5 Steps to prevent Heart Disease

Tuesday, April 28, 2015

Free Alcohol

Notes at 33,000 feet

I just had two Whiskey’s on Delta airlines on my way home from NYC.

I am in economy and it’s a 3 hour flight.  I am not afraid of flying, especially at age 63, I know the inevitable is coming and death in flight is better than death with Alzheimers.

Still it is God awful boring.  I read and I stand but it is so boring.

If there was ever a reason to have a drink this is it.

So I ask for a double Bloody Mary and I will buy a wrap turkey sandwich because I last ate 5 hours ago.

They don’t have vodka.

I am no longer on Victoza because of stomach discomfort.

I want to eat because I know I will get hyperphagic if I wait two more hours to eat.  A smart person would have brought a protein bar.  Ha!

Anyway, they have no lunches for sale, but they give me extra peanuts (they really should have pistachios, walnuts or almonds) and  offer more free snacks.

I don’t want the carbs but then I realize I am hungry.  (always a revelation to the reduced obese), so I ask for some biscuits, which the Delta steward was very generous with and gave me two without my asking.  Nice.

Anyway, I agree to two whiskeys and a diet coke.  I taste the whiskey and after a week of (near) abstinence at the conference I taste the whiskey and I realize I don’t need the diet coke.

I give them my credit card and their  transmitter doesn’t work so they give me the whiskey for free. ( I had already opened it).

Anyway, life is good.

Alcohol dissolves will power, but after a week at an Obesity conference I was taught once again that the reduced obese don’t suffer from being lazy or lack of will power, they have a chronic disease called Obesity which was probably caused by epigenetics in fetus or being too fat as a child. I hope I can go home to Topeka and spread this message and teach folks how to maintain weight loss with satiety.  I am excited and feel empowered with knowledge.  It’s better than my last 3 trips around the world. 

Monday, April 27, 2015

Satiety is the solution to obesity

4 minute video slideshow on Topeka Tubby Program for obesity

This is a quick video slideshow outlining a approach to weight loss that does not emphasize exercise, severe calorie reduction or meetings.  

Sunday, April 26, 2015

6 minute video on Satiety is the solution to obesity.

Topeka Tubby Treatment for Obesity

Link to slideshow on Satiety is solution for obesity

I spent the last week at Columbia Obesity Conference.

I not only validated what I had written about the Sponge Syndrome,  I also thought of a weight loss and maintenance plan that should work because it is based on satiety.  

Wednesday, April 22, 2015

At Columbia Obesity Board review in NYC

Rosenbaum lecture on failure to maintain weight loss LINK 3 MINUTE VIDEO

I had a great day today listening to Mike Rosenbaum and R. Liedel at Columbia Obesity Board review.

Carb intake in 3 trials- compliance with Atkins?
One trial with weight loss drugs.
All had regain in weight after 6-9 months? I am not sure that was true of ATOZ trial.

Mike Rosenbaum said the Sachs trial NEJM 2008 kept the low carb arm to Atkins levels of 50g/d?  I found them to creep up to 175 g/d of carb, not being very different from the low fat arm?
He showed  study with Foster from Annals 2010 and at Foster, Wadden trial I found "A low-carbohydrate diet, which consisted of limited carbohydrate intake (20 g/d for 3 months) in the form of low-glycemic index vegetables with unrestricted consumption of fat and protein.
After 3 months, participants in the low-carbohydrate diet group increased their carbohydrate intake (5 g/d per wk) until a stable and desired weight was achieved"
ATOZ maintained < 50g for 12 months.

Rosenbaum’s point was that neg energy balance in humans can only be maintained for 6-9 months.  Wt. regain then starts due to Leptin reset in reduced obese.?

Rosenbaum also used  graph with wt loss drugs from Wadden NEJM 2005.  Again showing wt. regain with all drugs after about 20 weeks due to Leptin reset in reduced obese?

Monday, April 20, 2015

Can Gary Taubes still keep it simple?

Can Gary Taubes still keep it simple?

My comments in purple.

I am all in favor of simplicity.  That is difficult in Biochemistry.  I have culled significant quotes from a 2014 Biochemistry textbook that my son is using now in medical school.  People like to say Doctors are not taught nutrition, but this textbook is full of nutrition science.  
I have coined the term:
to try to simplify what has become a very complex science of the reduced obese.  
I think Mr. Taubes might compare this textbook to the endocrinology text he quoted in 2001.  I think the validity of LCHF has come a long way since 2001 and I think the quotes below support that.  Remember, for people with metabolic syndrome or DM2, I think it is clear that #LCHF diet is the way to go.  American Diabetic Association is slowly getting there.

Taubes pg 463 in afterword of Good Calories Bad Calories

From 2001 textbook, Endocrinology:An Integrated Approach to Endocrinology “The overall action of Insulin on the adipocyte is to stimulate fat storage and inhibit mobilization.’

Taubes goes on to say:

“With that physiologic fact as a given, any explanation for obesity or the obesity epidemic that looks beyond the influence of carbohydrates on insulin is one that is willfully trying to complicate an explanation when a simple one might suffice.”

p307-8 Ferrier text:

“Insulin is the most important hormone coordinating the use of fuels by tissues.  It’s metabolic effects are anabolic, favoring, for example, synthesis of:
2-triacylglycerols (TAGs) {also known as triglycerides}

p 309
“Ingestion of a carbohydrate-rich meal leads to a rise in blood glucose,  the primary stimulus for insulin secretion.”

p 311
“Adipose tissue responds rapidly to a rise in insulin, which causes a significant reduction in the release of fatty acids by inhibiting the the activity of hormone-sensitive lipase, which degrades lipids in adipose tissue.”

“Insulin also increases the transport and metabolism of glucose into adipocytes, providing the glycerol 3-phosphate substrate for TAG (triglyceride) synthesis.”

p 316
“Postprandial hypoglycemia is the second most common form of hypoglycemia.  It is cause by the exaggerated insulin release following a meal... causing mild adrenergic symptoms… The only treatment required is that the patient eat frequent small meals rather than the usual three large meals.”

p 325
“Circulating insulin levels are elevated in the absorptive state, resulting in an influx of glucose into adipocytes via insulin-sensitive GLUT-4 recruited to the cell surface from intracellular vesicles.

p 326
“in the fed state, elevated levels of glucose and insulin favor storage of TAG (triglycerides)”

p 366
“There is no direct evidence that the consumption of simple sugars is harmful….except dental caries.”

p 366
“Carbohydrates are not essential nutrients, because the carbon skeletons of most amino acids can be converted into glucose… The RDA for carbohydrate is set at 130 g/d for adults and children based on the amount of glucose used by carbohydrate-dependent tissues, such as the brain and erythrocytes.”

p 366
“The clinical importance of the glycemic index is unresolved,
but the evidence suggests that a low-glycemic index diet improves glycemic control in diabetic individuals.
 Foods with a low glycemic index tends create a sense of satiety over a longer period of time and may be helpful in limiting caloric intake.”

p 356
“Virtually all diets that limit particular groups of foods or macronutrients lead to short-term weight loss.  Long term maintenance of weight loss is difficult to achieve.”

We are still waiting for the evidence of long-term weight loss from #LCHF

The largest and most successful weight loss trial was LOOK AHEAD.

The research arm in the LOOK AHEAD trial was on
a low fat diet <30 fat="" nbsp="" span="">
and < 10-15% saturated fat.

However, Orlistat was used in the treatment arm and not the control arm.  see Orlistat in LOOK AHEAD

I have been on LCHF or Atkins diets since 1/2011.  My data here