Tag Archives: metabolic syndrome

November 4, 2015 · 8:42 PM

Well Over Half of Adults in U.S. Are On Drugs

"These are flying off the shelves!"

“But selling drugs is good for the economy, silly!”

Over the last decade, the percentage of U.S. adults taking prescription drugs has risen from 50 to 60%. UPI has the pertinent details. A snippet:

Many of the most used drugs reflect the effects of metabolic syndrome, a group of conditions tied to obesity and diet.

“Eight of the 10 most commonly used drugs in 2011-2012 are used to treat components of the cardiometabolic syndrome, including hypertension, diabetes, and dyslipidemia,” researchers wrote in the study, published in the Journal of the American Medical Association. “Another is a proton-pump inhibitor used for gastroesophageal reflux, a condition more prevalent among individuals who are overweight or obese. Thus, the increase in use of some agents may reflect the growing need for treatment of complications associated with the increase in overweight and obesity.”

I’m not anti-drug, generally. Lord knows I prescribe my fair share. But in addition to the cost of drugs, we have side effects and drug interactions to worry about. If we in the U.S. would effectively attack overweight and obesity, we’d be much better off.

It’s a lot easier to just pop a pill, isn’t it? Especially if someone else is paying for the pill.

Steve Parker, M.D.

PS: My books cost far less than most prescriptions and cause only rare paper cuts.

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June 25, 2014 · 4:00 AM

Study Finds Shortened Lifespan From Obesity Even If “Metabolically Healthy”

I'll eat my hat if this dude doesn't have metabolic syndrome

I’ll eat my hat if this dude doesn’t have metabolic syndrome

See details at MedPageToday.

Some studies suggest you can be healthy and long-lived while obese as long as you are “metabolically healthy.” That is, if you have normal blood pressure, LDL cholesterol, triglycerides, blood sugar, and waist circumference. A new meta-analysis finds that isn’t the case: you’re still at higher risk for death or cardiovascular events if you’re obese and free of metabolic syndrome features.

“Our results do not support this concept of ‘benign obesity’ and demonstrate that there is no ‘healthy’ pattern of obesity,” Kramer and colleagues wrote. “Even within the same category of metabolic status (healthy or unhealthy) we show that certain cardiovascular risk factors (blood pressure, waist circumference, low high-density lipoprotein cholesterol level, insulin resistance) progressively increase from normal weight to overweight to obese.”

Click for the scientific journal abstract.

This report does not directly address the “fat but fit” concept, whereby you can counteract some of the adverse health effects of obesity by being fit. By fit, I mean regularly exercising and achieving a decent level of capacity and tolerance for physical activity. Fat but fit still holds. In other words, if your choice is between being fat or physically fit, you’ll probably live longer and be healthier if you’re fit.

Steve Parker, M.D.

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June 16, 2013 · 12:22 AM

Should People With Diabetes Restrict Carbohydrates?

MB900402413Dr. John Rollo (a surgeon in the British Royal Artillery) in 1797 published a book, An Account of Two Cases of the Diabetes Mellitus. He discussed his experience treating a diabetic Army officer, Captain Meredith, with a high-fat, high-meat, low-carbohydrate diet. Mind you, this was an era devoid of effective drug therapies for diabetes.

The soldier apparently had type 2 diabetes rather than type 1.

Rollo’s diet led to loss of excess weight (original weight 232 pounds or 105 kg), elimination of symptoms such as frequent urination, and reversal of elevated blood and urine sugars.

This makes Dr. Rollo the original low-carb diabetic diet doctor. Many of the leading proponents of low-carb eating over the last two centuries—whether for diabetes or weight loss—have been physicians.

But is carbohydrate restriction a reasonable approach to diabetes, whether type 1 or type 2?

What’s the Basic Problem in Diabetes?

Diabetes and prediabetes always involve impaired carbohydrate metabolism: ingested carbs are not handled by the body in a healthy fashion, leading to high blood sugars and, eventually, poisonous complications.  In type 1 diabetes, the cause is a lack of insulin from the pancreas.  In type 2, the problem is usually a combination of insulin resistance and ineffective insulin production.

Elevated blood pressure is one component of metabolic syndrome

Elevated blood pressure is one component of metabolic syndrome

A cousin of type 2 diabetes is “metabolic syndrome.”  It’s a constellation of clinical factors that are associated with increased future risk of type 2 diabetes and atherosclerotic complications such as heart attack and stroke. One in six Americans has metabolic syndrome. Diagnosis requires at least three of the following five conditions:

■  high blood pressure (130/85 or higher, or using a high blood pressure medication)

■  low HDL cholesterol:  under 40 mg/dl (1.03 mmol/l) in a man, under 50 mg/dl (1.28 mmol/l) in a women (or either sex taking a cholesterol-lowering drug)

■  triglycerides over 150 mg/dl (1.70 mmol/l) (or taking a cholesterol-lowering drug)

■  abdominal fat:  waist circumference 40 inches (102 cm) or greater in a man, 35 inches (89 cm) or greater in a woman

■  fasting blood glucose over 100 mg/dl (5.55 mmol/l)

Metabolic syndrome and simple obesity often involve impaired carbohydrate metabolism. Over time, excessive carbohydrate consumption can turn obesity and metabolic syndrome into prediabetes, then type 2 diabetes.

Carbohydrate restriction directly addresses impaired carbohydrate metabolism naturally.

Carbohydrate Intolerance

Diabetics and prediabetics—plus many folks with metabolic syndrome—must remember that their bodies do not, and cannot, handle dietary carbohydrates in a normal, healthy fashion. In a way, carbs are toxic to them. Toxicity may lead to amputations, blindness, kidney failure, nerve damage, poor circulation, frequent infections, premature heart attacks and death, among other things.

Diabetics and prediabetics simply don’t tolerate carbs in the diet like other people. If you don’t tolerate something, you have to give it up, or at least cut way back on it. Lactose-intolerant individuals give up milk and other lactose sources. Celiac disease patients don’t tolerate gluten, so they give up wheat and other sources of gluten. One of every five high blood pressure patients can’t handle normal levels of salt in the diet; they have to cut back or their pressure’s too high. Patients with phenylketonuria don’t tolerate phenylalanine and have to restrict foods that contain it. If you’re allergic to penicillin, you have to give it up. If you don’t tolerate carbs, you have to give them up or cut way back. I’m sorry.

Carbohydrate restriction directly addresses impaired carbohydrate metabolism naturally.

But Doc, …?

1.  Why not just take more drugs to keep my blood sugars under control while eating all the carbs I want?

We have 12 classes of drugs to treat diabetes.  For most of these classes, we have little or no idea of the long-term consequences.  It’s a crap shoot.  The exceptions are insulin and metformin.  Several big-selling drugs have been taken off the market due to unforeseen side effects.  Others are sure to follow, but I can’t tell you which ones.  Adjusting insulin dose based on meal-time carb counting is popular.  Unfortunately, carb counts are not nearly as accurate as you might think; and the larger the carb amount, the larger the carb-counting and drug-dosing errors.

2.  If I reduce my carb consumption, won’t I be missing out on healthful nutrients from fruits and vegetables?

No.  Choosing low-carb fruits and vegetables will get you all the plant-based nutrients you need.  You may well end up eating more veggies and fruits than before you switched to low-carb eating.  Low-carb and paleo-style diets are unjustifiably criticized across-the-board as being meat-centric and deficient in plants.  Some are, but that’s not necessarily the case.

3.  Aren’t vegetarian and vegan diets just as good?

Maybe.  There’s some evidence that they’re better than standard diabetic diets.  My personal patients are rarely interested in vegetarian or vegan diets, so I’ve not studied them in much detail.  They tend to be rich in carbohydrates, so you may run into the drug and carb-counting issues in Question No. 1.

Steve Parker, M.D.

PS:  The American Diabetes Association recommends weight loss for all overweight diabetics. Its 2011 guidelines suggest three possible diets: “For weight loss, either low-carbohydrate [under 130 g/day], low-fat calorie-restricted, or Mediterranean diets may be effective in the short-term (up to two years).”  The average American adult eats 250–300 grams of carbohydrate daily.

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June 10, 2013 · 4:58 AM

Is Sugar the New Fat?

Lumps of Death

Lumps of Death

In the 1950s, John Yudkin wrote a book, Pure, White, and Deadly (amazingly still available at Amazon), blaming sugar as the primary cause of heart disease (coronary heart disease).  The idea didn’t gain sufficient traction and the dietary fat theory of heart disease became the reigning dogma.  Now that the latter theory has been discredited, researchers are looking at sugar again.

The British Medical Journal has a pertinent article you’ll undoubtedly enjoy, if you’re the sort of person who enjoys these things.  I quote:

“In recent years, and slowly, the sugar hypothesis has been making a comeback, driven in part by the emerging perception of heart disease as a consequence of what’s now described as the metabolic syndrome: obesity, dyslipidaemia, raised blood pressure, and insulin resistance. Although there is still no consensus about the causes of the syndrome, an excess of fat in the liver—a response to dietary sugar—is one of the acknowledged possibilities.  Fructose, found in large quantities in nearly all added sugars, is known to increase lipogenesis in the liver and the synthesis of hepatic triglyceride.”

Steve Parker, M.D.

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March 5, 2013 · 5:46 AM

What’s Metabolic Syndrome?

metabolic syndrome, low-carb diet, diabetes, prediabetes

He’s at high risk for metabolic syndrome

“Metabolic syndrome” may be a new term for you. It’s a constellation of clinical factors that are associated with increased future risk of type 2 diabetes and atherosclerotic complications such as heart attack and stroke. One in six Americans has metabolic syndrome. Diagnosis requires at least three of the following five conditions:

  • high blood pressure (130/85 or higher, or using a high blood pressure medication)
  • low HDL cholesterol:  under 40 mg/dl (1.03 mmol/l) in a man, under 50 mg/dl (1.28 mmol/l) in a women (or either sex taking a cholesterol-lowering drug)
  • triglycerides over 150 mg/dl (1.70 mmol/l) (or taking a cholesterol-lowering drug)
  • abdominal fat:  waist circumference 40 inches (102 cm) or greater in a man, 35 inches (89 cm) or greater in a woman
  • fasting blood glucose over 100 mg/dl (5.55 mmol/l)

What To Do About It

Metabolic syndrome and simple excess weight often involve impaired carbohydrate metabolism. Over time, excessive carbohydrate consumption can turn overweight and metabolic syndrome into prediabetes, then type 2 diabetes.  Carbohydrate restriction directly addresses impaired carbohydrate metabolism naturally. When my patients have metabolic syndrome, some of my recommendations are:

  • weight loss, often via a low-carb diet
  • low-carb diet if blood sugars are elevated
  • regular exercise, with a combination of strength and aerobic training

If these work, the patient can often avoid costly drugs and their potential adverse effects.

Ask your doctor what she thinks.

Steve Parker, M.D.

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July 24, 2011 · 2:00 AM

Research Round-Up

 

I have a stack of scientific articles I’ve been meaning to review in depth and blog about.  But I have to finally admit I don’t have the time.  Here they are.  Click through for details.

  1. Long-term calorie restriction in humans appears highly effective in reducing atherosclerosis risk factors (lab tests) and actual carotid artery atherosclerosis. Only 18 study subjects, however.
  2. A very-low-carbohydrate diet improved memory in older adults with mild cognitive impairment over six weeks.  Twenty-three subjects were randomized to either high-carb or very-low-carbohydrate diet.  The low-carbers improved verbal memory performance, lost weight, reduced fasting blood sugar and fasting insulin levels.  Ketone levels were positively correlated with memory performance.
  3. A high-fat diet impairs cognitive function and heart energy metabolism in young men.  Sixteen test subjects.  Crossover study design with a five-day high-fat diet deriving 75% of energy from fat, compared to a low-fat diet deriving 23% of energy from fat.  High-fat diet led to impaired attention, speed, and mood.  I’m sure low-carb bloggers have been all over this.  At first blush, it appears they were testing during “induction flu” phase of very-low-carb eating, between days 2 to 7 of a new ketogenic diet.  It takes several weeks to adapt metabolism to running almost entirely on fat rather than standard carbohydrates.  Suspect results would have been different if given time to adapt.
  4. Weight-loss with the laparoscopic gastric banding procedure has poor long-term outcome, according to Belgian surgeons reporting on 82 patients.  Four in 10 patients had major complications.  Nearly half of the 82 patients needed to have the bands removed, and six of every 10 required some kind of re-operation.
  5. Trust me, you DON’T want age-related macular degeneration.  Women, reduce your risk of ARMD with a healthy lifestyle, including regular exercise, avoidance of smoking,  and by eating abundant plant foods (vegetables [including orange and dark leafy green ones], fruits, and whole grains) and limit foods high in fat, refined starches, sugar, alcohol, and oils.  At least according to these researchers. 
  6. Leafy green vegetables and olive oil are linked to reduced heart disease (CHD) in Italian women.  Fruit consumption had no effect.  This is from a subset of the huge EPIC study, following 30,000 women over almost eight years.
  7. The Mediterranean diet protects against metabolic syndrome, reducing risk by about a third according to a huge meta-analysis from Greek and Italian investigators.  It works best in Mediterranean countries. 
  8. The Mediterranean diet was linked to slower rates of cognitive decline in Chicago residents over the course of almost eight years.  The comparison diet was the Healthy Eating Index-2005.  Of the 3,800 participants, about two-thirds were black.  A Manhattan population showed lower risk of dementia when eating Mediterranean-style.

There ya’ go.  This is better than letting the articles just sit in my briefcase for months on end, eventually to be thrown out.

Steve Parker, M.D.

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July 21, 2011 · 2:00 AM

Spanish Ketogenic Mediterranean Diet Cures Metabolic Syndrome

The very-low-carb Spanish Ketogenic Mediterranean Diet cures metabolic syndrome, according to investigators at the University of Córdoba in Spain. 

The metabolic syndrome is a collection of clinical factors that are linked to high risk of developing type 2 diabetes and heart disease.  Individual components of the syndrome include elevated blood sugar, high trigylcerides, low HDL cholesterol, high blood pressure,  and abdominal fat accumulation.

Spanish researchers put 26 people with metabolic syndrome on the Spanish Ketogenic Mediterranean Diet for twelve weeks and monitored what happened.  At baseline, average age was 41 and average body mass index was 36.6.  Investigators didn’t say how many diabetics or prediabetics were included.  No participant was taking medication.

What’s the Spanish Ketogenic Mediterranean Diet?

Calories are unlimited, but dieters are encouraged to keep carbohydrate  consumption under 30 grams day.  They eat fish, lean meat, eggs, chicken, cheese, green vegetables and salad, at least 30 ml (2 tbsp) daily of virgin olive oil,  and 200-400 ml of red wine daily ( a cup or 8 fluid ounces  equals 240 ml).  On at least four days of the week, the primary protein food is fish.  On those four days, you don’t eat meat, chicken, eggs, or cheese.  On up to three days a week, you could eat non-fish protein foods but no fish on those days. 

How’s this different from my Ketogenic Mediterranean Diet?  The major differences are that mine includes one ounce (28 g) of nuts daily, less fish overall, and you can mix fish and non-fish protein foods every day.

Regular exercisers were excluded from participation, and my sense is that exercise during the diet trial was discouraged. 

What Were the Results?

Metabolic syndrome resolved in all participants.

Three of the original 26 participants were dropped from analysis because they weren’t compliant with the diet.  Another one was lost to follow-up.  Final analysis was based on the 22 who completed the study.

Eight of the 22 participants had adverse effects.  These were considered slight and mostly appeared and  disappeared during the first week.  Effects included weakness, headache, constipation, “sickness”, diarrhea, and insomnia. 

Average weight dropped from 106 kg (233 lb) to 92 kg (202 lb).

Body mass index fell from 36.6 to 32.

Average fasting blood sugar fell from 119 mg/dl (6.6 mmol/l) to 92 mg/dl (5.1 mmol/l).

Triglycerides fell from 225 mg/dl to 110 mg/dl.

Average systolic blood pressure fell from 142 mmHg to 124.

Average diastolic blood pressure fell from 89 to 76.

So What?

A majority of people labeled with metabolic sydrome continue in metabolic sydrome for years.  That’s because they don’t do anything effective to counteract it.  These researchers show that it can be cured in 12 weeks, at least temporarily, with the Spanish Ketogenic Mediterranean Diet.

ResearchBlogging.orgVery-low-carb diets are especially good at lowering trigylcerides, lowering blood sugar, and raising HDL cholesterol.  Overweight dieters tend to lose more weight, and more quickly, than on other diets.  Very-low-carb diets, therefore, should be particularly effective as an approach to metabolic syndrome.  It’s quite possible that other very-low-carb diets, such as Atkins Induction Phase, would have performed just as well as the Spanish Ketogenic Mediterranean Diet.  In fact, most effective reduced-calorie weight-loss diets would tend to improve metabolic syndrome, even curing some cases, regardless of carb content. 

Most physicians recommend that people with metabolic syndrome either start or intensify an exercise program.  The program at hand worked without exercise.  I recommend regular exercise for postponing death and other reasons.

Will the dieters of this study still be cured of metabolic syndrome a year later?  Unlikely.  Most will go back to their old ways of eating, regaining the weight, and moving their blood sugars, triglycerides, and HDL cholesterols in the wrong direction.

Steve Parker, M.D.

Reference: Pérez-Guisado J, & Muñoz-Serrano A (2011). A Pilot Study of the Spanish Ketogenic Mediterranean Diet: An Effective Therapy for the Metabolic Syndrome. Journal of medicinal food PMID: 21612461

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June 28, 2010 · 2:00 AM

MSDP Protects Against MetSyn (NCEP ATP-III Criteria) in FHSOC

ResearchBlogging.orgTranslation:  A Mediterranean-style dietary pattern protected against onset of metabolic syndrome (as defined by National Cholesterol Education Program Adult Treatment Panel III) in the Framingham Heart Study Offspring Cohort.

Made you look! 

Don’t you just love acronyms?  Lately it seems you gotta have a clever acronym for your scientific study or it won’t get published or remembered. 

Metabolic syndrome is a constellation of clinical traits that are associated with increased risk for developing cardiovascular disease (two-fold increased risk) and type 2 diabetes (six-fold increased risk).  It’squite common—about 47 million in the U.S. have it.  Metabolic syndrome features include insulin resistance, large waist circumference, low HDL cholesterol, elevated fasting blood sugar, high triglycerides, and elevated blood pressure. 

For optimal health, you want to avoid metabolic syndrome.

Boston-based researchers reported in American Journal of Clinical Nutrition last December that followers of the the Mediterranean diet had less risk of developing metabolic syndrome; not by much, but it was statistically significant.  The study population was the Framingham (Massachusetts) Heart Study Offspring Cohort.

Several thousand men and women were studied via food frequency questionnaires, lab work, and physical exams.  Adherence to the Mediterranean diet was measured via a calculated score ranging from zero to 100.  No diabetics were enrolled.  Average age was 54.  Follow-up time averaged seven years.

They found that those adhering closely to the Mediterranean diet had fewer metabolic syndrome traits at baseline: less insulin resistance, lower waist size,  lower fasting blood sugar, lower triglycerides, and higher HDL cholesterol levels.

Not only that, the Mediterranean dieters developed less metabolic syndrome over time.  Over seven years, 38% of the folks with least compliance to the Mediterranean diet developed metabolic syndrome.  Of those with highest adherence, only 30% developed it.

This is the first study to show a prospective association between the Mediterranean diet and improved insulin resistance.  Avoiding insulin resistance is a good thing, and may help explain the Spanish study that found lower incidence of type 2 diabetes in Mediterranean diet followers.

Why didn’t the investigators report on the incidence of diabetes that developed over the course of the study?  Surely some of these folks developed diabetes.  Are they saving that for another report?  “Publish or perish,” you know.

You can start to see why the Mediterranean diet has a reputation as one of the healthiest around. 

It would be interesting to score these study participants with a very low-carb diet score (VLCDS—yeah, baby!).  Such diets are associated with lower blood pressure, lower blood sugars, lower triglycerides, and higher HDL cholesterol.  Like Mediterranean diet followers, I bet low-carbers would demonstrate lower prevalence of metabolic syndrome at baseline and lower incidence over time. 

Reference: Rumawas, M., Meigs, J., Dwyer, J., McKeown, N., & Jacques, P. (2009). Mediterranean-style dietary pattern, reduced risk of metabolic syndrome traits, and incidence in the Framingham Offspring Cohort American Journal of Clinical Nutrition, 90 (6), 1608-1614 DOI: 10.3945/ajcn.2009.27908

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June 25, 2010 · 2:00 AM

Seminal Paper: Carbohydrate Restriction for Type 2 Diabetes and Metabolic Syndrome

Carbohydrate-restricted eating is slowly gaining mainstream acceptance as treatment for type 2 diabetes and metabolic syndrome.  I thought it would be useful to present one of the watershed reports that summarize the potential benefits.  The article is from 2008.  Among the co-authors are some of the brightest names in this field: Richard K. Bernstein, Annika Dahlqvist, Richard Feinman, Eugene J. Fine, Robert Lustig, Uffe Ravnskov, Jeff Volek, Eric Westman, and Mary C. Vernon.

ResearchBlogging.orgThese are not wild-eyed, bomb-throwing radicals.  They are on faculty at some of the best institutes of higher learning.  They note that while many of the national diabetes organizations downplay the benefits of carb restriction, we have enough evidence now to warrant careful reconsideration.

Here are some of their major points, all backed up by references (68) from the scientific literature:

  1. Glucose (blood sugar) is a “major control element,” whether directly or indirectly through insulin, in glycogen metabolism, production of new glucose molecules, and in formation and breakdown of fat.
  2. The potential adverse effects of dietary fat are typically seen with diets high in carbohydrate.
  3.  Carb restriction improves control of blood sugars, a major target of diet therapy.  Many of the supportive studies were done with overweight or obese people (85% of type 2 diabetics are overweight).  Very low-carb diets are often so effective that diabetic medications have to be reduced at the outset of the diet. 
  4. For weight loss, carb-restricted diets work at least as well as low-fat diets.  They are usually superior. 
  5. Carb-restricted diets usually replace carbs with fat, resulting in improve markers for cardiovascular disease (lower serum triglycerides and higher HDL cholesterol levels). Replacing dietary fat with carbohydrate—the goal of many expert nutrition panels over the last 40 years—tends to increase the amount of artery-damaging “small, dense LDL cholesterol” in most of the population. 
  6. Carbohydrate restriction improves all five components of the metabolic syndrome: obesity, low HDL cholesterol, high triglycerides, high blood pressure, elevated blood sugar.
  7. Beneficial effects of carbohydrate restriction seem to occur even without weight loss. 
  8. Still worried about excessive fat consumption?  Many low-carb dieters demonstrate a significant increase in the percentage of total calories from fat, but without an increase in the absolute amount of fat eaten.  That’s because they simply reduced their total calories by reducing carb consumption. 

This post was chosen as an Editor's Selection for ResearchBlogging.orgThe authors in 2008 called for a widespread reappraisal of carbohydrate restriction for type 2 diabetes and metabolic syndrome.  It’s been happening, and many patients are reaping the benefits.

Steve Parker, M.D.

Reference: Accurso A, Bernstein RK, Dahlqvist A, Draznin B, Feinman RD, Fine EJ, Gleed A, Jacobs DB, Larson G, Lustig RH, Manninen AH, McFarlane SI, Morrison K, Nielsen JV, Ravnskov U, Roth KS, Silvestre R, Sowers JR, Sundberg R, Volek JS, Westman EC, Wood RJ, Wortman J, & Vernon MC (2008). Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutrition & metabolism, 5 PMID: 18397522

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December 7, 2009 · 2:00 AM

Are Fructose and High Fructose Corn Syrup Bad for Us?

Table sugar (sucrose) is a combination of glucose and fructose

Darya Pino earlier this month posted at her Summer Tomato blog a video regarding high fructose corn syrup.  The speaker in the video is pediatric endocrinologist Robert Lustig, M.D., of the University of California—San Francisco.
In the U.S. between 1970 and 1990, consumption of high fructose corn syrup increased over 1000%.  During those two decades, the incidence of overweight and obesity nearly doubled.  Many wonder if this is more than just coincidental. Most of this fructose is in soft drinks.  Soft drink consumption per person in 1942 was two servings per week.  In 2000, consumption was two servings per day.  Of course, these drinks typically have few nutrients other than sugars.
I wrote about fructose possibly being “the new trans fat” almost two years ago.

Dr. Lustig is convinced that high fructose corn syrup (HFCS) is a chronic toxin, at least in the amounts many of us eat, and the cause of our current epidemic of childhood and adult obesity and overweight.  Even if this idea is not new to you, you may be interested to hear the biochemistry and physiology behind his position.  If you didn’t enjoy college lectures or are not a food science geek, you probably won’t be able to sit through this 1.5-hour video. 

I enjoyed the heck out of it!  Made me feel like I was back in college again.  Few of my professors were as good as Dr. Lustig at lecturing. 

Here are a few of his other major points:

  • HFCS was invented in Japan in the 1960s, then introduced to U.S. markets in 1975
  • sucrose and fructose are both poisons
  • in the U.S. we eat 63 pounds (28.6 kg) of HFCS and 141 pounds (64.1 kg) of sugar per year [he didn’t define “sugar” in this context]
  • he praises Yudkins book, Pure, White, and Deadly [I’ve written about the Cleave-Yudkin carbohydrate theory of chronic disease]
  • the triglyceride/HDL ratio predicts heart disease much better than does LDL cholesterol
  • chronic high fructose intake causes the metabolic syndrome [does he think it’s the only cause?]
  • only the liver can metabolize fructose, in contrast to every other tissue and organ that can use glucose as an energy supply
  • high fructose consumption increases the risk of gout and high blood pressure
  • fructose interferes with production of our body’s production of nitrous oxide—a natural circulatory dilator—leading to higher blood pressures
  • fructose increases de novo lipogenesis—in other words, it creates body fat
  • fructose interferes with natural chemical messengers that tell your brain you’ve had enough food and it’s time to stop eating
  • high fructose intake reduces LDL particle size, potentially increasing the future risk of cardiovascular disease such as heart attacks [small, dense LDL cholesterol is more damaging to your arteries that large, fluffy LDL]

So What? 

You don’t need polititians to reduce your consumption of sugary soft drinks and high fructose corn syrup—do it yourself starting today.  Read food labels—HFCS is everywhere.  I’ve found it in sausage! 

The food industry greatly reduced use of trans fats in response to consumer concerns, before the polititians ever dabbled in it.  HFCS can go the same route.  Consumption of soft drinks, sports drinks, and other sugary beverages—the major sources of HFCS—is up to you.

Steve Parker, M.D.

PS: The Advanced Mediterranean Diet and Ketogenic Mediterranean Diet are naturally low in fructose.

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