Diigo Links

Thursday, July 19, 2007

If you follow one link from this website, let it be this one

Health Report - ABC Radio National - Fructose and your Liver

What's a blog good for if you can't use it to force-feed ideas on people you know? I've emailed this link to a couple people because I was so moved by it, but instead of emailing it to you I'm going to set it down gently to rest here for a while. It may be followed, the contents may be read, and lives could be changed. Who knows? And I don't think it's an exaggeration to say "lives could be changed". I've got some history here, which I will relate. But first, what are we talking about?

Fructose. Not to be confused with the hub-ub over High Fructose Corn Syrup (HFCS), but maybe including it. This is only the story of fructose and your liver. The broad strokes:

"Insulin's job is to store energy, insulin's job is to make you gain weight."

"when your insulin is high and you're storing energy you make another hormone, and that hormone is called leptin, and leptin is supposed to go to your brain and tell your brain that you've eaten enough."

"So when you can't see your leptin your brain thinks you're starving, you feel crappy, you certainly don't want to exercise and you're going to eat more."

"So we see these children with brain tumors who can't see their leptin and we asked the question -- could we somehow influence this disastrous feedback cycle? What we did is we gave a drug called Octreotide and we knocked down their insulin levels with this medicine and all of a sudden, not only did these kids stop eating, they started exercising spontaneously, they just did it."

"by getting the insulin down instead of the energy that they were eating being forced to fat, the energy that they were eating could now be burned by muscle, could now be burned by the rest of the body, made them feel better."

"what causes the leptin resistance, what causes you to not be able to see your leptin? "

"in fact exercise is the best treatment. The question is why does exercise work in obesity? Because it burns calories? That's ridiculous. Twenty minutes of jogging is one chocolate chip cookie, I mean you can't do it. One Big Mac requires three hours of vigorous exercise to work that off, that's not the reason that exercise is important, exercise is important for three reasons exclusive of the fact that it burns calories."

"The first is it increases skeletal muscle insulin sensitivity, in other words it makes your muscle more insulin sensitive, therefore your pancreas can make less, therefore your levels can drop, therefore there's less insulin in your blood to shunt sugar to fat. That's probably the main reason that exercise is important and I'm totally for it."

"The second reason that exercise is important is because it's the single best treatment to get your cortisol down. Cortisol is your stress hormone, it's the hormone that goes up when you are mega-stressed, it's the hormone that basically causes visceral fat deposition which is the bad fat and it has been tied to the metabolic syndrome. So by getting your cortisol down you're actually reducing the amount of fat deposited and it also reduces food intake. People think that somehow exercise increases food intake, it does not, it reduces food intake."

"And then the third reason that exercise is important, which is somewhat not well known, but I'm trying to evaluate this at the present time, is that it actually helps detoxify the sugar fructose. Fructose actually is a hepato-toxin; now fructose is fruit sugar but we were never designed to take in so much fructose. Our consumption of fructose has gone from less than half a pound per year in 1970 to 56 pounds per year in 2003."

"it's not the calories that are different it's the fact that the only organ in your body that can take up fructose is your liver. Glucose, the standard sugar, can be taken up by every organ in the body, only 20% of glucose load ends up at your liver. So let's take 120 calories of glucose, that's two slices of white bread as an example, only 24 of those 120 calories will be metabolized by the liver, the rest of it will be metabolized by your muscles, by your brain, by your kidneys, by your heart etc. directly with no interference. Now let's take 120 calories of orange juice. Same 120 calories but now 60 of those calories are going to be fructose because fructose is half of sucrose and sucrose is what's in orange juice. So it's going to be all the fructose, that's 60 calories, plus 20% of the glucose, so that's another 12 out of 60 -- so in other words 72 out of the 120 calories will hit the liver, three times the substrate as when it was just glucose alone."

"There's clear scientific evidence on the fructose doing three things that are particularly bad in the liver. The first is this uric acid pathway that …., the second is that fructose initiates what's known as de novo lipogenesis."

1. "causes an increase in uric acid. Uric acid is an inhibitor of nitric oxide, nitric oxide is your naturally occurring blood pressure lowerer. And so fructose is famous for causing hypertension."

2. "Excess fat production and so VLDL, very low density lipoproteins (bad form of cholesterol) end up being manufactured when you consume this large bolus of fructose in a way that glucose does not"

3. "the last thing that fructose does in the liver is it initiates an enzyme called Junk one, and Junk one has been shown by investigators at Harvard Medical School basically is the inflammation pathway and when you initiate Junk one what happens is that your insulin receptor in your liver stops working"

"when your insulin receptor doesn't work in your liver that means your insulin levels all over your body have to rise. "

"-- why do you need fructose in pretzels, why do we need fructose in hamburger buns?"

"This has nothing to do with one fructose meal, this has to do with a year's worth of fructose meals, or a lifetime's worth of fructose meals, because as you become insulin resistant, which fructose clearly does and has been shown by many investigators not just me -- that interferes with that leptin signal which causes you to eat more"

"sucrose is half fructose. You know a lot has been made over this high fructose corn syrup being particularly evil. In fact high fructose corn syrup is either 42% or 55% fructose, the rest is glucose. Well sucrose is 50% fructose the rest is glucose. In fact high fructose corn syrup and sucrose are equally problematic".

"Fibre turns any food into a low glycaemic load food. In fact we are supposed to eat our carbohydrate with fibre, that's the key. Processed wheat is white, when you go out into the field it's brown but by the time it gets to your bakery it's white. What happened? Well the bran was stripped off, well the bran is the good part, the bran is what we're supposed to be eating."

So that's the arc of the article. Also mentioned in the article is the fact that fructose acts on the liver in exactly the same way as alcohol. But we generally know when we're taking alcohol, and we don't pack kids' foods full of alcohol. As an adult, however, you have to keep in mind that the cycle described above applies to alcohol too.

I mentioned up the top that I have a bit of history with fructose. In 1990 I moved out of the family home, went to university, and turned vegetarian. But in turning vegetarian I didn't bother to turn full macro, live, active, vegan health food nut. I was more the type of vegetarian who continues to eat all the same crap your average teenager eats (like cereal for dinner), except meat. That general diet continued through to early 2007, or late 2006. At that point I started eating meat, but I didn't stop eating all the crap your average teenager eats.

It wasn't until a couple months back that I took hold of my diet and made a conscious decision about the things I would eat. I didn't do this to lose weight, although it was done under the guise of a "fat off" competition with some mates. I did it to improve my affective range, which is to say mood. I also did it to get more energy from the things I eat in order to have more fun doing what some people would consider exercise. I just call it fun ( primarily riding bikes, but some running also).

Three weeks into this diet I noticed a dramatic change in mood, an increase in energy, better sleep, less need for sleep. Just three weeks after that and other people started to notice weight loss. I lost 6kg without changing my exercise regime at all ( which consists of a 40min ride at lunch as often as possible, so 3-4 days/wk).

And what was this diet? I've written about it before as the "sharp stick" diet. As close as I could get, I was trying to stick to the Paleolithic diet. The idea of this diet is to only eat the types of things that would have been available to cavemen wearing a loin cloth and wielding a sharp stick as a hunting weapon. It's a sort of lowest common denominator diet.

I've steadily been drifting away from the strict sharp stick diet. But I've kept sugar off the menu. I've continued to lose weight (and feel good: energy, mood, etc.). I'm now down 10kg from my highest weight earlier this year. And I've begun to look for foods that'll help me to put the weight back on.

What I've noticed in reading the Health Report article, and a key thing I noticed when starting the sharp stick diet, is my addiction to sugar. I've been totally addicted to sugar for years, and the article above details how and why that's affected me the way it has.

One "for instance": a couple years back, totally out of the blue, some kidney stones smited me down. What are kidney stones? Crystalline accretions of uric acid, similar to gout in the kidney. Why would I, who at the time was very active and very fit, come up with kidney stones? Elevated uric acid. Where did that come from? Elevated red wine intake combined with elevated sweets intake. Where did that come from? Well, I was falling in love and lots of chocolate and wine went along with that.

Another: What I now believe to be gout in my elbow. Same uric acid scenario, but also related to working in a high sugar environment (office too close to the company store packed with cheap candy).

I could go on and on with examples. But having seen what a stint on the sharp stick diet can do, and having read the Health Report article linked to above, I'm sticking to a very low sugar diet, infrequent alcohol consumption, and reading labels with an eye for fructose, sucrose and sugar. You read, you do, you see what it holds for you. I'm converted.

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