It is wrongly assumed that excessive caloric intake is the root cause of obesity. A calorie of food energy has different metabolic fates depending upon the hormonal stimulation. That same calorie may be used to generate body heat or stored as body fat.
Obesity is a disease of failed energy partitioning, not one of the total energy intake. The primary driver of this partitioning is the hormone insulin. Insulin is specifically a fat storage growth hormone.
Processed seed oil is associated with T2DM. Cohort studies confirm that plasma saturated fatty acids from dairy sources such as cheese and yoghurt is inversely related to the incidence of type 2 diabetes.
The food industry has a fiduciary responsibility to produce profit for its shareholders.
Unfortunately, the food industry downstream cost to public health is bankrupting most westernized societies.
Unfortunately, academics, institutions, and journals whose primary responsibility is to patients and scientific integrity have at times colluded with industry for financial gain.
It is incredulous to suggest that consuming 22 teaspoons of sugar daily falls within recommended guidelines. This is despite the known science that for optimum health there is no dietary or biological requirement for sugar to be consumed in the human diet.
Consumption of fat induces satiation and when compared to the other macronutrients such as protein and carbohydrates, and comparatively fat has the least impact on blood glucose and insulin production. Excessive insulin production and subsequent insulin resistance is the precursor to type 2 diabetes.
A meta-analysis of the evidence available prior to the 1977 US change in dietary guidelines did not support the dietary fat restrictions. Despite the lack of scientific consensus, these guidelines advised limiting total fat to 30% of calorie intake and saturated fat to 10% of calorie intake, creating the low fat craze and a national experiment on diet-induced metabolic dysfunction.
The Women’s Health Initiative is one of the largest randomized controlled diet trials ever performed using 48,835 post-menopausal women, with a mean follow-up period of 8.1 years, randomized to either a standard western diet or a low-fat, calorie-reduced diet with increased exercise.
The authors had postulated that a low-fat, calorie-reduced diet with increased exercise would reduce cardiovascular disease. The intervention achieved an 8.2% energy decrease in total fat intake and a 2.9% energy decrease in the saturated fat intake but did not reduce the risk of CHD or stroke.
The reduction in dietary fat and total daily calories (361 calories/day reduction) failed to produce any significant weight loss over the duration of the study, rejected the hypothesis that the low-fat diet is either beneficial for cardiovascular disease or weight loss.
Important Points:
- Microbiome
- Bacteria
- Storage
Human Microbiome
We traditionally think of bacteria as dirty, something we want to keep outside of our bodies. Intestinal bacteria are very important for digestion; they break complex fiber polysaccharides (sugar molecules connected to each other) into simple absorbable sugars by a process called fermentation, converting nutrients into calories. The large intestine alone houses over 1400 species of bacteria numbering over 100 trillion. In reality, the human body contains ten times more microbial cells than human cells, and the human body is dependent upon the genetic information encoded in these bacterial cells for specific metabolic pathways.
Our microbial partners have co-evolved with us, in a beneficial (symbiotic) relationship involving nutrient sharing. The ability to store energy would be a beneficial attribute for ancient humans as they had variable access to food. When nutrient dense food supply was available, their consumption and storage would benefit both them and their bacterial symbiotes later when food supplies were diminished. However, in modern, developed societies where there is ready access to large-portion, high-calorie diets, this “benefit” becomes a detriment, and we develop a previously rare condition called over-nutrition, over-storage, or obesity.
Obese individuals have a different mix of bacteria in their guts than thin people. The ratio of Firmicutes to Bacteroidetes (called the F/B ratio) is higher in obese people than in lean people, and it drops as those people lose weight. Both Firmicutes and Bacteroidetes bacteria are involved in complex polysaccharide breakdown, but Firmicutes are much more efficient than Bacteroidetes bacteria; therefore, having more Firmicutes bacteria in our gut makes more energy available leading to increased caloric intake and eventually obesity. Firmicutes overload is also associated with slowed intestinal motility, commonly known as chronic constipation.
In studies of genetically identical twins, bacterial populations have been found to differ, depending on whether the twin is lean or obese, with much higher level of Firmicutes in the obese twins. In obese patients undergoing gastric bypass surgery, colonic bacteria change to become more like those of normal-weight individuals after the operation, reducing their Firmicutes levels.
Antibiotic over utilization may also indiscriminately eradicate the beneficial bacteria in your gut along with the bad ones. Conventional farmed meats are doped with antibiotics, with nearly 50-70% of all antibiotics produced in the United States used on healthy livestock to promote growth and weight gain in the animal feed. Consuming these antibiotic-laden meats may be a significant factor enhancing growth and weight in the human population [obesity] as well. Eating grass-fed and organically raised meats of all kinds can reduce this antibiotic intake.
The amazing thing to keep in mind is that you can rapidly – within 72 hours – change your gut bacteria to a healthy ratio simply by immediately eliminating refined carbohydrates and increasing your fiber intake. Supplements of “get thin bacteria” will soon be available as well
Evidence from multiple randomized controlled trials reveals that a higher fat, lower carbohydrate diet is superior to a low-fat diet for weight loss and cardiovascular disease risk reduction. A meta-analysis of 53 randomized controlled trials involving 68,128 participants conducted by the Harvard School of Public Health concluded
“when compared with dietary interventions of similar intensity, evidence from randomized controlled trials does not support low-fat diets over other dietary interventions for long term weight loss. In weight loss trials, higher-fat weight-loss interventions led to significantly greater weight loss than low-fat interventions.”
Using data from the National Health and Nutrition Examination Survey 2009-2016, less than 12.2% of the US population is now considered metabolically healthy.
“Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009-2016,” was published online Nov. 28 in the journal Metabolic Syndrome and Related Disorders.
Almost all of the patient’s that present to our clinics is overweight, and when we evaluate their biochemical markers, they have prediabetes and metabolic inflammation.
The changes in immune cells concentration and in function, which can cause an increased migration of these inflammatory cells to already inflamed tissue. There is also the upregulation of cytokines. This immune activation begins during the pre-diabetic state.
Important Points:
- Gastro Intestinal tract (GI)
- Inflammation
- Gut flora
- Gut bacteria
- Microbiome
- Balance
What can you eat to improve your gut flora and reduce inflammation?
Your gut microbiome is made up of trillions of bacteria and other microorganisms — both friendly and unfriendly. Maintaining the right balance of bacteria in your gut is believed to improve digestion, reduce inflammation, decrease anxiety, and even improve brain function and mood. A healthy balance of gut bacteria is also said to boost metabolism, eliminate cravings, and help you shed unwanted weight. We will look at ways in which you can achieve this by the food you eat.
What functions happen in the gut?
Digestion: Carbohydrates the body is otherwise unable to process are fermented in the large intestine,where our friendly bacteria reside. Through this process they reduce gut inflammation, stimulate and improve metabolic function, and produce essential nutrients such as vitamin K.
Brain Health: Our gut prompts the production of several neurotransmitters, including serotonin; remarkably, 95% of serotonin is actually produced in our gut! Serotonin affects every part of your body and is viewed as a natural mood stabilizer regulating anxiety, happiness and mood. It is said that the way to a man’s heart is through the stomach. Is this why?
Immunity: Approximately 70% of our immune system is situated in the gut. The beneficial flora our immune system is able to differentiate between friend and adversary and rebalance the immune system when it gets off-kilter.
How can we improve our gut health?
Proactive ways to improve our gut health:
- Proper digestion: When we eat, we need to make sure that proper digestion takes place. The key to proper digestion is making sure we absorb all our food. How can we optimize our absorption? We can start by turning off the T.V., putting aside all our work, and sitting down at the table, so that all our energy can be focused on eating and digestion. Food is meant to be enjoyed, so chew and taste it!
- Re-establish gut bacteria: Probiotics and fermented food, such as sauerkraut, kimchi and miso are the key to reestablishing the good bacteria in your gut. Eating plenty of whole plant foods, packed with fiber is another critical part of nourishing a healthy microbiota. Warning! Gluten-free foods and even a lot of salads can actually be low in fiber. To support the growth of good bacteria, probiotics aim to consume certain prebiotics, such as: almonds, bananas, garlic and onion, which will help to feed those friendly bacteria in your gut.
- Take an anti-Inflammatory diet: Aim for fresh food or one-ingredient foods such as fruits, vegetables, legumes, lean meat or dairy and minimize processed foods. Omega 3 is a beneficial anti-inflammatory nutrient, so try incorporating salmon, walnuts, chia seeds or flax seeds into your diet. To spice up soups, stews, or stir fries, add turmeric as it is another amazing anti-inflammatory food.
What should you eat to boost your Gut Health?
Foods that boost your microbiome:
- Eat more prebiotics
Scientists have identified a few species among the many trillions of microbes that live in your intestines playing a crucial role in gut health and maintaining a balanced immune system. Your dietary intake is vital to allowing these species to flourish and to preventing imbalances that can lead to disease. Prebiotics provide a good food source for certain populations of healthy gut bacteria, such as bifidobacteria, which, in turn, prevent intestinal inflammation. Studies have shown that prebiotics can be particularly beneficial for obese people, as they reduce insulin and cholesterol levels, while lowering the risk of heart disease and diabetes. Prebiotics can be bought as supplements or taken in naturally by eating asparagus, leeks, bananas, garlic and Jerusalem artichoke.
- Focus on fiber and wholegrains
Western diets tend to be rich in fat and sugar with most of our food coming from only Twelve plant and five animal species. However, following a diet rich in high-fiber foods such as apples, artichokes, blueberries, chickpeas, lentils, peas and beans can limit the growth of harmful bacteria and stimulate Bifidobacterium, lactobacilli and another healthy species called Bacteroidetes.
- Take fermented products
Fermented foods such as kimchi, kefir, kombucha, natural yoghurts and fermented soya bean milk have been shown to promote the abundance of healthy gut bacteria and reduce the levels of enterobacteriaceae, a family of bacteria linked to a number of chronic diseases. Natural yoghurt enriched with bifidobacteria has also been found to alleviate lactose intolerance in children and adults, while yoghurts enhanced with lactobacilli have had some beneficial results in patients with inflammatory bowel disease. Avoid flavored yoghurts, which tend to contain high levels of sugar.
- Ensure you take some polyphenols
Polyphenols are plant compounds that are mainly digested by gut bacteria and are associated with a variety of benefits including a reduction in blood pressure, cholesterol and oxidative stress. They are found in almonds, blueberries and broccoli as well as in green tea, cocoa and red wine. The types of polyphenols found in cocoa are linked to changes in the microbiome that reduce inflammation and triglyceride levels.
- Avoid artificial sweeteners at all costs
Artificial sweeteners such as aspartame are commonly used in food as replacements for sugar. Aspartame specifically has been found to alter gut bacteria in human and animal studies, and these changes appear to result in elevated blood sugar levels and increased susceptibility to metabolic disease.
- Breastfeed your baby
Our microbiome is continually developing during our first two years of life. A number of studies have shown that babies who are breastfed for six months develop a much healthier gut compared with those who are fed with formula. Children who have been breastfed are also less prone to allergies, obesity, leukemia and diabetes; this is thought to be linked to the microbiome.
- Go vegetarian
Several studies have suggested that vegetarian diets may be good for the microbiome, with findings indicating that a largely plant-based diet decreases the levels of disease-causing bacteria such as E coli and Enterobacteriaceae. This may be particularly beneficial for obese people with type 2 diabetes or hypertension. One small study found that obese people who switched to a vegetarian diet had reduced levels of potentially harmful bacteria as well as lower levels of cholesterol and inflammation after one month.
- How to ensure your gut flora flourishes
The gastrointestinal tract is important to human health. In recent years, scientists have discovered that the GI system has an even bigger, more complex job than previously appreciated. It has been linked to numerous aspects of health that do not necessarily involve digestion, from immunity to emotional stress to chronic illnesses, including cancer and Type 2 diabetes.
There are trillions of bacteria found in the GI tract, which not only help us process food but also help our bodies maintain homeostasis and overall well-being. Experts say the key may lie in the microbiome—the makeup of bacteria and other microorganisms in the stomach and intestines or informally, the gut.
Research on the microbiome is still in its infancy. But studies have already found that certain environments, foods, and behaviors can influence gut health for better or worse. Fermented food sources—like yogurt, kefir, sauerkraut and kimchi—that have other nutritional benefits as well, should be considered in the front lines of influencing gut flora.
Finally, there are the cutting-edge ways in which doctors are beginning to manipulate the gut microbiome directly through Fecal transplants which introduce donor stool material containing healthy bacteria into the intestinal tract of a recipient, have been used to treat IBD as well as C. difficile, a dangerous infection that causes recurrent diarrhea. Researchers are also studying how bacteria-killing viruses can target strains of E. coli associated with Crohn’s disease. It is most beneficial to stick to natural food sources as much possible because a lot is still unknown about the microbiome and the effects of altering it.
References
- Healthline (2019): The Microbiome Diet: Can It Restore Your Gut Health? Retrieved from
https://www.healthline.com/nutrition/microbiome-diet
- Time (2019): Here’s Everything You Need to Know About Gut Health. Retrieved from
https://time.com/5556071/gut-health-diet/
- Food Yourself (2018): Gut Flora and How to Improve your Gut Health. Retrieved from
https://www.foodyourself.com/blog/2018/12/4/gut-flora-and-how-to-improve-your-gut-health
- NCBI (2013): Strict vegetarian diet improves the risk factors associated with metabolic diseases by modulating gut microbiota and reducing intestinal inflammation. Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/24115628
- The Guardian (2018): Seven ways to boost your gut health. Retrieved fromhttps://www.theguardian.com/lifeandstyle/2018/sep/10/seven-ways-to-boost-your-gut-health
Important Points:
- Diabetes
- Active
- Inactivity
- Health benefits
How much inactivity can trigger diabetes symptoms?
One of the core risk factors for diabetes and general unhealthiness is sticking to a sedentary lifestyle. Not moving around or having no physical activity not only promotes muscular decline and weakness of the heart, it can also lead to the development of type 2 diabetes.
According to a study published in The Journals of Gerontology, two weeks of inactivity in pre-diabetic individuals was enough to trigger symptoms of diabetes. Researchers asked the study participants to limit their daily steps to no more 1000 steps per day using a pedometer, and after two weeks’ worth of inactivity, the symptoms of diabetes became apparent, including an increase blood sugar levels, an increase in the onset of insulin resistance, reduction in skeletal muscle mass, and hastening of the onset of diabetes itself. Researchers expected these results but what shocked them the most was how much harder reversing the symptoms was. Even more alarming is the fact that it takes two weeks of normal activity to restore the body into its prediabetic symptoms state.
The silver lining we can get from this study is knowing the importance of staying active. If you want a more serious incentive to keep moving, keep in mind that activity directly prevents diabetes as well as producing overall health benefits. The National Institute of Diabetes and Digestive and Kidney Diseases recommends losing just 5 to 7 percent of your body weight as it helps delay the onset of type 2 diabetes, and keeping active will aid in losing that body weight, thus furthering the relationship between activity and diabetes prevention. Keeping yourself active – even just 40 minutes of moderate intensity exercise 3 to 4 times a week – will reduce your blood pressure and help regulate your cholesterol level.
Sedentary lifestyle and risk of obesity and type 2 diabetes
https://www.ncbi.nlm.nih.gov/pubmed/12733740
Failed Recovery of Glycemic Control and Myofibrillar Protein Synthesis With 2 wk of Physical Inactivity in Overweight, Prediabetic Older Adults
Health Risks of Being Overweight
https://www.niddk.nih.gov/health-information/weight-management/health-risks-overweight
American Heart Association Recommendations for Physical Activity in Adults