How Stem Cells may be the Primary Culprit in Heart Disease

Here is an interesting link to an NPR “Science Friday” discussion with a Stanford researcher that points to adult stem cells as the primary cause of plaque generation leading to heart disease.

This still leaves the debate open on what the primary culprit of the vascular injury process actually is.  What is injuring the cell lining that leads to stem cell accumulation and the subsequent plaque (i.e. “scar tissue”) formation?  It may be that damage to the endothelial cells of the vessels is caused by small-dense LDL particles (apo-B particles – which are likely elevated on a high sugar, refined carb diet) that are oxidized and then start the foam cell process.  This inflammatory damage then may spark the stem cells to activate and form a plaque (~scar tissue).  I’m no expert though…

Advertisements

Why the French don’t get heart disease despite eating a ton of butter and animal products

Why does the “French Paradox” exist?  Why can the French eat huge amounts of butter, full-fat dairy, and organ meat (all of which contain huge amounts of saturated fat) and yet not have high levels of heart disease in their population?

Besides the fact that saturated fat likely does not cause heart disease (at least, without reaching a simultaneous threshold in carb intake), a protective factor may exist in all of this fatty, animal goodness: Vitamin K2 (specifically, the MK-4, or menatetrenone variety).

It may be that Vitamin K2, found in copious amounts in certain types of butter, eggs, dairy, and meat (including organ meat like foie gras), works with Vitamins A and D to remove calcium from the bloodstream and therefore prevent calcium buildup in arterial plaques (which can lead to heart disease).  This may be why the French have (or had) such low rates of heart disease despite eating huge amounts of saturated fats from animal products.

According to this hypothesis, more Vitamin K2, in conjunction with Vitamins D and A, means less calcium in the blood, and less heart disease.

Dr. Stephan Guyenet, a PhD in Neurobiology, describes this potential link on his blog, Whole Health Source.  He’s crazy smart and crazy prolific so check out his site.

Why Veganism Might Make the Average Meat-eating American Healthier: i.e. it’s the sugar, stupid (this is directed at the now-vegan Bill Clinton, for obvious reasons, not you, the reader)

Disclaimer:  I have a deep and abiding respect for vegetarians and vegans because many choose to forgo eating animals due to ethical and environmental beliefs.  This is valid and honorable.  However, I disagree with them that meat-eating is inherently unhealthy and unnatural for humans (the same goes for saturated fats for the same reasons I’ll discuss).  There appears to be no science (randomized controlled trials) that actually backs up their claims (“The China Study” is neither scientific nor interesting: it is only a single, observational epidemiological study that shows associations, not cause and effect, and is likely confounded and biased (meaning, that the whole host of dietary and lifestyle habits associated with meat-eating in modern-day China, India, and America, might be what  are causing harm, not the meat-eating itself, see Taubes links below for more information).  If anyone does have compelling scientific research showing meat-eating to be bad or vegetarianism/veganism (hereafter referred to as “VV”) good, relative to the other, please let me know.  Thanks.

Here is an interesting video by a former vegan, Denise Minger, that highlights logical flaws in vegetarian/vegan (VV) arguments against meat-eating in terms of human health.  I am not addressing environmentalism or ethics here, just human health.

Her snarky, mocking tone aside, she makes a lot of good points, namely: that VV are associated with A LOT of different lifestyle and nutritional changes that make VV followers different then the average American meat-eater.  And that, ultimately, it may be the fact that VVs are eating less sugar, refined grains and starches (i.e. potato chips), drinking less, smoking less, meditating more, exercising more, blah blah blah that gives them a protective shield against insulin resistance and metabolic syndrome relative to the average American meat-eater (at least in America – in India, VV’s may be just as fat, if not more so, then non-VVs).

Plus the fact that a gillion recent randomized controlled trials comparing a high meat, low carb diet to a more-vegetarian, higher carb diet show the high-meat diet leading to lower body fat and better heart health (at least in obese people up to two years when “heart health” is defined as higher HDL, lower tryiglycerides, and less small-dense, apo-B, LDL particles).

Interestingly, when you look at diabetes and obesity in India, these diseases may be as or more common in the vegetarian populations than in meat-eating ones (I say may because I cannot find a high-quality, nationally-representative study assessing obesity relative to food intake in India that states this and am simply going off of anecdotal evidence: my boss, who is Indian, says obesity is rampant among India’s vegetarian populations and I witnessed this firsthand at a recent party at my wife’s Indian friends’ house: around 10 of the 12 native Indian people that I met at the recent party all were overweight or obese yet vegetarian (btw, dinner consisted of copious fried bread, i.e. samosas, and sweets)).  This is obviously not a scientific observation but it’s an important one nonetheless.

I think again, at least in certain Indian populations (mainly the urban elite), that vegetarianism is associated with sugar and refined carb intake (possibly the main drivers of insulin resistance and “diabesity”) just as meat-eating is associated with sugar and refined carb intake in America (or in any population that becomes wealthier – meat AND sugar intake increase in tandem, except in historically-VV populations such as in India).  Both nutritional habits are proxies for sugar intake (which is why I think VVs and paleos should unite against processed, high-sugar, high-refined carb, fake food to save our nation from our diabesity quagmire).

I am not aware of any studies that claim to show the benefits of a no-meat diet that actually compare only the individual meat variable, which is what you have to do to make claims that meat is bad for your health.  Since these studies do not do this, one cannot say that meat is inherently unhealthy (omega-6:omega-3 ratios aside).  And studies that make this claim, like Walter Willet’s latest Nurse’s Health Study laugh-riot, likely do not fully control for differences between the average American VV and meat-eater in their study (though Dr. Hu claims they did isolate the independent effect of meat on mortality here) (if you want a great example of how bad this study and observational epidemiology can be, at least in terms of how it’s used by health authorities and interpreted by today’s media, read this and this by Gary Taubes).

I think Willett’s results may be self-fulfilling: i.e., 40 years ago, health authorities came to believe that saturated fat >raised total cholesterol>heart disease and therefore, because meat (especially red meat and organ meat) has a lot of saturated fat, everyone who wants to be healthy should eat less of it.  Therefore, people who wanted to be “healthy” ate less meat, and also smoked less, drank less, exercised more, were likely wealthier and more educated (higher SES)…this means that the Nurse’s Health Study cohort was full of some people, who Taubes calls “the girl scouts” of the group, who did all of these healthy things together and also ate less red meat.  So when we examine CVD (cardiovascular disease ie. heart attack and stroke) and total mortality between the highest meat eaters vs. the lowest meat eaters (the VVs or “girl scouts” of the cohort), it might be that the meat>death association is confounded by differences in smoking, drinking, weight, BP, diabetes, SUGAR intake (which was not “controlled for” or excluded in their mathematical models), exercise habits, SES, etc.  This means that all of these related factors that track with high meat consumption could be making the “anti-girl scouts” less healthy and more at risk of death than the VV “girl scouts.”  Therefore, it might not be the meat, but all of the factors, especially sugar/HFCS (HF 55, or, high fructose corn syrup) that, at least in America over the past 40 years, trend, associate, correlate, are linked to meat consumption.  Meaning, it may be the sugar, not the meat itself (or possibly an interaction from the two).

To summarize Minger’s point from her video above, Dean Ornish tells his patients to not eat sugar, refined carbs, vegetable oils, drink alcohol, and to exercise and meditate more, all while improving their social networks and then states that it is the vegetarian aspect of his diet that makes people better.  He cannot do this while claiming to be a true scientist.  Obviously, any or all of these variables could be at work in promoting weight loss and better heart health compared with the typical, modern-American diet (lots of refined carbs, sugar, processed meats, no exercise, stressful jobs, etc.).

It is simply scientifically incorrect, and quite idiotic, to assign causal blame to ONE factor in this huge group of lifestyle changes that separate an American VV from the average American meat eater.  Personally, I think the main difference may be  the differences in sugary drink and sugar/HFCS intake but that’s just a guess.

Until vegans actually conduct (well) a large, randomized controlled trial where they randomize, let’s say, 1000 (or 1 million) obese subjects onto a VV diet (with low refined carbs and sugars) and another 1000 onto, let’s say, a Paleo diet (basically a vegan diet plus animal products), and follow them for 10-50 years, all their talk is just that: talk.  Unfortunately, such a study would be insanely expensive so we’ll likely never know.  It’s probably best if VVs and paleos turned their sights away from each other and towards the processed food industry because, again, it’s likely the sugar and refined grains/starches (and maybe artificial fats like vegetable oils) that are killing Americans, not meat itself.

Btw, humans likely evolved bigger brains and smaller GI tracts with the advent of hunting and likely need meat to reach their full health potential (i.e. for their genotype to be expressed as the healthiest human phenotype).

Please send me any comments you may have.

The Paleo Lifestyle Explained by a Harvard PhD Organic Chemist

Here is a 2010 interview with Harvard chemist, Mat Lalonde.  He’s a really smart dude and very articulate and scientifically accurate in his explanation of the current state of scientific research as it relates to human nutrition.

http://life.nationalpost.com/2010/06/10/qa-mat-lalonde-discuss-the-paleo-diet/

All credit for the interview goes to Daniela Andrews of The National Post newspaper.

Why Diets Fail: or, Why so Many Yo-yo Diet, Why Mother Nature is Unfair, and Why It’s Not Your Fault

Summary:

Diets almost always fail because they make you hungry, depressed, and prime your body to regain body fat at a lower caloric level than your pre-diet basal metabolic needs required once normal eating resumes (even with only moderate caloric restriction).  Hence, most people on these diets “yo-yo” between a lower weight and an ever-higher body weight because eating less than the body requires (“semi-starvation”) triggers an abnormal hormonal environment (study) that leads to the inevitable regain of lost fat mass when any form of “normal” eating is resumed (see Lustig video here).   Researchers refer to this as “poststarvation body fat overshooting” and was experienced by, to name one well known, very-strong willed individual, Christian Bale in his efforts to regain weight between “The Machinist” and “Batman Begins” (the reason I say “strong-willed” will become apparent later).

Therefore, if a 6 foot 200 pound man who just dropped 50 pounds eats the same amount of food as a visibly similar 6 foot 200 lb. man who never dieted, the former dieter will get obese again while the lean man will stay lean.  Mother Nature is cruel.  And for the very, very small minority of obese people who successfully lose weight and keep it off, they must starve themselves, literally forever, if they are to remain at their lower weight.  Almost no one can do this.

This means that diets might actually be counter-productive when it comes to body fat loss  and lead to greater weight gain over time .  Yikes.

Unabridged Post:

Whether you’re carrying a few extra pounds, have a “muffin top,” or are so fat that your corpse causes a crematorium to overheat, when you talk to your physician, read a magazine, watch the news, or talk to your cousin who just got their dietitian’s license, you’ll hear the same mantra: you are fat because you eat too much and move too little.  This statement is considered sacrosanct by the top health authorities around the US and the globe (including, but not limited to: the WHO, NIH, CDC, The US Surgeon General, AHA, “Biggest Loser” trainer, Jillian Michaels[ii],[iii],[v],[vi],[vii],[viii]    

They’ll then tell you to “eat less and move more” — as if you hadn’t thought of this.  Do they honestly believe that you, after years and possibly decades of trying to reduce your adiposity, hadn’t actually heard this advice and tried it?!   After all, who wants to be fat in a society that equates obesity with a lack of willpower, maturity, intelligence, class…?  The fact that you, the fat person, know what to do yet cannot do it, means that lean people judge you as “triply” weak and lazy: 1) you got fat so are weak and lazy 2) you know how to get thin yet cannot so are doubly weak and lazy 3) even if you lose weight, you were once fat so are weaker and lazier than a person of similar weight who was never obese.  In reference to #3, obese people who lose weight are even judged, at least in one study, to be less-attractive than people of the same weight/height who never were obese.  This anti-obesity stigma may depend upon which culture we’re looking at as anti-obese stigmas may be stronger in white populations than black populations, at lease in regards to female obesity (obesity).

So you try to lose weight again.  You then go off and buy some running shoes, join a gym, start a bootcamp session, and start counting calories and eating carrots and cottage cheese for breakfast and skinless chicken breast with spinach for dinner for 3 months.

You lose 20-30 pounds. Your clothes fit better.  You’re proud of your accomplishments and people applaud your efforts (usually in a condescending fashion, as if you’re a kid who learned toilet training – and the amount of condescension is probably directly related to how fat you were prior to your efforts).

However, the fact remains that, despite your weight loss, you’re hungry all the time, likely lethargic, , and your libido might dip (if you’re a male, quite literally – pun intended).

You reach your goal weight and consciously or unconsciously decide to reward yourself (and quell the ever-present hunger) by eating like your lean counterparts.  Before you know it, you’ve gained all the weight back.

But HOW!?

Caloric-restriction, i.e. eating less than your body requires for daily metabolic needs, drives the body to enter “starvation mode,” a lovely state of hormonal disorder that includes lowered metabolic rate, hunger, lethargy, depression, low libido, and an ever-present obsession with food.  Secondly, entering this state means that the fat tissue is likely re-regulated to regain its fat stores at a lower caloric level (whether this regulation occurs at the level of the brain’s hypothalmus or the fat tissue itself, is debated).

The sad state of affairs is that the advice to “eat-less and move more” has been ubiqutous for decades (see USDA Dietary Guidelines from 19802010) and yet obviously does not work as we’re still in the midst of an ever-worsening obesity epidemic that is affecting all ages and genders in our nation.

If eating less and moving more does not generate long-term weight loss (and, of more importance, metabolic health, which is the main point of obesity prevention and treatment), then it needs to be abandoned in favor of a better, more effective hypothesis.

What might this hypothesis be?  I’m not sure.  Perhaps it’s all about reducing circulating insulin levels to access our stored fat for fuel (see Peter Attia video).?  Maybe it’s about reducing the palatability of foods to reduce over-consumption(see Stephen Guyenet)?

I think the first step would be to reduce sugary drink consumption through high taxation, restriction on sales in schools, hospitals, etc., and massive education campaigns (see Lustig article and video).

What do you think?  Feel free to comment below or send me  a message.

References:

[ii] WHO. (2011). “Media centre: Obesity and overweight.” Retrieved from: http://www.who.int/mediacentre/factsheets/fs311/en/.

[iii] The Centers for Disease Control and Prevention (2011). Overweight and Obesity: Defining Overweight and Obesity. Retrieved from: http://www.cdc.gov/obesity/causes/index.html

[iv] American Heart Association. (May 5, 2011). “Obesity Information.” Retrieved from: http://www.heart.org/HEARTORG/GettingHealthy/WeightManagement/Obesity/Obesity-Information_UCM_307908_Article.jsp#.T0e_ZPF5F8E.

[vi] NIH, NHBLI. (Nov. 1, 2010). “What Causes Overweight and Obesity?” Retrieved from: http://www.nhlbi.nih.gov/health/health-topics/topics/obe/causes.html.

[vii] US Dept of HHS, US Public Health Service. (2010). “The Surgeon General’s Vision for a Healthy and Fit Nation.” Retrieved from: http://www.surgeongeneral.gov/library/obesityvision/obesityvision2010.pdf.

[viii] National Heart Lung and Blood Institute, National Institutes of Health. (2012). “Balance Food and Activity: What is Energy Balance?” Retrieved from: http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/healthy-weight-basics/balance.htm