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The Fast Solution
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  1. The Fast Solution Part 4 of 6 The Aetiology of Obesity

  2. Sugars Blood Sugar “Fruit” Sugar Simple carbohydrates - 1-2 sugars Complex carbohydrates – long chains of sugars Table Sugar Are sugars toxic? www.kidneylifescience.ca

  3. Rising Consumption www.kidneylifescience.ca

  4. Beverage choices www.kidneylifescience.ca

  5. Sugar sweetened beverages www.kidneylifescience.ca

  6. Juice and Childhood Obesity Increased offerings of whole fruits were associated with reduced adiposity gain Faith M S et al. Pediatrics2006;118:2066-2075 Fruit juice intake predicts increased adiposity gain in children from low-income families www.kidneylifescience.ca

  7. Sugar Sweetened Beverages Nurses Health Study 1991-99 Sugar-Sweetened Beverages, Weight Gain, and Incidence of Type 2 Diabetes in Young and Middle-Aged Women JAMA2004;292(8):927-934 Schulze MB www.kidneylifescience.ca

  8. Increased Diabetes Sugar-Sweetened Beverages, Weight Gain, and Incidence of Type 2 Diabetes in Young and Middle-Aged Women JAMA 2004;292(8):927-934 Schulze MB Nurses Health Study 1991-99 www.kidneylifescience.ca

  9. Hormonal Obesity Theory Vinegar Fibre Obesity High Protein High TG Low HDL Increased Insulin level Fattening Carbohydrates Hypertension Cortisol Diabetes Fatty Liver Insulin Resistance Time Dependent Metabolic Syndrome www.kidneylifescience.ca

  10. Carbohydrates raise blood glucose Usual Diet Co-factors Fat Fibre Speed of Digestion 55% CHO Diet Effect of a high-protein, low-carbohydrate diet on blood glucose control in people with type 2 diabetes Diabetes. 2004 Sep;53(9):2375-82 Gannon MC 20% CHO Diet www.kidneylifescience.ca

  11. Fructose is ‘healthy’ 1983 “We see no reason for diabetics to be denied foods containing sucrose” John Bantle NEJM 1986 “No conclusive evidence (sugars) demonstrates a hazard” FDA 2006 Can substitute sucrose “for other carbohydrates in the meal plan” ADA www.kidneylifescience.ca

  12. Fructose • Adolescent 1994 72.8 g/day www.kidneylifescience.ca Berry AJCN 2007 88;895

  13. High Fructose Corn Syrup Fructose Low glycemic index Cheaper Sweeter than glucose Prevented freezer burn Mixes easily Extends shelf-life Helps breads brown Keeps them soft Found in almost all processed foods especially low fat foods 55% fructose 45% glucose www.kidneylifescience.ca

  14. Obesity and HFCS www.kidneylifescience.ca

  15. Total Sugars “High Fructose Corn Syrup “or “High Fructose Table Sugar” Refined Sugar HFCS www.kidneylifescience.ca

  16. Fructose Metabolism Increased lipogenesis www.kidneylifescience.ca

  17. Fructose causes insulin resistance Impaired cellular insulin binding and insulin sensitivity induced by high-fructose feeding in normal subjects Am J Clin Nutr. 1980 Feb;33(2):273-8 Beck-Nielsen H Glucose Fructose Insulin Tolerance Tests 25% worse with fructose

  18. Fructose causes insulin resistance Endogenous glucose production 6 days of high fructose diet Indication of hepatic insulin resistance Effect of Fructose Overfeeding and Fish Oil Administration on Hepatic De Novo Lipogenesis and Insulin Sensitivity in Healthy Men Diabetes July 2005 54; no. 7 1907-1913, Tappy L www.kidneylifescience.ca

  19. Fructose causes insulin resistance Glucose Fructose Oral Glucose Tolerance Test www.kidneylifescience.ca

  20. Fructose causes hyperinsulinemia Glucose Fructose Oral Glucose Tolerance Test www.kidneylifescience.ca

  21. Fructose causes Insulin Resistance Insulin Resistance! JCI April 20, 2009 Havel et al. www.kidneylifescience.ca

  22. Hormonal Obesity Theory Vinegar Fibre Fructose Obesity High Protein High TG Low HDL Increased Insulin level Fattening Carbohydrates Hypertension Cortisol Diabetes Fatty Liver Insulin Resistance Metabolic Syndrome www.kidneylifescience.ca

  23. Fructose Overfeeding and Triglycerides Effect of Fructose Overfeeding and Fish Oil Administration on Hepatic De Novo Lipogenesis and Insulin Sensitivity in Healthy Men Diabetes July 2005 54; no. 7 1907-1913, Tappy L TG increased 79% www.kidneylifescience.ca

  24. Sugar and Triglycerides NHANES 1999-2006 Mean of 15.8% of consumed calories were added sugars JAMA. 2010;303(15):1490-1497 Vos Caloric Sweetener Consumption and Dyslipidemia Among US Adults www.kidneylifescience.ca

  25. Sugar and HDL JAMA. 2010;303(15):1490-1497 Vos Caloric Sweetener Consumption and Dyslipidemia Among US Adults www.kidneylifescience.ca

  26. Fructose and Lipids Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans JCI April 20, 2009 Havel et al. www.kidneylifescience.ca

  27. Fructose and Blood Pressure NHANES III 2003-2006 4,528 adults who developed hypertension Increased Fructose Associates with Elevated Blood Pressure J Am SocNephrol21: 1543–1549, 2010 Jalal D www.kidneylifescience.ca

  28. Reducing SSB lowers blood pressure Reducing Consumption of Sugar-Sweetened Beverages Is Associated with Reduced Blood Pressure: A Prospective Study among U.S. Adults Circulation. 2010 June 8; 121(22): 2398–2406 Chen L Tertiles of reduction in sugar sweetened beverages www.kidneylifescience.ca

  29. Fructose and Fatty Liver Effect of Fructose Overfeeding and Fish Oil Administration on Hepatic De Novo Lipogenesis and Insulin Sensitivity in Healthy Men Diabetes July 2005 54; no. 7 1907-1913, Tappy L 6x increase in DNL www.kidneylifescience.ca

  30. SSBs are addictive “An increase in liquid carbohydrates leads, perversely, to even greater caloric consumption” JAMA. 2004;292(8):927-934 Schulze MB www.kidneylifescience.ca

  31. Hormonal Obesity Theory Vinegar Fibre Fructose Obesity High Protein High TG Low HDL Increased Insulin level Fattening Carbohydrates Hypertension Cortisol Diabetes Fatty Liver Sugar Insulin Resistance Metabolic Syndrome www.kidneylifescience.ca

  32. Wheat To increase yield, seed head sizes increased www.kidneylifescience.ca

  33. Dwarf Wheat 99% of wheat grown worldwide www.kidneylifescience.ca

  34. BroadbalkWheat Experiment Evidence of decreasing mineral density in wheat grain over the last 160 years J Trace Elem Med Biol. 2008;22(4):315-24 Fan MS Introduction of high yield Semi dwarf wheat www.kidneylifescience.ca

  35. Whole Wheat Up to 5% of the wheat kernel removed 70% of the germ www.kidneylifescience.ca Contains most of vitamins, protein and fat

  36. Whole Grain Processing www.kidneylifescience.ca

  37. Multi-grain May be 2 refined grains Rice flour Dried potatoes Corn flour www.kidneylifescience.ca

  38. Speed of Digestion Traditional Stone grinder Modern Flour Mill www.kidneylifescience.ca

  39. Flour White flour 70% carbohydrate by weight 75% www.kidneylifescience.ca

  40. Amylopectin Amylopectin C is the least digestible (Legumes) Amylopectin B (Bananas, potatoes) Amylopectin A (Wheat) Most digestible Wheat is more efficiently converted to blood sugar than nearly all other carbohydrate foods www.kidneylifescience.ca

  41. Exorphins Digestion of gluten yields morphine-like compounds ‘exorphins’ Ability to cross blood brain barrier www.kidneylifescience.ca

  42. Comfort foods • Comfort foods (affect mood) often contain wheat and other highly refined carbohydrates • Mashed Potatoes and Gravy • Ice Cream • Apple Pie • Mac and Cheese • Pancakes • Spaghetti and Meatballs www.kidneylifescience.ca

  43. Problems with Wheat • Modern wheat is of lower nutritional value • Modern processing removes most of vitamins, fibre and fats • Modern milling (as opposed to stone ground) increases speed of digestion • High in amylopectin A (highly digestible) • May be addictive “Wheat Belly” www.kidneylifescience.ca

  44. The China Study “In both China Study I and II, wheat is the strongest positive predictorof body weight (r = 0.65, p<0.001) out of any diet variable” rawfoodsos.com www.kidneylifescience.ca

  45. Asian conundrum Vinegar Fibre Fructose Obesity High Protein High TG Low HDL Increased Insulin level Fattening Carbohydrates Hypertension Cortisol Diabetes Wheat Super-carbohydrate Fatty Liver Insulin Resistance Metabolic Syndrome www.kidneylifescience.ca

  46. How can we break the cycle? Vinegar Fibre Fructose Obesity High Protein High TG Low HDL Increased Insulin level Fattening Carbohydrates Hypertension Cortisol Diabetes Wheat Super-carbohydrate Fatty Liver Insulin Resistance Resistance requires: High Level Persistence Metabolic Syndrome www.kidneylifescience.ca

  47. Fasting “Our food should be our medicine.  Our medicine should be our food.  But to eat when you are sick is to feed your sickness."Hippocrates www.kidneylifescience.ca

  48. Fasting myths Puts body in “starvation mode” Deprives body of nutrients Weight loss from muscle/ water Causes hypo-glycemia “Yo-yo” diet Overwhelmed with hunger It’s “crazy” www.kidneylifescience.ca

  49. Hunger disappears • “The most astonishing aspect of this study was the easewith which prolonged starvation was tolerated.” E Drenick JAMA 1964 Jan 11; 187:100-105 • “A sense of well-being was associated with the fast” JAMA. 1962;181(4):309-312 Duncan GG • Effect of an acute fast on energy compensation andfeeding behaviour in lean men and women • Int J Obesity (2002) 26, 1623 – 1628 Stubbs RJ • Increased intake from 2436 to 2914 calories on the day after a fast • Over 2 days (2436 x 2) = 4872 Fasting 2914 Net deficit 1958 calories www.kidneylifescience.ca

  50. 382 day fast Weight 456 to 180 lbs then remained stable Features of a successful therapeutic fast of 382 days' duration Postgrad Med J(569); Mar 1973 www.kidneylifescience.ca