Thursday, November 28, 2013

The succesful evolution of a Paleo dieter: A timeline

Day 0:  "I'm sick of feeling like crap, I'm gonna change my lifestyle and give this Paleo diet/Primal way of living a crack.  I've pretty much got it figured out...Meat and veggies,  absolutely no carbs.  Check!"
Week 1: bacon bacon bacon bacon bacon bacon bacon bacon bacon bacon bacon bacon bacon
Week 4: "End of 1st month...Down 20lbs, joint pain gone, tons of energy...Woo hoo"
Week 8: "End of 2nd month... Hmmm, that's weird, only lost 10lbs this month.  Oh well, better than nothing."
Week 12: "End of 3rd month and no weight loss, wtf?  I even replaced all of my high carb processed foods with high fat processed foods like nut flours and butters.  Sisson and Wolf are full of shit.  Oh well, 50g of carbs is probably too much, I'll just cut them lower."
Week 16: "End of 4th month and damn, weight didn't budge, I think I need to join crossfit.  On a positive note I only seem to need 5.5 hours of sleep per night because I wake up every night to piss and don't need to go back."
Week 17: Joined a crossfit
Week 19: Sustained my first shoulder injury...Maybe snatching 75% of my bodyweight for 20 reps was a bad idea..."Nah, that's pussy talk."
Week 20: "Nice, 3 weeks of crossfit and down another 5lbs."
Week 24: "No weight loss?  WTF?  Time to start researching..."
Week 25: First stop at Whole Health Source.  "Who is this clown Stephan Guyenet?  Food reward, Leptin...What is he smoking?  Carbs are bad, nuff said."
Week 25.1: "These almond flour muffins are awesome and addicting covered in almond butter, I could eat a hundred of them a day.  Probably a bad idea though, only made 24 for the week so I'll have 5 today and 3 a day after that."
Week 25.5: "Guess I better make another batch of these muffins and pick up some more almond butter."
Week 26: "Up 3"
Week 27: "Crossfit coach said I may need to up the carbs, don't think she understands the Paleo diet...She must be thinking The Zone."
Week 28: 2nd trip back to Whole Health Source.  "I wonder if Guyenet realizes his PhD and 10+ years of research experience completely flies in the face of my 10 hours of youtube/wikipedia research.  I should send him an email...Nah, what's the point, he has his mind made up...close-minded asshole"
Week 32: "Man, I am wiped.  No sleep, coffee losing effectiveness, digestion terrible, feeling jittery all day, back and shoulder killing me. Maybe I'll take a few weeks off crossfit."
Week 33: "Damn, feel great, dropped another 5lbs, sleeping like a baby, back to the box to keep this momentum going...Psyched!"
Week 34: "Whaaaaaaaaaaaaaat the Fuuuuuuuuuuuuuuuuuck!!!!!!!!!"
Week 35Adrenal fatigue...Enjoy the next 6-12 months of diarrhea and feeling like you got run over by a bus, asshole.
Weeks 36-63: Lays off crossfit, walks daily, makes a concerted effort to get 8 hours of sleep, actually begins listening to Paleo Solution podcasts and reads more blogs about ancestral health..."Wait, I can eat carbs?"
Week 64: "Man, I feel great for the first time in forever.  Almost at my goal weight, getting great sleep, digestion normal again.  Think I'll enjoy some pizza to celebrate."  Eats 3/4 of a pizza followed by 4 pop tarts.
Next day: Gains 3 lbs "Ahhhhhhhh, food reward, now I get it."

Conclusion: Finally realizes that limiting all processed and highly palatable foods, including nut butters and flours, is a good idea.  Takes a more practical approach to exercise and lifestyle by putting the focus on limiting sedentary time and getting more walking in while trying to exercise a couple of times per week.  Realizes that low carb works for some and is typically not a good idea for people who want to exercise intensely or for people who are not going to be low carb on the weekend. 

Monday, November 25, 2013

Health Research Recap (Week of 11/18/2013)

New research on people termed the "Healthy Obese" shows that despite being healthy from a metabolic perspective, people with good blood numbers who are also obese are more likely to suffer Type 2 diabetes and heart disease later in life.  Personally, I've never believed that there was such a thing as the "Healthy Obese".  Obese people tend to be more sedentary and eat a diet that is of low nutrient density but high energy density when compared to lean individuals, the same poor lifestyle habits related to heart disease and Type 2 diabetes.  That is not to say that just because someone is lean that they are healthier than an obese person, just that people who tend to partake in these poor lifestyle choices are going to be unhealthy whether they are obese or not.  It just so happens that people who live this lifestyle tend to be obese.

As if reading my mind, another study looked at the association between lifestyle choices and risk for the metabolic syndrome.  The metabolic syndrome is a group of symptoms including high blood pressure, high blood  glucose, and excess body fat that are related to an increased risk of chronic disease including diabetes and heart disease.  In the study, the researchers found that obesity and poor nutrition were the lifestyle factors most significantly linked to an increased risk of the metabolic syndrome.  Participants in the study who were obese had an 8 times greater risk of developing metabolic syndrome and those who ate less than 5 servings per day were 4 times more likely to develop metabolic syndrome.  Recommendations...Increase fruit and vegetable consumption(Increase nutrient density) and lower calorie consumption(Decrease energy density).

In a study in mice, researchers found that severely overweight mice had a reduced ability to detect sweetness due to a decrease in the number of taste cells on the tongue responsible for detecting sweetness.  The mice also had a decreased ability to detect bitter but there was no effect on tastes related to meat consumption.

In a study on sudden cardiac arrest, researchers found that more than half of the men in their study had warning signs up to a month prior, making it not so sudden.  Of the symptoms that appeared, 56% experienced chest pain, 13% shortness of breath, and 4 % had dizziness, faintness or palpitations.  Most of the men had coronary artery disease, but fewer than half had been tested.  It's always a good idea to get checked out by your doctor if you experience any of the above symptoms.

New evidence shows that moderate physical activity can reduce damage to the heart in older sedentary adults.  Researchers placed sedentary people in to a physical activity group and a health education group for one year and measured levels of Troponin T, a blood marker used  to diagnose heart attack.  After a year the non-exercise group had 3 times higher levels of Troponin T in their blood than the exercise group.  This backs up a previous study which showed that elderly people who exercise are less likely to have an increase in Troponin levels than elderly people who are sedentary.

A study on insomnia and mortality risk found that men who had difficulty falling asleep or who had poor sleep quality were more likely to experience a cardiovascular disease related death within six years than people who slept normally.  The study found that men who had difficulty falling asleep were 55% more likely to die from cardiovascular disease and those who had poor sleep quality were 32% more likely when compared to those who slept normally.  Of course, since this is an observational study there is no way to know whether it is the lack of sleep causing cardiovascular disease or cardiovascular disease causing poor sleep.  At any rate, making better lifestyle choices that will improve overall health and making an effort to get quality sleep is always a great idea.

Researchers found a link between screens in the bedroom and shortened sleep time in kids with autism.  Having a television or computer screen in the bedroom is associated with reduced sleep time in all people regardless of whether or not they have autism, but the effect may be stronger in kids with autism.  Kids with autism who also had a screen in their room slept almost 2 hours less than kids who did not have a screen in their room, on average.  Since children with autism tend to have poorer sleep quality than kids without it, it's probably a good idea to remove any television or computer screens from your children's bedroom, especially if they have autism.

In research confirming what most anyone in the fitness field can plainly see, children's cardiovascular fitness has declined since 1964.  Since 1970, children's cardiovascular fitness has declined by 6% per decade between 1970-2000 and kids today are 15% less fit from a cardiovascular perspective than their parents were at the same age.  Less free play time and reduced gym in school are likely contributing factors.

Another study in children found that breaking up sedentary periods with times of activity improved health measures in children ages 8-11.  Children who got up more while sitting at the computer, television, or video games saw improvements in fasting insulin, fasting glucose, triglycerides, HDL cholesterol, C-Reactive Protein, waist circumference, and BMI.  The improvements were related to the number of times they got up, and not the amount of time they spent while up.  I take this to mean that you should focus on limiting how long your children are seated throughout the day.

What would a research review be without some gut bug love?  In a study looking at gut bugs and GI transit time, researchers found that gut bacteria influence food transit time through the gut via the hormone GLP-1.  GLP-1 is mostly associated with insulin secretion and appetite control, but increased GLP-1 levels slow gastric emptying and GI transit time.  Gut bacteria ferment fiber in to short chained fatty acids that suppress proglucagon secretion in the gut which lowers GLP-1 levels in the blood and speeds up GI transit time.

More power to the gut bugs.  In a study looking at how chemotherapy works to fight cancer, researchers found that central among it's effects are the gut bugs.  Researchers found that bacteria from the gut migrate from the gut to lymph nodes during chemotherapy where they stimulate an immune response which helps the immune system better fight the tumor.  To confirm these results, the researchers blocked the bacteria from the gut and the effectiveness of chemotherapy was reduced.  This study was done in mice so we need to see confirmation in human studies, but this study reinforces both the importance of healthy bacteria to the immune response and the importance of gut bacteria research in improving health as well as the effectiveness of therapeutic interventions.

Finally, researchers believe that investing in the biology of aging will pay far more dividends in understanding and treating disease than individually researching each disease.  I think this is a step in the right direction because aging is a risk factor for most of the diseases we see today.  Many people are familiar with chronological age, how many years old you are, but few understand that biological age is far more important.  Biological age is related to how well your body functions and can vary between people who have the same chronological age.  For example, 2 people may be exactly the same age but one may look a decade younger and have a better health status than the other.  Diet, lifestyle factors, and other environmental factors related to epigenetics more than likely underlie the discrepancy between chronological age and biological age and research in this area can tell us how we can slow down biological aging.  The entire National Academy on an Aging Society report can be found here.

Thursday, November 21, 2013

Anatomy of a great breakfast

People often ask me what I eat for breakfast since I don't eat cereal or bread.  For the most part, I stick to a similar breakfast every day as seen below:

This meal consist of 2 sausage links and 2 strips of organic bacon with veggies sauteed in bacon fat and a tsp of Kerrygold butter.  The veggies consist of parsnips, carrots, asparagus, russet potatoes, onions and red peppers.  I cook this in a cast iron skillet, so the added fat is to make sure it doesn't stick to the pan.  Normally I season the veggies with basil, parsley, and garlic but I got a little lazy today.  In the mason jar is 1 tbsp of unmodified potato starch mixed in water.  So let's break down the benefits of this breakfast.

Building a healthy gut

The first thing to notice is the volume of vegetables compared to meat.  Since my diet isn't low carb, I like to eat a large volume of veggies to help support GI health and a healthy community of beneficial bacteria in my gut.  Most people take a probiotic to do this, but in my opinion prebiotic fiber from vegetables is a much smarter direction to go.  Even if probiotics work, and I do believe they have some benefit, if you don't provide the proper food for the little guys to survive in your gut they won't.

Prebiotic fiber from vegetables helps cultivate a healthy microbiome by helping to heal the gut and providing food to help healthy bacteria do their job.  This is also the reason for the unmodified potato starch.  Unmodified potato starch is basically raw potato powder.  Unmodified potato starch is considered resistant starch, as long as you don't heat it you can't digest it but the healthy bacteria in your gut ferment it in to short chained fatty acids that heal the gut.  I've seen dramatic improvements in my gut health and blood glucose regulation by taking unmodified potato starch every day.  I suppose you could just eat raw potatoes if you wanted, I find the potato starch to be a more appealing option.

In addition to the prebiotic fiber, healthy gut bugs like polyphenols, especially quercetin.  Polyphenols help give plant based foods their color.  To make sure I am getting a wide variety of polyphenols, I eat as many different colors of vegetables and fruit as possible over the course of the day.  In this breakfast alone I get red, white, orange, green, and yellow.  In addition, I normally have wild blueberries during the week but tend to remove them during the weekend because I drink beer and that has a negative impact on my insulin sensitivity.

Antioxidant defense

Every 3 days I like to include a vegetable from the cruciferous vegetable family.  I chose asparagus this time, but we often rotate brussel sprouts, broccoli, kale, and cauliflower.  The reason I like to get cruciferous vegetables in my diet 3 times a week is because they activate the NRF-2 pathway, one of your endogenous sources of antioxidants.  Brocoli's anti-cancer benefits are at least partially through NRF-2 pathway activation.  Wild blueberries also have the same effect which is why I eat them during the week.  I cook my cruciferous vegetables and limit my total weekly consumption to less than 6 servings per week because they can have a goitrogenic effect, they can interfere with thyroid function, when consumed too much.  Cooking them lessens this effect, but doesn't remove it entirely.  Since their antioxidant benefit lasts 3 days, I don't feel the need to consume them more than every 2-3 days.

Allowing a little diversity

Every now and again I will rotate in a different meat or eggs for a while to break the monotony of eating the same thing every day.  I also rotate my oils between coconut oil, Kerrygold butter, ghee, and olive oil.  In addition, I rotate different vegetables frequently.  The other vegetables in the rotation that I haven't mentioned include escarole, sweet potatoes, beets, beet greens, dandelion greens, chard, celery, squash, yellow and green zucchini, green peppers, orange peppers, yellow peppers, and all sorts of different mushrooms.  Throughout a week, I like to get at least 20 different vegetables and a few different types of fruit, rotating different vegetables for breakfast helps get me there.


I like to set the tone for the day with a good breakfast.  The large diversity as well as high volume of vegetables helps keep my gut healthy and keeps me full until lunch, most of the time I could probably even skip lunch without becoming hungry.  From a calorie standpoint, this meal provides approximately 500 calories and is my second largest meal behind dinner.

Monday, November 18, 2013

Health Research Recap (Week of 11/11/2013)

Researchers have discovered an association between dietary acid load and an increased risk of diabetes.  Participants who ate more foods that created an acidic environment were 56% more likely to develop Type 2 diabetes.  While some see this as a knock against meat because animal protein intake increases net acid load, I would imagine this is more of a knock on low vegetable intake as fruit and vegetable consumption reduce net acid load in the diet.  Regardless of how you look at it, eating a diet high in meat and low in fruits and vegetables, which is the typical Western diet, may increase your risk of Type 2 diabetes.

Researchers in Canada theorize that eating vegetable oils high in Omega 6 fatty aids but low in Omega 3 fatty acids may not be a good idea for heart disease after all.  In a review of the literature, they discuss a recent study that found people who replaced saturated fat with safflower oil, a vegetable oil high in Omega 6s but low in Omega 3s significantly reduced their cholesterol levels but also increased their risk of dying from cardiovascular events.  Vegetable oils such as corn and safflower oil are high in Omega 6 fatty acids, low in Omega 3 fatty acids, and often used in processed foods.  The researchers recommend removing the heart healthy label from oils high in Omega 6s and low in Omega 3s.

In more fat news, the FDA announced plans to gradually remove artificial trans fats from the food system due to their toxic effects in humans.  Despite evidence in 1956 that suggested that trans fats were not safe, the FDA has categorized them as GRAS(Generally regarded as safe) and the Center for Science in the Public Interest(CSPI) has pushed them as being a healthy alternative to saturated fat.  Unfortunately, not only have saturated fats been vindicated, but evidence piling up since the 90s have shown trans fats to be far worse for cardiovascular health than previously thought.  From my perspective, this shows you how quickly we are to put something in to the food supply without enough evidence to determine it's safety.

In a study that yields both interesting and spooky results, many of the beneficial microbes found in young children had antibiotic resistant genes, even if the children had not been exposed to the antibiotic that the microbes had become resistant to.  This is worrisome because there is the potential that these genes can transfer to unhealthy bacteria, causing problems for the person harboring them.

Another study found that gluten in the diet may induce Type 1 diabetes by altering the microbiome in mice.  Mice who were fed a gluten free diet appeared to be offered a form of protection against Type 1 diabetes that went away once gluten was introduced in the diet and the microbiome of the mice changed.  What is interesting about this study is that these mice are bred to develop Type 1 diabetes, so a gluten free diet appeared to alter genetic expression in a way that prevented it from developing.  The researchers believe the effect was due to the change in the microbiome.

A recent study on gastric bypass surgery found that the procedure reversed aging at the cellular level, increasing the length of telomeres.  Telomeres are little caps on the tip of DNA that reduce in length over time and are associated with aging and disease.  In patients who underwent gastric bypass surgery, their telomeres actually increased in length as their levels of systemic inflammation decreased.  Call me cray, but this effect just screams microbiome.

A new study on caffeine consumption showed that 2-3 cups of coffee in the afternoon can reduce sleep time by up to 1 hour, even when it is consumed 6 hours prior to bed.  Furthermore, the subjects in the study weren't even aware that their sleep was disturbed.  If you don;t feel this pertains to you, remember that it's the umber of ounces you drink, not the total number of cups you fill with coffee. Do you hear that venti drinkers? :)

Thursday, November 14, 2013

How free radical formation and mitochondrial dysfunction can speed up the disease process

When you look at most of the diseases we see today, many share a few things in common.  Schizophrenia, Alzheimer's disease, Pakinson's disease, epilepsy, migraines, cardiovascular disease, diabetes, neuropathic pain, fibromyalgia, Huntington's disease, and cancer are all diseases that share three common threads.  Every one of these conditions, and even the process of aging itself, is associated with high free radical production, mitochondrial dysfunction, and inflammation(1, 2, 3).  In this blog we will discuss how these three phenomena work synergistically to take you down.

Free radical damage to cells

As discussed in my last blog, mitochondria are little organelles within your cells that are responsible for generating the bulk of your energy needs.  I also discussed how, as a natural byproduct of energy generation through the electron transport chain of the mitochondria, some free radicals are produced.  Free radicals, or reactive oxygen species(ROS) are molecules that have an unpaired electron in their outer shell.  Free radicals are very reactive, and since they are unstable until the unpaired electron finds a partner, they go around to other parts of the cell and try to steal an electron, turning that molecule in to a free radical.  It is important to note that this reaction isn't simply with free molecules that are floating around in your cells, free radicals interact with molecules that make up the machinery of your cells.  Obviously, if you want your cells to function properly, you want to keep free radicals from getting out of hand.

DNA and free radical damage

One of the problems that you run in to when free radicals get out of hand is the potential for the free radicals to alter the mitochondrial DNA.  Every one of our cells has 2 types of DNA, nuclear DNA and mitochondrial DNA.  The DNA most of us is familiar with is the nuclear DNA.  Both types of DNA contain instructions for building you, but 99.9999999% of those instructions are found in the nuclear DNA.  When your cells divide to form new cells, the nuclear DNA splits in to 2 and replicates to form a set of instructions for each cell.  If there is damage to the nuclear DNA, this can lead to copy errors which leads to unhealthy, irregular cells.

Certain types of radiation can cause damage to the nuclear DNA.  However, the nuclear DNA is surrounded by a membrane that protects it from other parts of the cell, so it probably doesn't get damaged directly by free radicals generated by the electron tranpsort chain in the mitochondria until you are producing huge amounts of them.  Since the mitochondrial DNA is within the mitochondrial membrane and is not separated from other parts of the mitochondria by a membrane, free radicals generated by the electron transport chain are free to react with the mitochondrial DNA.  While most of the important instructions are contained within the nuclear DNA, the mitochondrial DNA is mostly instructions for proteins contained within the electron transport chain.

Accumulation of free radical damage and mitochondrial dysfunction

Perhaps as free radical damage accumulates to the mitochondrial DNA, a tipping point is reached and the DNA is damaged to the point that new mitochondria made from this damaged mitochondrial DNA are dysfunctional and contain a poorly functioning electron transport chain.  This causes the generation of more free radicals leading to an environment of high free radical production and mitochondrial dysfunction.  In fact, there is scientific evidence that damaged mitochondrial DNA and a dysfunctional electron transport chain both lead to an increase in free radical production(4). As free radical production increases, so does systemic inflammation as free radicals activate genes that produce inflammatory cytokines(5).  What's more, since most of your cells contain many mitochondria(up to 2000 in liver cells), having many dysfunctional mitochondria can produce a large amount of free radicals that could eventually destroy the membrane surrounding the nuclear DNA and cause damage to it.

Keeping excessive free radical production at bay

While we cannot say for sure whether an environment of high free radical production, mitochondrial dysfunction and inflammation causes disease or that disease causes this environment, we do know for sure that this environment is not beneficial in any way to you or your cells.  If your goal is to be healthy, you should make it a point to limit excessive free radical generation by reducing the amount of energy going through your mitochondria and making sure your endogenous antioxidant defense system is generating antioxidants to help keep free radical production under control.  The easiest way to both of these things is to not over-consume calories and to get regular physical activity throughout the day, which is probably why doing both is associated with good health and a lower risk of most disease states. In fact, one could make the argument that there is a single general disease state in chronic disease, with each one of us being susceptible to different diseases based on our individual genetic code.

Monday, November 11, 2013

Health Research Recap (Week of 11/4/2013)

Researchers found that improved blood glucose control from gastric bypass surgery is related to increases in glucagon-like peptide 1(GLP-1).  It's often been reported that the rapid improvements in weight and blood glucose control from gastric bypass surgery are due to changes in the gut microbiome, the teeming zoo of bacteria found in the digestive tract.  Earlier studies have shown that the gut microbiota communicate with the brain by helping regulate hormone secretion from cells in the gut, including GLP-1.  This new study seems to add more support for changes in the gut microbiome being a key factor in the success of gastric bypass surgery.

Add colon cancer to the growing list of diseases associated with an altered gut microbiome.  Another study on gut microbes found a link between gut bacteria and tumor formation.  Transferring the gut microbes from mice with colon cancer to mice that were microbe free more than doubled the number of tumors compared to mice given a healthy microbiota.  Scientists have know for a long time that inflammation played a major role in colon cancer, this new study shows that inflammation and an altered gut microbiome both play a role.  It appears that inflammation is the fire, and a change in the gut microbiota is the gasoline that makes the fire burn out of control.

Another study identified the gene by which this process may occur.  The enzyme HDAC3 helps regulate genetic expression and the gene that codes for it has long been thought to be a tumor suppressor gene.  It turns out that mice bred without the HDAC3 gene had increased inflammation, poorer intestinal health, lacked certain antimicrobial cells, and had a different microbiome than healthy mice.  Furthermore, mice without the HDAC3 gene that were also germ free had healthy intestines.  It seems that this gene helps regulate the microbial population in the gut, and in turn that population helps control cellular behavior including inflammation.

In other gut news, researchers have found a link between the microbial community of the gut and rheumatoid arthritis.  Researchers found an increase in abundance of the bacterial strain Prevotella Corpi in people recently diagnosed with rheumatoid arthritis when compared to healthy controls and people with chronic, controlled rheumatoid arthritis.  Furthermore, the P. Corpi extracted from the patients recently diagnosed with rheumatoid arthritis was distinctly different than the P. Corpi from healthy individuals.  While this study only shows a relationship and doesn't show whether increased P.  Corpi causes rheumatoid arthritis or vice versa, there is a huge amount of evidence showing a clear link between gut health and systemic autoimmune diseases including rheumatoid arthritis.

On the pharmaceutical front, researchers have identified a class of drugs that have the potential to help treat inflammatory bowel diseases such as Crohn's Disease and colitis.  The new class of drugs work by helping turn down inflammation caused by low levels of oxygen in the gut.  If these drugs are used in an acute manner to help control inflammation that has become out of control in order to restore healthy function to the gut I can see them being very effective coupled with dietary change and other therapies including a fecal transplant.  If they are used chronically to subsidize poor behavior, which seems to be the tact most people take, I don't see them being very effective at all.

In autism news, a study looking at gut health and autism found children with autism are far more likely to experience GI problems than kids without it.  In addition, those with a higher severity of stomach issues had more severe symptoms of autism including irritability, social withdrawal, and hyperactivity.

Another study on autism found that breastfeeding may protect against autism by providing increased levels of insulin-like growth factor(IGF).  A review by the researchers found low levels of IGF to be a potential predictive test that could anticipate autism in children.  If a newborn is found to have low levels of IGF, the researchers believe increasing the length of breastfeeding can provide supplemental IGF to the child to help them develop properly.

Swinging over to obesity news, another study implicates obesity in the development of early onset puberty in girls.  While the study didn't look at causation, it found a fairly strong relationship between body mass index and early onset puberty.  When we look at what happens when people overeat, we see an increase in total daily energy expenditure even without increased physical activity.  Rather than looking at your body as a machine that burns the fuel you put in to it and stores the excess as fat, it seems that once the body meets it's energy needs, it certainly stores fat, but once a certain threshold is met it also decreases efficiency and burns more calories than it needs.  I believe the mechanism here is that it actually speeds up the aging process.  Not only will these girls go through puberty early, they will age faster overall.

A study looking at sleep duration and calorie consumption found that the longer kids sleep, the lower their calorie consumption is.  Kids slept for their normal amount of time for 1 week, then randomized to either more or less sleep for another week and performed the other one in the third week.  During the week the kids increased their sleep they ate 134 fewer calories a day, lost a half a pound, and had improved metabolic risk factors for obesity.

When compared to resistance training, aerobic exercise has a greater impact on improving metabolic risk factors associated with diabetes and obesity in obese girls.  If you are going to choose one over the other it may make more sense for girls to perform aerobic exercise over resistance training, but most studies show performing both provides the best results as they work through different mechanisms.

In brain news, elevations in brain magnesium levels prevented and reversed cognitive impairment in mice with Alzheimer's disease.  While this certainly doesn't mean low magnesium levels cause Alzheimer's in humans, the fact that the American diet coupled with coffee and alcohol consumption leads to low magnesium levels makes it a good idea to make sure you are getting sufficient magnesium on a regular basis.  The RDA for magnesium is 400mg for women and 420mg for men.

A diet high in wild blueberries may help prevent metabolic syndrome and cardiovascular disease.  The polyphenols in wild blueberries have been known to provide many health benefits.  In a study on obese mice, the polyphenols in wild blueberries helped improve blood vessel function and improve blood pressure.  Other studies from the same authors have found an anti-inflammatory effect as well as improvements in genetic expression in mice fed wild blueberries in their diet.  How you prepare the blueberries is important, another study found baking blueberries reduces their polyphenol content.

Thursday, November 7, 2013

Aging, exercise, and diet: Are free radicals to blame?

Many people have heard of antioxidants and free radicals, but few understand their importance to health.  Much like most health topics, antioxidants and free radicals have been reduced to the simplistic "antioxidants are good and free radicals are bad" explanation.  People certainly like simplicity, but what's the point in a simplistic explanation if it's outright wrong?  This has led to many people wasting money on supplements that they don't need at best, or could be potentially harmful at worst.  When we take a look at how the human body works and what research shows us, we can get a good idea of what we should be doing about antioxidants and free radicals.

It's not a controversial thing to say that eating in excess and limiting physical activity tends to have negative effects on the body.  Physical activity is a good thing whether it's via an exercise program or just regular, everyday chores.  Of course, this is all dependent on other things in that person's life as well as the dosage of physical activity.  A person who isn't sleeping or eating properly is adding to the amount of stress their body is under, so it's important to apply a level stress in the form of physical activity or exercise that is manageable to that person.  If exercise was as simple as more=better, people who run marathons and triathlons would live longer than the rest of us...They don't.  There is a fine balance between diet and exercise that is optimal, and letting that get out of balance may be one of the keys to this antioxidant/free radical relationship.

Free radicals and antioxidants

Free radicals are molecules that have an unpaired electron in their outer shell.  This makes that molecule reactive so it goes around reacting with stable molecules, pulling an electron from them.  While this stabilizes the free radical, it causes the other molecule to become a free radical.  Antioxidants work by donating electrons to free radicals, but this makes the antioxidant a free radical.  So, ingesting antioxidants such as Vitamins C or E really don't reduce the number of free radicals in your body, it just passes the buck from the free radical to the antioxidant.  In this way, antioxidants that you get from your diet really aren't that helpful on their own, they need help from the antioxidants your body makes on it's own, also called endogenous antioxidants.

The 4 endogenous antioxidants are superoxide dismutase(SOD), alpha lipoic acid(ALA), coenzyme Q10(CoQ10), and glutathione peroxidase(GPX).  These master antioxidants work by completely taking care of free radicals rather than just donating an electron and passing the buck down the road.  ALA, CoQ10, and GPX also have the ability to recharge the exogenous antioxidants you get from your diet by donating an electron to them, making them more stable.  Having a fully operational endogenous antioxidant defense system is very important to health, and it's fairly easy to accomplish when armed with the proper information.

Human metabolism and free radicals

It may come as a surprise to you, but one of the natural byproducts of human metabolism is free radical production.  Free radicals aren't all bad, they actually help perform some vital cellular processes so eliminating them is not something you should be looking to do.  Your primary goal should be to develop a balance between your endogenous antioxidant defense system and free radical production, not eliminate free radicals altogether.  This can be accomplished very easily, let's look at the relationship between energy production and free radicals.

Your mitochondria are organelles within your cells that are responsible for most of the energy production.  Mitochondria create energy aerobically which means they require oxygen.  One of the ways mitochondria make energy is via the electron transport chain.  The electron transport chain makes energy by passing electrons between complexes within the electron transport chain.  No machine operates at 100% efficiency, so as a natural byproduct of this process electrons can leak out and react with oxygen to make the free radical superoxide, which is very toxic and highly reactive.

Physical activity and the endogenous antioxidant defense system

When we are physically active, the endogenous antioxidant defense system within our cells is activated.  Gravity has a profound effect on the endogenous antioxidant defense system because when our muscles are activated, so is the endogenous antioxidant defense system.  Looking at astronauts in microgravity, research shows that a lack of or lower amounts of gravity lead to an increase in free radical damage(1).  This isn't from an increase in free radical production, it's from a downregulation of genes that produce endogenous antioxidants.

Other research sheds some light on how this effect occurs.  A study on breaking up periods of sedentary time by getting up and moving around showed that breaking up periods of sedentary behavior led to upregulation of genes responsible for antioxidant production when compared to remaining sedentary(2).  Another study found that exercise increases endogenous antioxidant defense system activity and capacity(3).  Therefore, the positive effect from exercise on free radicals more than likely occurs as a direct effect of exercise on stimulating the antioxidant defense system as well as increasing that system's capacity to deal with free radicals over time by increasing it's output.

Obesity and it's relationship to aging and free radicals

It should come as no surprise that there is a strong relationship between obesity and disease, and for the most part leaner people tend to look younger.  However, the relationship between obesity and disease is just that, a relationship. The fact that there is a relationship between them does not mean that obesity causes disease or that disease causes obesity, only that the two share something(s) in common.  It's quite possible that an imbalance between free radical production and the endogenous antioxidant defense system could be what links the two together.

Obese people tend to overconsume calories and have lower physical activity levels than their lean counterparts.  Despite having lower levels of physical activity, obese people tend to burn more calories than lean people.  In fact, total daily energy expenditure for humans is pretty static when you control for body size.  One study looked at the daily energy expenditure of modern day hunter gatherers and compared it to that of the more sedentary western lifestyle and found the same total energy expenditure when you control for body size.  While the hunter gatherers burned more calories from physical activity, Westerners burned more calories through an increase in metabolic rate(4).

One would have to think that, despite generating the same amount of energy, the hunter gatherers would have had a better balance between free radical production and endogenous antioxidant production than the more sedentary Westerners.  They also tend to have much better health outcomes and lower to non-existent rates of Type 2 diabetes, obesity, cancer, and heart disease, all of which share a relationship with an imbalance between free radical production and endogenous antioxidant production.

Perhaps obesity is simply the outward manifestation of putting an excess number of calories through the mitochondria without the beneficial effects of physical activity on endogenous antioxidant production in people prone to obesity.  Cancer, Type 2 diabetes, and heart disease all share the common trait of high free radical levels as well.  The relationship between obesity and  poor health could simply be a mismatch between free radical production and endogenous antioxidant production.  Obesity is what this looks like in people prone to it, but poor health is the outcome for all whether they are prone to obesity or not.  In other words, obese people tend to be less healthy because obesity shows that this process is going on, but some people don't have the forewarning that this is going on because they aren't prone to obesity.


The human body functions best when it is physically active and given a nutrient dense diet that has a moderate amount of calories.  It would be inappropriate to say that excess free radical generation is directly to blame for increased aging, obesity, and poor health outcomes.  It seems more likely that an imbalance between free radical production and endogenous antioxidant production brought about by a lifestyle that is not conducive to our physiology is to blame.  Taking antioxidant supplements or even eating tons of vegetables to provide the body with antioxidants will not put someone on the path to better health.  As I discussed here, certain vegetables can stimulate your body to produce endogenous antioxidants, but even then I wouldn't expect a revolutionary benefit.  A holistic approach that incorporates a nutrient dense, calorically moderate diet with high levels of general physical activity will do a much better job of improving your health while at the same time slowing down the aging process, or at the very least making it look like the process is slowing down.

Next Thursday I will discuss how free radical production and mitochondrial dysfunction, two factors in many of the diseases we see today, can speed up the disease process.

Part 2

Monday, November 4, 2013

Health Research Recap (Week of 10/28/2013)

A large review of the research found a strong relationship between physical activity and depression.  Even exercising for only 20 minutes a day may be able to treat or prevent depression.  Part of this effect is due to exercise stimulating brain neurogensis by the secretion of BDNF, a protein that supports the survival of neurons and helps create new ones.  Another study found even DIY activities such as gardening significantly reduce heart disease risk.  A third study found aerobic exercise to improve brain function in people with multiple sclerosis.  The study found a 54% improvement in memory function and 17% increase in hippocampal volume in 2 subjects with multiple sclerosis that performed 30 minutes of aerobic exercise 3 times a week for 3 months.  Since this is such a small study, further studies will be needed to confirm these findings.

Young athletes who specialize in one sport or play more hours per week than their age are more likely to get injured.  The study found, specifically, that kids who spent twice as much time playing a single sport than engaging in free play were more likely to become injured, especially with overuse injuries.  This is because playing the same sport over and over utilizes the same movement patterns while neglecting other movements.  Playing multiple sports that utilize many motor patterns and engaging in activities not directly related to their sport gives kids an opportunity to develop better overall as an athlete.  It also gives the tissues that are frequently used in their sport an opportunity to recover.

In cardiovascular news, people with rheumatoid arthritis are at a higher risk of cardiovascular disease.  The culprit?  The inflammation associated with the condition.  Rheumatoid arthritis, an autoimmune disease, is characterized by large levels of inflammation and the study found that the more severe a person's RA upon diagnosis, the more likely that person will experience cardiovascular disease.  This comes to no surprise for many researchers.  While most of America tries to lower their cholesterol for no apparent reason, science has long been looking at the effects of inflammation on cardiovascular disease.  The problem doesn't appear to be a cholesterol issue.  Cholesterol is vitally important to human physiology, but when chronic inflammation oxidizes cholesterol, it becomes "sticky" and can cling to areas of bifurcation, where 2 arteries come together to form one.

Another study found an association between people with Alzheimer's disease and an increased risk of cardiovascular disease.  This link should come as no surprise, another study found genes associated with increased immune activity in people with Alzheimer's disease, and other research is beginning to point to Alzheimer's disease as an autoimmune condition, much like RA.

A study looking at the relationship between Alzheimer's disease and high blood glucose levels confirms the link that other research has shown between the two.  When blood vessels in the brain were exposed to either high blood glucose or the beta amyloid plaques associated with the disease, there was no change in the viability of the vessels.  However, when the blood vessels were exposed to both high blood glucose and beta amyloid, the viability of the blood vessels decreased by 40%.  The researchers believe the effect is due to a compromised blood brain barrier from beta amyloid plaques and increased oxidative stress from the mitochondria when blood glucose levels are high.
In somewhat related news, researchers found an interesting link between HDL, the so called good cholesterol, and blood glucose control.  The researchers found that raising HDL cholesterol improves blood glucose control by enhancing the ability of skeletal muscle to use glucose.  In animal models, increasing HDL cholesterol protected against hyperglycemia and resulted in improved mitochondrial function as evidenced by a reduction in a marker for mitochondrial dysfunction.  How can one increase their HDL cholesterol?  Being more active and consuming saturated fat are both natural ways to increase your HDL cholesterol.

Gravity doesn't get a lot of play in the media, but don't let that downplay it's importance to human physiology.  Astronauts in microgravity experience increased oxidative stress and inflammation, leading to an increase in aging as well as cardiovascular disease risk.  These findings help show how important gravity is to human health.  If you don't think this pertains to you since you're not an astronaut, think again.  In a past study , researchers found that being in a position where one of your legs was not loaded(Aka sitting) and the other one was led to downregulation of genes associated with antioxidant and anti-inflammatory activity in the unloaded leg compared to the loaded one.  In another study, breaking up periods of sitting with standing led to increased activity of anti-inflammatory and antioxidant gene pathways in the lower body.  In other words, get off your butt.

Finally, in the "This is how research can be manipulated to say what we want" category, researchers claim to have determined that sugar does not lead to non-alcoholic fatty liver disease.  The study found that it is excessive calorie consumption and not consumption of fructose or glucose that leads to NAFLD.  If you take a close look at the study, it doesn't actually show what the authors state.  Subjects were randomized to either a high glucose or high fructose diet and consumed a number of calories that would not cause them to gain weight.  After a washout period, they then consumed the same diet with an excess number of calories.  Neither one led to increased liver fat in the calorie maintenance condition while both led to increased liver fat in the hypercaloric condition.  The problem with this study?  For one, the diets were only consumed over 2 weeks so we don't know if there is a long term effect of these diets in an isocaloric condition.  There was an increase in insulin resistance in the high fructose condition that may have worsened over time.  Second, there was no control diet for both conditions to see if the absence of both glucose and fructose in a hypercaloric diet led to an increase in liver fat.  What this study actually shows is that consumption of a high fructose or high glucose diet while at the same time overconsuming calories increases the risk of NAFLD.  This doesn't exonerate glucose or fructose, it only states that consuming them in moderation is probably not going to lead to NAFLD.  The question is, do people who consume a high fructose or high glucose diet tend to eat at maintenance calories, my guess is not.  Ironically enough, one of the researchers is on the scientific advisory board of Mars, inc. and Coca Cola.