Know someone in chronic pain? Know someone who has an addiction? Know someone who is diabetic? Addiction, chronic pain, and diabetes have one thing in common – metabolic syndrome, which is a cluster of conditions including increased blood pressure, high blood sugar, excess body fat, chronic inflammation, and abnormal cholesterol or triglyceride levels. Dr Gurpreet Padda, MD is an interventional pain specialist, and in his treatment has often found co-occurring addiction and diabetes. His practice is dedicated to working with, reducing, and in many cases curing all three – identifying and fixing pain paths, reworking patient nutrition and increasing movement and exercise. He has clear recommendations on how to fix your diet and exercise regimen, which have met with great success.

Obesity has become rampant in recent times. It is said to affect almost 50% of the American population. It has been credited with being a leading cause of chronic illness and ill health. The carnivore diet has become very popular as the new way to lose weight, maintain a healthy lifestyle and ward off diseases. A major proponent of this diet is its ability to melt away the fat. How effective is it in the management of obesity? Do its effects last? In this article we will explore the role this diet can play in the curbing of obesity.

1. What is obesity?

Obesity is a complex disease involving an excessive amount of body fat. Obesity isn’t just a cosmetic concern. It is a medical problem that increases your risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers. There are many reasons why some people have difficulty avoiding obesity. Usually, obesity results from a combination of inherited factors, combined with the environment and personal diet and exercise choices.

2. What is the Carnivore diet?

The Carnivore Diet is a restrictive diet that only includes meat, fish, and other animal foods like eggs and certain dairy products. It excludes all other foods, including fruits, vegetables, legumes, grains, nuts, and seeds. Its proponents also recommend eliminating or limiting dairy intake to foods that are low in lactose — a sugar found in milk and dairy products — such as butter and hard cheeses.

A good number of people who have adopted the carnivore diet report faster weight loss, improved mental clarity, healthier digestion, and even improved athletic performance. Some have also reported remarkable relief from debilitating chronic health problems where conventional means did not succeed.

1. What does one eat on the carnivore diet?

This is what you are likely to eat if you are on the carnivore diet:

–Below is the Green List that is, food you should be eating all the time with an emphasis on fattier cuts of meat to take in enough calories:

• Meat: beef, chicken, turkey, organ meats, lamb, pork, etc.
• Fish: salmon, mackerel, sardines, crab, lobster, tilapia, herring, etc.
• Other animal products: eggs, lard, bone marrow, bone broth, etc.
• Low-lactose dairy (in small amounts): heavy cream, hard cheese, butter, etc.
• Water

Generally, salt, pepper, and seasonings with no carbs are allowed.

– Below is the RED list of what you should NOT be eating:

• Vegetables: broccoli, cauliflower, potatoes, green beans, peppers, etc.

• Fruits: apples, berries, bananas, kiwi, oranges, etc.
• High-lactose dairy: milk, yogurt, soft cheese, etc.
• Legumes: beans, lentils, etc.
• Nuts and seeds: almonds, pumpkin seeds, sunflower seeds, pistachios, etc.
• Grains: rice, wheat, bread, quinoa, pasta, etc.
• Alcohol: beer, wine, liquor, etc.
• Sugars: table sugar, maple syrup, brown sugar, etc.
• Beverages other than water: soda, coffee, tea, fruit juice, etc.

While some people incorporate some of these foods, a true Carnivore Diet does not permit them:

• Milk
• Yogurt
• Cheese

Coffee and tea: These may be plant-based, but some people keep these in the diet.

The carnivore diet can be considered to be a fad. Is there evidence that any traditional populations practiced the carnivore culture?

3. What effect might the carnivore diet have on obesity?

When on a carnivore diet, all you consume is meat, meat and more meat…Occasionally you could have some eggs and cheese and maybe a cup of coffee. What about this diet at a glance could help in combating obesity?

How does the carnivore diet work?

1. Cutting out sugar and carbohydrates

The absence of sugar and carbohydrates cause rapid and sustained fat loss without the need to count calories. Carbohydrates are hard to store and actually harmful if left to circulate in your system too long, so your body always wants to use them up first.

Your body releases insulin to shuttle blood sugar into muscles. To make sure the sugar gets used up first, insulin also tells your fat cells to store any fat you consume and to not release stored body fat for hours afterwards. If you eat a lot of easily-absorbed carbohydrates, your body releases a ton of insulin in response. Excess insulin can then remove too much sugar from your blood stream, resulting in hypoglycemia. The quickest way to restore blood sugar levels is to eat more carbs, which puts people on the carb roller coaster to weight gain.

The carnivore does away with all this by totally eliminating sugar and carbohydrates from your diet.

2. Eating a lot of protein suppresses appetite

One way that protein controls appetite is through the amino acid phenylalanine. Consumed protein is broken down into amino acids so it can be absorbed by the body. Multiple studies have shown how phenylalanine suppresses appetite and even improves mood and helps you burn stored fat. One study found that phenylalanine increases the release of an intestinal hormone called cholecystokinin in humans. This hormone signals the brain to feel satiated after eating and causes a reduction in subsequent food intake. A mouse study found that a single dose of phenylalanine caused an increase in another satiety hormone called GLP-1, it reduced levels of the hunger-hormone ghrelin.

3. Increase in dopamine

Protein foods are made from the building blocks of amino acids (including tyrosine), which are essential to the production of dopamine. It has therefore been suggested that upping protein intake may also boost dopamine production without increasing appetite. Dopamine is considered the reward-hormone and increasing its levels in your brain is helpful for making your weight loss diet less unpleasant.

4. The carnivore diet “imposes” time restricted eating

The carnivore diet tends to make people naturally adopt time-restricted eating patterns. Studies show that eating at night is a common cause of obesity. Junk food actually causes you to prefer late-night eating. Sugar and fat together, act as a trigger that cements the unhealthy habit of late-night eating. Worse yet, your body runs on an internal clock called circadian rhythms. These do more than set your sleep and wake times; they also determine your digestion and energy usage times. We’re meant to eat during the day and sleep at night. When you eat at night, your body doesn’t want to process those calories and instead they sit and cause metabolic dysfunction.

Protein does not seem to trigger a desire for late-night eating so the carnivore diet also helps curb that unhealthy practice. Late-night eating also reduces the quality of your sleep and poor sleep leads to poor eating the next day. Reduced sleep also increases stress and anxiety, so removing late-night eating not only improves weight loss, but helps your mood and overall feeling of well-being.

5. Does the carnivore diet stave off obesity?

There is a link between the Carnivore diet and sustained weight loss. In the absence of carbohydrates, fat can be kept off for long periods of time. The question becomes how safe it is to do the carnivore diet long term. More studies on this need to be carried out but in the meantime, this diet is one of the best in keeping obesity, and its associated diseases at bay.

References

1. Mayo Clinic (2019): Retrieved from https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742

2. NCBI (1994):L-phenylalanine releases cholecystokinin (CCK) and is associated with reduced food intake in humans: evidence for a physiological role of CCK in control of eating. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/8201963

3. NCBI (2012):The Carnivore Connection Hypothesis: Revisited, Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253466/

4. Lolo (2018):Carnivore Diet: Fad or the Future? Retrieved from http://unity.lolofit.com/blog/posts/carnivore-diet-fad-or-miracle-diet

5. Healthline (2019):All You Need to Know About the Carnivore (All-Meat) Diet. Retrieved from https://www.healthline.com/nutrition/carnivore-diet

If Hippocrates the father of modern medicine is to be believed, “All disease begins in the gut”. The gastrointestinal tract with its microbiota is a complex, open, and integrated ecosystem. It is widely accepted that healthy gut microbiota is essential for optimal health. Imbalance in the gut flora could lead to one being vulnerable to a large spectrum of infectious and non-communicable diseases, including diabetes and obesity. There is an urgent need to develop efficient strategies to prevent and treat metabolic disorders such as diabetes and obesity. In this article, we will look at the implications of gut microbiota in diabesity and review ways of achieving optimal metabolic conditions.

1. What is Gut Microbiota and Gut Microbiome?

The gut microbiota is a collective term for the microbial community in the gut, whereas the gut microbiome is defined as the full collection of genes in the gut microbiota. The intestinal microbiota is known to be associated with metabolic syndrome and related comorbidities. Associated diseases including obesity, T2D, and fatty liver disease (NAFLD/NASH) all seem to be linked to altered microbial composition; however, causality has not been proven yet. This points to the potential causal and personalized role of the human gut microbiota in obesity and T2D is highly prioritized.

The gut microbiome contains an immense diversity of microorganisms, varying from bacteria as well as viruses, fungi, phages, protozoa, and archaea all colonizing our adult bodies. There is a proposed view that our microbiota is a microbial (endocrine) organ living symbiotically inside our gut. This has led to a new perspective suggesting multiple lineages capable of communicating with each other and shaping host immune-metabolism in several ways. Some of the capabilities of these “organ” are:

• The degradation of otherwise indigestible components of our diet
• harvesting of energy and nutrients
• shaping of the host immune system
• maintaining the integrity of the gut mucosal barrier
• xenobiotic metabolism

In this way, gut microbiota complement our biology in ways that are mutually beneficial.

The current research data regarding the precision/personalized nutrition suggest that dietary interventions, including administration of pre-, pro-, and syn-biotics, as well as antibiotic treatment should be individually tailored to prevent chronic diseases based on the genetic background, food and beverage consumption, nutrient intake, microbiome, metabolome, and other omic profiles.

2. The gut and diet….

Diet is essential in the composition and the function of the gut microbiota. Microbiota alters rapidly when exposed to great and fast changes in diet. Short-term dietary changes such as switching between plant- and meat-based diets, or adding more than 30 grams of fiber per day to the diet, or following a diet with different fat/fiber content can change the human gut microbiota in function and composition significantly in 48 hours.

Fiber-enriched diets have been shown to improve insulin resistance in lean and in obese subjects with diabetes. However, only long-term dietary habits are effective in shaping the composition of the gut microbiota as short-term dietary interventions failed to change the major features and classification of the microbiota.

3. What is the impact of Gut Microbiome in Insulin Resistance and Type 2 Diabetes?

When there is low diversity in the gut microbiome, there is a higher prevalence of obesity, insulin resistance, non-alcoholic fatty liver disease (NAFLD), and low-grade inflammation. Furthermore, low bacterial diversity was characterized by pro-inflammatory properties, suggested by the reduction in butyrate-producing bacteria and the increase in mucin-degrading bacteria. These characteristics potentially impair the gut integrity causing low-grade inflammation through endotoxemia. This low-grade inflammation of visceral adipose tissue may provide a link between obesity and insulin resistance.

Ethnic differences between human populations may also affect microbiota composition. Karlsson et al. compared data of T2D-associated metagenomes between Chinese and Swedish subjects with T2D, which indicated that different intestinal bacterial species were involved in similar metabolic functions. The authors were also able to distinguish subjects with T2D from healthy subjects, with a predictive power exceeding that of body mass index (BMI).

4. What is the effect of Gut Microbiota in Lipid Metabolism?

In recent decades, it has become clear that many metabolic, inflammatory, and innate immune mechanisms are also coordinated by (dietary-derived) lipids. The nutritional importance of dietary lipids is unequivocal.

Lipid accumulation in conjunction with low-grade inflammation is a pathophysiological hallmark of atherosclerosis. There is emerging evidence that the pathophysiology of atherosclerosis is related to interpersonal gut microbiome differences. Atherosclerosis seems to be related to TMAO, which is a new marker associated with increased risk of atherosclerosis and coronary artery disease.

Other key intestinal regulators of lipid and cholesterol metabolism are bile acids, which are involved in facilitating intestinal absorption and transport of diet-derived nutrients, vitamins, and lipids. Whereas bile production takes place in the liver (and is facilitated by products derived from lipid catabolism), 95% of all bile acids will be reabsorbed in the terminal ileum and subsequently re-absorbed by the liver, constituting the so-called enterohepatic circulation.

The intestinal microbiota is responsible for converting primary bile salt to secondary bile salts via bile acid de-hydroxylation. Although short courses of oral antibiotics affect intestinal microbiota composition and bile acid metabolism in humans, we found differential effects on glucose metabolism.

5. What effect does the Gut Microbiome have on Appetite?

Obesity is defined as an imbalance between energy intake (usually food intake) and energy expenditure. The brain is a key regulator in detecting alterations in energy balance and induces behavioral and metabolic responses to correct these alterations. The hypothalamus plays an important role in regulation of both food intake as well as energy homeostasis, receiving hormonal and (vagal) neuronal information from the periphery.

Changing the gut microbiome composition with prebiotics has also been shown to affect portal vein levels of other hormones including GLP-1, which in turn affected food intake, followed by a decrease in body weight and fat mass.

6. What are the Microbial Signatures in T2DM and Obesity?

Dysbiosis, which is the disruption of normal microbiota, has been described to be involved in a large spectrum of diseases, including diabetes, obesity, and insulin resistance, through disturbing the energy balance. It has therefore been suggested that the modulation of microbiota, either directly (by antimicrobials, diet, prebiotics and/or probiotics, stool transplant, microbial-derived signaling molecules or metabolites) or indirectly (e.g., immunotherapy) may contribute to the therapeutic management of these pathologies.

7. What is the Influence of Diet on Gut Microbiota in Diabetes and Obesity?

Diet is one of the major lifestyle factors involved in the genesis, prevention and control of diabetes, obesity and other cardiometabolic diseases, being also strongly linked to changes in microbiota. Many reports have shown that the genetic susceptibility to obesity may have interacted with an obesogenic environment (e.g., a major shift in dietary patterns influencing the gut microbiota, a sedentary lifestyle and physical inactivity) in determining the obesity epidemic. To date, there are many popular diets including Mediterranean, gluten-free, vegan, Western, omnivore, vegetarian. To date, most of these diets have been clearly linked to different microbiome profiles.

Following the industrial revolution, countries in the West underwent a nutritional transition from the traditional diet to a diet rich in heavily processed foods, fats, sugars, proteins, plus different additives, while remaining low in micronutrients and dietary fibers (also referred to as Western diet). These diets were deficient of dietary fibers, which are essential for gut health due to their role in stimulation of the growth and/or activity of certain beneficial microorganisms.

Conversely, people in traditional societies, with a fiber intake of almost 50–120 g/day harbor a much more diverse gut microbiota, which indicates good health. SCFAs are found in lower amounts in individuals consuming a Western diet. Western diet was correlated with a decrease in the total bacterial load and in beneficial commensals. On the other hand, subjects consuming vegan and vegetarian diets which are rich in fermentable plant-based foods were reported to have a microbiota characterized by a lower abundance of Bacteroides sp. and Bifidobacterium sp.

The Mediterranean diet (vegetables, moderate consumption of poultry, olive oil, cereals, legumes, winenuts, fish and a low amount of red meat, dairy products, and refined sugars) provides beneficial effects through the elevated content in mono-unsaturated and poly-unsaturated fatty acids, as well as high levels of antioxidants, fibers and vegetable protein content. The gut microbiota in individuals receiving Mediterranean diet is characterized by a high colonization by Lactobacillus sp., Bifidobacterium sp., and Prevotella sp., and low levels of Clostridium sp, species which are associated with weight loss, improvement of the lipid profile and decreased inflammation.

Dietary proteins have also been reported to be involved in shaping the microbiota. Individuals consuming a diet rich in beef had high levels of Bacteroides sp. and Clostridia and were low in Bifidobacterium adolescentis unlike individuals eating a meatless diet. Several studies have recently shown that diets including vegetarian whey/pea protein, and animal protein (meats, eggs, and cheese) are linked with microbial diversity. Consumption of animal-based protein was positively associated to a richness in bile-tolerant anaerobes, including Alistipes sp., Bilophila sp., and Bacteroides sp.

8. What are the Future Perspective on the Gut Microbiome?

Accumulating evidence suggests that gut microbiota plays a significant role in the initiation and progression of MS. The gut microbiota was proven to modulate plasma glucose, appetite, serum lipids and pro-inflammation. In addition, prebiotics or probiotics, which are widely used to manipulate the microbiota, can reduce low-grade intestinal inflammation and improve gut barrier integrity to reduce plasma glucose and serum lipid levels, induce weight loss and decrease insulin resistance. Based on these current achievements, the gut microbiota may be a potential therapeutic target for MS. However, clinical trials addressing the efficacy and efficiency of current or potential treatments on therapeutic applications in metabolic syndrome are needed.

Also, Individuals who are obese are likely to have an imbalance in gut microbiota composition. This possibility is a thrilling avenue for further research and possible novel treatment targets. However, because most studies have been undertaken in animals, direct translation of the findings to human is limited.

Prebiotics or other newly identified beneficial bacterial strains are potential interventions that will be used for treatment in the near future, and it will be important to evaluate their efficacy. Similarly, interventional studies with metabolites of microbiota will be performed (including SCFA butyrate supplementation) to evaluate if this compound has similar effects on food intake, energy expenditure, and improved metabolic features in humans.

The modifiable effects of the human gut microbiota on the development of metabolic syndrome make its handling a promising therapeutic approach. Analyzing and mapping individual microbial composition on a metagenomic level provides insight into specific targets for treatment and contributes to personalized therapeutic interventions.

References

1. Frontiers in Nutrition: Gut Microbiota, Host Organism, and Diet Trialogue in Diabetes and Obesity. Retrieved from https://www.frontiersin.org/articles/10.3389/fnut.2019.00021/full

2. NCBI (2018): The Gut Microbiome as a Target for the Treatment of Type 2 Diabetes. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6013535/

3. NCBI (2017): Gut microbiota as a potential target of metabolic syndrome: the role of probiotics and prebiotics https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655955/

The Carnivore Diet is the new trend that has seen people feeling better, healing disease, and performing at new heights. Of all the people who attempt the carnivore diet, a large segment is those that move from keto dieting. Keto to Carnivore has become has become the natural progression. From bad diet, to Keto to Carnivore. In this article, we will take you through how to go through this progression in the most painless way.

1. How easy is it to move from keto to carnivore?
   While the Keto and Carnivore diets are similar in many ways, there are some critical differences one needs to be aware of when making the transition.Unlike the ketogenic diet, there are no macronutrient ratio preferences in the carnivore diet. You just eat meat. And because you’re not eating any carbs, you’ll likely reach ketosis on a carnivore diet.The process of going from a SAD (Standard American Diet) to a Ketogenic diet is a tough transition where one needs to get“fat-adapted”. Fortunately, the transition from keto to carnivore does not involve this phase as it has already happened.

   Listed below are some of the things they might actually go through:

1. While on Keto, one gets the“Keto Flu.”When transitioning from Keto to Carnivore, there is a somewhat similar process that can either be called the “Carnivore Flu“or the “keto flu”.
2. Loose stools are common and here’s why. As the major difference between the keto and carnivore is consumption of vegetables, fibre intake is severely affected. This may lead to significant change in bowel movements. Whilefiber is not necessary for healthy digestion (and can be causal of digestive issues) it does impact bowel function. Absorbing water, creating bulk, and regularity, fiber lets the colon to get lazy.A major function of the colon is to reabsorb water. Since fiber does most of this work in a diet high in plant-based foods, the colon gets lazy. It quits doing its job. It’s like a muscle that hasn’t been worked out. It gets weak.Going from a Ketogenic Diet to a Carnivore Diet results in a drastic change in fiber intake. And since the colon hasn’t gotten a good workout in a while, and is now being asked to do its job, it’s lost some of its capacity. It needs to “on-ramp.”  During this “on-ramp” water gets through.
3. Your stool is also not as frequent as it used to be. This is not constipation. You are just not making all that much stool as meat gets majorly absorbed and leaves little waste behind.
4. Fiber is food for bacteria in the large intestines.Bacteria love fiber. They ferment it and create the gases that make you unpopular at parties.Removing fiber makes some of these bacteria unhappy. There is research that shows that the microbiome can signal hunger and cravings as the bacteria do everything they can to get you to feed them before they die.We know very little about the microbiome. Most of what’s written is pure speculation. Research is lacking. But this is a “re-balancing” of gut microflora might actually be a good thing.
5. As your body gets used to doing without carbohydrates, you are likely to experience intense cravings. It advisable to eat more meat when the craving strikes. Many people that come from a Ketogenic Diet are use to maniacal measuring, counting, and testing.In this state, when they are told they can eat meat until satisfied, without measuring or monitoring, the flood gates break loose.The key is to let the appetite re-regulate and normalize. Let the body fuel up on the nutrition it needs and desires. Be in it for the long haul.After a time the appetite regulates and the cravings disappear. In fact, all you will want to do is eat a steak. Everything else seems non-satisfactory.
6. On the flip side, some people experience a lack of appetite.Meat is satiating. Protein is satiating.This can lead some people who transition from Keto to Carnivore to under-eat. Then comes the fatigue, the low energy, the crabby mood, the key is to eat.Early on, hunger is not the only signal to listen to as to when to eat. If you are tired, dragging, and crabby– eat2. How can you prepare to move from Keto to Carnivore?So, you are now ready to make the transition. What do you need to do?1. Analyze what you have been eating
   If you don’t already keep a food journal, then start immediately, ideally with an app like Noom. This will help you how much nutrition you get from plants as opposed to meat.
   
   2. Calculate how much of your calorie intake is from plants

   
   Now that you know how many calories you take in from meat and plants, you can determine how much you need to make up by replacing plants with animal products. If you’re at a healthy weight, then stick to the same calories.

   But if you still have some way to go to reach your weight loss goals, then consider reducing the calories a little more. I have found that the amount of all meat diet weight loss is higher than on keto. And the meat seems to keep me full for longer, so I can reduce my calories more efficiently.

3. Gradually replace greens with meats
   It is much easier on your body if you make the transition gradual, say over a period of 7-10 days.

4. Eat from a larger array of meats
   It is very difficult to constantly eat the same thing, even if it’s a delicious ribeye steak from grass-fed beef cooked in butter, you can quickly get sick of it. The best thing you can do is switch between beef, pork, chicken, fish, and organ meat for your meals.This also has the added benefit of providing a more diverse range of vitamins and minerals.

Monitor your ketone levels

As you gradually switch to more meat, you should notice an increase in ketones. You can buy devices, and test strips that measure these levels in your urine and they are reasonably accurate.

It’s a good indicator that you’re moving in the right direction. You should also start testing several times a day and keep track of the measures and note down what kind of mood you’re in. This can be a very motivating exercise, as generally speaking you’ll be in a better mood with high levels.

3. Are you now confident enough to make the transition?

In the whole keto vs carnivore debate, it really shouldn’t be a question of which one is better. They definitely complement each other. In case you are completely new to it all, then start with keto and after a few weeks transition to carnivore on regular on and off cycles.

The two major transition symptoms in switching from Keto to Carnivore are bowel changes from a lack of plant material and fiber, as well as appetite swings. Being aware of these and having a game plan and commitment to overcome these issues is key to a successful transition from Keto to Carnivore.

If for some reason you are struggling to commit to this lifestyle, then reducing your carbs is a good health move to make.

References

1. Kevin Stock (2018):How to go from Keto to Carnivore. Retrieved from https://www.kevinstock.io/health/how-to-go-from-keto-to-carnivore/
2. Carnivore Style (2019): Keto vs Carnivore Diet – Which One Is Actually Better? Retrieved from https://carnivorestyle.com/blog/keto-vs-carnivore-diet/
3. Perfect Keto (2019):The Carnivore Diet: Can Eating Only Meat Supercharge Your Health? Retrieved from https://perfectketo.com/carnivore-diet/

Diabetes was the leading cause of death in the US in 2015. To date, it follows closely behind cardiovascular disease and cancer.

For many people, the diagnosis of type 2 diabetes can be devastating as this comes with lots of risks and uncertainties. Also, this implies having to grapple with increasing healthcare costs to manage the chronic condition. The cost of treating diabetes in the US is approximately $7,900 per person each year.

Just across in the UK, the National Health Service (NHS) is looking for ways to curb the diabetes type 2 epidemic which is causing a strain on the already overstretched NHS budget. Towards the end of last year, the NHS initiated a program that involves starting 5,000 patients on a liquid diet of just over 800 calories a day for 120 days in a bid to reverse the condition. This is part of the NHS Diabetes Prevention Programme (NHS DPP) intended for people who are at risk of type 2 diabetes The project comes after a highly successful trial of the same nature. This liquid diet is meant to restrict the calorie intake of the patients with the hope of helping them achieve a healthy weight and healthy lifestyle. In the end, these lifestyle changes should lead to diabetes reversal.

What is diabetes type 2?

Diabetes is a condition that causes an individual’s blood sugar levels to become too high. Type 2 diabetes happens when a person progressively becomes insensitive to the effects of insulin. The pancreas then secretes more insulin leading to too much insulin in the body. Eventually, the insulin levels may decline when the production sources are exhausted.

Diabetes type 2 is linked to obesity and cancer. Fortunately, it is preventable through diet and lifestyle changes.

In the US, there are about 100 million people living with diabetes or prediabetes. 9 out of 10 of diabetes cases have diabetes type 2. The study alluded to above suggested that a liquid diet could help in reversing diabetes in most patients.

What Is A Liquid Diet?

A liquid diet (like the one used in the study) is generally a very low-calorie diet. It usually involves eating around 800 calories a day or less. Just to put this in perspective: this is a third of what a man usually takes and half of what a woman should take.

The liquid diet consists of shakes and soups, according to the NHS. A person should use this diet for no more than 12 weeks and should do this only under strict medical supervision.

Side effects to expect include:

• Dry mouth
• Constipation
• Diarrhea
• Headaches
• Dizziness
• Cramps
• Hair thinning

This diet is not suitable for everyone.

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Successful trial

The milestone study is called DiRECT which is an acronym for Diabetes Remission Clinical Trial/ As much as the study is not complete, preliminary findings have caused lots of excitement. So much so that NHS England has committed to piloting a Type 2 diabetes remission programme in 2019 with about 5,000 study participants.

The first-year results showed that almost half (45.6%) of those who took part in the programme were in remission after a year. By the end of the second year, 70% were still in remission. Overall 30% of study participants were still in remission two years. This is encouraging for the diabetic community as it dispels that myth that this is an irreversible disease.

The second-year results showed a close correlation between diabetes type 2 remissions and weight loss. The majority of those who lost more than 10 kilos maintained remission after two years. Weight loss was also associated with improved quality of life, improved blood glucose (sugar) control, and a reduced need for diabetes medications.

The researchers admitted that this approach cannot work for everyone. It is important to understand the biology underlying remission before implementing any treatment.

What Is Diabetes Remission?

Diabetes remission means that a person with diagnosed diabetes can maintain normal blood glucose levels without using any medication. This doesn’t mean diabetes has gone for good, but that the person is living symptom-free and medication-free as well. A person in remission still needs regular check-up and follow up by a physician.

What Is The NHS Plan

The NHS long-term plan is to empower people living with type 2 diabetes to take charge of their own health needs. By limiting their calorie intake and reducing weight, most patients can achieve diabetes reversal.

Ultimately, this will result in lower healthcare costs for the NHS as well as individual patients. Speaking to news, NHS England chief executive Simon Stevens had this to say:

“However this isn’t a battle that the NHS can win on its own. The NHS pound will go further if the food industry also takes action to cut junk calories and added sugar and salt from processed food, TV suppers, and fast food takeaways.”

• References

1. CDC: Death and Costs. Retrieved from https://www.cdc.gov/diabetes/data/statistics-report/deaths-cost.html
2. iNews (2019): Type 2 diabetes patients to be prescribed very low-calorie liquid diet to reverse. Retrieved from https://inews.co.uk/news/type-2-diabetes-patients-prescription-very-low-calorie-liquid-diet-reverse-condition-198716
3. BBC News (2018): Type 2 diabetes: NHS to offer 800-calorie diet treatment. Retrieved from https://www.bbc.com/news/health-46363869
4. Diabetes UK: NHS England announces Type 2 remission pilot, and plans to double the size of the NHS England Diabetes Prevention Programme. Retrieved from https://www.diabetes.org.uk/about_us/news/nhs-type2-remission-pilot

Stephen Edward:          Good morning and welcome to today on 95.5 R&B For The Lou. I’m your host Stephen Edward and joining us back on the program, Dr. Gurpreet Padda. He joins us back on [Batoto 00:00:12] today. It’s great to see your Dr. Padda. Welcome back to the show.

Gurpreet Padda:           Thank you. I appreciate being here.

Stephen Edward:          The last time you were here we talked about diabetes in women and the African American community. What a marvelous discussion we had. Dr. Padda. Got a lot of people to email me after our interview. I am so happy you had a chance to come back and discuss some other things that were on your plate. Today, our discussion is addiction and why treatment fails.

Gurpreet Padda:           Yeah, absolutely. I think that there’s a misunderstanding of what addiction is. I think it’s very important for us to understand how people get addicted so that we can treat them correctly.

Stephen Edward:          Dr. Padda, what is the relapse rate for addictive diseases and why is relapse a part of recovery?

Gurpreet Padda:           So we expect patients to have relapse. But first you have to back up and ask yourself, what is addiction? Addiction is the concept that I’d go back to a drug that I was using or go back to a substance that I was using because that substance made me feel differently. It made me feel better. It’s a central brain phenomenon. It’s part of our limbic system, and specifically it’s a section in our brain called the nucleus accumbens. When we take in a substance that goes to our nucleus accumbens and we get a dopamine release, and I know I’m using all these chemical terms, but when we get this chemical release-

Stephen Edward:          But you’re making it easy to understand that.

Gurpreet Padda:           Yeah. So you go to the nucleus accumbens, when it gets stimulated, whatever substance I took right before that, if the nucleus accumbens dumps a bunch of dopamine, my brain says, “Hey doc, this stuff is really good. Whatever it was, this was really good.” So then you back up and you ask yourself, “What are the things that caused the nucleus accumbens to dump dopamine?” Well, the primary one when you’re a little baby is oxytocin and the mom and the baby, when they are exposed to each other, they dump oxytocin and oxytocin causes the nucleus accumbens to release dopamine. So it causes bonding and it makes people feel connected to each other. As we grow certain types of food, especially in the hunter-gatherer communities that we had for two and a half, 3 million years, if we came across something that was really tasty, the brain reinforced the behavior saying, “Hey, whatever that was that you just ate, it was really good and I’m going to release some dopamine and make you want more of it.”

Gurpreet Padda:           This was all good. But then we started to refine some of these chemicals that we found in the wild. So we’ve had poppy seeds forever. We’ve grown poppy forever. It was only the last couple of hundred years that we refined poppy seed into morphine. When we refined poppy seed into morphine, then we started to get morphine addiction because we’d taken the morphine and it dumps a bunch more dopamine than we would normally expect, and all of a sudden we’re flooded with this dopamine and we go, “Hey, this stuff is really good.” So it’s a matter of perspective. We’re getting a tremendous release of dopamine. So you might think that everybody that gets morphine gets this huge amount of dopamine release and we’re all addicts.

Gurpreet Padda:           But that’s not the case. Isn’t that strange? Some people become addicted and some people don’t. So there’s more to it than just the dopamine dump. I’ll give you the example. During the Vietnam War, one of our biggest fears for people coming back from Vietnam was that they were going to be addicted to heroin.

Stephen Edward:          Sure.

Gurpreet Padda:           Because the use of heroin in the Vietnam War was between 30 to 50% of all of the armed forces. They were exposed.

Stephen Edward:          Right, right.

Gurpreet Padda:           So that would have meant that we had half of the troops coming back, zombies on the street taking heroin. That didn’t happen. It was only 4% of the population. So why-

Stephen Edward:          But they talked about it so much, doc.

Gurpreet Padda:           They talked about it, but only 4%. So that makes you wonder why is it that only 4% of the population truly was addicted, but half of it was exposed. So that brings us to an interesting study a researcher did. What he did was he took rats and he put them in a cage, and in one side of the cage he put bottles of water and next to the bottle of water he put a bottle of water with cocaine in it. He watched what would happen. The rats would taste the regular water and they go, “Well, I need water, so I’m going to drink that.” But then they would stumble upon the cocaine water and go, “Hold on. This releases dopamine. I like this.” They kept taking the cocaine water and whether it was cocaine or heroin or morphine, whatever it was, whatever he tested with, anything that we have as an addictive substance, the rats would overdose on it and die.

Gurpreet Padda:           So therefore, us as physicians concluded that if you expose a rat or a human to a substance, they’re going to overdose and die. So you would think that that would be the case. But we also know that only half of the rats, if you expose half of the rats and only 4% of them are truly addicted, what happens? So the same researcher did another study. He took the rats and he put them in a cage and he gave them water and he gave them morphine or he gave them cocaine in another set of water. But instead of just being there by themselves, he gave them things to do. He gave them other rats to have sex with. He gave them other rats to play with. He enhanced their environment. He gave them stuff to do instead of sitting in a sterile glass aquarium.

Stephen Edward:          Right.

Gurpreet Padda:           As soon as he did that, none of the rats died. The rats weren’t interested in the morphine, in the cocaine, heroin.

Stephen Edward:          They were interested in each other.

Gurpreet Padda:           They were interested in each other. The conclusion from that is the rats that are lonely become addicted. The rats that have a lot of stuff to do don’t get addicted. The same thing with humans. Fundamentally, fundamentally it’s an issue of your limbic system with the dopamine release, but it’s in the context of loneliness. When we take addicts and we isolate them because we ostracize them because they’re addicts and we make them more lonely and we imprison them, we’re only making addiction worse. Instead of ostracizing and isolating addicts, we need to treat them with love. We need to treat them with dignity. We need to bring them back. We don’t need to put them away. That’s our fundamental problem [crosstalk 00:06:44].

Stephen Edward:          So you’re saying doctor, we shouldn’t put the blame on the addicts. We’re actually putting the blame on the drug itself?

Gurpreet Padda:           I think the blame is in the context of where the person is and I don’t think that you should blame any of it because human beings and animals are hardwired to release dopamine. We’ve spent millions of years trying to get a dopamine release and we have these substances that cause dopamine release. But you don’t make an addict unless they’re lonely, unless they’re isolated.

Stephen Edward:          I never thought about that doctor. So most of these addicts out here, or doing these things because they have nothing to do.

Gurpreet Padda:           They’re bored.

Stephen Edward:          They’re bored, and some of them in some cases are lonely.

Gurpreet Padda:           They’re completely lonely and they’re completely bored. If you look at, and I’ve personally done this, so this may seem weird, but I wanted to see what it was like to be in a situation that where somebody was homeless. So I did a little experiment on myself. I became homeless for a day in San Diego and I wanted to see what the average person experienced being homeless. It is one of the most lonely experiences you’ve ever had because you are ostracized because you don’t have any money. You’re ostracized because they think that you’re homeless and you’re isolated and no one will talk to you and no one will interact. So it’s no wonder that our homeless population has the highest addiction rate. It’s no wonder that that’s the case. The more isolated we make human beings, the far worst the addiction and the harder it is to break. So the issue is you certainly have a chemical problem, but we have a societal problem. The only people that we have to blame is our own society for our own behavior and for not including and not loving these people that are desperate for attention.

Stephen Edward:          What are some of the most addictive drugs?

Gurpreet Padda:           So surprisingly, and of the hardest addictions for us to break is nicotine. It takes more quit attempts with nicotine than practically any of the other substances. That brings up something really interesting. We know that the companies that make cigarettes are really, really, really good at figuring out how to modulate and effect nicotine and effect the sales of nicotine. Those same companies are the ones that have taken over the big food corporations. That’s why since the late ’70s and the early ’80s as nicotine sales started to go down, big food sales started to go up and the food that we’re now producing is hyper addictive. You can see that because you can see that in the type of food that we have, in the glycemic index of the food that we have, in the concentration of the fructose that we have compared to what it should be.

Gurpreet Padda:           So you can see it in the way that the food is manipulated to be hyper addictive. It’s because they took the information from the cigarette industry and shifted it to the food industry. It’s just fascinating. If you watch the history of food and the history of addiction and you watch it from the standpoint of what are the things that we know are hyper addictive and cigarettes are one of the worst, and they’ve shifted those resources into big food and that’s what we’re dealing with now with this epidemic of obesity. It’s an epidemic of obesity because of addiction.

Stephen Edward:          Dr. Padda, what about the preservative that they put in the food? Is that part of it as well?

Gurpreet Padda:           Preservatives are certainly a part of it, but I’ll give you an example that’s a little bit more specific.

Stephen Edward:          Go ahead.

Gurpreet Padda:           So if I take a molecule of sucrose, table sugar, okay, and I break it in half because it’s a disaccharide. It’s two sugars bounded together. So if I break it, half of it will be glucose and half of it will be fructose. So that sounds interesting to you. Glucose and fructose comes out of one sugar molecule of sucrose. Now it’s one to one ratio. Your body knows how to handle a one to one ratio. If I did a special imaging study of your brain and I looked in your brain and I exposed you to table sugar, you would get a little tiny light up of your nucleus accumbens because that fructose activates the nucleus accumbens slightly. Now, if I give you high fructose corn syrup that’s in soda, it’s not a one to one ratio. It’s 55 to 65% fructose and 45% or less glucose, and all of a sudden I get a massive light up of your nucleus accumbens. So they’ve shifted the type of sugar in the soda so it’s more addictive.

Stephen Edward:          Our conversation this morning is with Dr. Gurpreet Padda. Our topic of discussion addiction and why current treatments fail. Dr. Padda, is it the glucose or the fructose that produces cancer cells?

Gurpreet Padda:           Any of the sugars can stimulate the cancer cell growth. Cancer is really dependent upon sugar as one of its major influences to grow and it’s called the Warburg effect. Cancer is dependent upon these necessary elements for it to grow rapidly and one of the things it really needs is glucose and fructose. It needs both. But it preferentially prefers glucose, but it doesn’t … It’s not a big deal until you get to high concentrations. Regular amounts of glucose are not a big deal. It’s the high concentrations that you see … Because we didn’t, before 1915 to 1920, we didn’t have a huge amount of cancer in the world. Dr. Warburg, who was kept alive by the Nazis, by Hitler, Warburg was a Jewish scientist. Hitler kept him alive because he was so terrified of this rapid increase in cancer in Germany and it was because we had started to get processed food.

Gurpreet Padda:           It was back then that we started to get it and it really didn’t take off until the 1960s and ’70s when we got a lot more processing of food. It became even more refined and we added vegetable oil. We added a lot of Omega-6 vegetable oils, industrial seed oils.

Stephen Edward:          Dr. Padda, you and I are in the same generation. We may be the same age, but back in the day when we were growing up, cancer was known as an old folks disease. That has changed.

Gurpreet Padda:           Yeah. It’s because of our nutrition. We haven’t changed our environment that much. We’ve changed it a little bit, but really what we’ve changed is our nutrition. We used to rarely hear of people being diabetic.

Stephen Edward:          That’s true, so true.

Gurpreet Padda:           The Joslin Institute, which is one of the preeminent institutes that studies diabetes type II, type II diabetes was rare. It was exceptionally rare and now half to two-thirds of our population is overweight or obese and half of those are going to end up with type II diabetes in the next 10 to 15 years. That’s outrageous.

Stephen Edward:          It really is.

Gurpreet Padda:           This is a trillion dollar problem. If we don’t fix this problem, we’re going to bankrupt this country with a lifestyle disease. Something that is easy to treat and easy to fix and what’s happened is our food is so addictive we can’t stop eating it. We can’t stop consuming it because we need it. Our brains are tricked into wanting it and it’s such a bad thing that it’s increasing our sugars constantly and as it increases our sugars, it increases our type II diabetes rates.

Stephen Edward:          That’s rough, doctor.

Gurpreet Padda:           It is. That’s unfortunately what addiction is. So I said, cigarettes are probably the most addictive substance and they carried that information from cigarettes into big food and here we are.

Stephen Edward:          What is the disease concept of addiction?

Gurpreet Padda:           So the disease concept of addiction is I need more of X, Y, Z substance because it makes me feel normal. It doesn’t me feel super normal because addiction is I need that now. I got exposed to it. It made me feel better and after awhile I go, “Hey, I got exposed to that and I need that just to be okay,” and without that substance-

Stephen Edward:          Dr. Padda, the opioid problem we have here in St. Louis, is it because we’re a transit community? We have a lot of people coming in and out of St. Louis. A lot of people are sharing medications. Is that the reason why st Louis ranks so high?

Gurpreet Padda:           We’re one of two states that actually has had an increase in opioid death rates in the last year.

Stephen Edward:          Missouri?

Gurpreet Padda:           Missouri, every other state minus one other has actually had a reduction in death rate. Missouri actually has had an increase and really what it is is the synthetic analog drugs that we have. So-

Stephen Edward:          Can you give us an example?

Gurpreet Padda:           Yeah, so fentanyl and carfentanil.

Stephen Edward:          Oh, yeah, of course.

Gurpreet Padda:           Are of course the drugs we’re talking about. Fentanyl is a synthetic opiate that we use in anesthesiology because I’m an anesthesiologist. We use it in anesthesia for cardiac operations. We use it to relieve pain during anesthesia and we use it for terminal cancer patients. It’s never really been intended to be out in the wild. It’s never intended to be used for regular patients. It was always used the requirements of anesthesia or used for palliative care for people that were terminal. But once you expose it to the wild population, once you put it in the wild, it so rapidly absorbs. It gives you such a high dopamine flux. It’s nearly the perfect drug to get that dopamine release. Carfentanil is nearly a thousand times stronger than fentanyl and fentanyl is probably a thousand times stronger than morphine. So a tiny dose of this drug is just incredible. People don’t know how to regulate the dosing on it. I’ll give you an example.

Gurpreet Padda:           So there was a conflict in Russia and in Russia there were a group of terrorists that had taken over a movie theater. This group of terrorists were holding hostage several hundred people, several hundred Russians. The Russian government thought, “You know what? We’re never going to get these people out. So what we’re going to do is we’re going to gas them with fentanyl gas. We’re going to dump a fentanyl bomb into this movie theater and then we’ll run in and we know that they’re all going to stop breathing and we’ll run in and we’ll resuscitate the people that are the good people and we can then arrest the terrorist.” So they put this bomb in there, and what they ended up doing was killing almost everybody in the theater because it is so potent and worked so rapidly that they couldn’t control it. It’s the same thing with somebody who’s taking fentanyl by accident.

Stephen Edward:          But doctor, if someone is having an overdose, what should they use? Naloxone?

Gurpreet Padda:           So Naloxone turns off those receptors and it takes somebody who’s overdosing, who stopped breathing and immediately reverses that.

Stephen Edward:          So Dr. Padda, you’ve been doing this for over 20 years. 20 years ago, the need and the popularity of using opioids were nonexistent.

Gurpreet Padda:           We’ve been observing this over time. I do mostly procedures to get rid of pain and I use a very low dose medication. The medications that people are using, the medications that they’re self using are 10,000 times stronger than anything that we prescribe. The real issue, the real issue is they don’t know how to dose it. It’s the same medication that we’re using, but in anesthesia, it’s the same medication but they don’t know how to dose it. This is not like somebody smoking a cigarette. The worst thing they’re going to have is a cough and maybe develop some lung cancer. If they take a fentanyl tablet, they’re going to overdose and die and they don’t have a chance to have the remorse to figure it out. They die so quickly that they don’t have that opportunity to reverse course. That’s why the Narcan is there that perhaps we can reverse course, but this is a dose escalation phenomenon.

Gurpreet Padda:           The more rapid the rise of the drug in the bloodstream, the more the dopamine release, the more the dopamine release, the more addictive the substance, the more addictive the substance, the more adherent the person is to that substance. If they have no reason not to do it, if they’re isolated, if there’s nothing else for them to do, if they’re bored, and this is what they do, if they’re hanging out by themselves, hanging out at the corner, and this is what all their friends do, if-

Stephen Edward:          That’s what they’re going to do too.

Gurpreet Padda:           Yeah, if this is what their tribe does, then this is what they’re going to do, and all of a sudden you have three or four dead people. Yeah, it’s the reality of what we’re dealing with now.

Stephen Edward:          Dr. Padda, there’s an awful lot of clinics popping up here in the St. Louis Metro East area because now there is a problem and before, no help. Now, all the help you can get, what do you think about that?

Gurpreet Padda:           Yeah, I think that the clinics, which most of them do medicated, medication assisted treatment, MAT, most of them assist the patient in reducing their craving, but that’s not the fundamental problem. The fundamental problem is that patients’ involvement in their community. What can we do? We can reintegrate people. We can give them things to do. We can give them a better hope and a better life to live for. If we continue to isolate our addicts, they’re going to die. That’s where we’re going to end up. We can’t do that. As a society, we cannot isolate these people. We’re taking away their opportunity to get jobs.

Stephen Edward:          Right.

Gurpreet Padda:           We’re taking away their opportunity to participate because all you’re going to do is isolate them, you’re going to kill them eventually. They have nothing to live for and we’re criminalizing, and unfortunately that’s the wrong answer.

Stephen Edward:          That’s not working.

Gurpreet Padda:           It hasn’t worked.

Stephen Edward:          Dr. Gurpreet Padda. This is [Batoto 00:20:52] today, and we’ll be right back after this.

Steven B.:         We’re back. This is Bethalto Today on 95.5 R&B for the Lou. I’m your host Steven B. Joining us in conversation this morning, Dr. Padda and our topic of discussion addiction and why current treatments fail. Dr. Padda, before we got into our break, we were talking about sugar and its addiction. What could it lead to doctor?

Dr. Padda:        That’s why we have an epidemic of addiction and we have 60,000; 70,000 dead people. It’s a big deal. We’re probably going to have killed more people than the Vietnam War with this addiction.

Steven B.:         Opioids?

Dr. Padda:        Opioids. We’re going to have killed more people than the Vietnam War with opioids. And you remember I said food is addictive. We’re going to kill 10, 100 times that in diabetes and excess of carbohydrate consumption, which is also an addiction. It’s just you can have a little remorse and it’s not going to kill you today. The fentanyl will kill you in five minutes. That cookie will take a couple of years.

Steven B.:         Dr Padda, sugar is in everything we eat, bread, cheese.

Dr. Padda:        Well that’s part of it. So there’s three things that I always tell my patients because the food companies have engineered this stuff. They’ve got this down to a science. They know exactly how to do this. And I’ll give you a wonderful example. They came up with these Fire Doritos and I don’t know if you’ve ever seen this.

Steven B.:         Yes. I’ve eaten them.

Dr. Padda:        So Fire Doritos are very interesting. Your brain has to be constantly modulated. If I give you one substance and I just give you a steady state of it, it’s not as addictive as if I give you a substance, give you more, then give you less and give you nothing and then give you more and then give you too much.

Dr. Padda:        And so it’s the cycle of up and down. So if you look at these Doritos and you look at this food that we’ve got, what happens is the different Doritos have a different hot point. They have a different amount of spice and specifically engineered to tantalize your taste buds so you don’t know what to expect on the next Dorito. And your brain suddenly gets a burst of dopamine. And then it gets less and then it gets a burst of dopamine. It’s like kind of hitting the jackpot in the casino. Three out of a hundred times you’re going to hit the jackpot. The other 97 you’re probably not going to get anywhere. And so every once in a while you’re going to hit the jackpot and you’re going to hear all of everybody else hitting the jackpot, which makes you participate in the casino.

Steven B.:         Doctor, where is your office located?

Dr. Padda:        So we have a about 10 clinic locations, 11 clinic locations. I’m mostly at the south city office on Chippewa. We have a location in Bridgeton, which is very accessible. It’s right next to DePaul Hospital. We have a location in South County and I prefer being in the city. I’m a city mouse, so I prefer hanging out in the city and dealing with the issues that are of this nature.

Steven B.:         Right, right. Of course. Dr. I mean, you’re at LaClede Town [crosstalk 00:03:02] back in the day.

Dr. Padda:        I grew up in LaClede Town.

Steven B.:         You’ve connected with the people downtown and you’re probably still connecting with friends for over years and their families.

Dr. Padda:        Yeah, we’re trying to connect as deeply as possible. There are a variety of projects that we try to connect into and try to assist in the community. My biggest thing right now is yes, we know that addiction to opiates will kill 60,000 but addiction to sugar and our fast food industry, and our processed food industry-

Steven B.:         It could happen to more.

Dr. Padda:        Well, it’ll be millions. The opioid epidemic, it’ll be 20, 30, 40, 50, 100 billion. But this epidemic of diabetes and metabolic syndrome from the food that we eat, we’re talking two or three trillion.

Dr. Padda:        And so my goal is to assist in fixing the bigger problem. And that is the consumption of the food that we shouldn’t be having. We can fix type two diabetes. We can fix it in one generation. We can fix it in three months. We can fix this entire issue. So why do we continue to ignore the biggest healthcare crisis that we have?

Steven B.:         Dr Padda cigarettes is subsidized by the government. How come we just can’t take those off the shelves?

Dr. Padda:        It’s money. These industries are heavily subsidized. They have really good lobbyists. And they continue to make money. So the people want the substance because it makes them feel better. It’s the opiate for the masses. And we give them what they want, and of course they’re going to demand more of it, but that doesn’t mean it’s necessarily healthy.

Dr. Padda:        And I understand that. I totally respect that. I own restaurants too, and I understand what it is to, to serve food and they’re trying to make money and we all get it. But at the same time, we as individuals have to make decisions that are best for our individual health.

Steven B.:         People are making money and they’re killing their own people.

Dr. Padda:        Exactly.

Steven B.:         Dr Gurpreet Padda. Thank you so very much for coming in on the show this morning.

Dr. Padda:        Thank you. I appreciate it.

Steven B.:         We got to do this again.

Dr. Padda:        Thank you, sir.

Steven B.:         Thank you. This is Bethalto Today. We’ll be right back after this.

 

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The failure of the to develop a “magic bullet” drug that safely promotes weight loss is evidence that a reductionist single biologic mechanism is unlikely to account for the obesity epidemic.

We have conquered most of the communicable diseases, the next phase of medicine needs a systems approach.

About complex system failure:

Complex systems are intrinsically hazardous systems. All of the interesting systems are inherently and unavoidably hazardous by the own nature.

Complex systems are heavily and successfully defended against failure. The high consequences of failure lead over time to the construction of multiple layers of defense against failure.

Catastrophe requires multiple failures – single point failures are not enough. Overt catastrophic failure occurs when small, apparently innocuous failures join to create opportunity for a systemic accident. Each of these small failures is necessary to cause catastrophe but only the combination is sufficient to permit failure.

Complex systems run in degraded mode. Complex systems run as broken systems. This is what most of medicine treats.

Attribution to a ‘root cause’ is fundamentally wrong.
Overt failure requires multiple faults, there is no isolated ‘cause’ of an accident. There are multiple contributors to accidents. Each of these is necessary insufficient in itself to create an accident. Only jointly are these causes sufficient to create an accident. It is the linking of these causes together that creates the circumstances required for the accident.

https://web.mit.edu/2.75/resources/random/How%20Complex%20Systems%20Fail.pdf

Glycation is a chemical reaction that spontaneously occurs in the presence of increased carbohydrates and is referred to as a Maillard reaction.

Glycation (non-enzymatic glycosylation) is the result of the covalent bonding of a sugar molecule, such as glucose or fructose, to a protein or lipid molecule, without the controlling action of an enzyme and is a haphazard process that impairs the functioning of biomolecules.
Fructose has approximately ten times the glycation activity of glucose.

Red blood cells have a consistent lifespan of 120 days and measuring HbA1c provides an easy measure of systemic glycation.
Glycation leads to advanced glycation end products (AGEs), which is implicated in many age-related chronic diseases: –cardiovascular diseases (endothelium, fibrinogen, and collagen damaged) –Alzheimer’s disease (amyloid proteins) –cancer (acrylamide) –peripheral neuropathy (myelin damage)

Normal HgBA1c <5.6

HgBA1C >5.7 is considered high, but most clinicians ignore the the result until it is >6.5. Unfortunately, your membranes are being damaged and you are incurring irreversible tissue damage between 5.7 to 6.5

Consider a HgBA1C as a check engine light, you need urgent maintenance. Take this to a mechanic who will pay attention, it is not normal.

In the 1960s, the sugar industry paid three Harvard scientists to publish a review of research on sugar vs. fat and their effects on heart disease. The Sugar Association paid the scientists the equivalent of about $50,000 today, cherry-picked the research included in the review; resulting in a biased article published in the New England Journal of Medicine stating that fat, rather than sugar, was the main culprit behind heart disease. One of the scientists, Dr. D. Mark Hegsted, went on to become head of nutrition at the U.S. Department of Agriculture, where he assisted in drafting what would become the country’s dietary guidelines. This manipulation by the food companies in nutrition science resulted in a long-term deleterious effect for the US, with likely millions of premature deaths and trillions of dollars wasted in healthcare.

Sugar Industry and Coronary Heart Disease Research: A Historical Analysis of Internal Industry Documents. Cristin E. Kearns, DDS, MBA; Laura A. Schmidt, Ph.D., MSW, MPH; Stanton A. Glantz, Ph.D. JAMA Intern Med. 2016;176(11):1680-1685. doi:10.1001/jamainternmed.2016.5394