While I was young and single, my fit (regularly running and lifting weights) weight was around 185 lbs. After getting married and having kids, my weight slowly crept up to a peak of 231.6 lbs on 2008-09-21. Afterwards, my weight would drift between 212 to 220 lbs. Besides the unhealthiness of being overweight, I didn't like the way I looked. I have been slowly working to become much leaner but, like for many people, this has not been easy. Over the years, my weight increased but every summer I had ambitions of burning off the extra pounds with exercise (biking, cutting my lawn, splitting wood, etc). By winter, I saw that the weight I had lost by autumn was temporary and insufficient. As I got older and heavier, my blood sugar increased and eventually needed medication to control diabetes.
In February of 2018, my doctor switched me to new medication that caused me to excrete excess glucose, which resulted in an immediate weight loss and reduction in my blood glucose. This also resulted in a reduction in my other medication. Although I thought I was eating reasonably well, starting with advice from the diabetic clinic's dietitian, I've been making an effort to eat a healthier diet and I've lost about 25 pounds since the medication change.
The population of western societies and especially those living in North America tend to be overweight. The obvious causes are poor diet and a lack of exercise due to a sedentary lifestyle. When it comes to shedding excess weight, exercise for the sole purpose of losing weight is unsustainable. It is important to stay stay active and keep moving as much as possible - easier said than done though.
- A Brief History of Fat, and Why We Hate It | Slate
- Why Am I Still Fat? | ABC
- What if we're wrong about diabetes? | Peter Attia | TedMed
- The mathematics of weight loss | Ruben Meerman | TEDxQUT (edited version)
The states of being overweight and obese are medical classifications based on BMI (Body Mass Index). Dr Arya Sharma explains that a person's highest body weight is the normal state that the body attempts to maintain at all times. If a person loses weight, the body has a various of responses that try to return the body to the "normal". Whatever method is used to lose weight is the method that must be continued to remain at that weight. Effectively, this means that obesity should be treated as a medically chronic condition. This is the reason that fad diets generally do not work in the long term and result in yo-yo weight loss.
- How to Lose 50 Pounds and Keep Them Off | Arya Sharma | TEDxUAlberta
- Obesity as a chronic disease Dr Arya Sharma (Webinar)
- Is your diet bulls**t? (CBC Marketplace)
- The Mindset for Healthy Eating | Gillian Riley | TEDxChelmsford
- Why dieting doesn't usually work | Sandra Aamodt | TEDGlobal 2013
- Dr. Jason Fung - 'A New Paradigm of Insulin Resistance'
A good mental attitude is crucial. People want to become less overweight for a variety of reasons (need to fit into dress for an occasion, going on vacation and want a beach body, etc). This will not work in the long term and will set you up for failure. Instead, a better reason is because you want to become slimmer because YOU like the way you look and feel. As you start to shed weight (or rather fat), the changes will be positive reinforcement for your efforts.
DISCLAIMER: My background is engineering and what I have written here is from my personal interest in staying healthy. If you disagree with any of it, let know what you feel is inaccurate and include some references so I can make corrections. This is a work in progress so check back often for updates as I continue to learn. CONSULT WITH YOUR DOCTOR BEFORE MAKING DIET AND LIFESTYLE CHANGES.
There are two kinds of diabetes: Type 1 and Type 2. Type I Diabetes (aka Diabetes Mellitus Type 1) is an autoimmune disease but Type II Diabetes (aka Diabetes Mellitus Type 2) is more of a lifestyle disease that can be controlled with diet and exercise. Insulin Resistance is the body's inability to properly utilize insulin and the main cause of Type 2 Diabetes. Pre-Diabetes is a condition where your blood sugar is higher than the normal range but below the diabetic range and requires increasingly greater amounts of insulin for control. Obesity can be a side effect of insulin resistance and, to add insult to injury, obesity adversely affects Type 2 Diabetes because it increases insulin resistance. Not sure if you're insulin resistant? Your body has a couple of signs of this condition: skin tags and dark skin creases (Acanthosis Nigricans).
People are often considered to be genetically predisposed to Type 2 Diabetes and health professionals want to know if Diabetes runs in your family. Since a majority of the North American population has Diabetes or Pre-Diabetes, I would argue that Diabetes is normal response to an unhealthy, carbohydrate-rich diet prevalent in developed countries. I think that people who can tolerate a high carbohydrate diet without developing insulin-resistance are the exception rather than the rule. Dr Robert Lustig of UCSF suggests that Type 2 Diabetes should be more accurately labeled as Processed Food Disease.
In contrast to conventional medical advice, Both Dr Sarah Hallberg and Dr Jason Fung believe that Type 2 Diabetes is a reversible condition that CAN be cured with a low carb diet and Dr Fung is a proponent of therapeutic fasting. Unlike caloric reduction, intermittent fasting doesn't reduce the basal metabolic rate. A ketogenic diet is compatible with low carbohydrate consumption and works well with fasting. Dr Fung says that it isn't easy to regularly fast, presumably because extended periods of hunger can be somewhat uncomfortable, although he says that it is easier to fast while on a ketogenic diet. Hunger typically comes in waves due to the hormone Ghrelin and peaks during accustomed eating times and will dissipate until the next meal time.
Being Type II diabetic now, I've been reading up on leading a healthy lifestyle and I've learned a few things. In no particular order:
- Understanding the role of pancreatic hormones (insulin and glucagon) is crucial in achieving overall health.
- Exercise has great health benefits but isn't very effective in rapid weight-loss. It doesn't burn-off nearly enough calories although you're probably not snacking while you're exercising. It's a lot more effective to avoid ingesting unnecessary calories than it is to metabolize them. For example, a 300 calorie donut will require about 60 minutes of walking (3.5 mph / 17 minutes/mile) or 30 minutes of running (5 mph / 12 minutes/mile) for a 155 lb person. See Calories burned in 30 minutes for people of three different weights.
- A healthy diet and lifestyle result in longevity, of which a healthy weight is a characteristic.
- No-one becomes overweight overnight and the weight you've gained over the years should be shed slowly.
- Your body is extremely good at energy conservation. If you lose weight too quickly, your body will reduce its metabolic rate and make weight loss even more difficult.
- The body's mechanism for reducing the basal metabolic rate in order to conserve energy is the Famine Response.
- Snacking between meals keeps insulin at a continuously high level and inhibits the body's ability to burn fat.
- Gut health is extremely important and you need to keep your microbiome healthy and well nourished.
- A good attitude is important. It is better to have positive thoughts that you are becoming healthier or more attractive than to to have negative thoughts about having a deadline for losing weight.
- Muscle is a denser tissue than fat so it is possible to become heavier even though you're becoming leaner, especially if you also engage in weight-training.
- Why we can't stop eating unhealthy foods
- Leptin & Insulin Resistance Balancing Tips w/ Jason Fung, MD
- Intermittent Fasting & Hunger - What the Science says
- 10 things I learned from 30 days intermittent fasting
The human body converts ingested carbohydrates to GLUCOSE, which is a specific sugar molecule used as energy in the bloodstream. There are there are two types of sugars: simple sugars (monosaccharides) and compound sugars (disaccharides). Oligosaccharides are short-chain carbohydrates containing 3-9 monosaccharide units. Polysaccharides are long chains of monosaccharides are often longer than 10 monosaccharide units and can either occur naturally or be manufactured for use as food additives.
- Fructose: occurs naturally in fruits, some root vegetables, cane sugar and honey and is the sweetest of the sugars. It is known as fruit sugar and is one of the components of sucrose. It is used as a high-fructose syrup, which is manufactured from hydrolyzed corn starch that has been processed to yield corn syrup, with enzymes then added to convert part of the glucose into fructose. Agave Syrup is another high-fructose sweetener commonly added to foods.
- Galactose: is generally found as the other half of lactose (milk sugar) and is less sweet than glucose. Interestingly, galactose is a component of the antigens found on the surface of red blood cells that determine your blood type.
- Glucose: occurs naturally in fruits and plant juices and is the primary product of photosynthesis but can also be manufactured from starch by enzymatic hydrolysis. It was originally found in grapes and is similar in structure to dextrose (manufactured from corn starch).
- Lactose: (galactose + glucose) occurs naturally milk. It is broken down into its constituent parts by the enzyme lactase during digestion. Children have this enzyme but some adults no longer form it and they are unable to digest lactose. The ability of adults to produce lactase is known as lactase persistence and people who are lactose-intolerant can consume some dairy products (eg, some yogurts and cheeses) because the fermentation process converts lactose into lactic acid. Bacteria in the microbiome may also help to digest lactose.
- Maltose: (glucose + glucose) is formed during the germination of certain grains (eg. barley), which is converted into malt, the source of the sugar's name. Maltose is less sweet than glucose, fructose or sucrose. It is formed in the body during the digestion of starch by the enzyme amylase and is itself broken down during digestion by the enzyme maltase
- Sucrose: (fructose + glucose) is found in the stems of sugarcane and roots of sugar beet. It also occurs naturally in some fruits and roots (like carrots) alongside fructose and glucose. The range of sweetness depends upon the proportions of sugars found in these foods. Sucrase enzymes split sucrose into its constituent parts during digestion.
- Maltodextrin is a food additive that can be 3 to 17 monosaccharide units derived from starch. Its sweetness depends on the length of polymerization with shorter chains having higher sweetness and solubility.
- Glycogen (sometimes known as animal starch)
High Fructose Sweeteners
While fructose is commonly found in fruits, fruit contains small amounts and it is bound to dietary fibre. Food manufacturers like to use sweeteners containing high quantities of fructose (like High Fructose Corn Syrup) because it is sweeter than other sugars and cheaper to produce, which makes it a great processed food additive for manufacturers. Corn starch is readily converted to glucose with enzymes and this glucose is then processed into fructose. The danger to human health is that, while glucose can be metabolized throughout the body, fructose can only be metabolized in the liver into glycogen and triglycerides. The liver has a limited capacity to store glycogen and excess amounts result in fatty liver disease, which is commonly associated with metabolic syndrome (diabetes, hypertension, obesity, and dyslipidemia).
Excess levels of the following foodstuffs metabolized in the same way in the liver, overload mitochondria in tissues, and cause metabolic syndrome:
- Branched Chain Amino Acids (eg, protein powder, corn-feed beef, chicken, & fish)
FRUCTOSE FOOD ADDITIVES ARE TOXIC!
- CSI - Carbohydrate and Sugars Terminology
- University of Nebraska - Sweeteners
- OSU - Dietary Sugar and Alternative Sweeteners
- Evolution of lactase persistence: an example of human niche construction
- Mayo Clinic - Lactose Intolerance
- Sugar: The BitterTruth
- Fat Chance: Fructose 2.0
- Why Fructose Sugar Is So Bad For You- 60 Minutes
- Supersized: The Dangers of Fructose, Obesity and Fatty Liver
- Robert Lustig - What is Metabolic Syndrome Anyway?
While all of the organs in the body work together, some organs have important roles in energy usage and storage.
The pancreas produces several hormones in specific cell areas known as pancreatic islets (islets of Langerhans). Glucagon is produced in alpha cells and Insulin is is produced in beta cells. Glucagon and insulin directly affect blood sugar and work opposite to each other. Insulin performs an anabolic function (synthesizing larger more complex modules from simpler ones, ie storing fat) where it stores glucose into adipose tissue while glucagon performs a catabolic function (breaking down of complex modules into smaller simpler ones, ie, burning fat) where it draws lipids out of adipose tissue and where they are ultimately converted them into ketones. Interestingly, insulin affects the entire body because pretty much every cell has an insulin receptor. Glucagon has no effect on muscle tissue.
Generally, high serum glucose levels cause the pancreas to secrete more insulin, which then signals other tissues like muscle and adipose tissue) to remove it. Low serum glucose levels cause the pancreas to secrete more glucagon, which signals adipose tissue to release lipids.
One of the effects of diabetes is that muscle tissue has trouble getting glucose delivered across its cell membranes. Insulin can be considered a key that helps glucose to unlock the boundary and cross that membrane into the muscle cell. Glycolysis is the process that allows cells to convert glucose to ATP for cellular fuel.
Fat in our bodies is stored in fat cells (Adipocyte) and the number of fat cells in adults is generally constant over their lifetimes. The number is set during childhood and adolescence, although obesity can cause the number of adipocytes to increase and fasting can cause the number to decrease. As your body digests food, excess glucose is stored as glycogen in the liver and skeletal muscle tissue but neither has a high glycogen storage capacity.
High glucose levels cause an increase in insulin (the fat storage hormone) and a decrease in glucagon (the fat burning hormone), which triggers Lipogenesis to then store triglycerides in fat cells . Insulin causes causes excess glucose to be stored in adipose tissue through lyposis. Acetyl-CoA is produced by the breakdown of both carbohydrates and lipids, which is then used to manufacture and store fat in both adipose tissue and the liver through Lipogenesis.
Low glucose levels cause an increase in glucagon and a decrease in insulin, which triggers the release of lipids from adipose tissue. As a result, the liver will manufacture ketones from those lipids through ketosis. The ketones in turn have an additional beneficial metabolic effect on adipose tissue in that it causes white fat to behave more like brown fat. The body uses the mitochondria in brown fat to generate heat and ketones cause the fat tissue to "waste" its stored energy as heat. Normally, mitochondria are "coupled" in that they only use as much fuel (glucose or ketones) as is necessary to manufacture ATP. Ketones tend to cause adipose tissue mitochondria to be "uncoupled" so that that they instead generate heat. Something to think about if your hands and feet are always cold.
The liver performs many tasks in managing energy usage in the body. The liver manufactures glycogen through Glycogenesis when IGR is high, which is used as a glucose energy reserve. When IGR is low, the liver uses Glyconeogenesis to manufacture glucose sourced from adipose tissue to maintain a minimum serum glucose level and it also uses the lipids in adipose tissue to manufacture ketones, which is the body's alternative fuel. While most tissues can use either glucose or ketones as fuel, only erythrocytes (red blood cells) must rely on glucose for fuel because they lack mitochondria and this conserves the oxygen they carry.
The body also excretes ketones through respiration (high ketone levels can result in "ketone breath") and urine, which adds another aspect to weight loss.
Insulin to Glucagon Ratio
The Insulin to Glucagon Ratio (IGR) determines whether the metabolism has a anabolic or catabolic tendency. The biochemical effects of insulin and glucagon are often antagonistic.
|Protein Synthesis||Decreased protein degradation||Increased amino acid uptake by liver;
Decreased amino acids in plasma
Effects of Insulin and Glucagon on body tissues
|Metabolic State||Muscle Tissue||Adipose Tissue||Liver|
- Dr. Benjamin Bikman - 'Insulin vs. Ketones - The Battle for Brown Fat'
- Dr. Benjamin Bikman - 'Insulin vs. Glucagon: The relevance of dietary protein'
- Understanding the role of glucagon and insulin with Benjamin Bikman, PhD
- Khan Academy: Regulation of glycolysis and gluconeogenesis
Having a healthy weight is a characteristic of a healthy lifestyle and should not be a goal in itself. Obviously, everyone knows that they should be doing things that are good for you and not doing things that are bad for you. One way to tell what things are good or bad is to look to groups who tend to have particularly long lifespans and a couple of them are people living in Japan (particularly Okinawa) and the Mediterranean (particularly Sardinia and Calabria in Italy and Icaria, Greece). Dan Buettner identified regions of exceptional human longevity in his article "The Secrets of a Long Life", which was the November 2005 cover story of National Geographic magazine. He found 5 locations (Blue Zones) with high incidences of centenarians:
- Sardinia, Italy
- The islands of Okinawa, Japan
- Loma Linda, California, USA
- Nicoya Peninsula, Costa Rica
- Icaria, Greece
How to live to be 100+ - Dan Buettner. Common characteristics of the older members (90+ years) of these areas include:
- Move naturally: use human power as much as possible, have physical activities you enjoy and don't be a couch potato.
- Not smoking or smoking infrequently.
- Have the right outlook
- Slow down & minimize stress in your life.
- Always have a sense of purpose in your life
- Eat wisely
- Drink moderately: having red wine with dinner is good.
- Have a mainly plant-based diet with a high consumption of legumes.
- Avoid overeating: stop eating when you reach 80% full.
- Always put loved ones first.
- Belong to a faith-based community.
- Find the right tribe (healthy social circle) to run with. Unhealthy friends tend to result in unhealthy lifestyles.
- Longevity Diet & Lifestyle Caught On Camera w/ Jason Prall
- Longevity: Journey into the blue zone | TechKnow
- Human longevity: Genetics or Lifestyle? It takes two to tango
Foods can be characterized with a Glycemic Index (GI), which is a scale that represents the rise in blood glucose 2 hours after the ingestion of a food. The Glycemic Index scale is from 0 to 100, where 100 is defined to be the effect of ingesting pure glucose. Any food that does not cause a rise in blood glucose will have a Glycemic Index of zero. A food's Glycemic Response is the food's effect on blood glucose levels over time, starting from the moment the food is consumed.
Sarah Hallberg (Medical Director of the Medically Supervised Weight Loss Program at IU Health Arnett) has the following Rules for Eating, which are consistent with the importance of glycemic response in Blue Zones diets:
- If it says "light", "low-fat" or "fat-free", it must stay in the grocery store.
- EAT FOOD.
- Don't eat anything you don't like.
- Eat when you are hungry. Don't eat when you are not.
- NO GPS - No grains, potatoes, or sugar.
Ketogenic Diets are by definition low-carb and many people report excellent results with weight loss and improved blood sugar control with it. The only part of the body that absolutely requires glucose are erythrocytes (red blood cells) due to their lack of mitochondria. While weight loss and reduced insulin resistance are great benefits of a ketogenic diet, there can also some minor side effects such as "keto flu" (headaches, muscle cramps, brain fog, etc). Because insulin causes the body to retain water, lower insulin levels result in greater fluid excretion along with some electrolytes (ie, sodium). The loss of electrolytes causes keto flu symptoms and is remedied the consumption of salt. Ketogenic diets reportedly tend to absorb excess body proteins such as excess skin from weight loss and skin tags. The Adkins Diet is one type of low-carb diet and was popular at one of my workplaces several years ago. Although most people who tried it loved the resulting weight loss, no-one was able to stay on it for periods much longer than 6 months. I think the boss really liked it because it gave him the excuse to eat fried chicken all the time.
Dr Paul Mason states that a ketone meter is an excellent tool for finding the optimum level of carbohydrate restriction. His clinic regularly tests for ketone, which is the result of fat metabolism. He reports that higher ketone levels (0.4 mmol/L & higher) act as an appetite suppressant, which is obviously helpful in aiding weight loss by reducing your caloric intake. If you're a diabetic, you're probably already monitoring your blood glucose. Using your glucometer's ketone measuring capability, it is extremely useful to see the effect of various foods on your fat metabolism by keeping a food log correlated with blood ketone. If you don't have a glucometer, you can also measure ketones in your urine although less accurately.
Glucose-Ketone Index (GKI) is a means of estimating your level of ketosis and is a unitless number based on mmol/L. GKI = (serum glucose, mmol/L) / (serum glucose, mmol/L)
If you're using mg/dL for blood sugar, divide your reading by 18.016 to convert to mmol/L. The following table summarizes various ketosis states. Having any ketone measurement result above zero suggests to me that you have a low IGR, which will also tends to result in lower serum glucose levels. It's not that hard to reach 0.5 mmol/L of ketones without fasting so you would only need a blood sugar measurement of 4.5 mmol/L be in a low ketosis level, which can be maintained through gluconeogenesis on a low-carb diet. A normal fasting blood glucose level falls within the range of 3.9 to 5.6 mml/L.
|>9||Not in Ketosis||Not in Fat-Burning Mode|
|6 - 9||Low||Weight loss|
|3 - 6||Moderate||Metabolic Syndrome Treatment|
|<3||High||Epilepsy & Cancer Treatment|
- Reversing Type 2 diabetes starts with ignoring the guidelines | Sarah Hallberg | TEDxPurdueU
- Dr. Sarah Hallberg - 'Ketogenic Diet for Type 2 Diabetes'
- Dr. Sarah Hallberg on avoiding the keto flu
- Junk food is killing us, how to create a new recipe for health | The Nature of Things
- The Nature of Things: Food for Thought
- Dr. Paul Mason - 'Low Carb from a Doctor's perspective'
- A Bug in the System for Artificial Sweeteners
- Artificial sweeteners linked to risk of weight gain, heart disease and other health issues
- Long-term effects of a ketogenic diet in obese patients
- Dom D'Agostino on the Side Effects of Ketogenic Diet
- CarbLoaded: A Culture Dying to Eat
- Metabolic Effects of the Very-Low-Carbohydrate Diets: Misunderstood "Villains" of Human Metabolism
- Robert Lustig, M.D., M.S.L. — "Processed Food: An Experiment That Failed"
- Dr. Paul Mason - 'How iron deficiency and inflammation can make you fat - a female perspective'
- What is The Glucose Ketone Index (GKI)?
The health of the microbes living in our gut is crucial to our health and well-being. The various areas of the body are populated with their own specific communities of microorganisms (microbiome). Two types of foods that influence human gut flora are:
- Prebiotics - foods that are digested by bacteria in the colon, such as Resistant Starch and Dietary Fiber
- Probiotics - foods that contain beneficial bacteria that are intended to improve the glut flora.
The effect of consuming probiotics is inconclusive about populating the gut. While the specific effects of the microbiome are not well known, having a healthy and diverse microbiome is desirable. Junk foods (highly processed, loaded with empty calories) should be avoided and eating foods with a high proportion of prebioitics will help keep the gut microbiome well nourished. Even though science writer Ed Jong is an expert in microbiomes and is familiar with probiotics, he eats yogurt because he likes the flavour and not because he expects any improvement in his own microbiome. Dr Paul Mason suggests that high amounts of dietary fiber are not necessarily conducive to weight loss.
The consumption of antibiotics (both therapeutic and dietary) should be done with care. Indiscriminate antibiotic use can be potentially be considered as "carpet bombing" the gut's microbiota and wiping out a large populations of both beneficial and harmful bacteria.
- Is probiotic yogurt effective? | CBC Marketplace
- Food for thought: How your belly controls your brain | Ruairi Robertson | TEDxFulbrightSantaMonica
- Follow Your Gut: Microbiomes and Aging with Rob Knight - Research on Aging
- The Nature Of Things - It Takes Guts
- Debunking diet secrets and weight loss: The Answer Might be in Your Gut
- The Microbes Within Us | Ed Yong
- Dr. Paul Mason - 'From fibre to the microbiome: low carb gut health'
Lectins are carbohydrate-binding proteins and people can have a sensitivity to them that ranges from not at all to very. Lectins have been implicated in a variety of health issues including autoimmune diseases such as Inflammatory Bowel Disease and Type 1 Diabetes. Lectins can be factor in obesity due to their ability to bind to Leptin (a hunger-regulating hormone) and to stimulate insulin receptors in fat tissue. Lectin-rich foods (eg tomatoes, can stimulate histamine production in the stomach, thereby exacerbating acid-reflux (heartburn). Maybe the roasted peanuts (high-fat, low GI) I like as a snack may not be an ideal diabetic snack.
- Dr. Paul Mason - 'How lectins impact your health - from obesity to autoimmune disease'
- Are Lectins Bad for You? (+ How to Avoid Them) • Dr Paul Mason
- Dr: Gundry - Lectins & Beyond: How Eating Out-of-Season Makes You Fat
Related to gut health is the notion to purge toxins from the body with a "cleanse". No-one that recommends a particular kind of cleanse ever states what toxins the cleanse will be removing nor are there any clinical studies to back up the recommendation. The body's natural toxin cleansing organ is the liver and it performs this task extremely well.
- Detox diets: Testing Dr. Oz's detox cleanse (CBC Marketplace)
- Why "Detox Diets" And "Cleanses" Are B.S
Another important consideration somewhat related to diabetes is Arteriosclerosis or hardening of the arteries. Atherosclerosis is a specific type of arteriosclerosis that involves a restriction in the flow area of the arteries resulting from a build-up of plaque (fatty deposits) on the arterial walls. This flow restriction can result in circulatory issues and severe cases can result in bypass surgery. While arteriosclerosis has a variety of causes, some of which are genetic and some are lifestyle-related. Lifestyle-related causes include:
- Various forms of tobacco (and possibly similar non-tobacco) consumption.
- Obesity, diabetes/insulin resistance.
- High cholesterol and/or high triglycerides (related to blood lipids/fat)
The prevention of Arteriosclerosis is similar to the control of Type 2 Diabetes: not smoking and maintaining healthy weight. Maintaining a healthy weight requires a healthy diet and staying physically active.
I mention Arteriosclerosis because there has been some controversy about eating a low fat (and especially low cholesterol) diet in order to control [blood] serum cholesterol and triglycerides. There are 2 kinds of serum cholesterol: HDL (High-Density Lipoprotein: “good” cholesterol) and LDL (Low-Density Lipoprotein: “bad” cholesterol). LDL Cholesterol (LDL-C) causes plaque to form on arterial walls but HDL Cholesterol (HDL-C) scavenges some of the LDL from the bloodstream and carries it to the liver for excretion.
Excess calories (from carbohydrates, proteins, & fats) in the body are converted into triglycerides and stored in fat cells throughout the body. While there are many kinds of triglycerides, they can simply categorized as either being saturated or unsaturated. Saturated meaning that the available molecular positions are occupied by hydrogen atoms and saturated fats are typically solids (as opposed to liquids) at room temperatures. High levels of both LDL Cholesterol and Triglycerides have been linked to heart disease so it is better to keep these in check.
Fats (and oils) are composed of three fatty acid molecules combined with a glycerol (aka glycerin) molecule . Fatty acids are long, straight chain carboxylic acids and glycerol is an organic compound containing multiple hydroxyl groups. Omega-3 fatty acids are a particular kind of polyunsaturated (fat molecules that have more than one unsaturated carbon bond in the molecule) fatty acid that is important for normal metabolism and that the body is not able to manufacture. While Omega-3 fatty acids can be obtained from plant-based sources (such as seeds and nuts), fish (such as salmon, mackerel, tuna, herring, and sardines) are an especially rich source. The best forms of cooking oils are the ones that have a lower levels of Omega-6 fatty acids such as olive oil, avocado oil, coconut oil, and red palm oil. Good refined vegetable oil alternatives are canola oil and palm kernel oil.
The liver manufactures the majority (about 80%) of the cholesterol in your body with the remaining 20% coming from the food you eat. As a result, it is difficult to control LDL cholesterol levels purely with changes to your diet.
There are 7 types of LDL cholesterol (LDL-1, LD-2, LDL-3, ... LDL-7). Pattern A LDL cholesterol consists of Types 1 & 2 (LDL-1, LDL-2), which are benign and the good forms of LDL cholesterol while Pattern B consists of the remaining Types 3-7, which are the bad forms. The main risk from high levels of LDL cholesterol is that glycation of the Pattern A LDL from high levels of blood sugar which converts cholesterol to the Pattern B LDL. High levels of Pattern B cholesterol are the ones that form the plaques in Atherosclerosis. Increasing blood glucose levels tends to increase LDL glycation so this is another excellent reason to keep blood glucose in control. Glycated LDL modules (Pattern B) become more damaged when they are oxidized and they are more prone to oxidation in the presence of Omega-6 fatty acids.
While Lipids are frequently tested in Laboratory Blood Work, doctors generally do not request the advanced lipid particle size test (Lipid Electrophoresis: a lipid subfraction test) that identifies the LDL type proportions (ie, Pattern A & B). A good way to estimate whether you have Pattern A or Pattern B is through the Triglyceride and HDL tests. LifeLabs indicates a target range of <1.71 mmol/L of Triglycerides and >1.29 mmol/L of HDL Cholesterol in their Lipid Tests.
|Lipid Test||High Likelihood of Primarily
Pattern A LDL-C
|High Likelihood of Primarily
Pattern B LDL-C
Target: <1.71 mmol/L
Target: >1.29 mmol/L
Eggs can be good source of Omega-3 fatty acids if the chickens are fed an enriched diet. While eggs contain both unsaturated and saturated fats, the saturated fats in eggs tend to have a high HDL to LDL ratio. Even so, one egg per day (or a total of 7/week) is a safe recommended limit for healthy people, while a somewhat lower consumption (up to a total of 4/week) has been recommended for diabetics. Since eggs have a glycemic index of zero, egg consumption should help to reduce blood sugar levels, which would in turn reduce the risk of cardiovascular disease. If you're already on a low-glycemic-index-carb/high-fat diet and your blood sugar is under control, it would appear that egg consumption would actually be beneficial part of your diet.
Trans Fats are generally vegetable oils that have been partially hydrogenated but some animal fats (eg, beef fat & dairy fat) also contain small amounts of trans fats. Saturated fats are fully hydrogenated. Hydrogenation make vegetable oils more stable and rancid-resistant. Trans Fats have adverse effects on human health and their consumption should be avoided or at least minimized. Trans Fats are bad because they simultaneously raise LDL and lower HDL cholesterol and they contribute to insulin resistance and create inflammation.
- The Nutrition Source: Types of Fat
- The truth about fats: the good, the bad, and the in-between.
- Healthy Canadians: Fats
- Dietary Fat and Cholesterol | Colorado State University
- The Nature of Things: The Cholesterol Question
- Dr. Paul Mason - 'Saturated fat is not dangerous'
- Dr. Paul Mason - 'Blood tests on a ketogenic diet - what your cholesterol results mean'
- Dr. Paul Mason - 'Treating Metabolic Syndrome'
- Eggs might help your heart, not harm it
- Dr. Nadir Ali - 'Why LDL cholesterol goes up with low carb diet and is it bad for health?'
Glycated Proteins (Advanced Glycation End-products - AGEs) have a multiple of nasty effects in the body in addition to damaging LDL cholesterol from healthy Pattern A to CVD-causing Pattern B. Related to Cadiovascular Disease is peripheral artery disease (blockage in arteries leading to the limbs) and carotid artery disease (blockage in arteries leading to the brain). High blood glucose is responsible for also causing:
- Retinopathy - damage to blood vessels in the retina
- Nephropathy - damages to the tiny filtering units of the kidney
- Neuropathy - damage to nerves, often causing a loss of sensation in the feet and toes
- Pancreatic beta cell dysfunction and necrosis
- Osteoarthritis - damage to cartilage
- Fibromyalgia - widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues
- Cancer - links between obesity and cancer.
- Premature Aging - premature cellular senescence in human skin fibroblast and higher degree of collagen cross-links
Researchers have found a link between Alzheimer's Disease and insulin resistance and some have gone as far as identifying Alzheimer's Disease as Type 3 Diabetes.
People being treated for Type 2 Diabetes with insulin injections often require increasingly higher doses of insulin to combat insulin resistance. While high blood sugar is damaging to tissues, high levels of insulin are also damaging to some tissues.
- Hypertension - high blood pressure
- Leptin Resistance - inability to sense when caloric needs are satisfied, leading to overeating
- TheThe Root Cause: Links Between Insulin Resistance & Disease ft. Dr. Benjamin Bikman || #96
- Is insulin resistance the cause of fibromyalgia? A preliminary report.
- Psychology Today: The Brain Needs Animal Fat
- Links between Osteoarthritis and Diabetes: Implications for Management from a Physical Activity Perspective
- National Cancer Institute: Obesity and Cancer
- Increasing evidence of a strong connection between sugar and cancer
- High serum glucose levels are associated with a higher perceived age
- The Full Spectrum of Alzheimer’s Disease Is Rooted in Metabolic Derangements That Drive Type 3 Diabetes
- Alzheimer's Disease Is Type 3 Diabetes–Evidence Reviewed
- Diabetes.co.uk: Type 3 Diabetes
- Brain metabolic dysfunction at the core of Alzheimer's disease
- Oxford Academic: Actions of insulin on the mammalian heart: metabolism, pathology and biochemical mechanisms
- Advanced glycation end products and nutrition.
Modern government health departments generally have good advice about what to eat and the recommendations are similar and easy to follow.
- UN FAO: Food-based dietary guidelines
- Canada's Food Guide
- Dietary Guidelines for Americans
- United Kingdom: Eatwell Guide
- Dietary Guidelines for the Brazilian Population
Basically, their dietary recommendations are:
- Eat plenty of colorful fruits and vegetables.
- Eat plenty of nuts, seeds, and legumes (low glycemic indexes and lots of dietary fibre).
- Grain-based foods should contain the whole grain with a minimum of refining/processing.
- Eat more foods that contain unsaturated and polyunsaturated fats.
- Eat less foods that contain saturated fats.
- Minimize the consumption of red meat. Consume fish, poultry, beans or nuts instead.
- Avoid highly processed foods.
- Avoid foods containing trans fats.
- Drink water whenever you're thirsty. If you're craving a snack, drink some water instead because might be mistaking a hunger for thirst.
- Don't drink your calories (soda, fruit juices, etc). Artificially sweetened drinks have an adverse effect on health.
There are significant benefits to having a high-fat, low-carb diet. HFLC diets recommended by experts (such as Dr Ben Bikman, Dr Sarah Hallberg, Dr Paul Mason) contradict government dietary recommendations to maintain healthy, lean body mass. This is my understanding of a good high fat, low carb diet:
- Minimize the consumption of carbohydrates (approximately < 50g/day) and ensure that those carbohydrates have a low glycemic index.
- Consume more protein (1-2 g/kg of body weight per day).
- Consume the balance of your daily caloric requirements from high-quality, minimally-processed fats.
- Consume more Omega-3 fats and less Omega-6 fats.
- Avoid foods that a metabolized in the liver, especially those that contain added sugar (sucrose & fructose).
- Avoid foods manufactured from industrial processes.
- Consume more protein as you get older.
- Saturated fats (including those from red meats) are OK to consume.
- Eat when you're hungry, don't eat when you're not. No need to count calories because fat consumption tends to be self-regulating in total daily caloric intake.
- Avoid snacking between meals (unless you're hungry) to allow blood sugar to fall low enough for fat burning to occur.
Some sites for healthy diet recipes:
- Canada's Food Guide Recipes
- Canadian Living Magazine's Recipes (one of my wife's favourites)
- Diet Doctor: Low-Carb Recipes
More information about Blue Zone diets:
- Eating To Break 100: Longevity Diet Tips From The Blue Zones
- Okinawa Diet
- Mediterranean Diet
- Ikarian Diet
- Sardinian Diet
- Loma Linda Diet
- Mesoamerican Agriculture
Long periods of exercise is not necessary to lose weight and to keep a low weight. I would argue that it is counterproductive in the long run because it would be extremely difficult to maintain an time-consuming exercise routine over a lifetime. Centenarians in the Blue Zones instead stay physically active with activities that are low intensity such as walking and gardening. They don't rely on labor-saving devices in their daily routines. However, research has shown that there are significant benefits to short periods of high-intensity (where your heart rate is over 80% of its maximum) exercise.
No matter what your daily routine is, it is important to always keep moving:
- Are We Sitting Ducks? - Podcast | Quirks & Quarks
- One minute is all you need to stay young and healthy - Podcast | Quirks & Quarks
- 7 reasons to try interval training | Mayo Clinic
- High-intensity physical exercise will boost your health: Øivind Rognmo at TEDxTrondheim
- Why some vigorous physical activity could save your life | Klaus Gebel | TEDxJCUCairns
- Why fitness is more important than weight | Leanne Spencer | TEDxWandsworth
- Diabetes and Exercise: Why Exercise Works When Insulin Does Not | Dr. Laurie J. Goodyear
For Christmas, my daughter gave me a Fossil (Android) smart watch, which integrates with the Google Fit app. I've come to appreciate the feedback that the watch gives me about my activity level. I now try to increase activity (though still nowhere close to any level of high intensity) because of the continuous activity tracking.
Since our goal in losing weight is to shrink fat cells, we need to get the lipids out of the fat cells, which will in turn reduce the size of the fat cells.
Dry Jason Fung makes the case for using intermittent fasting as means burning fat. The idea is to first consume the body's glycogen which then reduces the insulin level. Since insulin and glycogen are low, the body will then start converting triglycerides in the fat cells back into ketones and glucose. This requires you to fast (ie, not eat), which can be problematic for diabetics whose blood sugar can fall too low. Dr Fung suggests that there are benefits to alternate day fasting where cut your food intake on the fasting day to 500 calories. He regularly has 23 hour fasts - that is, he only eats once a day at supper. It appears that it is not beneficial to continuously graze all day but instead to allow your blood sugar levels to fall between meals so as to draw upon your glycogen stores. Especially if you're diabetic, make sure that you only undertake fasting with the supervisor of your doctor.
Similarly, it would be useful to engage in physical activities that also increase your caloric consumption. The body tends to use a greater percentage of fat with lower levels of endurance exercise intensity and the shift toward carbohydrate consumption increases with exercise intensity. Training tends to increase the body's fat metabolism which in turn improves the body's ability to conserve carbohydrates (carbohydrate sparing). Low to moderate intensity endurance exercise doesn't require your body to first draw down its glycogen stores. While low-intensity exercise favours fat metabolism, blood glucose is still impacted and the effect also temporarily increases insulin sensitivity after exercise. However, with training, your body becomes more efficient with glycogen storage so it increasing amounts of physical activity could require increasing time for glycogen depletion.
Cities often have Active Transportation programs (like Fort Erie's FEAT Committee) to encourage healthy lifestyles. Take advantage of your town's recreational trails and bike routes whenever you can but, with North America's car-oriented suburban environments, walking and cycling for errands may often be impractical. In parking lots, parking far from the entrance has the added benefit of reducing door dings and other parking lot mishaps. Take the stairs whenever you can.
Strength training tends to increase muscle mass and and additional muscle tissue increases the body's basal metabolic rate. Additional benefits of strength training include increased bone mineral density and increased connective tissue strength.
- Fat cell number is set in childhood and stays constant in adulthood | National Geographic
- Dr. Jason Fung - 'Therapeutic Fasting - Solving the Two-Compartment Problem'
- Depletion of muscle and liver glycogen during exercise. Protective effect of training.
- 5. Carbohydrate Metabolism During Exercise | Science of Exercise | University of Colorado Boulder
- 6. Carbohydrate Metabolism Continued | Science of Exercise | University of Colorado Boulder
- 7. Fat Metabolism During Exercise | Science of Exercise | University of Colorado Boulder
- Physical activity and its influence on obesity, insulin resistance and diabetes - Part lll, by Professor Bente Stallknecht
Even though our energy consumption during sleep can be much lower than while we're awake, getting adequate and quality sleep is important for overall health. Not getting enough enough quality sleep can lead to weight gain. Many people regard sleep as an inconvenience: they can sleep when they're dead. However, sleep is not a wasted time and this part of a daily routine has important biological functions, some of which we don't understand very well.
- Sleep and weight
- Why do we need to snooze each night? While You Were Sleeping | The Nature of Things
Many people suffer from Obstructive Sleep Apnea, which is condition where breathing stops during sleep with a resulting interruption in sleep. Snoring is a symptom of sleep apnea and is a result of obstruction in the airway. Talk to your doctor if you always feel tired after a sleeping and especially if you snore. Treatments often involve CPAP (Continuous Positive Airway Pressure) machines that blow air into your nose while you're sleeping.
Some people have had success with chin strap devices that hold the mouth closed during sleep to encourage breathing through the nose.
If you're overweight and trying to work towards a healthier weight, please recognize that being overweight is a chronic condition that requires a doctor's supervision. Since obesity is closely related to Type 2 Diabetes, seek the help of your local diabetes clinic where you can get advice from a diabetic nurse and a dietitian.
- Obesity Canada
- Cardiac Exercise Research Group - NTNU
- Low Carb Down Under
- Low Carb Doctors
- Nutrition Coalition
- Health Canada - Nutrient Data
- Glycemic Index Food Guide - Canadian Diabetes Guidelines
- International Tables of Glycemic Index and Glycemic Load Values: 2008
- University of Sydney: Glycemic Index & Load of Foods
- UCSF - SugarScience
- Intensive Dietary Management (IDM) Coaching Program
If you're wondering what I've been eating lately, the following list is what my daily meals typically look like. We've been getting seeds and nuts from the local Bulk Barn and buy just enough to use the coupon in the BB flyer.