and diminished deposition of fat in response to overfeeding with diet containing medium chain triglyceride
Am J Clin Nutr. 1982 Apr;35(4):678-82.

St-Onge MP, Jones PJ.
Greater rise in fat oxidation with medium-chain triglyceride consumption relative to long-chain triglyceride is associated with lower initial body weight and greater loss of subcutaneous adipose tissue.
Int J Obes Relat Metab Disord. 2003 Dec;27(12):1565-71.

Clegg ME.
Int J Food Sci Nutr. 2010 Nov;61(7):653-79.
Medium-chain triglycerides are advantageous in promoting weight loss although not beneficial to exercise performance

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Diabetes Prevention: Can We Stop Type 2 Before It Starts?

weigh-inPredictions for an increase in diabetes are dreadful. One in three children born in the United States in the year 2000 are apt to become diabetic unless they change the way they eat and start to move more. The implications of this epidemic are frightening because blindness, amputations, kidney failure and heart disease are in their futures. From the mid 60’s to the mid 90’s, the number of diagnosed diabetes cases has tripled. The type 2 diabetes that appeared at age forty is now showing up at age twelve. Almost all of those kids are overweight.

The Department of Health and Exercise Science at Wake Forest University, in North Carolina, recently concluded a study of the Diabetes Prevention Program that focused on lifestyle influence on type 2 diabetes, and found that overweight and lack of exercise are still principal causes of the disease.  The study included more than three hundred volunteers with body mass indexes (BMI) between 25 and 40, some of whom served as controls, while the others received a diabetes education program that included dietary interventions.  By now, you already figured that the intervention group experienced significantly greater decrease in glucose, insulin, and insulin resistance.  Not only that, but also they lowered their BMI’s and lost about an inch from their waistlines.  (Katula. 2011)  Getting rid of that gut makes a ton of difference.  (Pun intended.)  Parallel studies at Indiana University Medical School yielded similar results, with the additional benefits of improved blood pressure and total cholesterol levels.  (Ackerman. 2011)

In type 1 diabetes, where insulin is required, science is trying to prevent the loss of beta cells, the ones in the pancreas that make insulin.  Examining genetic susceptibility to disease is one step in the process.  Family history is part of that.  Up to now, there are no known pre-diagnosis steps that can be taken to prevent the onset of type 1.  On the other hand, there are several possibilities for helping to save beta cells shortly after a diagnosis of diabetes.  (Wherrett. 2011)  Assiduous effort is put into this area, with the expectation that some factors known to trigger autoimmunity and the eventual destruction of beta cells can be controlled.  Early trials offer promise, but have not yet reached fruition.  (Thrower.  2009)

The list of diabetic complications is long and fearsome:  coronary artery disease, cerebrovascular disease, peripheral vascular disease, retinopathy, and neuropathy, to name a few.  Researchers are looking closely at plants that can offset the costs and side effects of pharmaceuticals, and even obviate their use, but admonish us that diet and lifestyle still need to be reined in.  (Haque. 2011)  Because soy foods are integral to Asian cuisine, it seems appropriate to look for components of soy chemistry that might affect blood glucose.  The soy phytoestrogen, genistein, was reported to protect against glucose-induce pancreas cell death in a study done in China.  (Zhong. 2011)  The applicability of this finding to either type 2 or type 1 diabetes, or both, is yet to be determined, but the prospects have merit.

Patients already diagnosed with type 2, or those who feel themselves candidates, may be comforted to know that alpha lipoic acid, a sulfur compound found in organ meats, spinach and broccoli, and also available as a supplement, prevents a rise in diabetes markers while improving the efficiency of glucose metabolism.  In German studies it was found that administration of alpha lipoic acid for ten days, either orally or intravenously, improves insulin sensitivity in both lean and obese individuals.  (Konrad. 1999)  (Jacob. 1999)  It would be imprudent, though, to expect supplemental alpha lipoic acid to do something we wouldn’t do for ourselves, such as lose weight and exercise.

Dietary fiber gets lots of attention, and is mostly associated with digestive health.  The soluble type is fermented in the gut and makes some physiologically active byproducts.  The insoluble type is comparatively inert and absorbs water to make elimination an efficient process.  Legumes, some cereals and fruits, psyllium, and tuberous vegetables provide soluble fiber.  Wheat and corn bran, whole grains, and nuts and seeds are sources of insoluble fiber.  Psyllium has received considerable interest as an ingredient in high-fiber breakfast cereals, where it’s been reputed to lower cholesterol and to reduce blood glucose response to a meal.  More than one study has reported psyllium to be effective for both.  As little as 5 grams of psyllium taken either with, or just before, a meal has effected improvement in lipid and glycemic control.  At the University of Virginia Diabetes Center, scientists noted a 14% reduction in postprandial glucose at breakfast, and a 20% reduction at dinner, compared to placebo, in people diagnosed with non-insulin-dependent type 2 diabetes.  (Pastors. 1991)  Analyses in Mexico and Texas arrived at the same conclusion, but recorded a pronounced positive effect on total cholesterol, LDL cholesterol and triglyceride levels.  (Rodriguez-Moran. 1998)  (Lee. 1994)

The United States is not alone in the quest to control the diabetes epidemic by recommending lifestyle changes.  The Japanese saw a risk reduction of more than 67% through weight loss, and the Finns realized risk reduction by controlling total and saturated fats and increasing dietary fiber, as well.  (Kosaka. 2005)  (Lindstron.  2006).   Globally, children do not eat enough vegetables.  Those who do, often limit their repertoire to only a few.  French fries don’t count.   What they are missing is magnesium, the prophylactic mineral that is able to improve glucose and insulin balance, especially in obesity.  (Song. 2004)  (Huerta. 2005)  (Lopez-Ridaura. 2004) This mineral is loaded with properties that boost health. The prevention of diabetes is as simple as exercising, losing a few pounds, getting ample fiber, and eating magnesium-rich produce.  Here, an ounce of prevention really is worth a few pounds of cure, not to mention getting stuck with a needle.

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