Archive for July, 2005

Fructose and Obesity

Yahoo! News today featured an article about research published in the July issue of the Journal of Obesity Research – Fructose Sweetener Spurs Obesity. Unlike previous studies that focused on high-fructose corn syrup, this study, conducted in mice, suggests that one form of natural sweetener — fructose — may be especially likely to encourage weight gain.

In the study, researchers at the University of Cincinnati allowed mice to freely consume either plain water or fructose-sweetened water and soft drinks. The mice that drank the fructose-sweetened water and soft drinks gained weight, even though they took in fewer calories from solid food. By the end of the study, the mice that consumed fructose-sweetened beverages had 90 percent more body fat than the mice that consumed water only.

One particular aspect of this study is noteworthy – the mice that consumed the fructose actually ate less calories than the water consuming mice and were still fatter! The findings suggest that the total amount of calories consumed when someone includes fructose in their diets may not be the only cause of weight gain. Consuming fructose may actually affect metabolism in a way that leads to more fat storage.

“Our study shows how fat mass increases as a direct consequence of soft drink consumption,” study author Dr. Matthias Tschop, associate professor in the University of Cincinnati’s psychiatry department and a member of the Obesity Research Center at the university’s Genome Research Institute, said in a prepared statement.

“We were surprised to see that mice actually ate less when exposed to fructose-sweetened beverages, and therefore didn’t consume more overall calories. Nevertheless, they gained significantly more body fat within a few weeks,” Tschop said.

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July 29, 2005 at 5:10 pm 1 comment

Long-Term Evidence CCARBS Study

Low-carb diets are criticized for a lack of long-term evidence that shows such a dietary approach not only enables one to maintain weight loss, but also poses no long-term risks to overall health. Albert Einstein College of Medicine of Yeshiva University currently is investigating the long-term effects of controlled-carb diets in a study called CCARBS (The Controlled Carbohydrate Assessment Registry Bank Study).

In a press release about the study it was said that CCARBS will address many of the ongoing and long-term questions posed by the growing role of controlled carbohydrate weight-loss diets in obesity and obesity-related disease management. The study will also function as a unique source of ongoing data for qualified investigators and journalists seeking to answer specific hypotheses and questions. CCARBS is the first database to provide an accurate assessment of the controlled carbohydrate lifestyle population in the United States.

The purpose of CCARBS is to establish an Internet-based epidemiological cohort of dieters who are using or have used controlled carbohydrate diets. With the data we collect we plan to identify key lifestyle patterns associated with using controlled carbohydrate diets and predictors of success with using them. We will also be looking at the effect of controlled carbohydrate diets on cholesterol levels and other blood lipids in a subset of CCARBS participants and compare them to age and gender-matched people who use low-fat diets for weight control.

The eligibility criteria for becoming a participant in the CCARB study is:

  • To have been on a controlled carbohydrate diet for at least two months within the past two years
  • To be 18 years or older
  • To be willing to answer questionnaires online for three years (at baseline, three months and then annually for three years)

If you’d like to learn more about participating in this landmark study, please visit their website at http://epi.aecom.yu.edu/ccarbs

July 29, 2005 at 2:00 pm 3 comments

What is the "Planned Splurge" Anyway?

It isn’t often that I find myself concerned with the ideas promoted by other low-carb and controlled-carb advocates. We run the spectrum of ideas from very low-carb approaches like Atkins to moderate levels of carbohydrate recommended by the Zone (40% of calories) to even Paleo approaches that eliminate the most recent additions to our diet, namely grains, dairy and other agricultural additions not found in the wild. Each approach has merit and supporting evidence is within the available literature.

Most even agree that occassionally enjoying something considered “decadent” (something typically not eaten) is within reason – often dubbed the “planned splurge” done now and then as a “treat.” It’s a little gift your give yourself now and then.

This concept though has been taken to a whole new level by my fellow blogger, Jimmy Moore, who writes the blog Livin’ La Vida Low-Carb. He’s written a number of articles that highlight how the “planned splurge” has helped him stay on track and maintain his 180-pound weight loss – which to be fair, not only his weight-loss but his ability to maintain his weight-loss deserves accolades and heartfelt congratulations.

That said, however, he recently, included the details of his vacation which included a “planned splurge” – a meal that, are you ready – consisted of 30-slices of pizza, 6-glasses of diet soda and 15-cinnamon sticks at Pizza Hut. I kid you not. While planned splurges have helped a lot of people maintain a controlled-carb approach, but the question begs, is the concept of the splurge really an all-out-anything-goes-eat-yourself-silly meal?

As I posted in the comments on his blog, the meal he ate as his “splurg” totaled:

  • Calories 7450
  • Total Fat 265g
  • Saturated Fat 140g
  • Cholesterol 750mg
  • Sodium 17620mg
  • Carbohydrates 945g
  • Dietary Fiber 60g
  • Sugars 200g (more than 1-cup of sugar)
  • Protein 350g

I can’t even begin to imagine the strain on his pancreas, liver, kidneys and entire system to digest that meal. My entry today really isn’t to rail on Jimmy, but is to ask, what is a “planned splurge” anyway?

From my perspective and what I generally recommend is taking an approach that provides something that you really like, and while it may not really be all that “healthy” you still make an effort to ensure it’s as healthy as possible.

Afterall, it is still your body and what you choose can have consequences if you’re careless.

For example, if you choose to eat something loaded with man-made trans-fats, you’re going to have systemic consequences not only in the short-term of the hours following the splurge, but for months – yes months – after as your body rids its cells of the trans-fatty acids it has incorporated into your tissues. When you eat trans-fats the body requires 51 days to metabolize half of them. This means that half of the trans fats you eat today will still be inhibiting essential enzyme systems in your body 51 days from now. (Schmitt, Walter H., Jr. Compiled notes on clinical nutritional products. Mahopac, NY: David Barmore Productions, 1990) Trans fats interfere with important, normal functions by inhibiting enzymes which are necessary for the body’s normal metabolism of fats and they keep doing it for a long time.

So how do you really enjoy a splurge and still take care of your body?

Quite simply, you go for quality.

I’ve previously written about my fondness for brownies. Now I could easily hop over to the grocery store and pick up some decent tasting brownies and be done with it. But, as I’ve previously written, cheap food now costs later in terms of health and healthcare costs. So, rather than risk my health for a short-term indulgence with a cheap commercial brownie, I’ll take the time to make brownies that taste a heck-of-a-lot-better and have some redeeming value for nutrient-density too!

I’ll have one good size serving and no more. I’ll do this perhaps once every couple of months and no more. It’s not only satisfying but does have the appeal of “getting away with something” that may not be all that healthy. One important thing I keep in mind though – my long-term health is more important that short-term satisfaction. With that in mind, here’s my guide to planned splurges:

  • If at all possible, make whatever it is you plan to eat yourself, using real, whole ingredients
  • Limit the whole idea of the “planned spluge” to very special occassions or the occassional treat once every couple of months
  • If any particular food triggers cravings or over-eating following the splurge – well, I hate to be the one to break it to you, that food can’t be a splurge in the future. Your long-term well-being, both physical and emotional, is more important than that food
  • Go for quality – nothing less than the absolute best ingredients – if you’re going to have an indulgence make it worth it for goodness sakes
  • Take care to still avoid trans-fats, refined grains, highly processed foods or damaged fats – there is nothing redeeming in any of these and nothing you cannot make on your own with better ingredients
  • A splurge isn’t a license to gorge but rather to enjoy a simple pleasure in life – an occassional treat you don’t normally eat day in day out
  • Lastly, enjoy your spluge without guilt knowing you’ll be back to your normal eating pattern again – an indulgence really is just an occassional pleasure you give yourself – a gift of taste, quality and enjoyment meant to be savored in the moment; not something to regret later!

July 28, 2005 at 4:56 pm 5 comments

Death by Inflammation

HealthSentinal reported yesterday about Newsweek’s Summer 2005 Special Edition article highlighting the detriments of chronic low-level inflammation on health and well-being.

Years ago oxidation was being considered as the main culprit in many diseases. Now oxidation is grabbing more of the attention. According to neuroscientist James Joseph of Tufts University, “Inflammation is the evil twin of oxidation. Where you find one, you find the other.” This discovery is solving “medical puzzles” such as [why] people with high blood pressure have an increased risk for Alzheimer’s or why people with rheumatoid arthritis have higher rates of sudden cardiac death. All these conditions are tied with a connecting thread of inflammation.

Many view inflammation as a “problem” to be “fixed” in the body. Often the “fix” is a pharmaceutical to reduce the inflammation. This is simply masking the problem and is not eliminating the cause of the inflammation. To restore health, the cause of the inflammation must be addressed.

To understand how chronic inflammation wrecks havoc in the body, we must understand what is causing the inflammation. This means understanding the protective function of inflammation and then looking at what the immune system is trying desperately to protect itself from when inflammation is low level and chronic in the body and not caused by an obvious injury or infection. From this perspective, inflammation is now a “red flag” to alert us of an underlying assult on the body that must be addressed, not masked since “band-aid” remedies are not solving the underlying cause of the inflammation.

Inflammation is always due to an injury or infection of some sort. For example, if you bang your finger while hammering a nail, the body’s response is inflammation to the injury – resulting in pain, swelling, redness, warmth and often a temporary loss of funtion of the finger. This response is protective to allow for healing time by the immune system and protecting the injured finger from further injury while healing.

Low-level inflammation – the kind you often do not visibly see or feel – is caused by similar assults on the body that are just less obvious. This inflammation is still an immune response by the body trying to protect itself and heal. Over time, if the root cause of the inflammation is not eliminated, the inflammation remains and is then chronic, which causes progressive damage to the affected organ systems. This type of inflammation is systemic and deadly!

Chronic low-level inflammation is associated with:

  • Obesity
  • Diabetes
  • Heart Disease
  • Rheumatoid Arthritis
  • Asthma
  • IBS
  • Allergies
  • Atherosclerosis
  • High Blood Pressure
  • Insulin Resistance/Metabolic Syndrome
  • PCOs
  • Cancer
  • Alzheimer’s Disease
  • Fibromyalgia
  • Kidney failure
  • Lupus
  • Stroke
  • Pancreatitis
  • Psoriasis
  • Surgical Complications

As Life Extention Magazine noted, [a] critical inflammatory marker is C-reactive protein. This marker indicates an increased risk for destabilized atherosclerotic plaque and abnormal arterial clotting. When arterial plaque becomes destabilized, it can burst open and block the flow of blood through a coronary artery, resulting in an acute heart attack. One of the New England Journal of Medicine studies showed that people with high levels of C-reactive protein were almost three times as likely to die from a heart attack (Ridker et al. 1997).

C-Reactive Protein is one marker – but what is the cause?

There are a number of things that are found in the literature, and not surprisingly, all but two are associated with our dietary habits:

  • Advanced Glycation End (AGE) products, are formed when food is cooked at high temperatures. AGE’s are toxins in the body and some are now calling them “glycotoxins”. According to a Proceedings of the National Academy of Sciences study, consuming foods cooked at high temperature accelerates the glycation process, and the subsequent formation of advanced glycation end products. When you eat foods with AGE’s your body responds with inflammation to try to protect itself.
  • Sleep Deprivation. In 2002, researchers at the annual meeting of the Endocrine Society held in San Francisco reported that sleep deprivation markedly increases inflammatory cytokines. Getting a good night sleep allows your body time to build and repair tissue – a process that is inhibited during waking hours.
  • Damaged Fats. Oil starts to degrade upon heating and over a relatively short period of time, within 30-minutes, 4-hydroxy-trans-2-nonenal (HNE) begins to reach critical levels. HNE’s are toxic in the human body.
  • Trans-Fatty Acids. Man-made trans-fats are disruptive in the body since they are not natural and the body does not know what to do with them.
  • High Blood Sugars and/or Insulin Levels. It is well documented that high blood sugar and/or insulin levels produce inflammation in the body. Quite frankly, our bodies are simply not designed to handle the excessive amount of sugars we eat daily. Prolonged elevated insulin levels disrupt cellular metabolism and spread inflammation.
  • Nutrient Deficiency from any number of vitamins, minerals and elements along with essential fatty acids (specifically omega-3) and essential amino acids. When your body does not have all the ingredients it needs for health, it makes do with what it has for survival and makes compromises. In that compromise process, it also works to protect itself and inflammation is one result of a nutrient-poor diet.
  • Stress, an often over-looked component in chronic inflammation. When you are stressed, your body releases a number of hormones and chemicals to try to counteract the affects of the stress. Chronic stress means constant elevated levels of stress hormones and inflammation. Relaxation, meditation, exercise and simple general activity all help to reduce stress and thus reduce stress hormones in the body.

If you look carefully at the above list, every last item you control. You choose what you eat, how you cook your food, how much sleep you allow yourself each night and even if you proactively seek to relax and help yourself relieve stress.

While there may be instances where pharmaceutical intervention may help in the short-term – you must look at the long-term and work to eliminate what is causing the inflammation in the first place! By modifying your diet to be nutrient-dense, being careful with your cooking methods, choosing carbohydrates carefully, getting enough sleep and relaxing, you can make a difference in your health.

July 28, 2005 at 4:15 pm 4 comments

<!–strtcv–>Low-Fat Diet = Lower Testosterone in Men<!–stptcv–>

Can it be true that eating a low-fat, high-fiber diet decreases testosterone in men?

Researchers at University of California-Los Angeles investigated the effects of a low-fat, high-fiber diet on 39 middle-aged, white, healthy men (50-60 yr of age). At the start they consumed their usual high-fat, low-fiber diet and then an 8-week modulation to an isocaloric low-fat, high-fiber diet.

The details of the findings on the high-fiber, low-fat diet includes:

  • Mean body weight decreased by 1 kg, whereas total caloric intake, energy expenditure, and activity index were not changed
  • Mean serum testosterone (T) concentration fell (P
  • Small but significant decreases in serum free T (P = 0.0045)
  • Small but significant decrease in 5 alpha-dihydrotestosterone (P = 0.0053)
  • Small but significant decrease in adrenal androgens (androstendione, P = 0.0135; dehydroepiandrosterone sulfate, P = 0.0011)
  • Serum estradiol and SHBG showed smaller decreases
  • Parallel decreases in urinary excretion of some testicular and adrenal androgens were demonstrated
  • Metabolic clearance rates of T were not changed
  • Production rates for T showed a downward trend while on low-fat diet modulation

The researchers overall conclusion was clear: We conclude that reduction in dietary fat intake (and increase in fiber) results in 12% consistent lowering of circulating androgen levels without changing the clearance.

Testosterone levels reach a peak during a man’s twenties. Aging and lifestyle factors such as stress, improper diet, physical inactivity, smoking, drinking and the use of prescription medications can significantly reduce these levels.

Low levels of testosterone can result in:

  • sexual dysfunction
  • depression
  • fatigue
  • lack of energy
  • irritability and mood swings
  • loss of strength or muscle mass
  • increased body fat
  • hot flashes

Currently, the more subtle symptoms of low testosterone are commonly attributed to stress or the natural process of aging.

The evidence shows that a low-fat diet can lower testosterone in men. Following a good diet strategy is important not only for health reasons, but also for vitality. The IAS Bulletin recently included recommendations for a good diet strategy:

  • Eat moderate amounts of protein
    “Protein” in Latin means “above all else.” Adequate protein is a dietary necessity as it stimulates testosterone release – it’s also the fundamental building block for muscle repair and growth.
  • Eat more vegetables
    Especially green, leafy and cruciferous vegetables such as broccoli, cauliflower, kale, Swiss chard, Brussels sprouts, green leafy lettuce and cabbage. These vegetables contain phytochemicals essential for healthy metabolism of estrogen.
  • Limit your intake of refined, high-carbohydrate foods
    These include simple sugars such as cookies, candy and ice cream; and starches such as breads, potatoes and pasta. Excess intake of these carbohydrates raise blood sugar rapidly, creating chronically elevated levels of the hormones insulin and cortisol. These two hormones oppose the action of testosterone and diminish its production.
  • Eat healthy fats
    Essential fats such as the Omega 3 fatty acids (found in fish and flaxseed) and saturated fats are essential for normal testosterone production. All steroid hormones are produced from cholesterol and when fats are deficient in the diet, this process will be inhibited. Studies clearly indicate that low fat diets result in lower testosterone levels. Those higher in protein, lower in carbohydrate, and moderate in fat cause the greatest sustained levels of testosterone.
  • Take a high-quality, multi-vitamin mineral supplement
    Vitamins A, E, C and B6 and zinc are all used by the body in converting prohormones to testosterone. In fact, of all the minerals found in the body, zinc is the most crucial for testosterone production. Zinc deficiency is very common in the U.S. population, especially among athletes and the aged. Not only is zinc absent in most commercially-processed foods, it can be depleted from the body by alcohol and many prescription medications including diuretics.

July 28, 2005 at 2:40 pm 3 comments

<!–strtcv–>A Question of Government Surveillance<!–stptcv–>

In September, the New York City Board of Health may vote on a proposal to require city labs to report results of A1c blood tests to track blood sugar control of diabetics. As CNN reported, this type of surveillance by the governement is raising a number of questions.

A century after New York became the first American city to track people with infectious diseases as a way to halt epidemics, officials here propose a similar system to monitor people with diabetes, a non-contagious foe.

“There will be some people who will say, ‘What business of the government is it to know that my diabetes is not in control?”‘ said Dr. Thomas R. Frieden, the city’s health commissioner.
The answer, he said, is that diabetes costs an estimated $5 billion a year to treat in New York and was the fourth leading cause of death in the city in 2003, killing 1,891.

The proposed system requires no consent from the patient, which begs the question, does the government have the right to your medical records without your consent?

There are those who argue, as Dr. Frieden does above, that in the interest of containing costs the government must intervene. Also included in the arguements for surveillance that are supported by the American Diabetes Association:

  • it would allow doctors better access to medical information especially among patients who frequently switch doctors
  • it would allow the city Department of Health or individual physicians to follow up with patients who miss appointments
  • it would save the city millions by preventing complications of the disease

Over time, doctors could receive letters, telling them whether their patients have been getting adequate care. People who skip checkups might get a note from their doctors, reminding them of the dangers of untreated diabetes.

First of all, I highly doubt doctors are going to appreciate letters in the mail suggesting their patients are not receiving adequate care. What exactly is going to happen to a doctor who has too many patients who are not controlling their blood sugars well enough? Will the city revoke their license? Will they be criminally negligent?

Before this type of plan can be even considered, one must know the consequences of non-compliance of a patient for the doctor treating them. Let’s not forget that doctors cannot make a patient follow a treatment plan. Ethically they are bound to communiate to the patient the effects of the disease, the treatment available and do their best to motivate the patient to move forward with treatment to control the disease. They cannot, however, make a patient follow a treatment plan. And, taking that to the next step, a letter to the lax patient? Does the city think that doctors are not already aggressively communicating the importance of blood sugar control to diabetics? Do they really think pestering a diabetic to control their blood sugars is going to be effective?

What is to become of the lax patient who simply will not do what it takes to get their blood sugars under control? What exactly does the city have in mind for them? Does the city recognize the potential for such a plan to be counter-productive in that doctors may simply decide the risk to their practice is not worth accepting new diabetic patients in the future? What then?

Do patients have the right to refuse treatment, not comply with treatment plans and/or simply ignore their doctors’ advice?

Dr. Amy Fairchild, an expert on public health ethics at Columbia University, said disease monitoring programs have historically been able to overcome privacy worries if the health threat is sufficiently frightening.

“We respond with surveillance when we believe something has reached epidemic proportions,” Fairchild said. “And this may fit the profile. Have we become a nation of obese people who are all going to get diabetes?”

The program’s success, she said, may depend partly on how patients respond. “It’s not necessarily that someone has that information. It’s that they’re pestering you. ‘The next thing I know, you’ll be telling me what I can and can’t eat,”‘ she said.

Which brings me to my last concern about such a government surveillance program – what’s next?

Will the government decide to monitor what we eat? How much we weigh? What our cholesterol is? How often we engage in active exercise?

July 27, 2005 at 3:30 pm 3 comments

Splenda Ads Deceptive – New Zealand Advertising Standards Authority

The New Zealand Advertising Standards Authority (ASA) has upheld a complaint against Johnson & Johnson for misleading marketing practices in advertisements for the chlorinated artificial sweetener Splenda. “This complaint is on the basis that Splenda is being compared directly to sugar and misleading and confusing consumers into thinking it’s as natural as sugar because it’s ‘made from sugar and tastes like sugar,'” according to the upheld complaint.

The Authority’s Advertising Standards Complaints Board, made up of representatives from New Zealand’s advertising and marketing agencies, reviewed 15 second and 30 second versions of an ad for the artificial sweetener along with focus group input. The Board determined that the ad deceived consumers into thinking Splenda is all natural like sugar, when it is actually a chemical compound. “The (Splenda) advertisement…gave rise to a likelihood of a consumer being confused and mislead as a result of the comparison in the advertisement,” the Board decided. According to the ASA, when the Board upholds a complaint, they ask the company not to run the ad again. Read more…

July 27, 2005 at 2:15 pm 1 comment

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