Monthly Archives: January 2007

Greedy Guts: How the Bugs in Your Guts Might Just Make You Fatter

Greedy Guts:  How the Bugs in Your Guts Might Just Make You Fatter

Competency # 1 Risk

Reference: Nature 2006 Dec p1022-1023

“I don’t get it, I get fat when I eat the exact same food as my friends, and they don’t.”  Heard that before?  Rolled your eyes? Said it was just an excuse.  Well, maybe not so! Here is another story about the bacteria in your intestine!  The research team at Washington University School of Medicine have unlocked another fascinating piece of knowledge about you and just published it in the Journal Nature and the Proceedings of the National Academy of Sciences.  Some people have bacteria in their intestine that digest more calories for them.

Here’s how it works.  Most of us have 90% of our gut’s bacteria in the form of two families, the Firmicutes and Baceroidetes.   The Firmicutes turn out to be able to digest what most of us think of as indigestible fiber.  They turn that fiber into simple sugars.  You absorb the sugar and you get fat.  (Remember the column last year we did about how our guts make us look like a cow.  Well, that’s what those bacteria do in a cow too.)  The less Firmicutes you have, the thinner you are.

Now, it’s not quite that simple.  Turns out, if you can lose weight, the balance of the two families changes back to the amount found in skinny folks.  So which came first?  What that does mean is that as we get bigger, the bacteria in our guts change and with that change comes a greater “efficiency”.  It’s like double jeopardy, a slippery slope.

The story gets weirder.  The bacteria in your normal gut do more.  As in almost all biological systems, there are multiple layers of control.  What the researchers found was that the normal bacteria suppress the production of a substance called “fasting-induced adipose factor”.  That helps your body store fat.  You suppress it at your own peril.  They also found a suppressed level of adenosine monophosphate-activated protein kinase.  That makes it harder for you to burn the fat you already have.  This is not Double Jeopardy, it’s Triple or even Quadruple Jeopardy!  Not only do the bacteria make more calories available by making lousy old fiber into digestible glucose, but then they manipulate your own internal genes and make you more efficient in two different ways.  This is terrible news the month after the Holidays when the average American gained 5 pounds.

I used to say, “A calorie is a calorie is a calorie.”  I apologize.  That’s just not true.  For some of us, a calorie is a 110% calorie.  The bigger we get, the higher the number might be.  For those of us who feel like our destiny is to be eternally struggling, as least you have the solace of knowing you were a little bit right.  You can blame it on the greedy bugs in your guts.

WWW: What Will Work for Me.   Remember, to lose weight effectively, you do have to eat fewer calories. What Brian Wansink convincingly says in his book, “Mindless Eating” is that we fail when we deprive ourselves and feel deprived.  Just let go of 100 calories here and 100 there and you don’t feel starved, just a touch below normal.  I can deal with a touch.  A hundred calorie battle won each day is a pound a month.  Eat an apple instead of a bowl of ice cream at 8 o’clock when you turn on CSI.  New Years Resolution: lose just one pound a month.

Folate: A Vitamin with Unintended Consequenses – Frail Elderly May Get Demented Faster

Folate:  A Vitamin with Unintended Consequenses – Frail Elderly May Get Demented Faster

Competency # 17 Vitamins

Reference: American Journal of Clinical Nutrition, Vol. 85, No. 1, 193-200, January 2007  Morris et al

This is a serious story of unintended consequences.  In an attempt to solve the problem of spina bifida, we may have created a worse problem.  Spina bifida leaves children paralyzed for life.  It has been shown to be related to folate deficiency.  (Interestingly enough, folate is degraded by sun exposure on Caucasian skin.  Pigment in skin protects that from happening, which is probably why humans evolved with dark skin.  We developed depigmented skin to live in lower sun climates where we needed Vitamin D more than folate).  In 1998, America added folate to many foods.  Literature exists to show that it worked.  The rates of spina bifida has gone down dramatically.  Big win.

We do know that Vit. B-12 deficiency causes dementia.  We get B-12 from meat.  B-12 and folate also work together to prevent anemia.   To absorb B-12, you have to have a protein in your stomach bind to it.  It’s not only a function of how much you eat, but rather how much you can absorb and how much is bound.  Getting gradually B-12 deficient can be a slow and “pernicious” process, so we call B-12 deficiency pernicious anemia.  As we get older, it can be part of why we lose some of our mental acuity.

What we didn’t expect was the effect of folate supplementation on B-12 deficiency.  The National Health and Nutrition Examination Survey or NHANES monitors our nations nutritional health by drawing blood, testing mental acuity etc on a statistical sample of Americans every year.  What they found was very disturbing.  Since adding supplemental folate to our diets, frail elderly with B-12 deficiency may be accelerating their mental decline and getting more anemic.  And there are thousands of frail elderly at risk compared to the small number of spina bifida patients.

This is a big deal.  We are now living in a folate-supplemented environment.  You almost can’t avoid unless you just eat fruit and vegetables.  If we are gradually and imperceptibly becoming B-12 deficient, that extra folate may be a problem for us.   It may make our brains rot out a little faster!   You may lose it before you know it’s gone.  We all forget to buy the milk on the way home.  I want to be able to remember that I forgot!

This isn’t certain.  This week there was an article from the Archives of Neurology suggesting that extra folate may help prevent Alzheimer’s.  That’s not necessarily conflicting, but it’s a story suggesting we need the vitamin.  It’s the mix and combination that may be the point.

My goal for you, and for me, is to live graciously and with your brain fully loaded with its intended capacity until “your time”.  This changes things.  To keep your brain as healthy as possible, we need to add a new strategy to make sure we are well.

What Will Work for Me?   As I get closer to being “elderly”, my brain health is important.  I will never be able to beat Irene at bridge if I can’t remember she lead the Queen of Hearts the first round.  I am going to add to my annual physical exam a request to have my B-12 checked on an annual basis.  Everyone over 55 probably should too.  I take a vitamin pill every day but taking B-12 doesn’t count.  It’s what is absorbed in my stomach that counts, and the only way to know what I’m getting is to measure it in my blood.  We’re going to see more recommendations on this one.  But you heard it here first.  The trick is to remember where you heard it!  And ask your doctor.  If you have frail elderly parents, talk to them about it too.  This is important.

The Stefansson/Anderson Story

Metabolic Syndrome:  Understanding the Fire Within #1: The Stefansson/Anderson Story

Competency # 20 Culture Lifestyles of the long-lived

Reference:  Good Calories, Bad Calories by Gary Taubes,  Published 2007

“They are the healthiest people on earth.  They eat nothing but blubber and fish and have no diseases,” said Danish explorers Stefansson and Anderson after returning from a prolonged exploration of the Inuit peoples in the Canadian arctic.  How could any people be healthy eating only meat and blubber?  The scientific community of the 1920’s, a community that had just figured out vitamins and solved many deficiency diseases, couldn’t conceive that a diet of pure meat and fat could possibly be healthy.  Yet, here was an example of a whole culture that survived on a diet of fish, meat and blubber.  The Inuit ate no fruits or vegetables.  None.  How could they be healthy?

Stefansson and Anderson themselves had lived for a prolonged time in the Artic with the Inuit and had returned healthy.  To back up their claim of these amazing, healthy indigenous peoples of the north, S and A volunteered for a unique experiment.  They offered to eat the same diet for a year in New York City, being studied all the while to ensure they weren’t cheating and to see just what happened to them.  In 1928, the two were closely followed by the premier nutritionists of the era at Cornell on New York City.  Weekly urines were collected to ensure their compliance.   Two pounds of meat a day, 79% fat, 19% protein, 2 % carbohydrate from the glycogen in the muscle/meat composed their entire diet.  And nothing happened.  After a year, the two weighed 3 and 6 pounds less.  They had their blood pressure drop from 140/80 to 120/80.  No kidney damage, no heart damage.  No vitamin deficiency.  No scurvy.   Amazing.  Even more amazing is that this story has been lost and forgotten.  It was clear to the nutrition community at the time that no vitamin deficiency disease developed on a pure meat diet.  Meat is a good source of many vitamins, but not C.  Even scurvy did not develop.  This suggests that diet of meat can be completely healthy, in 1928 terms prior to the ability to understand all the nuances of fat and cardiac disease.  And their blood pressure dropped, their weight dropped and they felt fine.  Two components of the “metabolic syndrome”, weight and blood pressure, got better on an all meat and fat diet.  Wow!

We started the year talking about goals around “metabolic syndrome” and how to improve it.  To improve it you have to understand how it works and where it comes from.  I think a fair look at the scientific evidence will reveal to us many findings that will spark our imagination.  The Stefansson – Anderson story has been repeated in many forms over the last hundred years around the world as primitive societies with very low rates of heart disease, obesity and diabetes, transitioned into the world of “western” food.  As soon as they did, they developed western diseases, like diabetes and heart disease.  The story is repeated in the Pima Indians, the Zulu in Africa.  Schweitzer, in Africa, was amazed at the lack of cancer he found.  Hutton, a missionary in Labrador, wrote that he didn’t see a case of cancer or heart disease in the Inuit until they settled and started eating western foods, meaning biscuits, flour and sugar.

Metabolic syndrome is a result of obesity and diabetes.  Sixty percent of us have it. I want to explore how we are all getting fat, or can’t lose weight no matter how hard we try.  I want you to learn how to keep yourself lean and healthy and to prolong a fulfilling, optimally healthy life.  To do that, we need to sort out how metabolic syndrome happens.  And there was a time on this planet when it was virtually absent.  It is a new disease, a disease of “western civilization”.  If it’s new, it must have something to do with our environment.  And we can change that.

WWW:  What will work for me.  This is the first in a series of explaining metabolic syndrome.  I used this story because it suggests that eating red meat and saturated animal fats isn’t the problem we’ve thought it to be.  Yet, that’s what we teach when we tackle the enigma of the metabolic syndrome.  Are we barking up the wrong tree?  Has organized medicine been going down the wrong path?  Do we need to refocus?   I’m taking as my guide the best book on nutrition I’ve read in 10 years: Good Calories Bad Calories by Gary Taubes.  It was published just last year.  He makes a very provocative premise that the enemy is not red meat, but rather white carbohydrates.   I’m not rushing out there to start eating meat breakfast, lunch and dinner, but I think it’s reasonable to try and sort out this “metabolic syndrome” puzzle.  Let’s look at the evidence.