Team McCallum

R&D for Lifetime of Life

Udiet: the battlefield.

2010 was stuffed with debate over the reasons why people in developed countries are getting heavier.

 The most simplistic explanations focussed on overeating, or inactivity, or both. HFCS (high fructose corn syrup) also came in for a beating. The problem with this is that Europe imports very little HFCS, but countries in Europe are reporting more and more problems associated with obesity.

 www.obesitymyths.com comes up with a much larger range of interesting possibilities. But in 2005, the New York Times linked this site to sponsorship from fast food producers such as Coca-Cola and McDonald’s, in this article.

Two reputable groups of scientists published work where they found that the mantra of ‘eat less and exercise more’ doesn’t cover all of the potential reasons.

 A government group in the UK called Foresight was asked to predict what will happen there over time, based on best evidence, and building in realistic assumptions. In order to do so, they had to scour published research to identify the drivers of obesity and build a very detailed model of which drivers are most important. Written in simple English, this is probably the best explanation there is of the obesity epidemic.

The full report is available as a free PDF download here. However, at over 160 pages, it won’t be everyone’s cup of tea.

The second group of scientists published a summary of obesity drivers in November 2009. Again, this is available free using this link.

Their findings outline the battlefield for the Udiet.

1. Overeating, particularly re heavily marketed energy dense foods.

2. Underactivity, again with an organisation driver behind it.

3. Infection caused by bacteria and viruses.

4. Epigenetics, whereby prenatal and early postnatal exposure to the environment alters how genes are expressed without changing the genes. For example, babies born very underweight at birth who are incubated and fed rich diets to catch up weight have a higher risk of obesity and associated issues later in life.

5. Increasing maternal age. Animal studies have shown that babies born to older mothers are fatter than those born to younger mothers.

6. BMI breeding effect. Studies have found that those with a body mass index somewhat above average are producing slightly more children, on average, than the rest of the population, causing the population BMI to increase over time.

7. Assortitative mating is taking place. This hypothesis is that those with higher BMI prefer partners of similar kind, and due to the genetic effect, this leads to even heavier children. A wide range of population studies support this idea.

8. Sleep debt is happening, and leads to increased eating, increased fat deposition and lowered activity. Research shows metabolic changes occur to support this, and also leads to higher risk of diabetes and heart disease. For example, one study shows that getting one and a half hours less sleep than ideal over a two week period results in a diabetic-like profile for glucose and insulin.

9. Endocrine disruptors interfere with estrogen and androgen signalling, and have been building up in the human environment for some time.  These have been found to be involved in obesity in animals and in humans.

10. Commonly used medicines are known to contribute to weight gain. These include medicines for diabetes, high blood pressure, steroids, contraceptives, and anti-histamines.

11. Artificial ambient temperature. The hotter your environment, the less energy you burn keeping warm. The UK home went from 13 centigrade in 1970 to 18 centigrade by 2000. US homes went from 18 centigrade in 1923 to nearly 25 centigrade in 1986.

12. Mothers input. The state of the mother’s glucose and insulin handling systems directly affect the number of fat cells and the fat cell content of the baby.

13. Reduction in smoking rate. The scientists considered this so well documented they excluded it from their list.

14. Altered US demographics. A 2006 article along the same lines had found that alterations in the US population were increasing the races which tend toward higher BMI, therefore  increasing the average BMI of the nation.

The aim of the scientists’ report was not to remove the first two reasons from focus, but to show that the battlefield is considerably more complex than simply food and exercise.

These 14 points are not comprehensive. For example, other researchers have found that altering the circadian rhythm, by staying up late in artificial light and not synchronising your body clock to early morning light, is also a risk factor for weight gain. Also, breastfeeding v formula milk wasn’t mentioned, although formula milk is associated with higher risk of obesity.

January 9, 2011 Posted by | Activity, BMI - body mass index, Breastfeeding, Child Health, CVD - cardiovascular disease, Diabetes, Environment, Epigenetics, Exercise, HFCS - high-fructose corn syrup, High blood pressure, Obesity, Pregnancy, Pregnancy, Success, Thermogenesis, UK, United States, Weight management | Leave a comment

What you should know about SICK fat.

The International Journal of Clinical Practice is running a special section in its December issue covering male health. Dr Harold E Bays, Dr Joseph M Gonzalez-Campoy, and Dr Alan B Schorr, 3 experts in metabolic syndrome and related conditions, have written a reference summary on the topic.

It is called “What men should know about metabolic syndrome, adiposopathy and ‘sick fat’, but it also covers women. So it’s really a summary of adiposopathy, where ‘adiposo’ means fat, and ‘pathy’ means sick or diseased, hence SICK FAT.

The article is free, and quite short, but it is fairly technical.

In simple English, the 3 doctors are suggesting that metabolic syndrome is a rather loose term covering a series of problems that lay people understand better in other terms – high blood pressure, blood fats that are wrong, blood sugar level wrong, type 2 diabetes and increased risk of cardivascular disease (CVD) and other illnesses.

The first key point is that fat is not an inactive store of calories. It has a wide range of hormonal functions essential for human health. So there is ‘good’ fat.

However, visceral fat (that stored around the organs inside the abdomen) can turn from healthy fat into sick fat (adiposopathy). Sick visceral fat does not look like or work like healthy visceral fat. When it turns sick, it churns out a range of inflammatory substances, increases blood pressure and unbalances a range of hormones.

It decreases testosterone levels in men and increases them in women, closing the gender gap. “One of the biochemical consequences of obesity is often a closer approximation of the genders with regard to sex hormone levels.”

There is a quick review of all the major treatments for metabolic syndrome diseases, ranging from exercise and good diet through all the major medications to bariatric surgery (stomach bypass or banding). This shows the impact on blood sugar levels, blood pressure and blood fat profiles work similarly across all.

The experts then discuss which path is wiser – treating the results of sick fat, or curing the sick fat. They concluded “An emerging concept is that the development of antiobesity agents must not only reduce fat mass (adiposity) but must also correct fat dysfunction (adiposopathy).”

They conclude that scientists have known about the disease-causing potential of fat for more than 50 years, but that it is only in the last 10 years that fat has been thought of as being a major active component in the human hormone system.  “Clinicians may find that: ‘A discussion as to how increasing body weight may cause their fat to becomesick,or how losing body weight may cause their fat to becomehealthier, might be better than discussing the diagnostic components defining themetabolic syndrome.’”

The only notable omissions from an excellent round-up are – why visceral fat turns sick in the first place – and – whether there is a smarter or faster way to cure sick fat than simply overall weight loss.

Our recent articles on fructose (in the form of pure fruit drinks) and sugar-sweetened beverages suggest that both dump in more fructose than the body can handle at one go. This suggests one trigger for making it sick, and one way to cure it faster, though this is unlikely to be the only cause/cure.

Click here for a full copy of the article by the 3 doctors.

November 15, 2010 Posted by | Adiposopathy - sick fat, CVD - cardiovascular disease, Diabetes, Diet, Exercise, Gastric banding, Health, HFCS - high-fructose corn syrup, High blood pressure, Metabolic syndrome, Obesity, Soft drinks, Success, Weight management | Leave a comment

Fructose v gout.

Two years ago, Dr Hyon K Choi reported in the British Medical Journal that fructose raised the risk of gout in men. Now, in the Journal of the American Medical Association, Dr Choi has reported the same findings in women.

Gout affects around 5% of women in their 70s, and rates of gout have been rising in the US, nearly trebling between 1977 and 1996.

This increase corresponds with an increase in fructose consumption in sweetened soft drinks and fruit juices. These drinks contain large amounts of fructose, the only carbohydrate known to increase uric acid levels in humans, leading to gout.

It has been shown that the increase in uric acid for a given load of fructose is higher in people prone to gout or with a history of high uric acid than it is in the general population.

Emerging evidence is linking gout to insulin resistance, metabolic syndrome, diabetes, heart attacks and premature death.

For this study, Dr Choi used the Nurses Health Study, which provided detailed information on the diet of 79,000 women from 1984 to 2002.

Known risk factors for gout include alcohol consumption and body mass index (BMI), while dairy is protective. Dr Choi stripped these out to look at the impact of other factors.

Compared to drinking less than one drink/month, women drinking 1 drink of sweetened soft drink had a 74% higher risk of getting gout, and on 2 or more servings/day the risk was increased by double this (140%). When looking at juice (which has natural fructose) the risk was 41% up for 1/day, and 140% up for 2/day. The drink sizes here are 6oz, while a standard US/UK drink size is 12oz/33cl.

As with the study in men, diet soft drinks did not increase the risk of gout.

Some media reports named orange juice as a culprit, but Dr Choi’s full report shows that this came from the simple fact that much more orange juice was being consumed than apple juice or other fruit juices. The fructose content of most fruit juices is quite similar to that of orange juice, so should lead to the same effect.

November 12, 2010 Posted by | Alcohol, CVD - cardiovascular disease, Diabetes, Gout, Health, HFCS - high-fructose corn syrup, Metabolic syndrome, Soft drinks, Success | 1 Comment

Sugared drinks v diabetes.

Dr Frank B Hu and 5 colleagues in N America have found that sugar-sweetened drinks, even at a low level, are linked to an increased risk of type 2 diabetes and metabolic syndrome. This effect is independent of any impact the sweetened drinks have on weight or on total calorie consumption. Further, it kicks in at levels as low as 1 to 2 standard size drinks per day.

The research team combed medical literature for good quality studies, in order to combine them. They found 8 studies of sugar-sweetened drinks and type 2 diabetes, covering 311,000 people, and 3 studies for metabolic syndrome, covering nearly 20,000 people.

From these they calculated that 1 to 2 sweet drinks per day, compared to less than 1 per month, raised the risk of type 2 diabetes by 26% and metabolic syndrome by 20%. One drink was a standard 12 oz size in the US, which is slightly larger than the 330 ml size in Europe. They found the result was dose-dependent, so more soft drinks increased both risks.

They concluded “In addition to weight gain, higher consumption of sugar-sweetened beverages is associated with development of metabolic syndrome and type 2 diabetes.” 

The full research paper shows that the sweetening component has quite different effects depending on whether it is fructose, glucose or an artificial sweetener. However, in the form of an added sweetener at this magnitude all have undesirable health effects.

The paper also references other research to show that the preferred US sweetener, HFCS (high fructose corn syrup, a 55/45 mix of fructose and glucose) and the standard European sweetener (sucrose, a 50/50 mix of fructose to glucose) both increase the risk of metabolic syndrome and type 2 diabetes through not only weight gain but through other paths. These extra paths include increased dietary glycemic load leading to insulin resistance, beta-cell disruption and inflammation. Further problems are hypertension and an increase in visceral fat (bad fat).

These findings dovetail neatly with recent research that there are good carbs and bad carbs.That report is here.

As soft drinks increase visceral fat, and both increase the risk of type 2 diabetes, this may explain why US adults have larger waist sizes than their UK equivalents, and also twice the rate of diabetes. That report is here.

October 28, 2010 Posted by | Diabetes, Diet, Frank B Hu, Glycemic index, Health, HFCS - high-fructose corn syrup, Metabolic syndrome, Obesity, Soft drinks, Success, Sugar, UK, United States, Waist circumference, Weight management | Leave a comment

Fructose intolerance?

At a meeting of the American College of Gastroenterology, two doctors have reported that in children with frequent unexplained abdominal pain the reason is often fructose intolerance. The solution, a low-fructose diet, had the bonus of cutting excess weight in many cases.

Dr Daniel Lustig and Dr Bisher Abdullah examined 245 children aged 2 to 18 with chronic abdominal pain which could not be explained with known medical conditions. A 1990 study of women with irritable bowel syndrome had implicated fructose intolerance or malabsorption, so the doctors carried out a simple test. The patients were given a dose of fructose and their breath was tested for hydrogen.

Just over half (54%) tested positive, so they were referred to a dietician. Of those referred, two thirds had complete resolution of symptoms, with a strong link between sticking to the low-fructose diet and reduction of problems.

Many of the kids were overweight or obese when first seen by the doctors, and a side advantage was significant weight loss on the low-fructose diet.

Fructose appears naturally in fruit, some vegetables and honey. It is also present in sugar and HFCS (high fructose corn syrup), which are common in packaged food.

According to Dr Lustig “The challenge is finding those foods with low fructose and still maintain a healthy nutritional balance that patients will adhere to, especially teenagers”.

While Dr Abdullah noted “The principal culprit in many cases was fructose-sweetened soft drinks. The human body was not designed to handle that much fructose”.

There was no information on whether cutting out fructose-sweetened drinks alone made an improvement.

October 19, 2010 Posted by | Child Health, Diet, Health, HFCS - high-fructose corn syrup, IBD, Obesity, Soft drinks, Success, Sugar, Weight management | Leave a comment

Cancer, fructose, HFCS.

Dr Anthony Heaney has found that pancreatic cancer gets fuel from both fructose and glucose, in two quite different pathways. This suggests that blocking one of the pathways might cut the risk of cancer.

The results came from experiments with human cancer cells in Petri dishes, but should apply in real life.

It is likely that the twin pathway finding applies to other cancers as well.

That’s the science. Then there is the press release from the University of California Los Angeles.

The source of fructose in the Western diet is high fructose corn syrup (HFCS), a corn-based sweetener that has been on the market since about 1970. HFCS accounts for more than 40% of the caloric sweeteners added to foods and beverages, and it is the sole sweetener used in American soft drinks.

Between 1970 and 1990, the consumption of HFCS in the US has increased over 1,000%, according to an article in the April 2004 issue of the American Journal of Clinical Nutrition.

“I think this paper has a lot of public health implications,” Heaney said. “Hopefully, at the federal level there will be some effort to step back on the amount of HFCS in our diets.”

HFCS is typically 55% fructose and 45% glucose. Sucrose – table sugar – is broken down by the stomach to its components – 50% fructose and 50% glucose. Fructose is the natural sweetener in honey and fruit.

Europe consumes almost no HFCS, and sweetened soft drinks are made with sucrose. Europe is far from obesity-free or cancer-free.

A recent study of UK consumption over the last 20 years found total sugar consumption per person was unchanged. Table sugar and sugar from cakes and biscuits had declined, while sugar in soft drinks had made up for this.

If you want to cut your risk of obesity or cancer, cut the empty calories of sweetened soft drinks, whether they are HFCS (US) or sucrose (Europe).

August 4, 2010 Posted by | Anthony Heaney, Cancer, Diet, HFCS - high-fructose corn syrup, News, Obesity, Soft drinks, Success, Sugar | 1 Comment

Sugar raises blood pressure.

Prof Liwei Chen studied the blood pressure of 810 adults, with mild to moderately elevated blood pressure, over a period of 18 months. After stripping out other factors, she found that cutting sugar-sweetened drinks lowered blood pressure.

One drink per day equated to 1.8mm systolic and 1.1mm diastolic. Part of this effect was due to weight loss, but when that was factored out, the results remained significant. This level represents a 5% change in risk of death by stroke and a 3% change in risk of death by heart attack.

One drink is 12oz US, pretty close to a 330ml can size in the UK.

According to Chen – “We found no association for diet beverage consumption or caffeine intake and blood pressure, suggesting that sugar may actually be the nutrient that is associated with blood pressure and not caffeine which many people would suspect.”

Sugar-sweetened drinks were defined as those sweetened with sugar or high-fructose corn syrup including regular soft drinks, fruit drinks, lemonade and fruit punch.

May 25, 2010 Posted by | Coffee, CVD - cardiovascular disease, Diet, Health, HFCS - high-fructose corn syrup, High blood pressure, Liwei Chen, Soft drinks, Stroke, Success, Sugar | Leave a comment

High-fructose corn syrup row.

Princeton University issued a press release yesterday on studies by Professor Bartley G Hoebel and team, which looked at the effect of high-fructose corn syrup (HFCS) on rats.

It states that rats with access to high-fructose corn syrup gained significantly more weight than those with access to table sugar, even when their overall caloric intake was the same. Long-term consumption of HFCS led to abnormal increases in body fat, especially in the abdomen, and a rise in circulating blood fats called triglycerides.

The full press release covers much more.

The Corn Refiners Association responded with its press release.

This attacks the Princeton study on 3 issues – that the rats were getting an equivalent of 3,000 calories per day from HFCS alone, way over total daily energy itake in humans – that the researchers did not have controls on consumption of sucrose (table sugar) – and that rat studies are not applicable to humans.

There is more in the CRA response here.

The research was published on-line on 26 Feb 2010 by Pharmacology Biology and Behavior.

There were 2 experiments, the first in male rats lasted 8 weeks and the second looked at male and female rats over 6 months (long-term).

In the first “Rats with 12-hour access to HFCS gained significantly more body weight than animals given equal access to 10% sucrose, even though they consumed the same number of total calories, but fewer calories from HFCS than sucrose.”

In the second “Both male and female rats with access to HFCS gained significantly more body weight than control groups. This increase in body weight with HFCS was accompanied by an increase in adipose fat, notably in the abdominal region, and elevated circulating triglyceride levels. Translated to humans, these results suggest that excessive consumption of HFCS may contribute to the incidence of obesity.”

The research abstract is here.

March 23, 2010 Posted by | Bartley G Hoebel, Diet, Health, HFCS - high-fructose corn syrup, Obesity, Weight management | Leave a comment