Don’t panic.  I don’t have a paid ad for the RealAge Test stretching across the top of my blog post today.  This one is for illustration purposes only.  If you are like me, however, you’ve run across this banner countless times in your online surfing.  It seems to pop up everywhere.  Or at least it used to.  It hasn’t too much lately since the big New York Times exposé, more about which later.

But first let’s take a look at something else brought to the public by the team of Roizen and Oz.  I came across this page on their RealAge website while I was googling something else.

According to these two (or their team of ‘world-renowned scientists and doctors’) we should all avoid fructose and load up on glucose, the ’sugar that staves off hunger.’

Sugar is sugar, right? Maybe not. Turns out that there is one type of sweetener that helps fill you up, while another leaves you craving more.

The two sugars in question: glucose and fructose. Glucose appears to quell hunger, and fructose seems to ramp it up.

The sugars may affect your appetite differently because of the unique ways in which they affect malonyl-CoA, an important appetite-suppressing molecule in the brain. Glucose causes malonyl-CoA to rise, resulting in less food intake. Fructose, on the other hand, lowers malonyl-CoA, resulting in more food intake.

The implication of their message is that if you eat glucose you won’t be hungry, but if you eat fructose you will.  They go on to discuss how important it is to cut fructose from the diet since fructose makes you eat more.  And, by implication, to add glucose.

I agree that we should all cut most of the fructose from our diets, but not for the reasons these guys (and their team of purported experts) give.

I would assume that both of these docs went to medical school and had many years of post-medical school training.  I would also assume the same about their ‘world renown’ staff of experts.  What I don’t understand, then, is how they can make such stupid statements that have no grounding in actual biochemistry.

The ‘important appetite-suppressing molecule’ under discussion is malonyl-coenzyme A (malonyl-CoA), which is one of the major signaling molecules in the body.  Malonyl CoA sits at the crossroad of fat storage and fat burning and drives the reaction one way or another.

If we’ve eaten a lot, especially a lot of carbohydrate, malonyl-CoA levels increase.  Increased levels of this substance then shift the flow of fat away from burning and toward storing.  Among its activities, Malonyl-CoA stimulates fatty-acid synthase (FAS), the enzyme that converts carbohydrate to fat.  And it inhibits the enzyme (CPT-1) that carries fat into the mitochondria where it is burned for energy.

If we haven’t eaten, or if we have been eating a low-carb diet, the opposite happens.  Malonyl-CoA levels are low, which removes the inhibition of CPT-1.  Fat is shunted away from storage in the fat cells and instead is transported into the mitochondria where it is burned.

Since malonyl-CoA is one of the main substances in the body that determine what happens to fat, it would make sense that this molecule would somehow be involved in the regulation of hunger.  Elevated malonyl-CoA levels indicate that we’ve got plenty of fuel aboard and that the body is in the process of getting it stored away, so it would stand to reason that these elevated levels may affect the hunger centers in the brain, sending the message not to eat any more.

Researchers have looked into this notion, and it indeed appears – in rodents, at least – that elevated levels of malonyl-CoA do suppress the hunger centers in the hypothalamus.

If you do a quick thumb through any decent medical biochemistry textbook looking for what makes malonyl-CoA go up, you’ll find that it is driven up by insulin and glucose, the surrogates for being well fed.  But here is where Roizen/Oz and the team of experts go off the rails.  The glucose in question isn’t dietary glucose – it’s blood glucose.  As I’ve written about before, the entire amount of glucose we have circulating through us if we have a normal blood sugar level is around 4 grams, a little less than one teaspoon.  If we eat a medium-sized baked potato, we ingest about 50 grams of glucose (potato starch is made of pure glucose), which is more than ten times the amount regularly circulating in our blood.  Our bodies quickly deal with this excess by increasing insulin and driving the glucose into the cells.  As a practical matter, dietary glucose never really impacts malonyl-CoA.  What does impact it is the level of blood sugar.  So if blood sugar is higher than normal, then more malonyl-CoA is made, and more fat is stored.  Which is one of the reasons type II diabetics are usually obese to some extent.  These people have the double whammy of too much sugar and, since they’re almost always insulin resistant, too much insulin.

Any readers who have type II diabetes will have increased levels of malonyl-CoA.  I will ask those of you who have this condition: are you less hungry?  I didn’t think so.  Despite the fact that in rodents (and probably in people who are normal weight) malonyl-CoA may suppress hunger, it doesn’t seem to do so in those who are overweight and insulin resistant.  It may a little, but there are other forces driving hunger more than the malonyl-CoA suppresses it.  And in any case, it doesn’t have anything to do with dietary glucose – a fact our illustrious crew of ‘world renowned’ experts should have known.  Their implying that adding glucose to one’s diet will decrease hunger is just plain stupid.

But let’s look at something a little more sinister than just plain ol’ stupid.

These same guys are behind the RealAge test that (until fairly recently) was popping up every time you turned on your computer.  I saw the ads for this test over and over and over again, and I wondered what they were selling to justify the huge expense such unremitting advertising requires.  Then I read a New York Times article that explained it all.

As it turns out, the RealAge test is a means for Roizen/Oz et al to gather health information from those who take the test.  I’ve taken the test, which requires many pages of questions, and discovered that I am about 8 years younger than my chronological age.  I also discovered that I would be younger yet if I didn’t eat so much red meat.  You can guess how to perform well on the test: tell them you eat no red meat and a lot of soy.  (My choices on the red meat were: no red meat; red meat once per week; or red meat more than once per week.)

During the course of the test, after a long list of medical problems that are to be checked if the test-taker suffers from them, this question pops up:

If the answer is yes, you may be bombarded with information from various pharmaceutical companies that make drugs to treat the checked diseases. Or if, according to the Times, you decide to become a RealAge member.

Yep, that’s right.  These guys who seem so compassionate and are giving away their RealAge test (after capturing your email address) and providing all kinds of lifestyle change recommendations are really capturing your info and peddling it to Big Pharma.  Which, of course, is how they can afford the many ads for their ‘free’ RealAge test.

Says the NY Times:

But while RealAge promotes better living through nonmedical solutions, the site makes its money by selling better living through drugs.

Pharmaceutical companies pay RealAge to compile test results of RealAge members and send them marketing messages by e-mail. The drug companies can even use RealAge answers to find people who show symptoms of a disease — and begin sending them messages about it even before the people have received a diagnosis from their doctors.

While few people would fill out a detailed questionnaire about their health and hand it over to a drug company looking for suggestions for new medications, that is essentially what RealAge is doing.

Pretty sleazy, if you ask me.

They still provide their RealAge test, but as far as I can tell, only if you go to their website.  They are probably waiting for the fallout to be over from the Times piece.  Until then, they are dragging people to their website with idiotic pieces such as the one I discuss above.  If you are googling a health problem, nutrient, diet, etc., you may come upon their website and be presented with the RealAge test.

But, if the article I read is any indication of the value of their advice, I would be real leery.  The advice may be stupid, but the strategy behind the RealAge test is definitely sleazy.

I figure it’s about time for another grab bag of a post updating everyone on what’s going on at Casa Eades and throwing up a few interesting articles and websites.

The Verdi Requiem

The Santa Barbara Choral Society’s Verdi Requiem was a triumph last weekend.  As you can see from the photo above, MD was pretty whipped when it was over.  Apparently, it’s pretty demanding on soloists, orchestra and chorus.  And, as you can see from the photo above, the listeners don’t have the same burden.  Other photos here.  A recent review of the concert here.

The concert was pretty well attended, although not as well attended as it would have been had the entire city not been consumed with worry about the fire from the week before.  Santa Barbara is just now returning to normalcy.  The receipts from the door covered a little over 40 percent of what it cost to put on the production.  When I heard that figure, I thought the whole thing was a financial disaster, but I learned that that figure is typical for non-profit arts productions.  Around 40 percent of the cost comes from the people who buy tickets – the other 60 percent comes from patrons who sponsor the event.  In other words, the ticket prices are subsidized by the nobless oblige of the wealthy, a large number of whom consider it their obligation to support the arts.  So, next time you go to a great performance that costs you $25 to see, thank a rich person that you didn’t have to pay $60.

Twitter adventures

As anyone who has followed me on Twitter knows, I spend a lot of time reading and posting to Twitter since I first posted about it.  It’s a great way to do mini posts because users of Twitter are limited to 140 characters, so it’s tough to get too verbose.

I was pretty clueless about Twitter until I started using it, so I assume others are clueless as well.  If you are not in the know about this social networking tool and would like to keep up with these mini posts, there are a couple of ways you can do it.  You can sign up for Twitter and follow me (and anyone else you would like to follow).  It takes maybe one minute to sign up for Twitter.  All you need is a working email address and a username and you’re in.  Once you are a Twitteree (or whatever they’re called), and sign up to follow me, you can read these mini posts as I put them up.  If you want to sign up, click here and get started.  If you do start, you will probably find that a bunch of your own friends are using Twitter, so you can keep up with them as well.

The other way you can access these mini posts is by clicking on the little blue bird logo that says FOLLOW ME ON TWITTER.  If you click there, you will go to a page that gives you all the latest mini posts, but you’ll have to keep going back to get the updates as they come in.  Here is a link to the page you will find.

I occasionally Tweet (a Twitter mini post is called a Tweet, a loathsome word if there ever was one, at least when applied to activities of grown humans) on personal stuff, but mainly the Tweets are mini posts on medical articles or other news articles that I think are of interest along with anything else I find that strikes my fancy.

For those of you who do follow me on Twitter, I apologize for any Twitter faux paux I may have committed.  One of the things that most appealed to me about Twitter was the notion that I could put up these mini posts without anyone responding.  But, alas, I was wrong.  I discovered a few days ago that people can respond and several hundred have.  I was taking time from feverishly mini posting by looking around my Twitter home page when I found a highlighted link that said: @DrEades.  When I clicked there, I was appalled to find several hundred responses to Tweets I had made.  I learned that when people respond to Tweets, it ends up in that section.  So, I wasn’t off the hook.  But I couldn’t possibly respond to several hundred people – even at 140 characters a response.  So, if you replied to something I wrote and I didn’t respond, you now know what happened.

I did have a couple of interesting experiences in responding however.  When I discovered the @DrEades section and found the zillion responses to my Tweets waiting there, the most recent one was from a lady who took me to task for one (or several) of my political Tweets.  She wrote that she had always liked my nutritional writing but that my political postings had alienated her.  I decided to reply to her just to see how the whole reply thing worked.  I sent her one of my favorite Thomas Jefferson quotes:

I never considered a difference of opinion in politics, in religion, in philosophy, as cause for withdrawing from a friend.

Then I watched her site and found that she had deleted the Tweet to me, which is how I learned that one could delete these things once they are up.  They can’t be changed, so if you make a grammatical error (which, sadly, I have done a few times) it can’t be fixed, only deleted.  Then she deleted me from her list of people she follows.  I guess the Thomas Jefferson quote alienated her even more.

People are really strange.  I posted a Tweet about an email that I had received a dozen times about how George Bush has a state of the art, energy-efficient ranch house in Crawford, TX while Al Gore has a giant, energy-gobbling house in Nashville.  I always ignored the email because I thought it probably was an urban legend kind of thing.  Then someone sent me a link to the Snopes report on it, which said that the email was true.  I posted the Snopes report on Twitter.  Then I started to wonder what makes Snopes the last word authority on everything, so I started looking into that.  I discovered that Snopes is a husband – wife team, who live in a double-wide house trailer on the outskirts of Los Angeles.  They do all the checking themselves.  I was stunned.  I always figured that Snopes was some kind of outfit with a staff of hundreds that checked out all these things.  The notion that the ultimate authority on everything was just a mom and pop operation who make their living by ads on their snopes.com website.  Now that I know the situation, I’ll be more careful when I accept snopes as the last word on everything.

I put up a Tweet that said basically Who would’ve thought Snopes was a mom and pop operation?  Some guy signed up to follow me on Twitter, and immediately sent a nastygram to @DrEades that said If Snopes is a mom and pop outfit, what does that make the Protein Power blog? A ‘Pop’ outfit?  I replied that the Protein Power blog is a ‘Pop’ operation, but isn’t considered by anyone to be the last word on everything.  He then deleted me from his list of people he followed. As I say, a lot of bizarre people in the weeds out there.

The whole experience has been very strange indeed.  But I’m still working my way through it, probably alienating people right and left.  So join up, follow me, and watch the fun.

Upcoming travel plans

MD and I are leaving late Sunday night for Hong Kong, then to Guangzhou, back to Hong Kong, then to London.  Sadly, the entire trip will be a working trip.  We’re hard at it in our efforts to change the world, and this trip is all about that.  By the time we get back, I should be able to write about what we’ve been working on.

I will take a lot of photos and continue to blog during the trip.  And Tweet.

Comments on the blog

I continue to be mired in comment woes.  I just checked, and I have 78 comments in moderation, some of which have been there for weeks.  It has kind of become a comments graveyard.

I’ve whined about the comment situation for that last two years. I’ve said that I wasn’t going to continue to answer questions and was just going to post the comments as they came in.  My resolve would last for about two days, then I was right back answering all the questions.  Now, I’ve gone into a funk over the whole thing, and have devolved into just ignoring the comments that require answering and letting them stack up, which I hate doing.  But, I’ve been so busy lately that there isn’t much else I can do.

I was reading a book titled Economic Sophisms by one of my heroes, Frederic Bastiat, when I came across the following paragraph that, in a way, applies to the comment situation.

We must admit that our opponents in this argument have a marked advantage over us.  They need only a few words to set forth a half-truth; whereas, in order to show that it is a half-truth, we have to resort to long and arid dissertations.

It’s easy to pen a comment that says, Hi Doc, what are your thoughts on this article? and attach a link.  I have to read the article, pull the actual study, read it, think about it, then write an answer that is considerably longer than the original comment.  What takes a commenter 20 seconds to write ends up costing me an hour or two to come up with an intelligent answer or even an ‘arid dissertation.’

I’m also getting a lot of comments asking for my ideas and recommendations on personal health issues.  People send me lab results and want to know what I think.  Without treating a given individual as a patient, medico-legal restrictions prevent me from answering these kinds of questions.

I never read the comments on blogs that I read, so I must assume that many people don’t read the comments on this blog.  But I end up spending way more time dealing with the comments than I do writing posts.  If I didn’t have to deal with the comments, I would write more posts.

I noticed that Mark Sisson, whom MD and I had lunch with yesterday, has started making posts out of some of his comments in a Dear Readers section of his blog.  He takes several comments that he thinks may be of interest to all his readers, posts them, and throws them out for the combined wisdom of all his readers to deal with. I may start doing this myself and weighing in along with the readers.  If anyone out there has any advice for me on this issue, I’m all ears.

Soda tax in New York

I just read this article this morning.  Was going to make a mini post out of it, but thought it would be better here.

A New York state senator (I’ll leave it to you guess from which party) says that by adding a measly one cent tax to each can of non-diet soda sold, the state of New York can add $100 million per year to its coffers.  If this is true, it means that citizens of and visitors to the state consume 10 billion cans of non-diet soda annually!  The population of New York state is a little over 19 million.  Dividing 10 billion by 19 million calculates out to about 525 cans of non-diet soda per man, woman and child in the state.  That’s almost 90 six-packs per person per year.  Wow!  There have got to be some low-carbers who live there who drink zero six-packs per year, which means that some other poor slob is drinking 180 six-packs per year.  That’s a lot of high-fructose corn syrup.

To my way of thinking, this is an onerous tax.  It moves $100 million from the pockets of the citizenry and puts it in the coffers of the bureaucrats to spend.  And, despite the fact that it sucks off 100 million bucks, the tax isn’t high enough to discourage consumption, so it really has no societal advantage except for transferring funds from the citizens to the government.

Where does your beef come from?

I don’t mean what part of the country.  I mean what part of the cow.  Here is a great site created by the University of Nebraska and the University of Florida showing way more than I (and probably you) need or want to know about beef anatomy.  But if you really do wonder where a flank steak or some other piece of beef comes from on the cow, click here to find out.  A lot of work went into this site.

Gradient gel electrophoresis

For those who hate to pay big bucks to have a lab tell you how much small, dense LDL you have, here’s how you can do it yourself.  That’s right.  With a drinking straw and a few other simple ingredients, you can make your own electrophoresis equipment and test your blood anytime you want for minimal expense.  Warning.  This is a real geek site.  I doubt that many will want to put together their own equipment, but at least it shows what’s involved in making a primitive version and how complex the testing process is.  May make you not feel so bad dropping the money to get the test done professionally.

Feel better immediately

And, finally, here is your feel-good YouTube of the day.  Watch this huge prank (if that’s what you would call it) played on the people in the train station at Antwerp one morning.  Really delightful.  Watch the faces of those watching.

Remember, don’t forget to help me out on this comment issue.  All suggestions will be appreciated.

Just a bunch of odds and ends, none of which is worth an entire post.

Low-carb gains a foothold.

First, I’ll start off with the good news, then I’ll finish with the bad.

I took the photo above yesterday at Raley’s, a giant supermarket (and I mean giant) in Incline Village, NV.  There were no signs promoting low-fat foods anywhere in the store.  I took this to be a sign that enough customers were looking for low-carb foods and had asked for help that management decided to make the low-carb section (there really is one) easier to find.  I take this as a positive sign.

Tahoe skiing

We’ve been skiing with the kids and grandkids, all of whom have come to town for spring break.  We’ve had a blast, but family commitments have kept me from attending to this blog as much as I usually do.  Family commitments along with a few snafus, more about which later.  The picture below is from the top of a foggy ski run overlooking Lake Tahoe.  It was taken Monday when the weather was less than optimal.  Fortunately, it has improved since.

Airline/Expedia cautionary tale

One set of kids and grandkids flew in from Dallas and had a disastrous experience, which I want to relate in the hope of perhaps preventing it for some of you readers.  The tickets for this trip were purchased long ago through Expedia and were on US Air from Dallas through Phoenix to Reno.  When purchased, the confirmation had seat assignments for all four of the passengers.  Our son and fam arrived at the airport about an hour and a half early and went through the automated boarding pass machines.  The boarding passes that were issued them had no seats listed.  When my son went to the counter to speak with an actual human, he was told there were no seat assignments because his entire family had been bumped from the flight.  When he showed her the Expedia confirmation complete with seat assignments, she told him that Expedia travelers got bumped first.  She also told him that it was the airlines policy to overbook by about 20 percent, which almost never caused a problem because of cancellations and no shows.  She said that the only two times this didn’t hold was over Christmas and Spring break weeks, the only time, she said, that she really hated her job.  It would seem to me that the airlines would realize this and maybe not oversell the flights during these periods, but that’s just me.  I’m not an airline decision maker, but it seems pretty obvious.  Especially since they had to fork over four free flights on US Air and a bunch of meal vouchers.

The fam was booked on a later flight, and, of course, had no seats together.  So they had to fight that fight in order for a parent to be able to sit with each kid.  Same thing on the flight to Reno.  The kids got to the airport early in the day, waited around, and finally got to Reno at about 10:30 PM (midnight thirty for them and a long, long day for two little boys).  The other part of the fam came into the Reno airport as well, and we had it timed so that everyone got in at about the same time.  This airline fiasco caused a huge logistics problem for the family Eades, but we made it through it.

Two tired little boys late at night at the Reno airport

The moral of the story is to not book through Expedia and expect all to go smoothly, especially during busy times.  The son involved called the airline and made sure they had confirmed seats on the way home.  If you book with Expedia, I would recommend you do the same.

I use Expedia or Travelocity to find the least expensive flights and best routes between destinations, then I go directly to the airline site to reserve.  It’s usually a little less expensive than Expedia or Travelocity, and I am confirmed with the airline directly.

Blog info and snafus

There are a few blog issues I need to deal with.  First, I performed the much-loathed task of going through the stacked up spam caught by the spam filter and found about a dozen comments lodged therein.  I don’t know why they got caught – they didn’t have a bunch of links embedded, which is usually what trips them up.  I don’t know why the spam filter got them, but it did.  If you have had a comment over the past week or so that has remained unposted, you’re probably one of the victims.  I’ll get to them all soon.

Another thing I discovered, to my great chagrin, is that I have about 500 emails in my Gmail account from readers of this blog.  A couple of years ago I hired a blog consultant to help make my blog better.  The installed Feedburner to allow readers to sign up for the blog in their Google or other readers.  It also allowed people to sign up to receive the blog via email.  What I didn’t realize is that the blog came to those who signed up under my Gmail address.  Many people simply hit reply and sent me a comment or a question about the blog – much as others do in the comment section.  Problem is I never read my Gmail mail.  I have it as a repository for all my emails, which I have forwarded from my regular email address.  I keep all the emails in the Gmail account so that I will have them all in one place since I use so many computers.  I want to have them in case I ever need them.  But I never read them in Gmail.  When I heard from someone that he had been trying to contact me numerous times and hadn’t gotten a response, I asked how he had been trying.  He said through Gmail.  When I went to the account and searched, I found hundreds of people who had done the same.  I fixed the situation so that readers can’t simply hit reply.  I can’t possibly deal with all those emails that are already there, so if you have been waiting for an answer, you had better resubmit through the comments section.  Sorry for all the hassle.

Out of control taxation and regulation

The above sign affixed to the restroom door of the Squeeze In, my favorite breakfast restaurant in Truckee, CA is a symptom of the disease of a government run by Democrats allowed to go wild.  If you are interested in seeing what the country would look like after many years of an unopposed Democratic government, you have to go no further than California.  Due to a bipartisan gerrymandering over the past few years making basically all state legislative offices non-competitive, the Democrats have controlled the state government.  And they’ve never come across a regulation or tax they didn’t like.  (I’m sure that in Republican-dominated states there would be problems, too, but as far as I know, there isn’t a Republican-dominated state.)  Not only does California tax and regulate the bejesus out of anything it can, it aggressively enforces all these taxes and regulations.  Which brings me to the sign on the door at the Squeeze In.  If a California regulator were to walk in to the restroom at this restaurant and find writing on the wall, there would be a fine.  Which isn’t really a fine, but is a shakedown.  When the state needs money, the regulators are on the prowl.  Let me explain what I mean.

I have a friend who works as a consultant for many different industries.  He recently had a gig working for a financial institution with offices all over California.  One of the California regulations is that the lettering on the signs in these facilities giving the interest rates must be two inches high.  Regulators recently did a savage burn on all these facilities throughout the state, descending upon them with rulers in hand.  They measured the height of the letters and found in multiple instances that the letters were from 1/16 to 1/32 of an inch short.  They then levied fines of almost two million dollars.  These institutions then had to hire a legal team to do battle with the state, which ultimately reduced the fines to about $150,000.  This was a shakedown for money pure and simple.  It may as well have been Tony Soprano.

Los Angeles is the second largest city in the United States and has no (none, zero) Fortune 50 companies headquartered there.  Why?  Because of the outrageous tax situation.  Why do business there and deal with all the tax and regulatory nonsense California slings out when you could headquarter your offices in Texas, where the population is growing by about 1,000 people per day?  And those people ain’t going there for the weather, let me tell you.  I’ve spent a lot of time in one other high-tax state, that being Massachusetts.  But there, people have learned to deal with it by creating and underground cash-based economy.  I can’t tell you how many businesses we ran into in Cambridge that took cash only.  No checks, no credit cards, cash only.  Anyone who came to work at your house demanded to be paid in cash.  It doesn’t take a rocket scientist to figure out what’s going on there.

In California people are inured to it, I guess, because they simply pony up and keep on electing the same people again and again.  Now the residents of the state have been saddled with a huge tax increase that all share in.  Increased gas taxes, sales taxes, car fees, and income taxes – all went up.  It should be no surprise that a state as burdened by taxes and regulations as California should be the one in the most trouble due to the recent downturn.  People are out of work, houses are being foreclosed on right and left, the economy is in the tank, and, as a consequence, the state government is short of funds.  So instead of working to help business, which is the machine that drives the economy, the state did the only thing it knew how to do: raise taxes on those workers and businesses still standing.  Makes a lot of sense. At least to California legislators.

Underhanded internet sales technique

Some of the comments on the recent post about Pentabosol reminded me about how some sleazy operators do business online.  If you’ve never been involved in a direct response (selling directly to customers) business, you probably don’t have any idea what kinds of shenanigans people pull to try to sell products.  Let’s look at how it works with weight loss supplements.  You want to make some money selling a weight loss supplement, but you don’t have the funds to mount a normal direct response campaign, so you decide to let others do the work for you.  You start your company to sell your supplement.  Let’s call it Weight Be Gone.  You create a website extolling the virtues of Weight Be Gone and set up a shopping cart so that people can buy it.  Then you create another website called something like Webscamsreview.com or weightlossscamreporter.com or something similar.  Then you write reviews of all the other legitimate supplements out there – Pentabosol, for example – and you find them all wanting.  You then say that the only supplement that you have tested that passes the stringent requirements for your Webscamsreview company is Weight Be Gone.  And, of course, you provide a link to your own website.  Then you go out and buy Google placement for other supplements, such as Pentabosol, and when people look up Pentabosol on Google, they find the Pentabosol site listed first but right below is a site supposedly providing an unbiased review of Pentabosol.  Who can resist taking a look?  Often the people who do take a look end up purchasing Weight Be Gone because they believe the fake reviews (both positive for Weight Be Gone and negative for all the other supplements) on the allegedly ‘independent review’ site, which is actually an ad and portal for their own supplement.

Sugar, the new health food

Finally, some bad news.  It looks like sugar is making a comeback.  And not just a comeback, but a comeback as a health food.  Expect to start seeing more sugar and less high-fructose corn syrup HFCS).  It’s easy to see why.  HFCS has a real image problem.  After all, would you feel better about eating something containing organic pure cane sugar or high-fructose corn syrup?

Both are about the same.  HFCS contains a little more fructose, but not a lot.  And the little difference that it contains probably doesn’t make much of a difference unless intakes are huge, in which case it doesn’t much matter anyway.

The problem I see with HFCS is that it works much better than sugar as a food additive.  It has properties that sugar doesn’t have, making it perfect for many processed foods that otherwise wouldn’t contain sugar.  As a consequence we now have a lot of foods with sweetener in them that we didn’t have when sugar was the only sweetener available.   Problem is that the battle between sugar and HFCS isn’t fought on the field of these small amounts of additives, but on the field of products such as soft drinks that contain a ton of one or the other.  People will still get the additional sugar from HFCS in all the small portions added to processed foods and will get sugar instead in drinks and other highly sweetened foods.  And they’ll think they’re eating a health food because it is pure cane sugar and not that nasty HFCS.  I suspect that all this will do nothing but bring about an increase in sugar intake.  Why?

Because HFCS is sweeter than sugar.  And since people have become accustomed to this level of sweetness, when HFCS is replaced by sugar, more sugar will be required to give the same degree of sweetness.  And so sugar intake will increase.  All in the name of health.  A sorry situation indeed.

I have been dilatory in posting over the past few days and embarrassingly dilatory about approving comments.  I’m way, way behind, but I’ll get caught up ultimately.  So, if you have a comment doing time in comment Purgatory, don’t despair.  I will get to it.  Ultimately.

My excuse for not devoting my normal amount of attention to this blog is that I’ve been extremely busy as of late.  MD and I made a quick trip to Seattle to work on our world-changing project, then came back and spent a couple of days at the zoo that is Expo West (more about which momentarily), then the Seattle team came to us and we continued to work.  During all this, MD had a concert in which she had to perform Mozart’s Requiem and Lauridsen’s Lux Aeterna (my favorite piece of choral music) along with a couple of lesser pieces.  And tomorrow we drive back to Tahoe.  So, we’ve been busy little beavers and this blog has suffered.

Expo West has got to be the world’s largest natural foods expo.  It takes place every year at about this time in Anaheim.  And every year at about this time we drag ourselves to it.  The photo at the top of this blog represents one tiny little portion of this gathering.  To see how huge it is, take a look at the photo below of the map of the thing.

Find the red You-are-here arrow on the top middle left.  The picture at the top of this post is looking to the left from that spot on this map. And you can see only a short space down, kind of to where the aisle turns.  Imagine that view in each direction, then add a couple of floors made of several large multiple gymnasium-sized rooms, and you can kind of get the picture.  There are thousands of exhibitors and thousands of attendees.  It is one monster extravaganza of foods, supplements, beauty supplies, and anything else you might imagine having anything to do with diet, health, food and natural clothing.

I hate to go to the thing because I hate throngs of milling people and I hate the exhibitors always trying to sell you something.  But I also really enjoy it because I find new stuff and I learn a lot.  And there are the booth babes, to boot.  Although not so many this year.  Times are tough and booth babes are costly.

Each time I go to Expo West, I notice trends.  And this year was no different.  So, for what it’s worth, here are the trends I noticed after God only knows how many hours spent and miles walked traipsing through the giant Anaheim Convention Center.

Tea

There were a multitude of tea purveyors.  There was black tea, green tea, white tea, herbal teas of every description, and a dozen kinds of maté.  Way, way more tea than I’ve ever seen.  I guess the spate of recent studies that have appeared showing the purported health benefits of drinking some kind of tea has not been lost on tea vendors.  They were there in droves.  And all were babbling about studies demonstrating how tea cures this or that disease.  I didn’t have the heart to tell them that all of the studies they were using were observational studies and not worth a flip for proving that tea helps anything.

Agave

Agave was the big new product this year.  Last year there were a few vendors; this year they were everywhere.  They were selling agave syrup, agave nectar, agave crystals, agave this and agave that.  An entire other group of vendors was promoting various products sweetened with agave.  For those of you who don’t know, agave is the latest entry into the caloric-sweetener sweepstakes.  It comes in a variety of forms – syrup, nectar, crystals -  from the agave plant, a succulent plant found mainly in Mexico.  The claim to fame of this sweetener, which was emblazoned on banners, literature, labels and just about everywhere, is that it is a low-glycemic sweetener.  And it is was being touted as a great food for diabetics and any others with glucose-intolerance problems.  And it is indeed low-glycemic because it is composed of about 90 percent fructose.  If you think high-fructose corn syrup is bad at 55 percent fructose, just imagine what Agave syrup can do for you.  Yet all these ignorant people are ga ga over it as if it were the second coming.  My advice is to avoid it like death.  But be prepared to be seeing it everywhere.

Xylitol

There were a lot of products made with xylitol on display.  Products that are probably pretty good, but that I would never have imagined.  Nose spray, for example.  Xylitol is a sugar alcohol that is antibacterial, which is why it is in gums that dentists recommend.  It actually prevents tooth decay because of its antibacterial properties.  It does the same thing if sprayed into the nose, a place where a lot of bacteria live.  I saw a product made of xylitol that was to be dissovled in water and used in a Neti pot to irrigate sinuses, which, like the nose spray, makes sense.  There have been randomized control trials showing the benefit of xylitol for prevention of tooth decay and prevention of ear infections in kids.  I didn’t see any papers showing studies on the nose sprays or other products, but it’s a reasonable assumption that they probably work.  I certainly wouldn’t hesitate using them.  Based on the number of vendors I saw, expect to see a lot of xylitol-containing products in the days to come.

Sweeteners

There were a fair number of non-caloric sweeteners on display.  Most were made of combinations of RebA, the active ingredient in stevia, and other non-caloric sweeteners.  I saw a lot of erythritol and erythritol combinations as well.  If numbers of vendors are any indication, expect to see a bunch of non-caloric sweeteners hitting the shelves.

Coconut milk and oil

In what I view as an extremely positive trend, there were a zillion purveyors of coconut milk and products made from coconut milk.  In the past, there weren’t many, but this year they were everywhere.  There were a bunch of companies making ice creams and gelato made of coconut milk.  These aren’t low-carb by any stretch, but they are still more healthful (in my opinion) than regular ice cream because of all the great fats in coconut milk and oil.  I took one for the team and tried several of these, and I can tell you that they were delicious.  There were also outfits selling coconut milk that was like regular cow’s milk.  It didn’t taste quite the same, but it wasn’t far off the mark.  I thought it tasted better, but others might disagree.  The milk comes in cartons just like regular milk.  There were chocolates and any other product you could think of that would normally be made of milk or dairy made of coconut milk or oil.

Soy

In what I would consider another positive trend, there were way, way fewer companies selling soy products than ever before.  Since I’ve been attending Expo West soy has been everywhere and in everything.  All of a sudden, this year it’s kind of taken a powder.  There were a handful of people there selling soy-based products, but not anywhere near what has been there in past years.

Nuts

Every year there are people there selling nuts.  This year they wre all over the place.  I’ve never seen so many nuts on display.

Low-fat

Surprisingly there wasn’t a lot of emphasis on the low-fat nature of products.  Previously it was much more visible with banners and stickers on anything that could make the claim, but not so much this year.  Many more products were advertised as having no added sugar or sugar-free than were advertised as being low-fat.  I think the times they are a changing.

Low cholesterol

Strangely, there was more emphasis on low-cholesterol than I’ve noticed in the past few years.  More emphasis, in fact, than there was on low-fat. There were many products on display that proudly proclaimed their cholesterol-lowering properties.  The one that took the cake is pictured below.  The company makes tortilla chips that allegedly lower cholesterol.  Now you know what to do if your cholesterol is a little high: go face down in these chips.  Not!  Actually, they would probably do you less harm than taking a statin.

Meat and eggs

Yet another positive trend was the large increase in the number of vendors selling both fresh and processed meats.  Way more vendors than in the past.  And a large number selling eggs.  I saw many booths that had packets containing two hard boiled eggs and a little salt and pepper.  A good kind of fast food, if you ask me.

Resveratrol

I was expecting there to be a zillion people selling resveratrol, but there weren’t many.  In fact, I couldn’t find anyone selling just the raw stuff.  The only vendors I found selling it were selling their own proprietary versions in which resveratrol was mixed with other compounds.  Given all the press lately about resveratrol I was really surprised at how little there was.

Krill oil

All the krill oil sellers were there, and I spent a good amount of time with them.  They all had large booths, so it was apparent that krill oil has been very, very good to them all.  I finally learned all the distinctions between all the oils available and will be doing a post on them as soon as I have a little time to go over all the papers I’ve pulled to make sure I am accurate.

Vegetarian products

It’s hard to say, but if I had to bet, I would bet that there were slightly fewer this year than last.  They were still there, and they were still obnoxious, but just not in the numbers as before.  At least it appeared that way.

One of the things that constantly amazes me about Expo West and all the other natural food and health food shows I go to is how typically American all the people look who are selling this stuff.  They truly are a mirror of American.  The vast majority are overweight and they don’t look like the picture of health, yet there they are pimping products that are supposed to make the purchasers of them healthy.  If I looked like most of these people, I would hire someone who at least look lean, trim and healthy to man my booth, but these people don’t.  Most are definately not walking advertisements for their products.

Here are a couple of photos to show you what I mean. These pictures give you an idea of what a typical booth at Expo West looks like and typical people working these booths.  I didn’t pick these just because they were hawking vegetarian products, I picked them because I happened to have my camera at hand and they were right across the aisles from one another.  They were not out of the ordinary.  They look like most of the vendors.

I plan to dragoon MD into doing most of the driving tomorrow so that I can catch up on my medical reading (as much as I can anyway while keeping a close eye on the road).  When we get home, I’ll get back on my normal schedule of posting.  Hang in there ’til then.

In my mailbox today (click to enlarge)

If you don’t think high-fructose corn syrup is taking an economic hit, read on.

I went to the mailbox today and retrieved a package from the Corn Refiners Association (CRA), the lobbying group for high-fructose corn syrup (HFCS).  It was addressed to me in the same style that all my medical junk mail comes in, so I assume the above group bought a mailing list of primary care physicians from the American Medical Association, which sells such lists.  I tore open the large envelope and looked at the contents, which are all pictured above.  Having done a number of mailings in my lifetime, I’ve got a pretty good handle on what such a mailing costs.  I would reckon that in the volume they purchased, these pieces probably set them back at least a couple of bucks apiece.  Add the postage and the list rental and your probably looking at a couple of million dollars, if not more, to send this thing out to all the primary care docs in the country.

Inside this packet was a load of propaganda about the virtues of HFCS.  And buried in one of the pages was the following statement that was the dead give away as to why this advertising surge:

Consumption of high fructose corn syrup has been dropping in recent years…

Which lets us know why the CRA has also made a couple of TV commercials that have played around the country and are being sent around virally as well.  In case you haven’t seen them, these are presented below.

The main thrust of the ad package sent to me and these video commercials is that HFCS isn’t really any different than sugar.  And, as long as it’s used in moderation, it’s no more harmful than sugar.  Which, of course, is faint praise at best.  But is it true?

Here, for what it’s worth, is my take on the HFCS issue.

There are basically three versions of HFCS: one containing 42% fructose, another containing 55% fructose and one containing 90% fructose.  The most commonly used by far is the second, the one with 55% fructose.  Since sucrose (table sugar) is 50% fructose and 50% glucose, there really isn’t much difference, and most of the studies seem to bear that out.

There is one distinction between sucrose and HFCS, but in the studies I’ve seen, it doesn’t seem to make a big difference.  Sucrose is a disaccharide.  In other words, it is a molecule made of a molecule of fructose hooked to a molecule of glucose.  HFCS is a mix of monosaccharides (single sugar molecules): it has free fructose and free glucose.  You would think that the fructose would absorb better as a monosaccharide since it doesn’t have to be cleaved away from a glucose molecule first.  But, as I say, the majority of studies don’t seem to show any difference between the two in terms of blood sugar levels or metabolic effects.

There are a couple of things that I think are pernicious about HFCS.  First, it is a vastly superior food additive as compared to sucrose above and beyond its sweetening power.  It doesn’t crystallize, it mixes better, it provides more moisture, etc.  And, in this country at least (thanks to subsidies for corn and price supports for sucrose), it is much cheaper to use.  Consequently, HFCS finds its way into many products that contained no sweeteners before the advent of HCFS.  So, since it’s development, we are eating more sweeteners overall because HFCS is in so many things.  Second, the extra grams of fructose (as compared to glucose) don’t really matter all that much in people who don’t eat a lot of sweeteners, but it starts to add up as the sweet content of the diet goes up.

The last statistics I saw showed that the sweetener content of the average American diet was about 22 percent of calories.   If you consider that the average caloric intake is about 2500 kcal, then you can figure that represents roughly 140 grams of sugar per day, which calculates to 70 grams of fructose and 70 grams of glucose if all the sweetener is sucrose or table sugar (which is what it was pre HFCS).  Now, with about 70 percent of the sweetener coming from HFCS, these figures change.  Now the the 55/45 fructose/glucose ratio of HFCS comes into play, and the fructose goes from 70 grams to 75 grams per day – an extra 5 gm.  Does this matter?  Who knows?  But probably not.  However, since I eat no sweeteners throughout the day, someone else has to eat double to keep the averages the same.  And doubling all these figures gives an extra 10 grams of fructose per day.  And if you figure overall sweetener intake has gone up since the advent of HFCS (which it has), then the heavy sweetener users are probably eating an extra 20-30 grams of fructose per day as compared to what they would have eaten 30 years ago.  I suspect an extra 20-30 grams does make a difference.

If kids sit around MacDonald’s and slurp down a couple of Hugos, they could be getting an extra 10 or so grams of fructose right there, which is more than is found in a Paleo kind of diet in a day.  And that’s just the extra fructose as compared to the Hugo being made with sugar instead of HFCS.  It doesn’t count the 102 grams or so of fructose that would be the same if the drink were made with sugar.

Is it any wonder obesity is skyrocketing among teenagers?  As I’ve written in this blog often, I spent a lot of time at MacDonald’s during my teenage years from when I was a Junior in high school on.  But each drink I bought – there was only one size then, and it was tiny compared to the giant drinks of today – cost me an amount that was much higher in today’s dollars than it costs for one of the huge sodas available now.  And I got only one for that amount.  I couldn’t go back for refills.  Unlimited refills are a consequence of the substantially lower price of HFCS as compared to sugar.  Had I had access to unlimited refills, I wouldn’t have done any different than the kids today – I would have drunk one after another.  But I was limited by my pocketbook.

Just to add a little comedy relief to this dreary story of the advertising jihad of the Corn Refiners Association, here is a YouTube parody of the HFCS commercials.

Click here to view the embedded video.

Dinner tonight at Casa Eades

Last Sunday the New York Times published a color spread on the US Department of Agriculture (USDA) data on the changes in food consumption in this country between 1970 and 2006, which got me to musing.

To the uninformed, which, sadly, probably means most people working in the nutrition industry and even those employed in a nutritional capacity at the USDA, these changes (all save two) seem to be in a positive direction. The intake of dairy products has decreased; the intake of vegetables has increased; the intake of red meat has fallen; the intake of fish, chicken and skyrocketed; the intake of fruit is up; the intake of grains has increased markedly; and the intake of vegetable fats has almost doubled. The only two negatives are that sugar and sweeteners have increased and overall food consumption has gone up by about 11 percent, or an addition 1.8 pounds per person per week.

At the same time all these positive changes have been taking place, changes that all the (misinformed) people in the mainstream nutritional biz have been advocating, there has been an enormous increase in the rate of obesity. According to the Centers for Disease Control (quoted in the Times article) the rate of obesity has more than doubled since 1970, which is interesting because up until 1970 the rates of obesity hummed along at about the rate of 15 percent for decades.

What has happened since 1970 to cause this enormous societal change?

If asked, people give many answers: too much saturated fat, too much refined carbohydrate, too much food, etc.

I have my own opinions, which I will elaborate. I believe that the obesity epidemic has probably been driven by several dietary changes that have occurred since 1970. These changes are an increase in fructose and vegetable oil consumption and a decrease in saturated fat consumption. I believe that another contributing factor is the increased overall consumption of carbohydrates, which leads to an increased food consumption in general.

I want to emphasize that these are my opinions based on a pretty good knowledge of nutrition, metabolism, biochemistry, and physiology.

First, a sort of no-brainer. Since the USDA came out with the idiotic Food Pyramid that we all loathe, there has been a major strategy in the food industry to move away from fats and toward carbohydrates. We have all seen this in various food consumption statistics. And we can tease it out from this Times piece if we look at which foods have increased and which have decreased in the diet. There has been a large increase in carbohydrate consumption as evidenced by the large increase in grains, vegetables, fruits and sweeteners.

Forgetting about all the metabolic events that carb intake precipitates that we all know cause obesity (i.e., increased blood sugar, increased insulin, etc.), let’s focus on simply one of the brain processes that carbs affect. The satiety center, located in the hypothalamus, is the part of the brain that tells us when we’re full. Unfortunately, it runs about 20-30 minutes behind our actual eating pattern, so we can stuff food in for a good while before our brains tell us we’ve had enough. Fortunately, it works a little more quickly (thanks to the help of cholecystokinin and some other gut hormones) when we eat primarily fat. If you eat a big steak, you feel full more quickly than if you eat a lot of carbs. Carbs tend to override the satiety center, allowing you to eat more. Let me describe a situation we’ve all experienced, and you’ll see what I mean.

Your at a restaurant. You’re just at the end of a big meal and you’re stuffed. One of your dinner partners asks you to try a bite of his wonderful swordfish. It’s the best he’s ever tasted, he tells you. You say, I just can’t eat another bite. If I do, I’ll be sick. Then appears the waiter with the dessert tray, loaded with wonderful gooey treats. You look them over and say: I’ll take the carrot cake (or the chocolate mousse or whatever). How can you eat this calorically-laden dessert when you’ve just refused a bite of meat because you were so full? Because your brain’s satiety center is overridden by the carbs. And you haven’t even eaten the carbs yet. But experience has taught you that no matter how full you seem to be, there is always room for carbs. And fat, since most desserts are pretty high in fat as well. But it’s the carbs that do the satiety-center-blunting trick. It’s the reason dessert is always at the end of the meal. If you ate the dessert first, you would never be able to eat all the steak. And this carb overriding of the satiety center is why people don’t binge on steak, eggs and bacon. They binge on cake, chips, cookies and other high carb treats because they can stuff them without their satiety center telling them they’re full.

Since we’ve (as a nation) significantly increased our carb intake, it only makes sense that we’ve also increased the overall amount of food we eat. Carbs let us do that without even trying.

We have definitely increased our intake of fructose since 1970. I used the figures in the Times article to make my own calculations. Considering that table sugar is one half fructose and high-fructose corn syrup is 55 percent fructose (the most commonly used variety; some go as high as 90 percent fructose), I calculated that we ate about 50 grams of fructose per capita per day in 1970. By 2006 that figure had increased to 75 grams, a 50 percent increase. And we’ve got to bear in mind that these are average figures. I eat maybe 3 grams of fructose per day, and MD eats the same. That means that two other people out there are eating their 75 grams plus our extra 72 to make the averages come out as they do. I would suspect that most of the people reading this blog eat very little fructose, leaving a lot of other people to consume their share to keep the averages up.

But even 75 grams of fructose is a helluva lot. A little fructose – the amount you might find in a piece of fruit, for example – actually helps with glucose metabolism. It more or less primes the pump so that less insulin is required to reduce blood glucose. Large amounts of fructose are a different story, however. Fructose bypasses the enzyme phosphofructokinase, which is the rate-limiting enzyme in the glucose metabolism pathway. Consequently, large amounts of fructose are shunted past the sugar-regulating pathways and into the fat-formation pathway instead. The liver converts this fructose to fat, much of which, unfortunately, remains in the liver. ( Here is a nice paper on fructose metabolism. Ignore the idiotic conclusions, which is just another ad hoc attempt to make the data fit a preconceived notion acceptable to all academics.)

With continued consumption of large amounts of fructose, fat tends to accumulate in the liver leading to a condition called non-alcoholic fatty liver disorder (NAFLD). At this point, not only are we in an obesity and a diabetes epidemic, we are in an epidemic of NAFLD. Studies on ‘normal’ adults have shown that a little more than a third have significant fat accumulations in their livers. Even worse, 15-20 percent of children show the same thing.

NAFLD is the same disease people get who chronically over consume alcohol. Under the microscope NAFLD looks exactly the same; pathologically it acts the same. The only way to differentiate is by history of alcohol consumption: if there is fat in the liver and no history of chronic alcohol abuse, then NAFLD it is.

NAFLD has the same progression as the alcoholic variety. First, an accumulation of fat that becomes inflamed leading to a condition called non-alcoholic steatohepatitis (NASH), which means a non-alcoholic inflammation of fat in the liver. This condition can then progress to liver fibrosis, then to cirrhosis, then, ultimately, to liver cancer. Not all NAFLD follows this complete progression just as not all alcoholics get cirrhosis, but enough follow it to not make you want to get NAFLD if you can help it.

And one of the big ways not to get it is to avoid fructose.

By increasing fat in the liver, fructose also increases circulating insulin levels, which can lead to hyperinsulinemia and insulin resistance. How? Because a liver full of fat doesn’t work as well as a non-fatty liver. One of the jobs of the liver is to metabolize hormones and clear them from the circulation when their work is done. When you consume carbs or protein you stimulate the release of insulin to deal with them. Once insulin has done its job, the liver breaks it down to its amino acid components and puts them back in the circulating amino-acid pool. If the liver is filled with fat, it can’t do this as well. Insulin stays elevated (and in a diabolical twist even stimulates more fat synthesis in the liver) and tends to downregulate the insulin receptors, making them less responsive. The entire process can lead to insulin resistance, hyperinsulinemia and ultimately to obesity.

Below is a nice chart showing how the increase in obesity has paralleled the rapid increase in sugar consumption. Remember that table sugar is half fructose. Also remember that correlation is not causation. But in this case we do have the biochemistry of why worked out.

From Johnson RJ et al, AJCN 2007; 86:899-906

What about saturated fat? How does a decrease in saturated fat cause obesity. First, the decrease in saturated fat has tracked with the increase in vegetable oils, which are typically rich in omega-6 fats. Omega-6 fats have been shown in numerous studies to be proinflammatory. They have also been shown to worsen alcoholic fatty liver disease, and, one would assume, NAFLD as well. I haven’t seen any studies showing a worsening of NAFLD with increased consumption of vegetable oil – it hasn’t been studied as far as I know. (Maybe one of you readers can dig up a paper.) But it has been shown repeatedly with alcoholic liver disease, and since NAFLD is basically the same disorder, it makes sense that vegetable oil would worsen NAFLD as well. And if vegetable oil indeed does worsen NAFLD, then it promotes obesity by the mechanism described above.

Saturated fat is a healthful food. Read this article by Mary Enig that describes in detail the health benefits that come from eating saturated fat. I’ll address a couple of different issues.

Saturated fat is, well, saturated. That means that every carbon in the fatty acid chain has a full complement of hydrogens attached to it. There are no double bonds. In the picture below you can see a saturated fatty acid on top and a monounsaturated (one double carbon-carbon bond) fatty acid on the bottom.

Double bonds make fats unstable. These double bonds are the places that free radicals strike to convert unsaturated fats into peroxides, or oxidized fats. The more carbon-carbon double bonds a fatty acid has, the more susceptible it is to oxidation. Oxidized fats don’t function as well as non-oxidized fats. They make faulty cell membranes and less than optimal membranes for all the organelles within the cell. Oxidized fats can themselves become free radicals attacking adjacent fats and damaging them, or worse, starting an entire free-radical-fat-damaging cascade. All these forces work even more effectively at higher temperatures, so unsaturated fats shouldn’t be used for cooking. Unless, of course, your goal is to eat oxidized fats.

Saturated fats have no double bonds. They are immune to free radical attack. They are immune to heat damage. You can cook with them, you can hit them with a hammer, you can throw them on the floor and jump up and down on them. And they stay the same. Saturated fats are stable fats.

Most people don’t realize this, but the body has the ability to convert saturated fats to unsaturated fats. But the body doesn’t have the ability to convert unsaturated fats to saturated ones. The body can make saturated fats (palmitic acid, a 16-carbon-chain fatty acid) from excess carb consumption, but it can’t make a saturated fat out of an unsaturated one. If nature hadn’t wanted us to have saturated fat, why did she make us so that we make our own if we eat too many carbs. Could it be that during our evolutionary past the only time we might over consume carbs would have been when there was no meat available…and we needed the saturated fat? Sounds reasonable to me.

We have enzymes called desaturases that desaturate, i.e., add carbon-carbon double bonds, fats. We can take unsaturated fats and make them more unsaturated. And we can take saturated fats and make them unsaturated. But we can’t go the other way. In order to have saturated fats that provide the necessary structural stability that only saturated fats can provide is to get them in the diet, which we can do by eating saturated fats or by eating a whole lot of carbs. Since over consuming carbs comes with its own set of problems that we would rather avoid, that leaves eating saturated fats.

So how does avoiding saturated fats lead to obesity. In my opinion in a couple of ways. First, indirectly, by having them replaced by vegetable oil, particularly hydrogentated vegetable oil, i.e., trans fat. Due to their stability, saturated fats have cooking properties that no other natural fats have. Food chemists have created trans fats to have the same cooking properties – and in some situations even better cooking properties – as saturated fats. But the addition of trans fats to the diet creates a host of other problems. The medical literature is crawling with studies showing that trans fats drive the development of obesity.

The other reason is that saturated fats compose the lion’s share of normal membranous fats and of the brain. When membranes don’t work as well, especially mitochondrial membranes, our energy storage and regulation system doesn’t work as well. Anything that impairs membrane functioning impairs signaling function. If signaling function falls off, then various hormones, neurotransmitters, etc. lose function. As insulin loses function, more insulin is required, more insulin leads to more downregulation of receptors, all of which ultimately leads to obesity.

Even overeating carbs doesn’t help even though saturated fats are produced as a result. Carbs stimulate the production of palmitic acid, a 16-carbon chain fat. For proper membrane function and signaling we need shorter-chain saturated fats as well. These we can’t make – we get them from diet only. We can make shorter fats longer with elongase enzymes, but we can’t make longer fats shorter. We’ve got to get them via mouth.

Since this is speculation on my part – educated speculation, but speculation nevertheless – we may ultimately find that there are other reasons for the obesity epidemic instead of these or in addition to these. In fact, I can think of a few other minor causes, which I’ll save for a later post.) But I’ll bet that when all the work is done – which may not be for a hundred years given the academic climate of today – I’ll bet these ideas will be close to the mark.

Before we get into the study, let’s take a moment and discuss AGEs so we’ll all be on the same page. When proteins are incubated with sugars, over time the sugar attaches irreversibly with the protein in a process called glycation. (There are many names for the reaction: the Maillard reaction, Schiff’s base formation, the Amadori reaction, etc. with minor differences between these different processes, but debating the differences is pointless for our purposes.) If the protein performs a specific function in the body due to its unique structural conformation, and it finds itself with a sugar attached to it that it can’t get rid of, then this protein suddenly doesn’t function so well and becomes a junk protein that the body has to dispose of.

Since most of the structures in our bodies are made of protein, and since all of these proteins are bathed in blood that contains glucose, the normal course of events is for a portion of these proteins to undergo glycation. And the longer the proteins are in contact with the sugar, the more glycated proteins will be formed. All this goes on continuously in our bodies so as we age we accumulate more and more of these substances, thus the clever name AGEs.

If we set out two beakers filled with a protein solution and add an amount of sugar to one and double that amount of sugar to the other, we will end up with many more glycated proteins in the beaker with more sugar. The same thing happens in the body. If blood sugar is chronically high, then there are more glycation products. One of these products – hemoglobin A1c – is used to measure the average blood sugar concentration over the previous couple of months.

Hemoglobin is the protein in the red blood cells that binds to and transports oxygen throughout the body. There is always sugar in the blood, some of which binds to the hemoglobin via the glycation process. If the blood sugar goes up and stays up as it does in diabetes the elevated concentrations of glucose end up producing more glycated hemoglobin, called hemoglobin A1c. (Fructose is a much more potent glycating agent (it’s actually called a fructating agent) than is glucose (blood sugar), so the inclusion of high-fructose corn syrup into almost everything isn’t doing us a lot of good glycation-wise.) And hemoglobin isn’t the only protein being glycated – it’s just the one that’s commonly measured.

More glycated proteins are not a good thing. We all want our proteins to work as nature intended and not be gummed up by having a sugar hanging off of them. These glycated proteins end up in the lysosomes, the refuse boxes of the cells, and are thought to be one of the driving forces behind the aging process. Cells with too much junk don’t function properly. And when enough of our cells don’t function properly, we don’t function properly. (Click here to read an old post about de-junking your cells)

With that background in mind, let’s take a look at the paper.

Researchers looked at a group of 19 vegetarians (lacto-ovovegetarians) and used as a comparison a group of 19 omnivorous subjects recruited from the same region (Bratislava, Slovak Republic). As you can see from the table below, the omnivores (Traditional) actually consumed a little more carb (saccharides) each day than did the vegetarians (Alternative), but not enough to reach significance. What the vegetarians ate more of in significant amounts were fruits and vegetables, giving them a significantly increased intake of fructose.

When researchers measured levels of carboxymethyllysine, an glycation product that represents

a general marker of oxidative stress and long-term damage of proteins in aging, atherosclerosis and diabetes

it was found to be significantly elevated in vegetarians as compared to omnivores. Fluorescent AGEs are basically a direct measurement of AGEs in the blood. As the authors point out fluorescent AGEs serve

as an index of advanced glycation [and] increase linearly for human serum albumin [a blood protein] incubated with glucose and exponentially when fructose [is] added to the incubation medium.

Fluorescent AGEs were also significantly higher in the vegetarians.

Another interesting aspect of this study is the finding of the authors that the vegetarians

do not use high temperature for culinary treatment. They prefer heat treatment at lower temperature for short period of time.

I find this intriguing because so many anti-meat zealots constantly harp about the dangers of overcooking meat (or cooking it on a grill) because of the AGEs that are produced in the process, which, they seem to believe end up in the bodies of those who eat grilled or overcooked meat. I don’t think it’s too much to assume that most of the omnivores eat meat, and some probably overcook it or grill it, yet they have less accumulation of AGES than the oh so fastidious vegetarians.

I’m sure I’ll get a slew of comments from surly vegetarians after this post telling me how healthy they are and how healthful the vegetarian diet is. But in this case the data show otherwise.

A couple of weeks ago I wrote a post showing how the press fails to mention low-carb diets in weight loss stories, focusing instead on exercise or some other facet of an individual’s quest to lose weight and improve health. Today we’ll look at how the press, in an effort to minimize the untoward effects of carbohydrates on health, sometimes simply misrepresents the true outcome of studies.

A week or so ago a Swedish study (click here for a pdf) was released looking at the short term effects on the liver of a diet high in fast food. ABC News reported the study. Let’s first look at what the study was all about and what the data showed, then we’ll see how ABC reported it. By looking carefully at what ABC did to misrepresent the study, we can arm ourselves with the knowledge to identify this kind of press bias in future reporting.

First the study.

The goal of this study was to examine the effect of fast-food hyperalimentation (overeating) on liver enzymes and fat accumulation in liver cells. The specific liver enzyme in question was alanine aminotransferase (ALT), one of the liver enzymes routinely measured on standardize lab panels. Over the past couple of decades the prevalence of elevated ALT in routine labs has about doubled. Elevations of ALT are associated with an increased incidence of metabolic syndrome and all its attendant features, including non-alcoholic fatty liver disease. The Swedish researchers wanted to see if force feeding young, healthy subjects a diet high in fast food over a four week period would increase blood levels of ALT and increase the fatty infiltration of their livers.

Eighteen healthy subjects (12 males, 6 females) with an average age of 26 years were to try to increase their body weight by 5-15 percent in 28 days by adding two large fast-food meals daily in an effort to double their normal caloric intake. Researchers matched a similar control group for comparison.

The subjects took to their assignment with a vengeance. The average intake soared from 2273 kcal/day to 5753 kcal/day, a 153 percent increase! This caloric increase was driven primarily from an increase in fat, the consumption of which skyrocketed from 87 g/day to 261 grams per day (200% increase). Carbohydrate intake increased from about 275 g/day to 644 g/day (134% increase). And protein went up from 89 g/day to 180 g/day (102% increase). Sugar intake increased by 200%.

As a percentage of total calories fat rose from 36% to 43%. Carbs decreased from 48% to 45%. Protein also decreased from 16% to 12% of total caloric intake. So although the actual gram amounts of protein and carb went up as the subjects gorged on fast foods, their fractional percentage of the total calories went down.

What happened?

Over the four weeks subjects on the high-fast-food diet increased their weight by 9.5 percent, their serum ALT levels by 334 percent, and the content of fat in their livers by 155 percent. The control group showed no changes.

When the researchers ran the standard statistical analysis to determine which – if any – of the specific macronutrients correlated most directly with the increase in ALT, they discovered that

the average consumption of fat or proteins during the 3 days at the end of the first or third week weeks was unrelated to changes in ALT. [Blood was drawn in the non-fasting state at the end of the first and third weeks to more accurately monitor ALT levels.] However, the maximal ALT/baseline ratio correlated with carbohydrate intake during the third week.

One could, I suppose, argue with the standard statistical analysis program the researchers used to determine this correlation, but the fact remains that the researchers did report in the study as quoted above that the increase in carbohydrate intake was the driving force behind the elevation in ALT, not the increase in either protein or fat. You might imagine that those reporting the study would mention this finding.

Before we get to the biased article by ABC, let’s take a look at a more balanced piece of reporting by Yahoo! News. Marlow Hood, the Yahoo reporter, not only read the study but took the time to track down the author and interview him as to his findings. (As most of you who are long-time readers of this blog should know, I’m always leery of study authors’ interviews with the press because the conclusions these authors often report haven’t been run through the tempering of the peer-review process and in many cases don’t jibe with what the actual study shows. In this case, however, it did.)

Said Frederik Nystrom, the lead researcher

signs of liver damage were linked to carbohydrates was another key finding…

It was not the fat in the hamburgers, it was rather the sugar in the coke…

Dr. Nystrom also pointed out another surprising finding (surprising only to those, I suppose, who don’t understand lipid biology) that wasn’t included in this study but will be published in a future paper.

We found that healthy HDL cholesterol actually increased over the four-week period — this was very counter-intuitive.

The study showed that the increase in saturated fat correlated with the increase in healthy cholesterol.

Apparently Dr. Nystrom isn’t aware that HDL-cholesterol levels are fat dependent. In other words, increasing fat in the diet, particularly saturated fat, increases HDL-C levels.

Now let’s look at how ABC News reported this study to see a masterpiece of deception.

After a gratuitous opening to the article and the briefest of descriptions of the methods of the study, Radha Chitale, the reporter, pulls out one of the most commonly-used methods of slanting a story: she interviews someone other than the author. In this case she interviewed Dr. Kieth-Thomas Ayoob, an associate professor of pediatrics at the Albert Einstein College of Medicine. Given what Dr. Ayoob says, one really wonders if he even looked at the study or if it were merely synopsized for him by the reporter during a phone call.

Here’s how the reporter led into Dr. Ayoob’s comments.

Studies have shown that a diet high in fat and calories — the magic recipe for delicious, greasy fast food — puts people at greater risk for obesity and type 2 diabetes, both of which can lead to cardiovascular diseases and heart failure.

But the Swedish study, the goal of which was to double calorie intake and increase body weight by about 15 percent, showed that the liver is also at risk when you roll up to the drive-through window.

Here is Dr. Ayoob’s take on the study in his own words.

The extra fat is the big enchilada here, the equivalent of about three sticks of butter daily. The liver is basically using its compensatory mechanism to accommodate all this extra stuff.

Say what?!?!?!

Than the reporter follows up with

The liver processes fats in the blood. Excessive calories and fats overload the organ, causing fat to build up in the liver cells and leading to liver damage.

Jesus wept.

Not no where, not no how in this report does it say anywhere that carbs were the cause of the problem, which is the point the actual authors of the study were at pains to make.

If one were to read only the ABC News report, one would come away with the notion that this study shows in dramatic fashion how an increased fat intake can ruin a liver in only four weeks. But, as we saw above, that isn’t the case at all as shown by the study and confirmed by the study’s lead author. It just one more way that the media disses low-carb diets or the idea that excess carbs may actually be harmful by misrepresenting research reports.

An interesting corroborating side note to this study is found in one of the references. I’m sure these findings were a big surprise to the researchers running the analysis of the data, so they did what all researchers do in the same situation: they looked in the medical literature to try to get a handle on the situation. One of their references is to a study done at Johns Hopkins published a couple of years ago in Digestive Diseases and Sciences. In this study researchers found that the fatty infiltration and inflammation of the livers of morbidly obese patients who underwent bariatric surgery correlated with carbohydrate intake.

There were no significant associations between either total caloric intake or protein intake and either steatosis, fibrosis, or inflammation. However, higher CHO [carbohydrate] intake was associated with significantly higher odds of inflammation, while higher fat intake was associated with significantly lower odds of inflammation. In conclusion, present dietary recommendations may worsen NAFLD [non-alcoholic fatty diver disease] histopathology.

On another note, the Swedish fast-food study provides us with much more interesting material than the fact that excess carb intake runs up serum ALT levels. In fact this study gives us a glimpse into the subject of the existence of a metabolic advantage. It will be the subject of the next post.

Yesterday a reader sent me a film clip from ABC news about resistant starch. (Click here to view the video) In this film clip a young woman who is a registered dietitian (RD) spoke about the virtues of a “type of fiber” that she referred to as resistant starch. According to her, this substance can cure a multitude of ills.

There is a type of fiber called resistant starch that’s naturally found in some high carbohydrate foods.

And it’s amazing, the benefits. It ranges from helping us burn fat, helping us boost our immune system, control blood sugar, reduce the risk of type II diabetes and reduce the risk of cancer.

She’s really excited because, as she points out, there are over 160 studies showing the benefit of resistant starch.

Wow! Where do I sign up to get some? It sounds great. Or does it?

There are probably over 1600 studies showing the purported benefits of statin drugs, but we all know what those are. The 160 studies purporting to show benefit for resistant starch are probably in the same mold. Let’s forget about the studies right now and focus more on what we really know about starch and resistant starch to see how well this lady’s claims hold up to scientific scrutiny.

When asked about how resistant starch works, she claims that

it basically gets fermented in the digestive tract, and it creates beneficial fatty acids. One is called butyrate. And what that does is it helps to shut off the burning of carbohydrates. So carbohydrates are the preferred source of fuel, but if they can’t be burned, your body is going to turn to body fat and recently consumed fat instead.

All fiber goes through the digestive tract unabsorbed until it reaches the colon where it is acted upon by colonic bacteria (I suppose you could loosely call it fermented) that convert it to short chain fatty acids, one of which is butyrate (a four-carbon fat). These short chain fatty acids can be absorbed through the colon and used for energy just like any other fat.

So if butyrate “shuts off the burning of carbohydrates,” as our RD says it does, then wouldn’t it make sense to get as much of it as we can? And what happens to all that carbohydrate we don’t burn? Does it just continue to circulate in the blood running our blood sugar sky high? Or does it get stored as glycogen? Does butyrate encourage carbohydrates to head into storage? These are all questions she doesn’t address. Let me help clarify.

The list of foods containing resistant starch she mentions specifically are the following:

• Beans
• Potatoes
• Barley
• Corn
• Brown rice
• Under ripe bananas

She claims that these foods contain about 5 percent of their starch as resistant starch (which prety much agrees with other similar claims I’ve seen in the medical literature). If true, this means that 95 percent of the starch is not resistant starch and breaks down in the GI tract to glucose.

One half cup of any of these foods – so she says – contains all the resistant starch one needs to provide all the above benefits. Let’s take a look.

According to the USDA database if we consume a half cup of cooked potato we’ll end up with 12.9 grams of carbohydrate (almost three teaspoons), of which 10.5 grams are starch. If we go by our RD’s estimate that 5 percent of the total starch is resistant starch, we calculate that our half cup of potato contains about half a gram of resistant starch (0.5265 g to be exact). If we then convert this starch to butyrate we find that we have about 2.3 grams of butyrate (assuming 100 percent conversion to butyrate, which isn’t the case because some is converted to other short chain fatty acids).

So, we eat our half cup of cooked potato, and what do we get? We get almost three teaspoons of sugar and carb that convert almost immediately to glucose and head directly into the bloodstream. The blood volume of a person with a normal blood sugar contains about a teaspoon of sugar, which means that consuming the potato almost quadruples the amount of sugar in the blood. The pancreas then secretes insulin to drive this excess sugar into the cells. This extra insulin then does all the things excess insulin is famous (or infamous) for doing.

But what about the butyrate from the resistant starch? Oh yeah, the 2.3 grams of butyrate. I don’t see how the butyrate is going to do much to stop the insulin spike resulting from the ingestion of the sugars and starch from the non-resistant starch part of the potato. And even if butyrate really does all it is cracked up to do, we wouldn’t really need the potato with all its accessory easily absorbed carb because we can get the equivalent amount of butyrate from a single pat of butter. (Or almost the same – a pat of butter contains 1.45 g butyrate. Two pats of butter contain 3 g or about 1.5 times the amount generated by the resistant starch component of the potato.)

If the benefits of the resistant starch come from its conversion to butyrate as our RD avers, and if it requires the amount per day found in only one half cup of potato (or of the other foods she lists) as she also avers, then why not provide ourselves with one and a half times as much by eating a couple of pats of butter per day, which come without the extra three teaspoons of sugar? We get the butyrate without having to convert and we don’t get the extra carbs. Makes perfect sense to me.

Amazingly, our RD recommends adding the half cup of one of the resistant-fat-containing foods to the rest of whatever you’re eating that day. So, if you’re already on a ‘normal’ diet, i.e., one pretty high in carbs already, she is recommending that you add, say, a half cup of cooked potato to the mix so that you will ‘lose fat, reduce blood sugar, and lower insulin levels.’ Hmmm. Sounds a little snake oily. Sounds like she’s telling porkies.

While I’m at it, I have to mention one other little porky she tells during the interview. Says she

…and because resistant starch doesn’t get digested or absorbed it fills you up but you don’t get any calories from it.

Okay. Let me get this straight. First, she tells us that it converts to butyrate, a fat, which is absorbed and works miracles once it is absorbed. Second, she tells us that we don’t get any calories from it. Have I got that right?

She is correct in saying that resistant starch (as well as any other type of fiber) gets converted to short-chain fatty acids. And she is correct in saying that the short-chain fatty acids get absorbed. But when they do get absorbed, they contain 9 kcal per gram, just the same as any other fat. So they are not free of calories. That’s why fiber is counted in the total calorie count on nutritional labels. Fiber does make it’s way through the upper digestive tract without being absorbed, but it does get converted to fat and absorbed in the lower GI tract, i.e., the colon. So, I guess we could say she’s a fibber when it comes to fiber. At least in terms of its calorie content.

This brief discourse should put you off of resistant starch even without knowing what anti-nutrients are (resistant starch is an anti-nutrient), why they’re there and what they do. We’ll save that for a later post.

Now that you know the real story behind resistant starch, go back and watch the video to see how filled with misinformation it really is. Which also goes to show why you should never believe anything like this you see in a short spot on a news program without checking it out first.

Hat tip to Terry for sending me the video clip

Under the current system, the government guarantees a price floor for sugar and limits the sugar supply — placing quotas on domestic production and quotas and tariffs to limit imports. According to the Organization for Economic Cooperation and Development, sugar supports cost American consumers — who pay double the average world price — more than $1.5 billion a year. The system also bars farmers in some of the poorest countries of the world from selling their sugar here.

The North American Free Trade Agreement is about to topple this cozy arrangement. Next year, Mexican sugar will be allowed to enter the United States free of any quotas or duties, threatening a flood of imports. Rather than taking the opportunity to untangle the sugar program in this year’s farm bill, Congress has decided to bolster the old system.

Both the House bill, which was passed in July, and the Senate version, which could be voted on as early as this week, guarantee that the government will buy from American farmers an amount of sugar equivalent to 85 percent of domestic consumption — regardless of how much comes in from abroad. To add insult to injury, both also increase the longstanding price guarantee for sugar.

As long as the prices stay up on sugar, the more manufacturers will turn to high-fructose corn syrup. The more HFCS people get, the more fructose they consume, the more fructose they consume, the worse their insulin resistance and all that follows. This is not to say that plain old sugar is a health food because it’s certainly not. In fact sucrose (table sugar) provides almost as much fructose as HFCS, so it is probematic as well. But for those who consume huge amounts of sugar – I’m thinking teenagers here with their propensity to drink huge amounts of HFCS-sweetened soft drinks – the difference between the amount of fructose in HFCS and that in sugar add up to pretty large numbers.

It’s good to see that the relatively newly elected Democratic Congress is conducting business as usual, lapping up Big Sugar’s $3 million handout and seeing to it that the status quo is maintained. Too bad we get the trick while Big Sugar gets the treat.