Tag Archives: sugar

Paxlovid is a winner, but lifestyle changes are essential to mitigate Covid risk.

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This discussion was originally posted before PAXLOVID WAS AVAILABLE. The title was originally Lifestyle More Effective than Drugs.

But now we have Paxlovid. Paxlovid is very effective in reducing morbidity and mortality associated with Covid-19 infection but also appears to reduce risk of Long Covid. Standard dosing: PAXLOVID two 150-mg tablets of nirmatrelvir, one 100-mg tablet of ritonavir twice daily for 5 days.

Dose adjustments are necessary for certain medical conditions and there are many drug interactions that should be considered. But do not let that discourage you from asking your provider to prescribe this drug for an acute Covid infection. This is a truly effective drug. It decreases morbidity and mortality as well as risk for Long Covid.

The results of a randomized placebo controlled clinical trial in high risk individuals has been published in the NEJM. The study was done just when Omicron hit. The study demonstrated an 89% reduction of hospitalizations and deaths by day 28 (absolute reduction of 6.2/100) with ZERO deaths in the Paxlovid group (7 in the placebo group). Paxlovid also had LESS side effects than placebo.

Another study from Israel demonstrated equally impressive results as shown here.

In addition, a study from the VA has looked at longer term effects (pre-print publication, still waiting for peer review.)

The study included 9000 Paxlovid patients treated within 5 days of symptom onset during the Omicron and subvariant waves and compared the treated patients with approximately 47,000 matched controls.

There was a 26% reduction in Long Covid.

Here is a breakdown of the Long Covid Symptoms

The VA study also showed a 48% reduction of death and 30% reduction in hospitalization after the acute phase (acute phase = first 30 days) as demonstrated here.

Many drug intervention trials for treating COVID-19 early in the pandemic have been disappointing. No studies have shown benefit for hydroxychloroquine, with or without azithromycin. This topic has been covered in previous posts. Remdesivir was FDA approved based upon one study that showed reduction in duration of symptoms. The mortality rate with Remdesivir, however, did not demonstrate a statistically significant difference when compared to “usual care”. https://www.niaid.nih.gov/news-events/nih-clinical-trial-shows-remdesivir-accelerates-recovery-advanced-covid-19

Another study published in Lancet failed to show any clinical benefit from Remdesivir.

“No statistically significant benefits were observed for remdesivir treatment beyond those of standard of care treatment. Our trial did not attain the predetermined sample size because the outbreak of COVID-19 was brought under control in China. Future studies of remdesivir, including earlier treatment in patients with COVID-19 and higher-dose regimens or in combination with other antivirals or SARS-CoV-2 neutralising antibodies in those with severe COVID-19 are needed to better understand its potential effectiveness.”

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext

Likewise well designed studies of Ivermectin have shown no clinical benefit.

Monoclonal antibodies effective against early variants are no longer effective against the newer variants. So in terms of drug therapies for acute Covid infections we have Paxlovid for out patient care and dexamethasone for critically ill patients.

But we do know that certain underlying conditions such as obesity, diabetes, pre-diabetes (insulin resistance) and hypertension significantly increase risk of DEATH AND COMPLICATIONS with COVID-19. Since there are lifestyle interventions that can quickly and effectively mitigate these problems (diet, exercise, sleep, stress reduction….) now would seem like a good time to take our epidemics of obesity and diabetes in hand with aggressive lifestyle interventions to decrease the mortality rate of COVID-19 infection.

Such measures do not require expensive drugs or expensive drug trials, they simply require knowledge, guidelines and the will to implement change in our daily habits. Yet there has been little discussion about this in the media or on the part of public health officials.

Lets look at obesity in the US.

From 1999–2000 through 2017–2018, the age-adjusted prevalence of obesity increased from

30.5% to 42.4%, and the prevalence of severe obesity increased from 4.7% to 9.2%.

Click to access db360-h.pdf

The most effective tool for addressing obesity and diabetes is a very low carbohydrate diet.

Effects of the Low Carbohydrate, High Fat Diet on Glycemic Control and Body Weight in Patients With Type 2 Diabetes: Experience From a Community-Based Cohort

https://pubmed.ncbi.nlm.nih.gov/32193200/

This study was a done in a community-based program, not an academic practice setting. That is significant since it demonstrates feasibility outside of academic centers with standard community resources. The results of this study confirmed the results of many previous studies done in academic settings including better blood sugar control, reduction or elimination of diabetic medications, and significant weight loss.

“All patients following the LCHF diet who initially took
insulin had either a reduction or discontinuation of
this therapy by their healthcare provider when clinically
indicated, compared with less than a quarter of
those receiving usual care.“

In another study done in Italy, significant weight reduction (7 kg), waistline reduction (7 cm.), fat mass reduction (3.8%) and systolic blood pressure reduction (10.5 mmHg) were achieved in 3 months with a Very Low Carbohydrate diet.

Middle and Long-Term Impact of a Very Low-Carbohydrate Ketogenic Diet on Cardiometabolic Factors: A Multi-Center, Cross-Sectional, Clinical Study (https://pubmed.ncbi.nlm.nih.gov/25986079/

Nina Teicholz had an opinion piece published in the Wall Street Journal on May 30, discussing the USDA dietary guidelines that have largely ignored a massive body of evidence supporting a Very Low Carbohydrate Diet for obesity and diabetes. She cites many studies that have been ignored by the USDA dietary guidelines committee. Here is here opening statement.

“Americans with obesity, diabetes, heart disease and other diet-related diseases are about three times more likely to suffer worsened outcomes from Covid-19, including death. Had we flattened the still-rising curves of these conditions, it’s quite possible that our fight against the virus would today look very different.”

You can read the full article here:

https://www.wsj.com/articles/a-low-carb-strategy-for-fighting-the-pandemics-toll-11590811260

But think about that simple statement, THREE TIMES MORE LIKELY TO SUFFER WORSENED OUTCOMES FROM COVID-19. Yet these conditions are highly responsive to lifestyle interventions that not only mitigate obesity, insulin resistance and high blood pressure, but also enhance immune function.

More from Teicholz’s opinion piece:

“Other studies have found that dietary changes can rapidly and substantially improve cardiovascular risk factors, including conditions like hypertension that are major risk factors for worsened Covid-19 outcomes. A 2011 study in the journal Obesity on 300 clinic patients eating a very low-carbohydrate diet saw blood pressure quickly drop and remain low for years. And a 2014 trial on 148 subjects, funded by the National Institutes of Health, found a low-carb diet to be “more effective for weight loss and cardiovascular risk factor reduction” than a low-fat control diet at the end of the 1-year experiment.“

In a recent letter to the editor published in the journal METABOLISM, Dr. Casey Means points out:

A diagnosis of diabetes has been a key indicator of the severity of
COVID-19, and in this regard, the virus has relentlessly highlighted our
global Achilles heel of metabolic dysfunction, and points to a prime opportunity
to fight back.
That fight, however, is not going to be won with Clorox, Purell,
masks, or anti-IL-6 drugs. The fight will only be won through a serious
commitment to improving everyone’s foundational metabolic health,
starting with the lowest hanging evidence-based fruit: dietary and lifestyle
interventions.

Read the full letter here: https://www.metabolismjournal.com/article/S0026-0495(20)30118-9/pdf

In 2 pages the letter describes multiple benefits of better glucose control relative to COVID -19 infection and the immune system as well as reduction of factors that lead to cytokine storm (terminal event for many COVID-19 patients). The letter also discusses the benefit of reducing environmental toxins (discussed in previous posts about COVID-19 and other health problems) that would likely benefit COVID-19 patients.

Research published April 18th, 2020 found that patients exposed to
highest amount of environmental nitrogen dioxide (NO2) had increased
risk of death fromCOVID-19, and that long-term exposure to this pollutant
may be one of the most important contributors to fatality by
compounding lung inflammation [20].

Minimizing exposure to environmental
pollutants may serve a role in quelling the underlying pro-inflammatory
state that characterizes metabolic disease and COVID-19 associated
cytokine storms.

Other environmental toxins, including persistent organic pollutants
(POPs) found in air, water, and food generated from pesticides
and industrial chemicals, are also strongly implicated in the pathogenesis
of metabolic syndrome; promoting “clean living,” toxin-avoidant
strategies for patients as simple as emphasizing organic foods, home
air purification, and non-toxic home supplies could be considered, although
the clinical utility of these measures in the acute setting is unknown
[21].

In discussing the white elephant in the room he states:

What is starkly missing is the clear, simple, and strong recommendation for no added
sugar or ultra-refined carbohydrates, both of which are known drivers
of postprandial hyperglycemia and inflammation. As a medical community, we must not miss the opportunity to serve patients with straightforward, evidence-based nutritional and lifestyle strategies to assist in glycemic control.

I would encourage you to follow the link and read the 2 pages supported by multiple peer-reviewed references.

An ancestral (paleo) diet is also very effective for addressing insulin resistance, diabetes type 2 and obesity. Multiple studies have demonstrated this. Although an ancestral approach is typically low carb it is not typically ketogenic, but a ketogenic ancestral diet (high in non starchy vegetables to support the gut microbiome) can be implemented by restricting fruits to one serving of berries per day and limiting starchy vegetables.

Even without severe carbohydrate restriction, an ancestral anti-inflammatory diet will quickly address insulin resistance, type 2 diabetes, and obesity. In this study, insulin resistance was reversed in 10 days.

And another study compared an Ancestral (Paleo) diet to the Mediterranean diet in patients with ischemic heart disease AND insulin resistance (glucose intolerance or type 2 diabetes). Ancestral diet was superior to the Mediterranean diet in improving insulin sensitivity, blood sugar control and greater fat loss. Fasting blood sugars normalized in all patients on the Ancestral diet who had previously had abnormal blood sugars.

And here is a slide from one of my lectures with references on how an ancestral diet modulates immunity.

Leptin resistance, insulin resistance and obesity travel together. Here is yet another study demonstrating the effectiveness of an ancestral diet.

If you have obesity, diabetes or pre-diabetes the Very Low Carbohydrate version of the anti-inflammatory diet linked above would be the fastest and most effective intervention you can immediately employ to reduce your risk of succumbing to COVID-19. (Of course wear an N-95, follow good hygiene with hand-washing frequently, and use a HEPA filter or Corsi-Rosenthal box in your home, office, and enclosed work spaces)

In the context of the COVID 19 pandemic I will close with the usual summary.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels. Supplement with Vitamin D3 to get your levels above 30 ng/ml, >40ng/ml arguably better.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
  10. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)
  11. Drink water filtered through a high quality system that eliminates most environmental toxins.
  12. HEPA filters or the home-made version (Corsi-Rosenthal box) used in your home or workplace can reduce circulating viral load as discussed on this website.
  13. If you are eligible for vaccination, consider protecting yourself and your neighbor with a few jabs. Age > 50 and/or risk factors (Diabetes, pre-diabetes, insulin resistance, hypertension, obesity, heart disease, COPD, asthma, cancer treatment, immune suppression) suggests benefit from a booster. Risk for complications of boosters in adolescents, especially males, without risk factors, may equal benefit. Previous infection with Covid can be considered as protective as a booster. Discuss risk vs benefits with your doctor.

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

Western Diet (high sugar, refined carbs, unhealthy fats) alters genes and causes inflammation

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New study (in mice) shows fast food makes the immune system more aggressive in a detrimental way.

Major points:

  1. The immune system reacts similarly to a high sugar, high (unhealthy) fat and high calorie diet as to a bacterial infection.
  2. Unhealthy food seems to make the body’s defenses (innate immune system) more aggressive in the long term. Even long after switching to a healthy diet, inflammation towards innate immune stimulation is more pronounced.
  3. These changes may be involved in the development of arteriosclerosis and diabetes.
  4. These changes are due to alterations in gene transcription (up-regulation of genes associated with inflammation)
  5. This up regulation of pro-inflammatory genes persists even after converting to a healthier diet.

Read more at News from IRT

Here: Fast food makes the immune system more aggressive in the long term: Study shows that even after a change to a healthy diet, the body’s defenses remain hyperactive — ScienceDaily

And here Western Diet Triggers NLRP3-Dependent Innate Immune Reprogramming: Cell

This study is an example of epigenetics, where an environmental factor (diet) alters the expression of genes. We know that regular consumption of a variety of colorful vegetables mediates many beneficial effects and part of that process involves altering the transcription of many genes related to health and our ability to defend against Oxidative Stress .

The epigenetic effect of nutrition can be transmitted to the next generation.

The epigenetic effects of diet include many aspects of health including  cancer risk.

And epigenetic changes in humans can begin  before birth in response to maternal nutrition and maternal exposure to environmental toxins .

Diet also effects the gut microbiome, which in turn affects health .

So avoid fast food and other forms of processed-refined foods. Eat a whole foods-ancestral diet that includes a variety of organic colorful vegetables and fruits, grass fed/finished meats and wild seafood. This will not only provide important micro and macro nutrients but will also turn up and turn on genes that prevent disease.

Live clean, sleep well, laugh and love.

Doctor Bob

The Broken Brain Docuseries is now re-running

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Due to popular demand the producers of this terrific series are making it available again  on line this weekend. If you have not taken advantage of this information you can do it here:

Replay (YouTube) | Broken Brain

Enjoy

Bob Hansen MD

The Broken Brain on-line “docuseries” is running now.

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I would encourage everyone to watch this series of daily interviews and discussions on lifestyle and brain health. This was organized and produced by Mark Hyman MD, director of the Functional Medicine Clinic at Cleveland Clinic, well known author, speaker and physician, Discussions cover many topics including environmental toxins (such as heavy metals and Roundup), nutrition, exercise, sleep, stress reduction, gut bacteria, and more with specific reference to the effects on your brain and risk for dreaded conditions such as Alzheimer’s and other forms of dementia, Parkinson’s disease, multiple sclerosis, etc. These conditions can be prevented and when present, they can be treated with interventions not usually employed by modern medicine, unless you are fortunate enough to be working with a Functional Medicine practitioner.

You can sign up to receive a daily email with a link to the on-line video. Each video in the series is available for 24 hours starting at 3 PM PST, 6 PM EST.

Here is the link to get started with the third episode in this series.

Episode 3: Dementia and Alzheimer’s [LIVE] | Broken Brain

To Your Health,

Bob Hansen MD

Obesity Epidemic Requires a Paradigm Shift

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The obesity epidemic requires a paradigm shift. Several medical myths stand in the way of taking the most effective steps to safely help patients lose weight. The most important myth relates to saturated fat. Saturated fat consumption does not contribute to cardiovascular disease. This must be understood and accepted by the medical community so that sound advice can be given.

A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD.( Am J Clin Nutr. 2010 Mar;91(3):497-9. )

In fact, as early as 2004, Mozaffarian et. al. investigated the influence of diet on atherosclerotic progression in postmenopausal women with quantitative angiography and found that:

In multivariate analyses, a higher saturated fat intake was associated with a smaller decline in mean minimal coronary diameter (P = 0.001) and less progression of coronary stenosis (P = 0.002) during follow-up. (Am J Clin Nutr. 2004 Nov;80(5):1175-84)

In addition, they further found that:

Carbohydrate intake was positively associated with atherosclerotic progression (P = 0.001), particularly when the glycemic index was high.

            Polyunsaturated fat intake was positively associated with progression when replacing other fats (P = 0.04)

These findings should come as no surprise given the basic science of atherosclerosis. Oxidized and glycated LDL stimulate macrophages to become foam cells initiating the creation of plaque. Cellular receptors that allow macrophages to ingest oxidized LDL are specific for oxidized LDL. These receptors do not recognize normal LDL to a significant degree.

Holovet et. al. studied the ability of oxidized LDL versus the Global Risk Factor Assessment Score (GRAS) to detect coronary artery disease. GRAS identified coronary artery disease 49% of the time, while oxidized LDL was correct 82% of the time.

In a large prospective study, Meisinger et al found that plasma oxidized LDL was the strongest predictor of CHD events when compared to conventional lipoprotein risk assessment and other risk factors for CHD.

Polyunsaturated fats are easily oxidized, saturated fats are not. It is the polyunsaturated fatty acids (PUFA) in the membrane of LDL particles that become oxidized and then initiate the cascade of inflammatory events leading to atherosclerosis. The major source of these PUFA in the American diet are “vegetable oils” (corn oil, soy oil etc.)  rich in the omega-6 PUFA, linoleic acid.

So why is this important to understand relative to the obesity epidemic? Because the most effective weight loss “diet” is arguably a low carbohydrate/high fat (LCHF) diet. This approach does not require calorie counting. This approach has been demonstrated to spontaneously reduce caloric intake whereas low fat diets require calorie counting and result in persistent hunger.

When compared to low fat calorie restricted diets  the LCHF approach has been equal or superior with respect to weight loss, insulin sensitivity, blood pressure reduction, and lipid profiles whenever these parameters have been measured.

But LCHF has not been embraced by the medical community due to the perceived dangers of saturated fat consumption and a low-fat ideology that lacks legitimate scientific evidence.

Once we dispel the mythology of saturated fat, the safety and efficacy of LCHF will be more readily accepted by physicians, the media and the lay public.

The nutritional villains in our society are highly refined and easily oxidized “vegetable oils” filled with pro-inflammatory omega-6 PUFA (linoleic acid), added sugar (especially HFCS) so prevalent in most processed foods and soft drinks, and the nutrient poor wasted calories of processed flour foods. These three culprits are responsible for our epidemics of obesity, insulin resistance and metabolic syndrome. These three conspire together to generate fatty liver disease, atherosclerotic plaque, and chronic inflammation.

When a LCHF approach is combined with  eating only fresh whole foods and avoiding added sugar, refined flour, and unhealthy  “vegetable oils”, we have the perfect recipe for our obesity epidemic.

The following references provide examples of studies that have demonstrated the efficacy, safety and  usual superiority of the LCHF  approach to weight loss.

Dig Dis Sci. 2007 Feb;52(2):589-93. Epub 2007 Jan 12. The effect of a low-carbohydrate, ketogenic diet on nonalcoholic fatty liver disease: a pilot study. Tendler D, Lin S, Yancy WS Jr, Mavropoulos J, Sylvestre P, Rockey DC Westman EC.

Interview with Dr. Ede about preventing Alzheimer’s

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My friend and colleague, Dr. Georgia Ede, was recently interviewed concerning dietary interventions to prevent Alzheimer’s Dementia. Great interview, lots of information, references provided at the bottom of the transcript.

Here is the link.

Are You On The Road To Alzheimer’s? Interview With Dr. Georgia Ede – Choc & Juice

Another reason to eat a clean Paleo diet.

Eliminating sugar, flour foods, and fruit juices will also improve your gut flora and help to prevent dysbiosis.

Regards

Bob Hansen MD

Sugar Industry paid Harvard researchers to trash fat and exonerate sugar!

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By now most of you have already heard about the study published in JAMA that reveals an unsavory historical scenario wherein the sugar industry  funded an academic review paper that diverted the medical community’s attention from sugar as a vector for disease and erroneously placed it on saturated fat and cholesterol consumption. You can read about it by clicking on the following link.

How the Sugar Industry Shifted Blame to Fat – The New York Times

Here is a quote from the above cited article in the NY times:

The internal sugar industry documents, recently discovered by a researcher at the University of California, San Francisco, and published Monday in JAMA Internal Medicine, suggest that five decades of research into the role of nutrition and heart disease, including many of today’s dietary recommendations, may have been largely shaped by the sugar industry.

Here is the abstract of the article published in JAMA (Journal of the American Medical Association).

Sugar Industry and Coronary Heart Disease Research:  A Historical Analysis of Internal Industry Documents | JAMA Internal Medicine | JAMA Network

Early warning signals of the coronary heart disease (CHD) risk of sugar (sucrose) emerged in the 1950s. We examined Sugar Research Foundation (SRF) internal documents, historical reports, and statements relevant to early debates about the dietary causes of CHD and assembled findings chronologically into a narrative case study. The SRF sponsored its first CHD research project in 1965, a literature review published in the New England Journal of Medicine, which singled out fat and cholesterol as the dietary causes of CHD and downplayed evidence that sucrose consumption was also a risk factor. The SRF set the review’s objective, contributed articles for inclusion, and received drafts. The SRF’s funding and role was not disclosed. Together with other recent analyses of sugar industry documents, our findings suggest the industry sponsored a research program in the 1960s and 1970s that successfully cast doubt about the hazards of sucrose while promoting fat as the dietary culprit in CHD. Policymaking committees should consider giving less weight to food industry–funded studies and include mechanistic and animal studies as well as studies appraising the effect of added sugars on multiple CHD biomarkers and disease development.

This disturbing conspiracy reveals yet another industry sponsored distortion of science which had great impact on the health of our nation. The impact is accelerating today as the epidemics of obesity and diabetes rage out of control. But sugar consumption has not just been tied to obesity, diabetes, heart attacks and strokes. Sugar added foods and beverages have likely contributed to dementia,  many forms of cancer and other chronic debilitating diseases. Sugar and refined carbohydrates mediate these effects by increasing systemic inflammation and contributing to insulin resistance. Inflammation and insulin resistance are pathways to many disease processes. Metabolic syndrome (pre-diabetes) is the hallmark combination of multiple abnormalities with insulin resistance as the underlying root cause. Prolonged insulin resistance leads to type 2 diabetes and contributes to heart attacks, strokes,  cancer and dementia. In fact dementia is often referred to as type 3 diabetes, mediated in large part by insulin resistance in the brain.

Here are links to discussions and videos relevant to these topics.

Preventing Alzheimer’s Disease Is Easier Than You Think | Psychology Today

How to Diagnose, Prevent and Treat Insulin Resistance [Infographic] – Diagnosis:Diet

Reversing Type 2 diabetes starts with ignoring the guidelines | Sarah Hallberg | TEDxPurdueU – YouTube

I have previously provided links to the YouTube lectures given by the brilliant Dr. Jason Fung, These are worth mentioning again.

The Aetiology of Obesity Part 1 of 6: A New Hope

Insulin Toxicity and How to Cure Type 2 Diabetes

How to Reverse Type 2 Diabetes Naturally

Nina Teicholz is also worth a watch.

Nina Teicholz: The Big Fat Surprise – (08/07/2014)

And here is an important talk about sugar, refined carbohydrates and cancer.

Plenty to chew on.

We did not evolve to eat lots of sugar! It is dangerous stuff.

Bob Hansen MD

 

 

 

The Obesity Code, a must read book by Dr. Jason Fung.

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Doctor Jason Fung just published a terrific book titled The Obesity Code: Unlocking the Secrets of Weight Loss: 

Dr. Fung’s genius excels at simple, direct explanations with clarity and humor. His analogies are often hilarious and through his humor and logic he communicates simple but important truths. The major message is that obesity is a hormonal problem. Obesity is not a disease of excess caloric intake, nor is it a disease of sedentary lifestyle. Dr. Fung cites study after study in which obese patients (young and old alike) consumed less calories and exercised more with dismal results. He reviews the medical literature on the effects of refined carbohydrates and sugar on insulin and other hormones. He explains how sustained high insulin levels cause insulin resistance and weight gain. He clearly and decisively explains how 100 calories of sugar or flour effects the human body in a manner immensely different from 100 calories of broccoli.

“Have you ever seen anyone get fat from eating too much broccoli?”

Most importantly, Dr. Fung provides the solution that has helped hundreds of his patients. The solution is elimination of refined carbohydrates and sugar in combination with intermittent fasting. Intermittent fasting (consuming only water, coffee, tea, broth) for 24 -36 hours a few to several times per month helps to reset the brain’s set point for body weight. When combined with restriction of sugar and refined carbohydrate (foods made with flour) intermittent fasting presents a powerful tool to not only lose weight but to manage diabetes and prevent the many complications of obesity and diabetes.

Intermittent fasting increases the human metabolic rate, Your body actually burns more calories at rest per hour during fasting. The effects of intermittent fasting are distinctly different from what has been referred to as the “starvation response”. The “starvation response” ironically and confusingly refers to human studies that restricted (reduced) caloric intake but continued low calorie meals throughout the day.  It is unfortunate that those studies coined the term “starvation response” which is a decrease in resting metabolic rate. Caloric restriction diets reduce the human metabolic rate and therein lies the cause for the failure of all caloric restriction diets.

The confusion of these two approaches and their effects on human metabolism have clouded the discussion of obesity for decades.

Dr. Fung’s communication skills can be enjoyed by reading his book and viewing his many talks on YouTube.

His book and lectures should be mandatory for every medical student, physician, nutritionist and public health official. His book’s exhaustive medical references document the science that supports his theory and his clinical solution.

So take a leap, click on the link above for his book and the links below for some of his videos which are free on-line.

I think that Dr. Fung’s book is the most important book published on this topic in the 21st Century. His work will have profound influence during the next few decades. I encourage you to enjoy his genius.

Bob Hansen MD

The BigFatFix, a crowd funded film that explores the proper nutritional approach to diabetes epidemic

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This new film created by a GP in UK, funded by small contributions, describes how elimination of added sugar and implementation of carbohydrate restriction can cure diabetes and result in weight loss. The film also covers how the low-fat craze, based on bad science (ignoring the full data) began with Ancel Keyes and evolved into arguably the worst public health disaster experienced by the modern world.

Bariatric surgery is NOT superior to lifestyle changes

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There have been multiple studies comparing “lifestyle” interventions to bariatric surgery in treating obesity and diabetes. Repeatedly the authors conclude that bariatric surgery is superior to “lifestyle” interventions.

But none of these studies have utilized very low carbohydrate diets or medically supervised fasting as a lifestyle intervention. Instead, the diets employed for the “lifestyle” intervention are typically an ADA calorie restricted low-fat diet. I find this very frustrating as a physician.

The science in this area has demonstrated that very low carbohydrate diets consistently out-perform the low fat calorie restricted diet in terms of weight loss, blood sugar control, blood pressure control and lipid profiles.

Bariatric surgery carries a mortality rate of up to 3% depending on the surgeon, hospital and other circumstances. As an anesthesiologist and pain management physician I have seen multiple complications of bariatric surgery including but not limited to multiple chronic nutritional deficiencies (malabsorption), hernias, sepsis, renal failure, rhabdomyalisis, respiratory failure requiring prolonged ventilation, multi-organ failure requiring prolonged ICU care, and death.

And although many patients have profound weight loss in the first year after bariatric surgery many patients ultimately gain back most of the weight initially lost.

We need studies that compare bariatric surgery to very low carbohydrate and paleo diets. We need studies that compare bariatric surgery to intermittent medically supervised fasting. Until those studies are performed we should not conclude that bariatric surgery is superior to lifestyle interventions, particularly given the high complication rates of this surgery and the proven effects of VLC diets and medically supervised fasting.

Here are links to videos that discuss this topic.

They are all worth watching.

The SkinnyNews-Tim Noakes

The Aetiology of Obesity Part 1 of 6: A New Hope

The Science and Practice of Low-Carb Diets {Duke University Office Hours}

Prof. Tim Noakes; Medical aspects of the low carbohydrate lifestyles

Low-Carb Experts: Eric Westman, MD, MHS – Segment One (9:30)

Dr Eric Westman – Duke University New Atkins Ketogenic Diet for Weight Loss and Health

Dr Eric Westman about the new Atkins diet, part 1/2

Debunking Low Carb Myths with Dr. Eric Westman

Insulin Toxicity and How to Cure Type 2 Diabetes

How to Reverse Type 2 Diabetes Naturally

I have previously discussed the issue of carbohydrate restriction, diabetes and obesity with multiple scientific references provided in previous posts.

Peace,

Bob Hansen MD