Dec
19
2015

Beer Belly Bad News

You heard the expression “beer belly”, but now we learn “beer belly bad news”. It is an unflattering term for increased abdominal girth, especially in males. It is quite often that this picture is found in middle-aged men who consume more beer than what is good for them, but they may also mill around the hot dog stands at the ball game instead of being physically active. Any leftover calories are stored as belly fat, which protrudes their stomach as if they were pregnant.

There is a big difference between belly fat and body fat. Belly fat is metabolically much more active. Body fat is more sessile. So, it is the belly fat we need to do something about as this has been shown to be associated with heart attacks, strokes and diabetes.

 

Abdominal girth to hip ratio instead of BMI

Originally it was thought that excessive weight would best be measured with the body mass index (BMI). But subsequently it was shown that athletes with well-developed muscles could have BMI’s that were in the overweight (between 25.0 and 30.0) or even obese category (more than 30.0). Also, some people with heavy bones can have excessive BMI values despite them being normal based on other measurements. The new measurement is the old fashioned abdominal girth to hip ratio.

Weight gain leads to metabolic syndrome

You measure the abdominal girth, the hip girth and divide the abdominal girth by the hip girth. Normally this should be 80% (=0.8) or less for women and 90% (=0.9) or less for men. But a person with a beer belly will have ratios of 1.2 or 1.5.

If you take blood tests of that person you would also find elevated triglycerides, lowered HDL cholesterol (the protective cholesterol) and elevated LDL cholesterol (the bad cholesterol). In addition, we know from studies that often the insulin level is elevated in the sense of hyperinsulinism. In fact that person has often the metabolic syndrome, which is a characteristic change of the metabolism in an obese person. The blood is thicker with clotting factors floating around, there are inflammatory kinins that circulate and these factors work together on causing hardening of the arteries.

Why is a beer belly dangerous?

There are not only cardiovascular risk on the long-term causing heart attacks and strokes down the road. There is a danger of fat deposits in the liver, called fatty liver disease.

In time this can turn into liver cirrhosis and in some cases develop into liver cancer. Because belly fat causes inflammation in the system including in the lining of the blood vessels, this can in time also affect the immune system, weakening it and eventually allowing cancer to develop. Common cancers that are associated with obesity are breast cancer, ovarian cancer and uterine cancer in women, prostate cancer in men and pancreas and colon cancer in both sexes.

Estrogen from aromatase in beer bellies

In men beer bellies produce a lot of estrogen, the female hormone. This is so because fat tissue contains the enzyme aromatase that metabolizes male hormones into estrogen. Estrogen in men is only good in traces, but when the body produces it massively, it will counter testosterone production and will cause heart attacks and strokes.

What can you do about a beer belly?

We need to understand how beer bellies develop. One of the sources of fat from beer bellies is the consumption of foods that contain a lot of fructose. Food manufacturers have been diligent in mixing high fructose corn syrup into sugary drinks and into a myriad of processed foods.

Sugar itself can only be processed and stored until the glycogen stores in the liver and the muscles are filled. The liver metabolizes a surplus of sugar into triglycerides and LDL cholesterol. This is also the case for any fructose that comes from metabolized sucrose (table sugar) and from the high fructose corn syrup popular with the food processing industry. One problem is that fructose can only be processed by the liver, while glucose gets directly taken up by cells with the help of insulin.

German obesity wave after WWII in the 1960’s

The surplus of fructose metabolizes into triglycerides and LDL cholesterol before the body stores it as fat in fat cells. Unfortunately a lot of the fat will end up between your guts, in the liver as fatty liver and in the beer belly, a metabolically more active form of fat.

The sad part is that in the 1960’s I have seen the German economic wonder (“Wirtschaftswunder”) where many mid fifty to mid sixty business men died as a result of obesity and subsequent heart attacks and strokes. At that time Germans who were starving during World War II lived it up. This was in the late fifties and 1960’s. They ate whatever they could: cakes, fatty cheeses, whipped cream, fatty foods like pork roasts and beef.

Unhealthy hydrogenated fats, starchy food and sugar caused beer bellies

They also consumed loads of bread, buns, pasta and sugar. Margarine also became popular with its hydrogenated fatty acids that also contained free radicals. The end result was that they gained weight, did not exercise and developed their beer bellies.

In the 1980’s the school of thought was that saturated fatty acids  were responsible for heart attacks, strokes and obesity.  A low fat/high carb diet became popular and continued to steadily increase. Sure, the hydrogenated fatty acids did not help and should be cut out. But the bigger problem was the consumption of high fructose corn syrup and over-consumption of high glycemic-index carbohydrates.

Steps of how to get rid of the beer belly

Here is the solution of what to do get rid of the beer belly.

Eliminate sugar and high fructose from diet

Remove sugar and high fructose corn syrup from your diet.

Remove empty starches from your diet

The second effective step is to cut out as many empty starches that you can cut out like white rice, bread, sweets, cookies, cakes, ice cream and pasta. Starchy foods metabolize in the gut into sugar, which causes an insulin response. The extra insulin is responsible for developing inflammation in the arteries, which eventually leads to heart attacks and strokes.

Regular exercise

Exercise on a regular basis. This will produce HDL cholesterol, the protective cholesterol, which balances LDL cholesterol.

Rebalance your food intake

Perhaps the most important step is to rebalance your food intake. With this I mean that you replace high glycemic-index carbs with low glycemic-index carbs. This means you will eat a lot of salads, steamed vegetables, and fruit. This gives you a lot of extra fiber, which your system needs to slow down the rate of sugar absorption. It also  helps you to lower LDL cholesterol and detoxify your body in the gut where fiber binds toxins.

Moderate your alcohol intake

If you are heavily into alcoholic drinks, this is another source of refined carbohydrates. They metabolize into LDL cholesterol, triglycerides and can cause fatty liver disease and liver cirrhosis. A moderate consumption of alcohol (one drink for women per day and two drinks for men per day) lowers the risk of heart attacks and strokes, while excessive alcohol intake increases the risk.

Bioidentical hormone replacement

Bioidentical hormone replacement may be something you have not heard about. But if you are a woman above the age of 40 or a man above the age of 50 chances are that you need some hormone tests. As a male, your natural hormone production from your testicles or adrenal glands is likely not keeping up.  As a woman, your ovaries or adrenal glands are no longer keeping up with the demand of regular life. Part of the aging process is that the production of our sex hormones slows down. It does so shortly before menopause in women and shortly before andropause in men.

Lack of function of key organs in menopause and andropause

This will not only manifest itself in hot flashes and sleep disturbance in women. Men experience erectile dysfunction and grumpiness. Eventually this leads to a lack of energy production in the heart, the brain and other organ systems. When these organs have sex hormone receptors, but circulating sex hormones are missing, they cannot function optimally.

Lack of hormones causes heart attacks, strokes and cancer

A lack of hormones translates into yet another cause of heart attacks, strokes and certain cancers. This is an area where conventional medicine disagrees with anti-aging medicine. Years in general practice have taught me that heart attacks, strokes, colorectal cancer and pancreatic cancer happen more often when hormones are missing in both sexes. Cancer of the breasts, uterus and ovaries and prostate cancer are more common when sex hormones are missing. These cancers occur when natural sex hormone production declined.

On the other hand, with bioidentical hormone replacement the metabolism of all cells will return to normal. With this the likelihood of not developing all these illnesses at an earlier time is diminishing as well. It is not a panacea for eternal life, but it will add significant longevity. And with this comes the knowledge that you will not get premature disabilities, which is what we all need.

Beer Belly Bad News

Beer Belly Bad News

Conclusion

We need to assess our food intake habits and cut out the items that contribute to the beer belly. Next we need to ask ourselves what other change in lifestyle we require.  Think about anything to improve our body shape and our energy metabolism. Life is too precious to just throw away years of fruitful living in our golden retirement years. Work on these factors in midlife or even in younger years and you will enjoy disease-free aging.

Sep
19
2015

Obesity Shortens Life

This article is about the fact that obesity shortens life. Of all the factors that definitely shorten life, obesity stands out like a giant. Let’s review a couple of facts regarding obesity:

  1. Americans who were born between 1966 and 1985 became obese at a much earlier age than their parents
  2. Obesity occurs at a younger age than in the past. 20% of people born between 1966 and 1985 were obese in their 20s.
  3. The longer you are obese, the higher the chance of getting seriously sick or dying prematurely from complications of associated diseases like diabetes, heart attacks, strokes, kidney disease, liver disease and cancer.
  4. Severely obese people live up to 20 years less than non-overweight people.
  5. Obesity causes about 300,000 deaths in the U.S. annually

Change of metabolism

Obesity shortens life. Obesity leads to a change in metabolism, which is known as metabolic syndrome. The liver changes its metabolism slightly producing more triglycerides, LDL cholesterol and clotting factors, which increases the risk for heart attacks, strokes and pulmonary emboli. The pancreas produces more insulin, which gives rise to reactive hypoglycemia. This means that 2-3 hours after a meal you become hungry as your blood sugar declines from the extra insulin. You are craving a sugary drink, a donut or other starchy food (pizza, fries, bread etc.). Unfortunately, these types of foods reinforce the metabolic syndrome: the liver changes the sugar into LDL cholesterol and triglycerides.

Excess sugar oxidizes LDL cholesterol

Excess sugar will oxidize the LDL cholesterol, which causes atheromas (hardening of the arteries). Protein is being caramelized, which is called “advanced glycation end-products” or AGEs. This reference clearly explains how to counter this: increase your consumption of fish, legumes, vegetables, fruits, low-fat milk products and whole grains; also reduce your intake of solid fats, full-fat dairy products, fatty meats, and highly processed foods. There are other hormone changes that take place in obese people.

Death statistics due to obesity

In this study 849 autopsies were performed over 10 years, of which 32.3% were of obese persons. Leading causes of deaths in obese people were: malignancy (31.4%), infection (25.9%), ischemic heart disease (12.8%), pulmonary embolism (6.2%) and liver disease (2.9%). Table 2 of this link shows the causes of death in non-obese individuals as well: malignancy (32.5%), infection (23.8%), ischemic heart disease (10.4%), pulmonary embolism (2.9%) and liver disease (0.7%). The figures do not look all that different except that liver disease and pulmonary embolism are significantly more often the cause of death in obese patients than in normal weight patients. What you do not see in these figures is that obese people get these conditions at a much younger age as a result of complications from the associated diseases like diabetes, high blood pressure, cardiovascular disease, osteoarthritis, kidney disease and liver disease.

Diabetes

The metabolic changes with regard to the metabolic syndrome include insulin resistance.

As obesity worsens the balance is lost where the body can compensate and type 2 diabetes develops with increased blood sugar values and symptoms of diabetes. Surprisingly with regular exercise and changes in food intake (adopting a low glycemic index diet) this can be treated successfully. Usually this change is also associated with some weight loss, which helps to stabilize the metabolism. If nothing is done to to change diabetes, there is a high risk for heart attacks, strokes and subsequent secondary conditions like diabetic nephropathy, retinopathy, diabetic neuropathy and vascular complications.

Uncontrolled high blood pressure

High blood pressure is part of the metabolic syndrome. Unfortunately in obesity it is often difficult to control and may require several different antihypertensive medications in combination to control it. One way to quickly get the blood pressure under control is to make a concentrated effort to reduce a few pounds of weight; this can be achieved by cutting out refined carbs and sugar and starting an exercise program of walking and swimming.

Smoking

Smoking continues to remain a problem. Men as a group are now smoking less while women are increasing their smoking rates. Smoking causes various cancers, but also increases death rates from heart disease and strokes. In connection with obesity it is clear that the obese smoker has the highest risk of dying prematurely. This is depicted in this link based on the original Framingham study.

Disabilities and nursing homes

Obese people get disabled earlier, ending up in nursing homes. This poses a huge problem there for the staff. Back injuries and disabilities in the caregivers of nursing homes have increased significantly in the last few decades.

Osteoarthritis

80% of hip replacements and 90% of knee replacements are due to osteoarthritis. Obesity is the strongest modifiable risk factor that leads to osteoarthritis and subsequent surgery. There is a lot of morbidity and mortality associated with total knee and total hip surgeries. Part of this is the susceptibility to clot formation from the changes in metabolism associated with the metabolic syndrome. This often leads to pulmonary emboli and higher death rates following surgery when compared to surgery in people with normal weight.

Heart attacks and strokes

As there is an increase of the amount of heart attacks and strokes in overweight and obese people it is important to reduce your BMI when you realize that it is creeping up. Regular exercise along with a Mediterranean diet helps to improve this. Avoid processed foods that often have hidden sugar and refined carbs in them. Also cut out sugar. Use stevia, a natural sweetener, if you want to sweeten your food or drinks.

Nonalcoholic fatty liver disease (NAFLD)

In the past nonalcoholic fatty liver disease was rare. Now with the increase of obesity it is common. It can lead to liver cirrhosis with hepatic failure, a common cause of death. But after several years of liver cirrhosis, liver cancer may develop within the cirrhotic liver. Physicians saw this condition only rarely in decades past.

Obesity shortens life: Kidney disease

With obesity there is a negative effect on the kidneys from the metabolic syndrome. Hyperinsulinism affects the capillaries of the filtration units, called glomeruli. They start to proliferate and undergo a form of degenerative change, called glomerulosclerosis. This decreases the filtration capacity of the glomeruli and the kidneys as a whole. After a few decades of this process kidney failure can set in. When an obese person develops diabetes, this will also have a negative effect on kidney function and accelerate the deterioration of kidney function. The end result is kidney failure, which requires dialysis or a kidney transplant.

Cancer and obesity

Obesity shortens life. Chronic inflammation that is worsened by the metabolic syndrome leads to higher rates of various cancers. A prospective study of more than 900,000 US adults was conducted for 16 years. In 1982 when the study was started none of the participants had cancer. After 16 years 57,145 of the study participants had died of cancer. Those in this study who had a BMI of 40.0 or more had cancer death rates that were 52% higher for males and 62% higher for females when compared to normal weight men and women.

Higher cancer rates in people with obesity

It was noticeable that the digestive tract showed higher cancer rates in the obese: esophagus, liver, gallbladder, pancreas, colon and rectum; other more frequent cancers were kidney cancer, multiple myeloma and non-Hodgkin’s lymphoma. There were also trends of higher cancer death rates with regard to cancer of the stomach and prostate in men and breast cancer, uterine cancer, ovarian and cervical cancer in women. The authors concluded that due to the rising obesity rates in the US population cancer rates in men will soon reach the 14% level and in women the 20% level out of the total death rates.

Treating obesity

Treatment of obesity requires a multifaceted approach. I have discussed this in detail in this blog. Briefly, the diet of the obese person needs to be closely looked at. Sugar and starchy foods need to be eliminated. Low glycemic foods like vegetables, lean meat and salads should be encouraged. A regular exercise program needs to be instituted, starting with swimming and walking. Later a gradual transition into gym type activities could be contemplated.

Weight loss surgery has been successfully applied in some obese patients with a BMI that is greater than 30.0 up to a BMI of 39.9. In a 5-year follow up after LAP-band surgery no surgical complications were reported and the mean percentage weight loss was 15.9±12.4%.

Obesity Shortens Life

Obesity Shortens Life

Conclusion

Obesity shortens life. Obesity is a condition that has been gradually developing since the 1980’s. When you look at the food intake changes rationally it is not surprising that this is happening. Sugar consumption, high-fructose corn syrup consumption and the consumption of processed food have to be cut down, if not cut out completely. You can forget shopping at the middle section of any grocery store, where all that processed food is located. Go to the vegetable section and buy a lot of food from there. Low fat dairy products, eggs, and low-fat meats as well as salmon and other seafood are foods that are healthy. There is one problem though and that is the feeding of antibiotics to chickens, turkeys and beef cattle. This leads to superbugs and changes your gut flora.

Eat organic foods

I suggest you buy organic meats. I eat organic food and have cut out wheat also as wheat underwent forced hybridization in the 1970’s. All of the wheat in the world now is this type of wheat that is too rich in gliadin, which causes leaky gut syndrome and autoimmune diseases. For this reason, I avoid all wheat.

Gradually shed your pounds

I see no reason why obese people could not gradually shed their pounds and regain their stable metabolism. Those with diabetes will be able to shed that diagnosis as they shed their pounds. The kidney and liver function will also stabilize when you shed enough pounds. The goal should first be to reach a BMI of 25.0 to 30.0, which is the overweight category. The next goal would be to aim for shedding even more pounds until you reach a BMI of fewer than 25.0. If you say this is too tough to do, I am saying: giving up is not an option. Cherish your health!

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Aug
07
2015

Sugar As White Death

We can think of sugar as white death, as sugar is responsible for heart attacks, strokes and even some cancers. Sugar is causing disability and mortality to a much higher degree than most people are aware of: a recent study pointed out that worldwide 184,000 deaths per year are attributable to sugar-sweetened beverage consumption; among those there are 133,000 deaths from diabetes, 45,000 deaths from cardiovascular disease and 6,450 deaths from cancers. Those people who developed disabilities from strokes, heart attacks, osteoporosis and severe arthritis measured 8.5 million disability-adjusted life years throughout the world and were related to sugar-sweetened beverages. 4.5% of these were from diabetes that was related to sugar-sweetened beverages.

These statistics are only regarding sugar-sweetened beverages! This does not take into account mortality from sugar in processed foods, in cookies, cakes and candies. It also does not take into account starchy foods like pasta, bread, bagels, white rice etc. that are all digested by amylase in the mouth and in the gut to turn into sugar within half an hour of ingesting them.

In the following I like to give an overview of what sugar does to our system.

History of sugar production

The initial production of refined sugar was developed in India as this review of the history of sugar shows.

In Great Britain the consumption of sugar was 4 pounds per person per year in 1700; it rose to 18 pounds per year in 1800, to 36 pounds per year by 1850 and over 100 pounds per year by the twentieth century. Similar figures are true for the US and in all developed countries. In 1747 the German chemist Andreas Marggraf identified sucrose in beet root. Since then technology was developed to extract sugar from the beet root, which was cheaper to do than extracting it from sugar cane. Both methods are in use today. In addition high-fructose corn syrup has been developed in 1970 and it replaces sugar in many uses, for instance in soft drinks and in processed foods.

Overall we are exposed to sugar in all disguises, such as sugar-sweetened beverages, candies, sweetened yogurt that is sold as “healthy”, power bars that are sugar laden and many more.

Effect of sugar on our bodies

1. Diabetes

As already pointed out above the average sugar consumption has increased from 4 pounds per person in 1700 to above 100 pounds per person in our time. Our poor pancreas has to cope with this additional burden of sugar and if it can’t, we get diabetes. The CDC says that in 2008 there were 8 cases of new type 2 diabetes cases per 1000 people in the US. The CDC projects that in 2050 this number will likely increase to 15 new cases of type 2 diabetes per 1000 people.

This shows you that the capacity of the human pancreas is limited. There is a breaking point regarding our insulin production. The insulin production has a limit, because the insulin producing cells in the pancreas can only produce a limited amount of this sugar-clearing hormone. When this point is reached the person is said to have developed diabetes. Diabetes causes heart attacks, strokes, kidney failure, blindness and circulation problems in the legs leading to amputations.

2. Cardiovascular disease

Diabetes is not the only problem that sugar causes. Our cardiovascular system is suffering because sugar makes the liver produce more LDL cholesterol that gets oxidized by sugar; the triglycerides are rising as well with continued sugar intake and with too much sugar intake there is excessive weight accumulation causing type 2 diabetes. This leads to more lipids in the arterial walls, called arteriosclerosis. The end results are heart attacks and strokes.

3. Cancer

It may not be obvious how sugar intake can lead to cancer. But sugar has been found to oxidize tissues and in the process produce dangerous free radicals. This causes chronic inflammation leading to mutations in the DNA of cells and weakening of the immune system. This will in time lead to cancer. Many cancer researchers have investigated this in detail in the last decades. I reviewed this in this blog, if you would like more information about it.

4. Brain atrophy and Alzheimer’s disease

Sugar overconsumption has been found to be one important factor in the development of Alzheimer’s disease, which is associated with the development of brain atrophy. Brain atrophy is just the mirror lesion in the brain that comes from hardening of the arteries. Brain atrophy develops when not enough nutrients and oxygen reach your brain cells. Part of the brain surface dies off and memory cells are lost. The end result is dementia or Alzheimer’s. Read more about this here.

5. Arthritis can come from sugar overconsumption

As I have summarized in this blog arthritis often is due to over consumption of processed foods including sugar products.

As I am explaining in this blog Dr. Hoffer has developed a simple supplementation for arthritis that will reverse the metabolic changes that are associated with arthritis. But you must switch to a Mediterranean diet without sugar and starchy foods, if you want to experience relief from your arthritis symptoms.

6. Low fat diet not helpful to reduce heart attack rates

As I pointed out before the low fat diet that was popular in the 1980’s until the early 2000’s did not help reducing heart attacks.

The low fat diet was laden with sugar, meaning that it was a low fat, high carb diet, and all of the problems I described above with weight gain, high LDL, high triglycerides and the development of diabetes caused more heart attacks and strokes. The real solution to preventing obesity and lowering heart attacks and strokes is to use a low carb/low to medium fat diet like the Mediterranean diet.

7. We need our muscles in older age

When we eat too many carbs from chocolate, candy, donuts and pasta there is not enough quality protein in our food to feed our muscles. If this is combined with a lack of exercise we are in double trouble of having flaccid muscles. This leads to falls and fractures, but is entirely preventable by eating a proper diet and exercising regularly.

8. ADHD can be fuelled by sugar

I have reviewed ADHD (attention deficit hyperactivity disorder) and mentioned that sugar and gluten sensitivity may be part of the problem. It is important to sort out nutritional factors by going through an elimination diet. Often our Western style diet (sugar and fat rich) is making things worse for the child with ADHD.

Apart from other measures avoiding sugar is very important for the ADHD patient.

9. Chronic inflammation

What causes chronic inflammation in the body and is responsible for both hardening of the arteries as well as arthritis? If you guessed sugar intake, you guessed right. I explained this in detail in this blog.

This concept is one of the biggest new things in the 21st century. The research goes back to the mid-nineties and culminated in the detection of an inflammatory marker, the C-reactive protein (CRP). The CRP level can now be used as a readily available blood test to detect inflammation in the body. Often this test will be positive in patients with arthritis, autoimmune diseases and cancer.

10. Obesity

Processed food contains wheat and sugar. The problem is that the high gliadin concentration in the Clearfield variety of wheat makes people addicted to food and sugar makes them gain weight. This is the cause of the obesity and diabetes wave. The remedy is to cut out all wheat and sugar as well as starchy foods. Switch to a Mediterranean diet without sugar and starchy foods.

11. Pimples and acne

Who would have thought that acne could come from a combination of sugar and milk products? Careful epidemiological studies have shown that in some regions of Africa, Brazil and Japan teenagers who eat the local food do not get acne, but when they switch to a Western style diet they come down with acne.

12. Tooth decay from too much sugar

Gum infections and severe tooth decay were found in the 1990’s to cause inflammation in the blood, which can be measured by using the C-reactive protein (CRP). Streptococcus viridans, a bacterium that populates gums and teeth can cause subacute endocarditis, a dangerous infectious disease of the heart valves, which can be responsible for sudden death in younger persons. There are other bacteria in the mouth that feed on sugar that we eat, particularly if we do not brush and floss our teeth regularly. This means there is double trouble: Sugar causes cavities and gum disease, but also causes heart attacks and heart valve infections.

Sugar As White Death

Sugar As White Death

Conclusion

Sugar and starchy food consumption affect so many organ systems that it is no wonder that people say that they feel better when they switch from the standard American diet to a Mediterranean type diet. We do not really want to buy a heart attack, a stroke, diabetes and Alzheimer’s disease when we go to the grocery store. But this is what you get in time when you buy the starchy foods and sugar containing processed foods that are in the center part of the grocery store.

The neighbor’s shopping cart

When I go shopping I always eye the groceries of my neighbor before or after me. Sometimes it is scary to look at the content of some of the shopping wagons. There is bread, potato chips, pretzels, chocolate bars, cookies, and the whole line-up that is really rich in sugar. Manufacturers mix sugar into healthy yoghurt, so it becomes unhealthy. Honey or maple syrup makes granola unhealthy. Jams contain 50% sugar, and on and on it goes. It is sobering to see how illness and disability is for sale, one shopping at a time. The reassuring truth is that you have choices!

Jul
31
2015

Two Is Better Than One: Omega-3 And Krill Oil

Omega-3 fatty acids have gotten a lot of limelight in the press; krill oil was kept more in the background by the media. But both omega-3 and krill oil are important for your health.

What can confuse you is the following paragraph that I picked up from Facebook:

“I cannot believe that in the last 7 days 3 Doctors have asked me what krill omega-3 is. One would think that those who look after our health would realize that the high levels of mercury in the regular omega-3 has reached dangerous levels. Krill oil is harvested from pristine waters of the Antarctic Ocean and tested to be free from harmful levels of mercury. If you have not heard of it, it is for brain, heart, joint and immune health.”

Clarification of what Omega-3 fatty acids are

Depending on where fish is within the ocean’s pecking order of feeding, the levels of mercury of the fish oil that contains omega-3 fatty acids will be higher or lower. Tuna, for instance is one of the predator fish on top of the line. They are large predator fish, and as a result, not a fish you want to eat as it has very high levels of mercury. Salmon on the other hand is lower in the line of predator fish. That’s why it is still recommended to eat salmon two or three times per week. Fish oil is pooled from various fish and then molecularly filtered through a special filter that removes heavy metals like mercury, cadmium and others. Knowing these facts, the Facebook text above may be accurate in stating, “regular omega 3 has reached dangerous levels”, but it is inaccurate for the molecularly filtered omega-3 fish oil, which is the only one I would recommend as a supplement. Having said that there are still significant differences in quality according to a report online that tested 51 common products in the US. The omega-3 fatty acids EPA and DHA are stored in the membranes of platelets and in circulating plasma triglycerides, which is useful for the functioning of the lining of our arteries. This is called endothelium and needs to be healthy to lower blood pressure and prevent hardening of the arteries. Omega-3-fatty acids support the cardiovascular system foremost and the brain secondarily.

Where does Krill oil come from?

Krill oil comes from tiny crustaceans called krill that provides additional benefits that are not found in fish oil alone. Although the initial concentration of raw krill oil has less mercury per milliliter than omega-3 fatty acid fish oil, it still needs to be molecularly filtered to remove heavy metals. Also bear in mind, that the tiny crustaceans live in the same polluted ocean waters as other fish. It is a sad fact that our oceans are no longer pristine! The same is true for the Antarctic Ocean. After the filtering process both krill oil and omega-3 fatty acid fish oil are equal in their quality (free of mercury, other heavy metals, PCB and dioxins).

The omega-3 fatty acids of krill oil have an affinity to bind with phospholipids in red blood cells. This enables krill oil to cross the blood-brain barrier and get into the brain cells providing support for the brain. In this respect krill oil has an edge over omega-3 fatty acids to support the brain. But secondarily it is also good for your heart and the lining of the arteries.

Benefits of marine oils like krill and fish oil

It is best to think about krill oil and omega-3 fatty acids (fish oil) as complementary marine oils that have multiple beneficial effects on the body.

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

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

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

Fear mongering Facebook write-ups

In this context let me clarify the fear mongering Facebook write-up cited at the beginning of this blog. It is a misconception to think that krill oil is devoid of mercury. It is only so, if it was molecularly filtered, which removes all of the mercury and more, but it leaves the beneficial DHA and EPA (omega-3 fatty acids) intact. In the same vein omega-3 fatty acids from fish oil are initially more mercury containing, but after molecular filtration are entirely mercury free, the same as krill oil after molecular filtration. But the mix of omega-3 fatty acids is slightly different with krill oil being a bit richer in DHA and attaching to red blood cells easier while fish oil omega-3’s attach to triglycerides in the liquid phase of the blood, called plasma and also to platelet membranes. So neither krill oil or omega-3 fatty acids are better than the other; they are slightly different and that’s why you benefit from a mix of both. It would be a big mistake to follow the Facebook advice above and only take krill oil by blindly trusting the quotation. In my opinion it is simply a marketing plot to get you switched from fish oil to krill oil.

What combination of Krill oil and omega-3 fatty acid should I take?

Most trials with krill oil have been done with 300 mg of krill oil per day.  I take a dosage of one capsule per day of 300 mg. There are several manufacturers that produce similar products. I also take 3 capsules of omega-3 fatty acids twice per day. Each capsule has 647 mg of EPA and 253 mg of DHA, which translates into a daily dose of 3882 mg of EPA and 1518 mg of DHA. Again, there are several products from which you can choose. The reason I take a relatively high dose of fish oil is the fact that I come from a family background with severe arthritis that started in several relatives at an age of 50+. I have no sign of arthritis at age 70. It may be the result of taking these supplements and staying away from sugar and starchy foods. I need my joints to do ballroom and Latin dancing and I also need them to attend the gym regularly. Exercise by itself has been shown to prevent arthritis and prevent heart attacks and strokes. We need the benefit from all these things in combination: good nutrition, supplements and exercise.

Two Is Better Than One: Omega-3 And Krill Oil

Two Is Better Than One: Omega-3 And Krill Oil

Conclusion

Both krill oil and fish oil (omega-3 fatty acids) are needed as supplements to prevent arthritis, strokes, heart attacks, osteoporosis, diabetes, dementia, Alzheimer’s and inflammation. The key to a good krill oil or fish oil supplement is to buy the more expensive products that are molecularly distilled and therefore more concentrated, but also free of heavy metals and other contaminants. These supplements are only a small part of your overall anti-aging program that needs to include good nutrition (organic food), exercise, other supplements and if necessary bioidentical hormone replacement.

Reference: Dr. R. Schilling: “A Survivor’s Guide to Successful Aging“. Paperback through Amazon.com, 2014. This text explains the anti-aging program I follow and includes recipes composed by my wife for 1 week.

Jul
11
2015

Experiments On Humans With New Statin Drugs?

This article is about experiments on humans with new statin drugs. The FDA released new statin drugs for use on a high-risk segment of the population with genetically high cholesterol. This has the name familial hypercholesterolemia and runs in families. There was a fast track for these drugs strictly to treat a high-risk population. There was a completion of smaller trials, but the the FDA expects the results of larger trials only for 2017. This leaves the uncomfortable question, whether physicians should prescribe these newer statins despite the lack of completion of proper trials.  In other words, are we doing experiments on humans with the new statin drugs, when the final word regarding their safety is not out.

Introduction

There was a news release about this story. There are a number of new super cholesterol lowering drugs. Physicians administer them by injection. They reduce the LDL cholesterol fraction. Oxidation of LDL is what causes hardening of the arteries very quickly. What made the news right now is Amgen’s drug, evolocumab and Sanofi and Regeneron Pharmaceuticals’ drug, alirocumab. The traditional thinking is that when you lower the bad LDL cholesterol you would save the patient from heart attacks and strokes. I have blogged about the cholesterol story and statins in November 2013 pointing out that statins can hurt the consumer. One concerning side effect of statin therapy is myopathy, a painful muscle disorder where statins have to be discontinued.

We need to be cautious about simplifying cholesterol blood results

Cholesterol is vital for cell function, for insulation of nerve fibers (myelin sheaths) and for synthesis of our steroid hormones (sex hormones and vitamin D3, now considered to be a hormone). The medical establishment took most of the information regarding heart attack and stroke prevention from the ongoing Framingham study. This clearly pointed to the importance of lowering the LDL cholesterol fraction (the “bad” cholesterol) and maintaining or increasing the HDL fraction (the “good” cholesterol).

LDL delivers cholesterol to vital organs

LDL cholesterol is actually an important cholesterol fraction that the body uses as transport molecule to all vital organs like the heart, the skeletal muscles and the brain to replace lipids in cell membranes. It is inappropriate to label LDL cholesterol as the “bad cholesterol”. This is an oversimplification.

The assumption in the recent past was that LDL requires a reduction to prevent heart attacks and strokes. But strictly concentrating on this could hurt patients because vital organs require enough nutrients to replace their cell membranes. Without cell membranes there is no life!

Some details about what causes heart attacks and strokes

I like to explain how heart attacks and strokes develop. At the center of the problem is how hardening of the arteries develops. In the 1990’s and in the next decade, from 2000 to 2010 detailed research into this has been completed. It has shown that free radicals have a lot to do with hardening of the arteries. There is not one single cause, but a combination of multiple factors that cause hardening of the arteries. One of the key facts is that people in civilized countries consume too much sugar and starchy food. The digestive process of the gut metabolizes starch into sugar, which the blood absorbs. In response to all this sugar the pancreas secretes an overload of insulin every day.

High insulin levels cause inflammation

The high insulin levels cause inflammation, which releases a number of aggressive molecules that attack the lining of the arteries. Sugar also oxidizes the LDL cholesterol and the HDL cholesterol, which makes the LDL cholesterol more aggressive as it now reacts like a free radical. Macrophages take up the oxidized LDL cholesterol; they turn into fat-laden foam cells, which in turn burrow themselves under the lining of the arteries. Normally the HDL cholesterol incorporates oxidized LDL cholesterol and brings this to the liver for further processing. However, sugar oxidizes HDL itself and it loses its protective function. The end result is that there is an acceleration of the hardening of the arteries and when this reaches a critical point, a heart attack or stroke can occur.

We need to rethink how to prevent heart attacks and strokes

What struck me with the FDA decision is that they seem to doggedly hold on to the hypothesis that heart attacks and strokes develop from LDL cholesterol that is too high. If this were the case, statins would have worked wonders in terms of preventing heart attacks and strokes, yet the number one killer is still hardening of the arteries. What I wrote in my blog in November 2013 is still true.

The solution to preventing heart attacks and strokes may not be attractive to some, but it is found in a proper diet and exercise.

These points are important

  1. We need to cut out sugar and starchy foods. This includes grains. Kellogg’s and cohorts won’t be happy nor will be your friendly baker or the bakery department in your supermarket.
  2. A Mediterranean diet is now the gold standard and adding olive oil and nuts to it will be even more effective in reducing mortality from heart attacks and strokes.
  3. Exercise has been proven to elevate HDL cholesterol significantly, so why not do less sitting and do more moving? When you cut out sugar and starchy foods, HDL is fully functioning and this keeps the LDL cholesterol honest. This means that only LDL without oxidation reaches the vital organs for membrane exchange work, while HDL removes LDL with oxidation like a sponge and inactivates it in the liver.

Misleading statin trials without diet changes

This is all: a three-point approach with no statins and no super statins. Big Pharma does not like this, but the three-point approach was proven to be effective for several years (Ref. 1, 2 and 3).

What I find particularly concerning is the fact that most of the super statin trials will only come out with the full results in 2017. We witness that the FDA has approved these new super statins to be used on the most vulnerable people (familial hypercholesterolemia) on top of regular statins. I fail to see how vital organs can function, if the diet is not changed.

CoQ-10 is essential as a co-factor

It also disturbs me that the average physician does not recommend CoQ-10 as a supplement to counter at least some of the side-effects of statins and super statins. There was no such recommendation. I feel that the FDA allows patients with familial hypercholesterolemia to be subjected to a human experiment of this nature. They are receiving drugs that we do not fully know yet. After 2017 we will know whether they have reduced heart attack and stroke rates or not.

Experiments On Humans With New Statin Drugs?

Experiments On Humans With New Statin Drugs?

Conclusion

I remember very well from the 1980’s what the suggestions were treating patients with high cholesterol. Cholesterol-lowering drug guidelines told practicing physicians to first assess the patient’s diet and exercise status. If modifying these lifestyle factors were ineffective, we would then only be using the statin drugs to lower cholesterol levels. In the meantime the scenario has changed and experienced a complete reversal in terms of diets. The high carb /low fat diet has been replaced with the low carb/medium fat Mediterranean diet, which by itself can be very effective in reducing LDL cholesterol. Recently research has shown that adding olive oil and nuts can lower mortality from heart attacks and strokes even more. It seems that the FDA is completely ignoring all this research.

History teaches us

I think that physicians and patients alike would do well to remember the following. It all started with the introduction of sugar, starchy foods and processed foods into the civilized world about 100 years ago. This caused an increase of heart attacks and strokes because of the processes explained above. The real solution is the 3-point program suggested above. This will likely solve 80% to 90% of all cases of hardening of the arteries causing strokes and heart attacks. Physicians treated the rest cautiously with cholesterol lowering drugs, like the statins; however, there is no room for human experiments.

More info on arteriosclerosis (hardening of arteries).

References

1. Dr. Steven Masley, MD: “The 30-day Heart Tune-Up – A Breakthrough Medical Plan to Prevent and Reverse Heart Disease”, Center Street, A Division of Hachette Book Group Inc. New York, Boston, Nashville, USA © 2014

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

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

Feb
28
2015

A Low Fat Diet is Not Protective Of Heart Attacks

This article is about the fact that a low fat diet is not protective of heart attacks. The British Medical Journal (BMJ Publishing Group, James J DiNicolantonio) published a critical editorial review regarding the lack of science behind the low fat diet guidelines. The low fat guidelines became law  in 1977 in the US and in 1983 in England. The devastating fact was that it was based only on a study of 2467 men (not a single female included) and there was no evidence of lower heart attacks in the low fat diet group when compared to the normal diet control. Yet the guidelines were the cause of the obesity and diabetes epidemic that followed causing heart attacks and strokes. February, the month where we think about heart disease  is the appropriate month to discuss the findings of this British Medical Journal article that exposes it all.

No significant difference between control group and low fat diet group

The BMJ Publishing Group re-traced all of the data that were available at the time of the decision in 1977. There were six clinical trials (with randomization) that had a mean duration of 5.4±3.5 years where the researchers compared low fat diets to normal diets. They found that the authorities who wrote the dietary recommendations for a low fat diet should have come to the conclusion that there was no statistical difference between the experimental group and the control group. The summary of the present re-analysis of the studies that were available to the US government in 1977 and to the UK government in 1983 was as follows: “There was no statistically significant relationship between dietary interventions and all-cause mortality.”

The researchers noted that the all cause mortality was identical in the experimental group and the control group (370 deaths in both groups). There was no significant difference of coronary heart disease (CHD) between the low fat diet group and the control group.

Low fat diet recommendations based on false data

There was no statistically significant difference in deaths from CHD (heart attacks). The reductions in mean serum cholesterol levels were significantly higher in the intervention groups; however, this did not result in measurable differences in mortality from CHD or all-cause mortality.

What is troublesome is that the six studies with randomization were the basis of all of these observations.  The studies included only 2467 men, but there was not a single woman in the trial. Yet the researchers recommended the diet for both men and women alike.

The authors concluded “It seems incomprehensible that dietary advice was introduced for 220 million Americans and 56 million UK citizens given the contrary results from a small number of unhealthy men”.

Political mistakes introducing low fat diets

Dr. Robert Olson of St Louis University warned Senator George McGovern that the studies did not support the dietary recommendations the Senator was about to announce. To this objection Senator McGovern replied: “Senators don’t have the luxury that the research scientist does of waiting until every last shred of evidence is in”.

There was very good evidence that dietary changes (low fat diet) will not change the rate of heart attacks and strokes. Yet the government committees in the US and in Great Britain did not consider this evidence. Other publications have examined the consequences of replacing saturated fats with carbohydrates in the recommended low fat diets.

Sugar is the problem in low fat diets

The researchers made the following observations regarding low fat diets:

  1. In processed foods low fat diet meant that more sugar was added to bring the saturated fat content down. This has detrimental effects on insulin sensitivity and causes type 2 diabetes on the long-term. In these patients there is an increase of small LDL particles and triglycerides, while there is a reduction of HDL. Blood clot markers increase, weight increases causing obesity. Polyunsaturated fats of the omega-6 type (including oils from corn, soybean, safflower and cottonseed) replaced saturated fats.
  2. However, randomized controlled trials showed the following. When omega-6 polyunsaturated fats (without simultaneously increasing omega-3 fatty acids) replaced trans-fats and saturated fats, there was an increase of death rates from heart attacks and strokes.
  3. The Anti-Coronary Club trial showed that more people died from heart attacks when saturated fat was replaced by polyunsaturated fat.
  4. The reason for the heart attack causing omega-6-fatty acids (from polyunsaturated fats) has been worked out in several research papers between 2006 and 2012 (cited in this link): they cause inflammation, cause cancer, weaken the immune system, lower the protective HDL cholesterol and increase the susceptibility of LDL cholesterol to be oxidized.
  5. When polyunsaturated fatty acids (omega-6) replaced saturated fat there was more breast cancer and prostate cancer.

Low fat diets don’t work

This review stated that there was a lack of data that low fat diets help prevent heart attacks and strokes. We have now clinical trials that numbered 347 747 participants. These trials showed that increased fat intake did not cause heart attacks. The Women’s Health Initiative included 48, 835 postmenopausal women. It showed that a low fat diet did not reduce cancer. It also did not prevent heart attacks or strokes. All of this supports what has been summarized before in a critical review regarding “The Oiling of America“.

Low Fat Diet Not Protective Of Heart Attacks

Low Fat Diet Not Protective Of Heart Attacks

Conclusion

Enjoy saturated fat as it does not cause you harm. Cut out omega-6 fatty acids like oils from corn, soybean, safflower and cottonseed. Use virgin olive oil or coconut oil instead. Take regular supplements of omega-3 fatty acid (marine derived) to balance natural omega-6 fatty acids in turkey or chicken meat. You can eat cheese and enjoy nuts. But in the US buy organic or imported cheeses from Canada or Europe. In Canada and Europe bovine growth hormone is illegal.

It is most important to avoid sugar, honey and high fructose corn syrup. These all oxidize LDL cholesterol, which is the pre-stage for hardening of the arteries. The oxidized LDL cholesterol is part of the plaques of arteries and leads to strokes and heart attacks. This also means that you must avoid all processed foods that contain sugar and high fructose corn syrup (read labels).

It is not that difficult to follow such diet recommendations as my wife and I have done this since 2001. We use stevia to replace sugar for sweetening (no calories, no effect on insulin). Do what’s good for your body!

Nov
16
2014

Smoking E-Cigarettes Of No Benefit

Electronic cigarettes (e-cigarettes) were invented to help people get away from the carcinogenic content of real cigarettes and they were thought to help people in the process to quit smoking as well.

In the October 2014 issue of the BC Medical Journal a review article is entitled: “Electronic cigarettes: Do we know the benefits vs. the risks?” In it Dr. Roy Purssell, the Chair of the Emergency Medical Services Committee in BC, Canada reviewed the literature about e-cigarettes (Ref.1). He pointed out that several studies have shown that the number of cigarettes used may have declined with the use of e-cigarettes, but the quitting rate on e-cigarettes is not higher than when quitting conventional cigarettes.

Why were e-cigarettes developed?

Originally they were marketed as an alternative to cigarette smoking with the thought that they would only contain the nicotine, but not the myriad of cancer producing chemicals. However, studies now show that this is not the case. As explained earlier people use e-cigarettes, but they often still smoke real cigarettes on the side, in effect just reducing the number of cigarettes smoked per day. Says Dr. Purssell: “Reducing the number of cigarettes smoked per day is much less effective than quitting entirely for avoiding the risks of premature death from all smoking-related causes of death” (also based on Ref. 2).

Chemical composition of e-cigarettes

E-cigarettes are battery-operated vaporizers that give you the feel of smoking a tobacco cigarette. The container inside the e-cigarette can be refilled with “e-juice” that can be bought through the Internet. The liquid contains highly concentrated nicotine, propylene glycol, glycerin, and flavorings (you can choose from cinnamon to cherry flavor and more). The liquid is vaporized by a heating element and the vapor is inhaled. No long-term experiments are available at this time with regard to the safety of these inhaled chemicals in humans. Only short-term experiments are behind the FDA’s declaration that propylene glycol would be “generally recognized as safe” (GRAS) as a food additive. But there is still a difference between inhaling and ingesting propylene glycol, and the same is true for glycerin.

The manufacturers of e-liquid (or e-juice) always put this disclaimer on their products: “Warning: Always keep e-cigarette liquid in a safe place and out of reach from children and pets. Nicotine in its pure form is a poison, and can cause harm if ingested by a child.”

Smoking E-Cigarettes Of No Benefit

Smoking E-Cigarettes Of No Benefit

Toxic effects of e-juice (e-liquid)

From September 2010 to February 2014 there were 2405 reports to the poison control centers in the US about e-cigarette exposures. In the month of February 2013 there were 70 calls, in February of 2014 there were 215 calls, a 300% increase.  More than 50% of these cases involved young children.

In BC, according to Dr. Purssell the Drug and Poison Information Centre received 70 calls between July 1, 2013 and June 30, 2014. 50% of these involved children who were younger than 4 years old. There was no case of serious toxicity. If, however, enough fluid is swallowed, there can be deaths from nicotine overdose, particularly in children and in pets. Seizures can be caused by nicotine overdoses and poisoning of the breathing center in the brain stem.

Nicotine is highly addictive. In children and in adolescents nicotine has a negative effect on brain development. Here is a report from the Minnesota Poison Control Center, which reports poisoning incidences with e-juice that was swallowed by young children and it reports also about adolescents who overdosed on e-cigarettes.

It appears that the nervous system is more sensitive for toxic effects of nicotine at a younger age.

Regulations of e-cigarettes

At this point e-cigarettes are illegal because the FDA is still examining the pros and the cons. The situation in Canada is similar: Under the Canadian Food and Drugs Act regulations it is currently illegal to sell e-cigarettes containing nicotine. The international Union against Tuberculosis and Lung Disease has issued a position statement saying that its preferred opinion is to regulate e-cigarettes as tobacco products. The UK will be following this advice.

Dr. Purssell commented: ”This is a reasonable course of action for a product that delivers a highly addictive substance with negative effects on brain development and can cause serious poisoning.“

While the Internet merchants are busy marketing these products, it is important that the legislators around the globe take swift action to draft policies and regulations now to protect children and adolescents.

Conclusion

In conclusion it can be stated that smoking e-cigarettes (=vaping) does not have any benefits whatsoever. Smokers still smoke, as the addictive substance (nicotine) in e-cigarettes undermines their efforts to quit. It may be true that they are not exposing themselves to lung cancers as much as those who puff away on regular cigarettes, but instead their cardiovascular system is exposed to the nicotine that causes heart attacks and strokes. It sounds very sobering that they just traded one cause of  unnecessary death (lung cancer) for another one (cardiovascular disease leading to strokes and heart attacks).

More information on:

1. Causes of lung cancer: http://nethealthbook.com/cancer-overview/lung-cancer/causes-lung-cancer/

2. Heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

3. Strokes: http://nethealthbook.com/cardiovascular-disease/stroke-and-brain-aneurysm/stroke-prevention/

4. Here is a useful information about health risk from vaping.

References

1.BC Medical Journal Vol. 56, no.8, October 2014 (www.bcmj.org)

2.US Department of Health and Human Services. The health consequences of smoking – 50 years of progress: A report of the surgeon general. Atlanta, GA: Centers for Disease Control and Prevention and Health Promotion, Office on Smoking and Health, 2014.

Last edited Nov. 16, 2014

Oct
04
2014

The Problem Are Sugar And Starchy Foods

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

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

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

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

1.Liver metabolism

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

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

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

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

3. The finer points about subfractions of cholesterol

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

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

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

The Problem Are Sugar And Starchy Foods

The Problem Are Sugar And Starchy Foods

4. Four major conditions causing heart attacks and strokes

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

Conclusion

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

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

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

References:

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

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

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

Last edited Nov. 8, 2014

May
21
2014

Forty Percent Of Premature Deaths Can Be Prevented

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

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

1. Cancer:

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

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

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

2. Heart disease:

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

Forty Percent Of Premature Deaths Can Be Prevented

Forty Percent Of Premature Deaths Can Be Prevented

 

3. COPD/emphysema:

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

4. Stroke:

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

5. Unintentional accidents/injuries:

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

Conclusion:

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

More information on:

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

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

Last edited Nov. 8, 2014

May
10
2014

The Full Story About Testosterone

Much has been written about what happens when women get into menopause. This begs the question: do men experience a change of life? As a matter of fact, they do. It is called “andropause”, and they can experience problems as a result. Here is a study from the Massachusetts General Hospital in Boston, MA, which was published in the New England Journal of Medicine (Sept. 2013) describing in detail what happens when men get into andropause (the male equivalent of the menopause).

We know from other studies that in obese men testosterone is converted into estrogen because of the enzyme aromatase that converts testosterone into estrogen resulting in erectile dysfunction and loss of sex drive. In lean men above the age of 55 there is a true testosterone reduction because the testicles produce less testosterone. This results in less sex drive, moodiness and lack of energy. But these men will do well with bioidentical testosterone replacement.

Main findings of the Massachusetts General Hospital study:

  1. Testosterone was responsible for thigh muscle development and leg press strength, for erectile function and sexual desire.
  2. Surprisingly, estradiol (the main estrogen component in both sexes) plays a significant part in sexual desire in the male. This became particularly apparent in the post-andropause male who desired hormone replacement. When bioidentical testosterone is used to replace what’s missing there was no problem with sexual desire or erectile function as a small amount of the testosterone was aromatized into estradiol. The researchers were able to measure both testosterone and estradiol levels.
  3. Here is a surprising fact: a lack of estrogen leads to abdominal obesity. This could also be verified by hormone measurements.
  4. In the past doctors used synthetic testosterone products like methyltestosterone, danazol, oxandrolone, testosterone propionate, testosterone cypionate or testosterone enanthate. The problem with these synthetic testosterone products is that the body cannot metabolize a portion of them into estrogen that is desirable for a normal sex drive, so the testosterone compounds alone are not doing their job as well as the bioidentical testosterone that the body can aromatize.

In obese men the problem is that there is too much estrogen in the system, which leads to a disbalance of the hormones in the male with a relative lack of testosterone. Overweight and obese men produce significant amounts of estrogen through aromatase located in the fatty tissue. Aromatase converts testosterone and other male type hormones, called androgens, into estrogen. Excessive levels of estrogen cause breast growth, muscle weakness, lead to abdominal fat accumulation, heart disease and strokes. Dr. Lee described what happens in men who enter andropause years ago as indicated under this link.

The Full Story About Testosterone

The Full Story About Testosterone

Testosterone to estrogen ratio:

Dr. Lee indicated that in his opinion saliva hormone testing is more reliable than blood tests (Ref. 1). One of the advantages of doing saliva hormone tests of estrogen and testosterone is that you can calculate directly the ratios of these two hormones. In hormonally normal younger males the testosterone to estrogen ratio is larger than 20 – 40 (Ref.2). The testosterone to estrogen ratio in obese men is typically less than 20 meaning it is too low. But lean men in andropause produce too little testosterone and their testosterone to estrogen ratio is also less than 20, because they may still have enough estrogen in their system from aromatase in the fatty tissue, but they are lacking testosterone due to a lack of its production in the testicles (Ref. 1 and 2).

When a man in andropause is given bioidentical hormone replacement with a testosterone gel or bioidentical testosterone cream this is absorbed into the blood and body tissues and then partially metabolized into a small amount of estrogen. This can be seen when saliva hormone tests are done; a higher level of testosterone is detected and much lower estrogen level so that the testosterone to estrogen ratio is now 20 to 40 or higher and the affected person will no longer be the “grumpy old man” that had been a source of distress to his partner before.

This New England Journal of Medicine study is important because it confirmed what anti-aging physicians had been saying for years: a small amount of estrogen is necessary for the male for bone health as estrogen receptors will regulate the bone density, it also helps for a normal sex drive. The same is true for women: a small amount of the opposite hormone (testosterone) will help a woman’s sex drive, but she needs the right mix of progesterone to estrogen (a progesterone to estrogen ratio of 200:1 using saliva tests) to feel perfectly normal as a women.

Health and well-being of a man depend on normal testosterone levels:

It is important to realize that testosterone is not only supporting a man’s sex drive and libido, key organs like the heart, the brain and blood vessels contain testosterone receptors as well. The body of a man was designed to respond to testosterone all along. It is when testosterone production is no longer keeping up that premature aging becomes apparent, as the target organs do no longer receive the proper signals.

A healthy heart in a man depends on regular exercise and testosterone stimulation whether he is young, middle aged or old. The same is true for the lining of the arteries where testosterone receptors are present to help with the normal adjustment to exercise and relaxation. The brain cells have receptors for all of the sex hormones and in a man they are used to higher levels of testosterone and lower levels of progesterone and estrogen. If you take the balance away, the aging man will feel miserable and grumpy. Depression will set in. Here is a brief review how one man’s life has been changed by testosterone replacement.

So, bioidentical hormone replacement is not just a matter of replacing one hormone, you need to pay attention to all of the hormones. Lifestyle issues enter the equation as well. I have reviewed the issue of bioidentical hormone replacement for women and men in this blog.

Conclusion:

When a man reaches the age of 55 or older there comes a point where a lack of testosterone and estrogen sets in. It is wise to start doing intermittent blood or saliva hormone tests before this point is reached in order to gage when bioidentical hormone replacement treatment should be given. Along with an assessment regarding the hormone status it would be wise to also assess lifestyle issues as often other factors play a role in premature aging. I have reviewed these factors systematically in a recent publication (Ref. 3). It is best to combine bioidentical hormone replacement with life style interventions to achieve optimal preservation of a man’s health.

More information about male menopause (=andropause): http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/male-menopause/

References:

  1. John R. Lee, MD: “Hormone Balance for men- what your doctor may not tell you about prostate health and natural hormone supplementation”. 2003 by Hormones Etc.
  2. George Gillson, MD, PhD, Tracy Marsden, BSc Pharm: “You’ve Hit Menopause. Now What?” 2004 Rocky Mountain Analytical Corp. Chapter 9: Male Hormone Balance (p.118-148).
  3. Dr.Schilling’s book, March 2014, Amazon.com:“A Survivor’s Guide To Successful Aging: With recipes for 1 week provided by Christina Schilling”.

Last edited Nov. 8, 2014