5 Steps to prevent Heart Disease

Tuesday, May 22, 2018

The Validation of the Sponge Syndrome

I have posted this chapter from my book, 
The Chronic Disease of Obesity

Definition of Sponge Syndrome: I lost 80 lbs on 1500 calorie and exercise.  I gained back 50 lbs despite 2 hours of exercise a day.  I regained weight due to the fact I still had 80 billion fat cells after my 80 lbs. weight loss.  These cells were shrunken and thus secreted little leptin.  This told the brain my body was starving.  

LARGE number of FAT CELLS with LOW LEPTIN levels.  

This is why the Reduced Obese can't maintain their weight loss.



Chapter 12:   Sponge Syndrome Validation   
 I believe my Sponge theory as the main cause of Chronic Obesity
to be verified from multiple scientific discoveries.  
Most important is that we do not know what has caused the epidemic of obesity in the world.
Gaining weight and losing weight is relatively easy.
Maintaining the weight loss is the challenge.
Guidelines advise: Maintain weight loss with more exercise and
watch the calories around 1,000 to 1,500 depending on your height.
This guideline has only worked for about 5% of the chronic obese over the long term. {31}  
The Leptin  hormonal theory of weight regain in the reduced obese has clearly been elucidated.{17}  
The Leptin theory has also been validated by many medications that fool leptin by
telling your brain
it is not starving by several different hormonal pathways downstream from leptin
which are on the market.
Fact: weight loss and bariatric surgery do not reduce the number of fat cells,
they cause shrinkage of the adipocytes with subsequent low levels of Leptin
which acts directly on the brain.{28}  
Fact: small fat cells are more efficient at gaining weight in reduced obese.{22}
There are Leptin receptors throughout the body and the adipocytes also
send out MiRNA to tell the body via episomes to regain weight.{29}
Most diet books ignore all this science.
 As Dr. Aronne reminds us that it takes new science up to 14 years to accept the new data.
Nutrition science might be considered an oxymoron.
Nutrition science has three very good trials.
1- The Predimed trial
2- The Look Ahead trial.
3- DASH diet trial to treat hypertension.
Unfortunately we don’t know if the secret sauce in the Predimed is wine and nutritionists
discount the LOOK AHEAD negative outcomes.


“Consilience of inductions. Call it a “convergence of evidence” {23}
not found for low fat diet despite multiple trials and  
not found for exercise to maintain weight loss(see chapter 10).


I pushed the Sponge Syndrome theory as a common sense answer to
why people regain their weight loss.
What the nutritionists and the guidelines push to maintain weight loss has not worked.  
To give the same advice to maintain weight loss that doesn’t work
for 80-95% of the Reduced Obese might be called insanity.
Resistance to low carbohydrate high fat (LCHF) has been fierce.  
There is finally a paradigm shift.
 Some studies have shown some people do better on low fat diets
but overall the data for LCHF is excellent.
 Is it genetics or is it cultural?
Shifting from high carbohydrate diet to low carbohydrate diet is a difficult change in lifestyle
but it is possible if you stick with the Atkins type (LCHF) long enough
to get over the love of carbohydrates. It takes at least a month.
 I suspect the difficulty is cultural more than genetic. Time will tell.
I want people to lose weight with whatever diet worked before.
 Once they hit the plateau of weight loss, the low fat diet fails in the long run
because it is not ad libitum as the Atkins type diet is.
To be able to stay on a diet for life the diet must satiate hunger
(high protein and nutritional ketosis).
Also fat gives much of food it’s flavor.
You need to follow a reduced calorie diet that you can stay on for the rest of your life
just to maintain your weight loss, not for more weight loss.
Not matter what diet you go on, eventually it will fail because
none of them reduced the number of fat cells.
Only diet medications will overcome the low Leptin levels that tell your brain
the body is starving over the course of a lifetime{35}.
 This is science that is often not mentioned in articles on weight loss maintenance.
I have tried to present some of the science without getting too much into the weeds.
 I have tried to keep the science as simple as possible.
I took the American Board of Obesity Medicine boards.  
Unfortunately the other disciplines don’t know or will not accept this data from the Boards.
Thus  “convergence of evidence” went awry during the decades of low fat dieting.
Possibly the influence of the food production lobbyists  had something to do with it.
Dr. Ludwig writes about guidelines allowing fruit juices might have to do with lobby interests
on the guideline board in his tweets.
“The 2015 to 2020 Dietary Guidelines for Americans (DGAs)
recognize the role of 100% fruit juice
in health and in helping people meet daily fruit recommendations
and state that 100% fruit juice is a nutrient-dense beverage that should be a primary choice,
along with water and low-fat/fat-free milk.”{39}
  For my Sponge syndrome  “to overturn the consensus,
I would need to find flaws with all the lines of supportive evidence and show
a consistent convergence of evidence toward a different theory that explains the data” {23}    
The Hall analysis of the Biggest Loser puts a big question mark next to the advice
of exercise and low calorie intake as that did not work for 13 of 15 people in the trial.{14}
The Look Ahead data showed that after 10 years of the best exercise and diet program
with close personal support to keep behavioral changes
failed in primary outcomes compared to control.  
 This was a random controlled trial with large numbers of participants and a good control over 10 years.
It doesn’t get much better than this in nutrition science.
Yet this data did not change the guidelines.
 Most guidelines still advise 90 minutes or more of exercise to maintain weight. (see chapter 13)
The key to maintaining weight loss is a low calorie diet that you can stay on the rest of your life.
  The answer is an ad libitum diet and diet medications.
No guidelines should be written without a close examination of the many hormonal ways the brain
uses to make you gain weight again.
The Sponge Syndrome is the perfect storm for weight regain in the reduced obese.{34}  
 The number of fat cells has the last word.  
 I asked Dr. Leibel if adipocytes only live 10 years.
 He said there is some discussion of that but there is evidence that
the fat cells that die are rapidly replaced.
Thus the billions of excess fat cells of the obese are present for life in the Reduced Obese
act like a sponge for free fatty acids.
I had the privilege of listening to Dr. Michael Rosenbaum
talk about why weight loss maintenance is so difficult.
 I asked Dr. Rosenbaum if what I call the Sponge Syndrome
might also make it difficult to maintain weight loss.
Small fat cells are efficient at re-gaining fat.
Since the Reduced Obese continued to have a large number of fat cells
despite weight loss all these cells make it easy to gain weight.  
He(Rosenbaum) asked why the skinny people with skinny fat cells don’t also regain weight.
I don’t think he understood that I was referring to the Reduced Obese
who have a much higher Leptin threshold than a lean person
who was never fat and whose small fat cells are not increased in number
and thus don’t have the Sponge Syndrome.


Similar to the Frank Greenway review{19}, I was greatly gratified to find the Ochner review{22}
that also supported much of my Sponge Theory and it’s cause of the Chronic Disease of Obesity.
“Irrespective of starting weight, caloric restriction triggers several biological adaptations
designed to prevent starvation.3
These adaptations might be potent enough to undermine the long-term effectiveness of lifestyle modification
in most individuals with obesity, particularly in an environment that promotes energy overconsumption.”


Ochner adds  preadipocyte proliferation  increases fat storage capacity.  
This goes along with what I hypothesized in my Sponge Theory.


Ochner also says “that these biological adaptations often persist indefinitely,
even when a person re-attains a healthy BMI via behaviourally induced weight loss.3”


In accord with the thesis of my book, The Chronic Disease of Obesity, Ochner goes on to say

“few individuals ever truly recover from obesity;
individuals who formerly had obesity but are able to re-attain a healthy body weight via diet and exercise
still have ‘obesity in remission”

References

14- ‘The Biggest Loser,Their Bodies Fought to Regain”
by Gina Kolata NYT 5-2015


19- Obesity review by Frank Greenway
International Journal of Obesity (2015) 39,
1188–1196; doi:10.1038/ijo.2015.59; published online 26 May 2015


23- Scientific American article on Global Warming







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