Monthly Archives: June 2008

Obesogens: Eating tin is how your mother made you fat

Obesogens:  Eating tin is how your mother made you fat

Competency # 18 Environmental Toxins

Reference: Grün, F,  Blumberg B, Environmental Obesogens: Organotins and Endocrine Disruption via Nuclear Receptor Signaling Endocrinology Vol. 147, No. 6 s50-s55

Obesogens are a new type of chemicals that are being identified as toxins in our environment that affect our fat storage genes.  They are labeled as “obesogens” because they may explain part of how we get overweight, when otherwise we would not have.  Organotins (organic molecules attached to tin, the metal) have been described as one of the first sets of chemicals that do that.   The establishment of a genetic imprint early in life becomes our blueprint for all our lives.  That becomes the risks for the risks for the risks, R3.

How do they do that?  We are learning that there are events and exposures that can predict our risk for obesity from what we are exposed to during pregnancy.  For example, smoking during pregnancy doubles the risk of obesity, compared to smoking after delivery.  So, it’s not the smoking environment by itself, but the smoking while your mother is pregnant that matters.  And we have found that the chemicals we are talking about work at the nanogram level.  As our measuring technology becomes sophisticated enough to measure nanograms, we are able to measure the effects of chemicals that work at that minute level.

Organotin compounds are found in a variety of sources.  They are used as stabilizers for paint, for example.   TBT, or tetrabutyl–tin is the most talked about example of this class, as it seems to be what lasts in the environment the longest.  They are also used as fungicides on crops and in PVC pipe manufacture.  They have been found in seafood like clams and oysters, so they are relatively ubiquitous.  And they work through a variety of mechanisms.

What they seem to effect are your genes that regulate the set point for your fat storage.  Your “thrifty genes” are a set of genes that influences how efficiently you store fat.   Organotins seem to be implicated as stimulating the expression of those genes very early in life, and set the table for you for the rest of your life.  If your genetic predisposition is set while you are still a fetus, your activated  “thrifty” genes make your metabolism more sensitive to weight gain later on in life.  The PPAR system is part of how we regulate and differentiate fat tissue.  As is the RXR system.  Organotins stimulate both in utero.  That’s a problem.  To quote, “RXR-PPAR has been shown to play a key role in adipocyte differentiation and energy storage and is, therefore, key to the control of whole-body metabolism.  PPAR activation increases the expression of genes that promote fatty acid storage and represses genes that induce lipolysis in adipocytes in white adipose tissue.”

Ouch.  We live in an industrial world.  We presumed that all those chemicals we’ve invented to fight agricultural pests have been tested and found to be safe.  Well, they haven’t been.  We haven’t had the technology to test to nanogram levels, or the sophisticated science to understand the mechanisms of how our genes work.  But this is the cutting edge of science today.   The brave new world of understanding how our genes work, and how they get expressed by chemicals at the most subtle of levels is opening up a whole new world.  The risks for the risks for the risks.  R3.

WWW:  What will work for me.  This is too early to point fingers and definitively say what is what.  But this builds in me a conviction that eating local organic food is probably better.  For example, did you know that those perfect apples imported from far away have been sprayed over 40 times.  Did you think all that chemical washed off?  I’m washing my fruit more often.  So should you.  And those slightly blemished locally grown apples look suddenly much tastier.  They don’t have that tinny taste.

Reduce Your Risk of Heart Attack 50% Playing Outdoors!

Reduce Your Risk of Heart Attack 50%  Playing Outdoors!  Summer Starts Today

Competency #  17: Vitamin D – SuperVitamin

Reference: Archives of Internal Medicine, June 9 th 2008 Giovannucci et at from the Harvard School of Public Health
Date:  6/08

Another blockbuster study published this last week!  From the Harvard Professional Men’s Health Study prospectively following over 18,000 men who were initially free of heart disease, Dr. Giovannucci and team found that there was a linear relationship with increasing heart disease in all circumstances in which vitamin D is lower.  Simply put, there was a 50% increased risk for men in the lowest range (below 15 ngs) compared to men over 30 ngrams.  There were higher rates as the population moved further north (less sunshine and less D all winter), lower rates at higher altitude (up in mountains you get sunburned easier because there is less atmosphere to protect you from UVB – but you also then make more D with your skin.) and during the winter.  Vitamin D has been identified with all components of the clot making process that plugs you your arteries: vascular smooth-muscle-cell proliferation, inflammation, vascular calcification, the renin-angiotensin system, and blood pressure.

Only 23% of men had blood levels of vitamin D over 30.  If you lived in the tropics your blood level would be 60-80 ngrams.   Let me repeat.  The relative risk of a heart attack was DOUBLE for those with the levels below 15 ngs.  Many of us get below 15 ng without a supplement in winter.  And the study found a linear risk for more and more heart attacks the lower the D was.  The opposite suggests that the more D you have, the less risk of a heart attack.  What they didn’t test was whether blood levels above 32 were even more protective.  They couldn’t because numbers were too small.
This is a major study.  Heart attacks kill half of us.  If we can reduce your risk by 50% by raising your D level up to the minimum of 30 nanograms, think what would happen if we raised your level to 60.  That was not tested because so few men were above 30.  Yet we know that living in the tropics your blood level would naturally be 60.  The house of medicine is going to have to redo all of its research on heart disease to consider this new component of risk.  We need to add D deficiency to the list of heart attack risks because it seems to be just as dangerous as high blood pressure, cholesterol, diabetes, smoking and sedentary life style.  This same Harvard study of health professionals showed that you can reduce heart attacks 87% by 1) stopping smoking, 2) exercising 30 minutes every day, 3) eating lots of fruits and veggies (5 servings a day) with no trans fats and little red meat, 4) a glass of wine, 5) staying skinny (body mass index below 25).  Now we can add 6) go play outdoors.
We do know that 5-10% of people will not achieve a level of 30 on 2,000 U day.  We do know that optimal levels are around 60.  I suspect the recommended supplement level is going to have to go up to 3-5,000 IU a day to achieve that.  We do know 10,000 IU a day is safe, forever (NEJM last summer)  But we also know you will make D from sunshine.  It’s summer.  Get outside!

WWW:  What will work for me.  I’m already taking well over 2,000 U a day.  I want a blood level at least 60 year around.  We heard about reduced risk of breast cancer two last month with 2,000 U of D a day.  So Grandma was right.  You have to play outside in the sun, when the sun is out.  And high altitude gives you more Vitamin D exposure.  That’s new to my list now.  I’m booking my tickets for Rocky Mountain National Park.  I now know how John Denver got his “high”.  Sunblock only after 20 minutes in the sun.

Alkali Diet Part IV: Magnesium

What are the Benefits? The Minuet of Mighty Minerals Concludes with Magnesium

Competency # 16: Mighty Minerals

Reference: Web Link for the “Traditional” Poo-Poo to the Alkaline Diet.

http://www.brighamandwomens.org/healtheweightforwomen/special_topics/intelihealth0506.aspx?subID=submenu10

Here is where we may be getting a little bit ahead of the system.  There are NO good studies that show that eating a specifically alkaline diet will make a difference in cancer or heart disease by traditional medical research.  By studies, I mean a randomized controlled trial.  That’s the gold standard in medicine.  It takes out the placebo effect.  As you can intuitively understand, it’s hard to impossible to get people to eat a specific diet for many years in a randomized fashion. (You get the bread and water, I’ll take the …..)  We are talking about effects that take years, if not lifetimes, to develop.  So, research may not come in the fashion to which we expect it to.  With that in hand, it’s not hard to argue that the alleged benefits of the alkaline diet are not supported by the facts, especially when “the facts” that you quote require a randomized controlled trial.  Can we ferret out the truth another way?

What we do know is theoretical and historical.  We do know that societies that ate “pre-Western” diets had rates of cancer considerably below what we have now.  David Livingston, the famous African missionary, found virtually no cancer in Africa.  The same was found in many indigenous societies, prior to the introduction of Western foods.  The Inuit were virtually cancer free.  Native Americans, Zulu, Pacific Islanders, Maori.  The story repeats too often to ignore.  Many of those societies lived outdoors and got abundant Vitamin D.  They also ate tons of fiber (50-100gms/day).  Fruits and vegetables were abundant, in season.  But no sugar, white flour or “refined” foods.  Grains were more on the order of rye and barley, if any at all.

Intriguing also is that these indigenous societies don’t become hypertensive as they grow older.  We take for granted that we must become so in the west, as though it is a foregone conclusion.  So what is the difference?  It’s going to take a while, with our modern scientific methods and instruments to tease out the real effect and help us to figure out how to care for ourselves.

What we can measure, and say for sure, however is that a diet of abundant fruits and vegetables (base of the alkaline diet) provides us with lots more potassium and magnesium, two electrolytes that we don’t get adequate amounts of in our current western diet of fast food and sweet ice cream.  Magnesium may be one of the secrete sleepers in the “alkaline” diet.  We do know that our American diet provides us with only 50-60% of the magnesium we need.  Magnesium is a cofactor in an incredible number of enzymes.  It’s also crucial for bone health.  And what you measure in your blood is not an accurate reflection of your body’s total stores.   You can be very deficient and be virtually unable to tell.  And eating lots of acid producing foods flushes magnesium out of your body in the same way you flush out potassium.  The burden of acid is accentuated by table salt (sodium), so our high sodium diet in America is part of the cause of our low magnesium diet.  Eating plain Magnesium Sulfate has one immediate effect, not to be discussed in polite company.  You don’t absorb much when you eat it that way, that’s for sure.  But you do when you eat magnesium bound up in foods within the proteins and enzymes in those foods.

WWW: What Will Work for me.  Spinach (all greens), queens of magnesium.  Green leafy vegetables are terrific sources of magnesium.  Cut the salt, it makes you drain magnesium.  Three servings (3.5 oz=a serving) of vegetables and fruits for every meat.   Make it fish, or chicken.  And cut the cheese.  Any grains gotta be WHOLE.  And coffee.   Tons of magnesium in coffee.  Finally, something I like.