Evidently the Vietnamese are getting an alarming rise in Diabetes, according to an article in this Sunday’s New York Times June 9, 2013, entitled,  “Prosperity in Vietnam Carries a Price: Diabetes”.  Granted, with affluence come fast food restaurants, but this is happening to thin or only mildly overweight people, by American standards. 

Why is this happening?  Let me digress a minute and address my title: Diabetes and POPS”

What are POPS? They are persistent organic pollutants.  These are  compounds released from industrial processes such as solvents, flame retardants, polyvinyl chloride, PCBs (polychlorinated biphenyls), pharmaceuticals, and pesticides.  They characteristically are fat soluble, persist in the environment (and the bodies of humans and other animals) for long periods of time and bioaccumlulate.  This means they get more concentrated as you go up the food chain.  We’ve all heard of chemical exposure relating to cancer and neurodegenerative problems such as Parkinson’s disease, but Diabetes? 

How do POPs relate to Diabetes? 

An article in Diabetes Care in 2006 explains that there is a striking dose response relation between serum levels of six POPs and prevalence of Diabetes. And even more amazing, there was no association between obesity and diabetes when no POPs were detected!.  This indicates that obese or not, the real factor in the development of Diabetes is toxic chemicals persisting in the body.  No matter how obese a person gets, they don’t get Diabetes unless they have a lot of bad chemicals onboard. 

This brings me back to the New York Times article referred to above.  Why are these unfortunate people getting Diabetes at such an alarming rate?  I remember from the 60’s when there was a lot of defoliant called Agent Orange spread around the country. This stuff bio accumulates and persists in the environment and gets into the meat and milk.  What’s worse is that these people go barefooted a lot, and if they injure their legs or feet, they can end up with an amputation.  Going barefoot is also a good way to accumulate more toxins. 

http://www.nytimes.com/2013/06/05/world/asia/diabetes-is-the-price-vietnam-pays-for-progress.html?pagewanted=all

For the second time in 2 weeks we are learning a staple of our diet can raise risk of heart attack and stroke, and not through the usual mechanism that we all know, raising cholesterol.  

Last week we learned that a study by Dr. Stanley Hazen of the Cleveland Clinic showed that eating meat, which contains carnitine, or even taking carnitine supplements, affects the bowel bacteria and provokes them to make a substance called TMAO, which has been shown to cause heart disease in mice.  

Now we’re told, in a study published in the New England Journal of Medicine 4/15/13, that eggs do the same thing!  This time it’s the choline in the egg yolk. 

Choline is found in soy lecithin in the form of phosphatidyl choline (PC).
Supplements labeled as “lecithin” usually contain 10-20% PC.
Egg yolks are not the only source of choline.  Choline, the major constituent of PC, is also found in soy beans, liver, oatmeal, cabbage, and cauliflower, meat, and some vegetables. Lecithin (containing 10-20% PC) is added to many processed foods in small amounts, for the purpose of maintaining texture consistency and there is a small amount of choline in most multivitamins. 

Choline and Phosphatidyl Choline are important substances in the body. PC acts as a supplier of choline. Choline is needed for cell membrane integrity, to facilitate the movement of fats in and out of cells and the binding of substances to membrane receptors.   It is also a component of the neurotransmitter acetylcholine. For this reason, PC has been used in a number of preliminary studies for a wide variety of neurological and psychiatric disorders.

PC has  a positive effect on plasma lipids, lowers triglycerides and oxidized lipids, reduces risk of atherosclerosis, mobilizes cholesterol from blood vessel walls, improves insulin binding, decreases fasting blood glucose, and reduces signs of liver damage and fatty liver.  It also reduces risk of gallstones. 

To put it in perspective, It appears that Choline has many more benefits than risks and if you cultivate better bowel bacteria by eating more vegetables, you might not get the TMAO spike after all.

http://www.nytimes.com/2013/04/25/health/eggs-too-may-provoke-bacteria-to-raise-heart-risk.html?hp

We’ve heard a lot about the importance of bowel bacteria lately as it relates to weight loss, but this time it’s heart disease risk we’re talking about. The study was done by Dr. Stanley Hazen of the Cleveland Clinic, who has accumulated evidence for a surprising new explanation of why red meat may contribute to heart disease. It’s not saturated fat this time but a little-studied chemical that is produced by bowel by bacteria in the intestines after people eat red meat and then converted by the liver into yet another little-studied chemical called TMAO that gets into the blood and TMAO levels turned out to predict heart attack risk in humans, the researchers found.   When vegans, who had not eaten meat for at least a year, were given a dose of meat, they did not produce the chemical.  It appears that it is the amino acid, carnitine, in the meat that is setting off the reaction in the bowel bacteria.  carnitine is also found in other foods, including fish and chicken and even dairy products, but in smaller amounts. Red meat, is the major source, according to Dr. Hazen, and for many people who eat a lot of red meat, it may be a concern.  Even swallowing pills or energy drinks containing carnitine causes the reaction.
It appears that the ecosystem that is the intestinal flora is cultivated by what we eat and we can feed beneficial bacteria, or we can feed bacteria that put out toxic substances.



       http://www.nytimes.com/2013/04/08/health/study-points-to-new-culprit-in-heart-disease.html?pagewanted=all

 

A new study from the University of Colorado showed that adults who sleep less than 5 or 6 hours a night are more likely to be overweight, and the weight gain can be seen immediately.   16 healthy men and women were recruited for the 2-week study.  Half were allowed to sleep for 9 hrs and the other half got only 5 hrs of sleep.  Even though the 5 hr sleepers actually burned more calories, they gained an extra 2 lb. in the first week!  They found that not only did the light sleepers eat more calories, they overate carbohydrates and fats in particular and they also ate more at night and ate smaller breakfasts.

There was also a profound change in the ability of the cells to bind insulin, a metabolic change associated with diabetes and obesity.  “Metabolically, lack of sleep aged fat cells about 20 years,” said Matthew Brady, an associate professor of medicine at the University of Chicago and the senior author on the study.

The Well Column March 18, 2013, New York Times

http://well.blogs.nytimes.com/2013/03/18/lost-sleep-can-lead-to-weight-gain/

• http://www.medscape.com/viewarticle/780858?src=rss

Now you get injections to dissolve a double chin and avoid surgery or liposuction, according to a recent presentation at the 71st American Academy of Dermatology meeting on March 14, 2013.  The procedure is very long lasting and has very few side effects and only short term discomfort.  In addition the procedure causes the skin to tighten.

An open label study of Deoxycholic acid ( bile salts) showed improvement of submental fat (double chin).  Deoxycholic acid, when injected into fat, causes the fat cells to rupture and then the body dissolves it.

The researchers looked at 165 people treated at 21 centers. At 12 weeks past the final treatment, physicians reported that 87% of patients achieved a one-point or greater improvement on the rating scale.

In addition, 83% of patients reported "significant improvement" at the follow-up assessment.

“There can be some swelling and discomfort right after the procedure, but the results have been impressive and they seem to be lasting" according to Dr. Doris Day, a Manhattan Dermatologist.  Skin laxity following the removal of fat is also a concern. The researchers point out that approximately 96% of patients experience unchanged or improved laxity on a grading scale.

Skin Laxity

"We recognize that not only getting rid of fat is important," said Dr. Susan Weinkle, the lead investigator.  "Histologically you see some collagen septa forming at 28 days, which translates into some skin tightening in that area."

http://www.nytimes.com/2013/03/28/health/studies-focus-on-gut-bacteria-in-weight-loss.html?_r=1&

The bacteria you have in your intestines may help determine your weight, according to 2 new studies, one human, and one in mice.

Gastric bypass surgery can help people to lose 65% to 75% of their excess weight.  These surgeries have also been shown to change the balance of the bowel bacteria. Is some of this weight loss due to the change is bowel bacteria? If so, perhaps a treatment less invasive than bypass surgery could help people lose weight. 

Earlier studies have shown that the microbiota of an obese person changed significantly after the surgery, becoming more like that of someone who was thin. This study was to see if the bowel flora change had weight loss effects of its own. 

Dr. Lee M. Kaplan, director of the obesity, metabolism and nutrition institute at the Massachusetts General Hospital, is an author of the study published Wednesday in Science Translational Medicine.

The researchers took 3 groups of mice, one group got the bypass surgery, the other 2 groups got a sham surgery.  One sham group was kept on the rich food, while the other was put on a weight-loss diet.

In the bypass mice, the microbial populations quickly changed, and the mice lost weight. In the sham group, the microbiota did not change much — even in those on the weight-loss diet.

Next, the researchers transferred intestinal contents from each of the groups into other mice, which lacked their own intestinal bacteria. The animals that received material from the bypass mice rapidly lost weight; stool from mice that had the sham operations had no effect.

Exactly how the altered intestinal bacteria might cause weight loss is not yet known, the researchers said

                                Who knows, perhaps the next weight loss pill will be a probiotic!

Finally, there seems to be some recognition that gluten sensitivity can entail more than Celiac disease.   In this New York Times article 2/4/13, Celiac experts who convened in Oslo are calling it Non-Celiac gluten sensitivity. The problem seems to be growing and some are calling gluten free diets a fad.  But people know when they feel better avoiding a food. Dr. Thomas O’Bryan, a Chiropractor who has been raising awareness of gluten sensitivity, said that 30% of his patients have antibodies in the blood to gluten. 

Although not mentioned in the  article, Dr. O’Bryan presented a vast amount of scientific evidence tin a lecture of his that I attended to support the fact that Celiac disease (gluten sensitivity) can be associated with many non-bowel related symptoms, including Sjogren’s syndrome (dry eyes), Psoriasis, Cardiomyopathy (enlarged heart) a 2-4 fold increase in liver disease, Hashimoto’s Thyroiditis, Non-Hodglin’s Lymphoma, Arthritis, and a prevalence of autoimmune disorders that is related to the duration of exposure to the gluten. 

Gluten allergy can lead to devastating symptoms, which often end up being treated with very toxic drugs, even in children.  Writer Susannah Meadows writes in the 2/1/13 Sunday Times Magazine about a 3 year old boy who was unable to run or play due to joint pain, while his twin brother was fine.  He was diagnosed with Juvenile Idiopathic Arthritis (which simply means, despite the long name, arthritis of unknown causein a child of).  She went the traditional route of non steroidal anti-inflammatory pills until a much stronger drug, Methotrexate, was put on the table.  The child’s mom, at that point, decided to take matters into her own hands and go in a different direction.  She found a Functional Medicine practitioner who found the cause of the arthritis, gluten sensitivity.  A gluten free diet and natural anti-inflammatory substances eventually cured the child.

 http://www.nytimes.com/2013/02/03/magazine/the-boy-with-a-thorn-in-his-joints.html?pagewanted=all&_r=0

We are living in an “Obesogenic” world, in which we are surrounded by processed foods that are cheap and tasty but very unhealthy and have been  engineered to addict us.  In a recent New York Times article titled The Extraordinary Science of Addictive Junk Food, February 24, 2013 writer Michael Moss covered the science behind the addictive attributes of junk food. He described a meeting of food industry executives who met to discuss the childhood obesity epidemic. Food manufacturers were now being blamed for this.

They went over the statistics:

1.    More than half of American Adults were now considered overweight
2.    One quarter of adults are clinically defined as obese (40 million)
3.    Among children rates of obesity had doubled since 1980 to 12 million. 

When a connection was made between these statistics and the obesity epidemic by the lecturer, a former CEO of a snack food company, the CEOs said “Don’t talk to me about nutrition, talk to me about taste” and basically ignored the threat. 

Unfortunately the fat – sugar – salt – recipe of most processed foods is what got us into the obesity epidemic.  But we have a choice whether to fall into this trap and buy these products, or to choose healthy meals that will help us to live a long and healthy life.  At Take Shape For Life, we use meal replacements that satisfy the taste, but are healthy! 

You make the choice!