tag:blogger.com,1999:blog-1629175743855013102.post6389479508748292789..comments2024-03-28T11:29:46.845-07:00Comments on Whole Health Source: Interview with Aitor Calero of Directo al PaladarStephan Guyenethttp://www.blogger.com/profile/09218114625524777250noreply@blogger.comBlogger42125tag:blogger.com,1999:blog-1629175743855013102.post-5381221456047524872012-09-13T11:18:41.234-07:002012-09-13T11:18:41.234-07:00I'm surprised that you haven't mentioned L...I'm surprised that you haven't mentioned LDL (and HDL) subparticles, wich are much better determinants of cardiovascular risk than total LDL?Anonymoushttps://www.blogger.com/profile/02732819651509564078noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-44072938316347419002012-07-20T09:02:26.309-07:002012-07-20T09:02:26.309-07:00The thin type 2 diabetics probably skinny fat - ha...The thin type 2 diabetics probably skinny fat - have a lot of fat compared to lean muscle. So in a sense they are still over- fat.Suehttps://www.blogger.com/profile/03181442844616803097noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-82818969889465469332012-07-18T12:54:12.335-07:002012-07-18T12:54:12.335-07:00Hi unknown,
There will always be variability in a...Hi unknown,<br /><br />There will always be variability in any biological phenomenon, particularly if it's multi-factorial, so it is not a surprise that obesity and insulin resistance do not have a 1:1 correspondence. Roughly 20% of obese people are resistant to the metabolic effects of excess body fat. The same is true in animals-- genetic background determines to what degree excess body fat causes insulin resistance. <br /><br />Total body fat is highly (inversely) correlated with insulin sensitivity, however it may be because the fatter you get, the more ectopic fat you accumulate in your visceral depots, liver, muscle, etc. Total body fatness is well correlated with fat in these ectopic depots. Although even ectopic fat accumulation may be a marker of tissue energy overload that is not actually itself causal.Stephan Guyenethttps://www.blogger.com/profile/09218114625524777250noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-25958346034595358632012-07-18T12:20:46.477-07:002012-07-18T12:20:46.477-07:00What an interesting site!
http://therealfoodrunne...What an interesting site!<br /><br />http://therealfoodrunner.blogspot.com/Katherine https://www.blogger.com/profile/05010251849843080919noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-8806095009347392852012-07-18T11:47:26.072-07:002012-07-18T11:47:26.072-07:00If insulin resistance is caused by excess body fat...If insulin resistance is caused by excess body fat as Aitor Calero suggests, then why are about 25-30% of obese individuals insulin sensitive (Reaven 2010)? Furthermore, about 16% of normal weight individuals are insulin resistant (McLaughlin, Allison et al. 2004). Shulman’s group has demonstrated that liver fat (more specifically diacylglycerol) is strongly associated with insulin resistance (Kumashiro, Erion et al. 2011). Other research groups have published similar results (Magkos, Su et al. 2012). In addition, the severity of liver disease rather than the degree of obesity is associated with pre-diabetes. It has been suggested that visceral fat may just be an innocent bystander (D'Adamo, Cali et al. 2010).<br />D'Adamo, E., A. M. Cali, et al. (2010). "Central role of fatty liver in the pathogenesis of insulin resistance in obese adolescents." Diabetes Care 33(8): 1817-1822.<br />Kumashiro, N., D. M. Erion, et al. (2011). "Cellular mechanism of insulin resistance in nonalcoholic fatty liver disease." Proceedings of the National Academy of Sciences.<br />Magkos, F., X. Su, et al. (2012). "Intrahepatic Diacylglycerol Content is Associated with Hepatic Insulin Resistance in Obese Subjects." Gastroenterology.<br />McLaughlin, T., G. Allison, et al. (2004). "Prevalence of insulin resistance and associated cardiovascular disease risk factors among normal weight, overweight, and obese individuals." Metabolism 53(4): 495-499.<br />Reaven, G. M. (2010). "The metabolic syndrome: time to get off the merry-go-round?" Journal of Internal Medicine 269(2): 127-136.Jeffreagan2001https://www.blogger.com/profile/03709380861988124485noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-88546068580502737912012-07-18T09:28:28.662-07:002012-07-18T09:28:28.662-07:00Stephan-
Thanks so much for this interview. LOts ...Stephan-<br /><br />Thanks so much for this interview. LOts of information and it seems like a great summary of a lot of key points.Hunter Copelandhttps://www.blogger.com/profile/03232389221957103901noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-5373496263948058462012-07-17T06:46:54.941-07:002012-07-17T06:46:54.941-07:00@FrankG
You made a valid point. Is the same under...@FrankG<br />You made a valid point. Is the same underlying metabolic disorder which ultimately leads to Type 2 diabetes also responsible for the excess fat storage?<br /><br />The answer, from some work published earlier this year, appears to be yes. The disorder is failure of autophagy.<br /><br />'.. Autophagy is a catabolic cellular process involving the degradation of the cell's own components. ...the importance of autophagy in hypothalamic proopiomelanocortin (POMC) neurons, key regulators of energy balance, has not been addressed. The role of autophagy in leptin sensitivity that is critical for the control of body weight and appetite has also not been investigated. We produced mice with specific deletion of autophagy-related 7 (Atg7), an essential autophagy gene, in hypothalamic POMC neurons...[these] mice had increased body weight due to increased food intake and decreased energy expenditure. ...Our findings indicate a critical role for autophagy of POMC neurons in the control of energy homeostasis and leptin signaling. <br />...We and others have reported that autophagy is important in the maintenance of pancreatic β-cell mass, structure, and function...'<br />http://www.ncbi.nlm.nih.gov/pubmed/22334718<br /><br />Another paper published this year, about exercise-induced autophagy, says this:<br />'..in animal models, autophagy protects against diseases such as cancer, neurodegenerative disorders, infections, inflammatory diseases, ageing and insulin resistance. ..'<br />http://www.ncbi.nlm.nih.gov/pubmed/22258505?dopt=Abstract&holding=npgJanehttps://www.blogger.com/profile/18175128589806816624noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-22598757724240122702012-07-17T00:40:55.525-07:002012-07-17T00:40:55.525-07:00I learned a lot from him. Such a man with strong w...I learned a lot from him. Such a man with strong words.<br /><br /><a href="http://bellavitabags.com/" rel="nofollow">wine packaging</a>reginaghttps://www.blogger.com/profile/04885572472017596718noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-4192972499076402322012-07-16T18:45:20.171-07:002012-07-16T18:45:20.171-07:00Most of the genes associated with type 2 affect in...Most of the genes associated with type 2 affect insulin secretion, not insulin resistance. Yes, higher weight in general means higher insulin resistance. But people without "diabetes genes" just secrete more insulin to compensate.<br /><br />So is type 2 caused by IR or wimpy beta cells? Probably both. And ethnic groups with a lot of genetic IR can become diabetic by putting on only 10 pounds.<br /><br />There may also be factors we haven't discovered yet. Some people blame toxins.<br /><br />Type 2 diabetes is polygenic and complex. It's too easy to blame weight gain alone.<br /><br />BTW, that 58% statistic from the DPP was one of those statistics that magnify a small effect.Gretchenhttps://www.blogger.com/profile/17019921800841883073noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-47789218329560089032012-07-16T14:19:21.041-07:002012-07-16T14:19:21.041-07:00This comment has been removed by the author.FrankGhttps://www.blogger.com/profile/01980497914756341565noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-55214526763479425942012-07-16T13:57:05.154-07:002012-07-16T13:57:05.154-07:00This comment has been removed by the author.FrankGhttps://www.blogger.com/profile/01980497914756341565noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-4796962607510043232012-07-16T13:41:35.165-07:002012-07-16T13:41:35.165-07:00I believe something like 80 % of people who have t...I believe something like 80 % of people who have type II diabetes are over fat or obese.<br /><br /><br />I have heard and read , (as Stephan pointed out), that weight loss can help. Only losing a good 10 pounds can cause disproportionate health benefits. The normilization of one's body weight is not necessarily needed to have tremedous health benefits from only losing 15 pounds.<br /><br />I think Manuel is an exception. If it is true then it surprises the hell out of me. LOL !<br /><br />But, yes about the remaining 20 % ( who are normal weight to thin) have type II diabetes. <br /><br />In general, the more fat you gain the worse the outcome for increasing yuor type II diabtetes risk, especially if your lifestyle is bad as well. <br /><br />People like Stephan, Dr. Michael Rosenbaum and Dr. Douglas Coleman are more qualified to speak about this though. I am not that well versed on this particular subject, or at least not in great detail.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-47011501171546851482012-07-16T13:18:42.397-07:002012-07-16T13:18:42.397-07:00Hi FrankG,
The reality is that my statement is ba...Hi FrankG,<br /><br />The reality is that my statement is based on a variety of lines of evidence, both observational and controlled. <br /><br />Insulin resistance, in combination with eventual beta cell failure, is what underlies T2 diabetes. Overfeeding increases insulin resistance, and fat loss by almost any means imaginable (including simple calorie restriction, low-fat diets and exercise) increases insulin sensitivity. <br /><br />Experimental studies have shown repeatedly that changing fat mass affects insulin sensitivity exactly as one would expect, and calorie restriction lowers nearly all known type 2 diabetes risk factors except your genes. The huge DPP trial showed that weight loss and exercise reduced diabetes incidence by 58% over 2.8 years (www.ncbi.nlm.nih.gov/pubmed/11832527). Here's a quote from a follow-up study:<br /><br />"Weight loss was the dominant predictor of reduced diabetes incidence (hazard ratio per 5-kg weight loss 0.42 [95% CI 0.35–0.51]; P < 0.0001). For every kilogram of weight loss, there was a 16% reduction in risk, adjusted for changes in diet and activity. Lower percent of calories from fat and increased physical activity predicted weight loss. Increased physical activity was important to help sustain weight loss."<br />www.ncbi.nlm.nih.gov/pubmed/16936160<br /><br />I understand that these facts are inconvenient for the particular brand of unscientific noise that's been circulating lately, but unfortunately biology has no regard for wishful thinking.Stephan Guyenethttps://www.blogger.com/profile/09218114625524777250noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-19268920506496276972012-07-16T10:03:22.627-07:002012-07-16T10:03:22.627-07:00Supposedly, the world's former heaviest man, M...Supposedly, the world's former heaviest man, Manuel Uribe, who once weighed 1,234 pounds ( small Japanese cars come in lighter than that) had/has no high blood pressure, no high cholesterol, no diabetes. Supposedly.<br /><br />He is relatively healthy. He is only super obese.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-2941079431319148652012-07-16T09:33:59.838-07:002012-07-16T09:33:59.838-07:00Stephan,
My comment regarding cholesterol was mor...Stephan,<br /><br />My comment regarding cholesterol was more related to the fact that what you posted could imply that we need to watch our cholesterol intake. Yet there is a purported lack of association of dietary cholesterol to circulating blood cholesterol.Jimmy Geehttps://www.blogger.com/profile/16779443092901038058noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-9538422077340353822012-07-16T09:21:10.653-07:002012-07-16T09:21:10.653-07:00Angry Failing LowCarber Attack:
Quick everybody ...Angry Failing LowCarber Attack: <br /><br /><b>Quick everybody scroll!!</b>gunther gathererhttps://www.blogger.com/profile/15361732213105267048noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-46161741711042101792012-07-16T09:10:21.845-07:002012-07-16T09:10:21.845-07:00@Stephan: "There is absolutely no doubt that ...@Stephan: "There is absolutely no doubt that body fatness is a major risk factor for diabetes..."<br /><br />"Risk factor" or "relationship" are just other ways of saying "correlation" and as we all know <b>"correlation does not show causation"</b> ...we DO all remember that... right?<br /><br />Yes you can quote statistics showing that 80% of Type 2 Diabetics were overweight or obese AT THE TIME OF DIAGNOSIS but are we really so naive as to assume that the day before diagnosis they did NOT have Type 2? Or to dismiss any consideration (as just one other possible interpretation) that the same underlying metabolic disorder which ultimately leads to the Type 2 could also be responsible for the excess fat storage?<br /><br />The fact that you as an accredited scientist <i>-- required by the scientific method to rigorously consider ALL possible alternative interpretations of the observations --</i> that fact that you continue to spread the assumption that obesity CAUSES Type 2 is intellectually dishonest.FrankGhttps://www.blogger.com/profile/01980497914756341565noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-77490243472332299762012-07-15T20:28:54.150-07:002012-07-15T20:28:54.150-07:00Good interview.
Some excellent analysis, some emp...Good interview. <br />Some excellent analysis, some emphasis I'd dispute, but a lot of good sense all in one place.<br />Thanks.<br /><br />Here is an interesting post on the carbohydrate-denovolipogensis-only hypercaloric? question which resolved me once again never to take anything in abstracts for granted.<br />http://www.lucastafur.com/search/label/de%20novo%20lipogenesisPuddleghttps://www.blogger.com/profile/00953398103675945541noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-47687709670659836612012-07-15T10:43:37.321-07:002012-07-15T10:43:37.321-07:00Hi Jimmy,
I've been following Dr. Attia's...Hi Jimmy,<br /><br />I've been following Dr. Attia's series. It is certainly true that there can be discordance between cholesterol and lipoproteins. That is why just measuring circulating cholesterol is a blunt tool. That being said, blunt tools can still be useful, as this one is.<br /><br />Regardless of what's happening at the lipoprotein level, the TC:HDL ratio provides reasonable cardiovascular risk estimate on average, and this has been confirmed many times.<br /><br />I thought Dr. Attia's series was really nice until he began writing about the dietary influences on lipoproteins (like fructose), at which point his critical thinking seemed to lapse.<br /><br />Just because drinking 25% of calories as refined fructose causes potentially problematic lipoprotein changes, does not mean eating a mixed diet with fruit (or even a non-extreme amount of added sugar) has such an effect, and in fact the research suggests it doesn't.<br /><br />If you want to create experimental atherosclerosis in animals, there are much more effective ways to do it than sugar, although it's possible that refined sugar could exacerbate the problem.<br /><br />This study showed that a high fruit weight loss diet (14% energy from fructose-- this is a LOT of fruit) did not increase triglycerides, lower HDL, increase insulin resistance, or cause any other telltale negative lipid signs relative to a low-fruit diet. It also had no effect on energy expenditure relative to the low-fruit diet.<br /><br />www.ncbi.nlm.nih.gov/pubmed/16395633<br /><br />Another study (comparing a sucrose intake of 121 vs 12 g/day) found a similar result using refined sugar:<br /><br />"Results showed that a high sucrose content in a hypoenergetic,<br />low-fat diet did not adversely affect weight loss, metabolism,<br />plasma lipids, or emotional affect."<br /><br />www.ncbi.nlm.nih.gov/pubmed/9094871<br /><br />Energy intake seems to trump sugar intake every time where metabolism and blood lipids are concerned-- although in a hypercaloric context, refined sugar probably is worse than refined starch. <br /><br />To be fair, most people today live in a hypercaloric context. The point is that the root problem is excess calorie consumption, without which eating unrefined sugars in moderation is likely beneficial rather than harmful.Stephan Guyenethttps://www.blogger.com/profile/09218114625524777250noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-73751217396995968122012-07-15T09:02:40.067-07:002012-07-15T09:02:40.067-07:00Regarding this question and answer:
Do we have to...Regarding this question and answer:<br /><br />Do we have to be worried about cholesterol? Can we control it through diet or drugs?<br /><br /> Cholesterol in the blood is contained in particles called lipoproteins. Lipoproteins such as LDL (“bad” cholesterol) and HDL (“good” cholesterol) are causally related to the development of atherosclerosis (thickening and degeneration of the arteries), which increases heart attack risk. So yes, I think we should be worried about cholesterol. The ratio of total cholesterol to HDL cholesterol is a simple and effective indicator of risk. For people who are interested, the Framingham risk calculator can give an estimate of 10-year heart attack risk based on data collected from the Framingham study (3). <br />_________________________________<br /><br />I think that one should not be intertwining the word cholesterol with lipoproteins as they relate to cardiovascular risk. I would suggest readers as well as each of you review the cholesterol series blogged by Peter Attia - very enlightening.Jimmy Geehttps://www.blogger.com/profile/16779443092901038058noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-33382217723113214482012-07-14T19:30:45.509-07:002012-07-14T19:30:45.509-07:00Most people I have spoken with who have been to Fr...Most people I have spoken with who have been to France always love the cuisine. LOL !<br /><br />I am not surprised to hear abut the weight problem there as obesity is increasing even on remote islands etc. Infants only age 6 months have a significant increase in obesity apparently.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-15091277907809086712012-07-14T05:24:50.216-07:002012-07-14T05:24:50.216-07:00Stephan, I agree that body fat can cause insulin r...Stephan, I agree that body fat can cause insulin resistance and is a strong risk factor for type 2 diabetes, although some very fat people are very insulin sensitive. What I was saying was that this IR is superimposed on genetic IR.<br /><br />I also agree that then, as now, the diet of the rich was different from the diet of the poor and average. The daily diet was different from the diet on feast days. For that reason, when making generalizations like "there was no salt," it's important to specify which group you are talking about.<br /><br />And re salt, according to Colin Clair's history of eating, although peasants seldom ate meat, "even the humblest house had its larder where the bacon was kept after it had been salted down for the winter months." That suggests they had access to salt and occasional access to pigs, probably wild.<br /><br />I wasn't suggesting that the average person used cookbooks, but that herbs and spices were available. Some herbs like thyme grow wild and households had herb gardens. More exotic spices like cloves were the incentive for the lucrative spice trade. People risked their lives to find better routes to get the exotic spices, which implies a huge demand.<br /><br />Clair says they thought fruit was unhealthy, and the kitchen gardens grew mostly herbs, with few veggies except onions and leeks.Gretchenhttps://www.blogger.com/profile/17019921800841883073noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-84208701612427881242012-07-14T03:26:46.508-07:002012-07-14T03:26:46.508-07:00'..high fat in combination with high carbohydr...'..high fat in combination with high carbohydrate will not cause fat loss..'<br /><br />I think this depends on the starting point. A wholefood diet high in fat and carbs can in theory do this, if the starting point is crap mitochondria and the wholefood diet repairs them. <br /><br />I think the mistake made by Mediterranean diet advocates is to think you have to eat low-fat dairy. This can mean deficiencies of fat-soluble vitamins. <br /><br />I also think it's a mistake to think fat loss should be fast. Fast fat loss means the surrounding connective tissue doesn't have time to remodel itself, so either fat breakdown stops and reverses, or you end up with loose folds of skin requiring surgery. <br /><br />Jon Gabriel appears to have lost over 200 pounds without dieting, and has no loose skin at all.Janehttps://www.blogger.com/profile/18175128589806816624noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-46485019214561352202012-07-14T02:20:23.270-07:002012-07-14T02:20:23.270-07:00Gretchen, you're absolutely right that they...Gretchen, you're absolutely right that they're not fat-phobic, and it's no coincidence that a high-animal protein proponent like Dr. Dukan comes from France. <br /><br />But there is a growing weight problem here. I would say this has more to do with eating less fresh, whole foods over the last 15 years than any trend towards eating more or less of any one macro group.gunther gathererhttps://www.blogger.com/profile/15361732213105267048noreply@blogger.comtag:blogger.com,1999:blog-1629175743855013102.post-53118510839098437192012-07-13T21:07:10.084-07:002012-07-13T21:07:10.084-07:00Hey Stephan,
what is the mechanism in which mode...Hey Stephan, <br /><br />what is the mechanism in which moderate alcohol consumption raises HDL?DERIANhttps://www.blogger.com/profile/08364145799509803649noreply@blogger.com