The Nuts and Bolts of Food Addiction

July 11th, 2012

Matt Poteet, Pharm.D.

In last month’s article, Our Modern Food Addiction, I began laying the groundwork for a different way of looking at our modern obesity and dietary-induced chronic disease epidemic. In that article, I asked you to begin to open your mind and modify the way you look at food on the most basic level. Instead of food being a unit of energy, food should be seen as the powerful pharmaceutical agent that it is, which controls a very complex hormonal and biochemical environment. It is the corruption of this environment that what leads to poor health and weight gain. At the heart of the myriad of biochemical nutritional problems is one substance… sugar. Sugar not only contributes to terrible hormonal and biochemical environments in its own right, but actually is the engine which drives the poor health train due to one nasty biological effect which it has on our brain… it is a very addictive substance. As you will see, addiction causes a chain reaction of bad things to happen to your health, your weight, and your psychological relationship with food. We will begin exploring this phenomenon in this article by laying the physiological groundwork. We will take a look at the biology behind addiction, why a particular substance is addictive, and what happens when that substance is introduced into our systems.

How We Got Here

Addictive substances have been around as long ashumanity has walked the earth. Anthropology tells us that our ancestors frequently used (and obviously enjoyed) a wide variety of addictive stimulants, depressants and other agents. We find in the bones of these primitive peoples traces of cannibis, caffeine, nicotine, mescaline, opium, and many other substances. The mummies of Egypt have been found with traces of cocaine, nicotine, and caffeine in their tissues. Utzi the iceman, who was found in the early 90’s completely preserved in glacial ice in the Swiss Alps and is the oldest intact mummy that we know of on earth contained traces of caffeine. The want of many of these addictive substances have driven many of our pursuits of exploration, conquest, and destruction of indigenous societies in the years of world-wide exploration and conquest. Cortez may have crossed the see in search of El Dorado, but he returned to Europe with nicotine, caffeine, and chocolate (theobromine) to start the Europeans buzzing (literally). And we all know of the terrible tragedies of slavery and sufferings of Africans for the want of rum during the triangle trade period. Truly, addictive substances have played a massive role in the history of our species.

But at what point does a substance go from and “addictive” substance that is consumed to an addiction in an individual? After all, there are many individuals who eat, drink, and inhale substances and never become addicted to them. We all know of the occasional drinker, the occasional smoker. When is the point reached where a person has to have a substance?

What makes a substance addictive?

There are literally billions of unique substances on this earth, and many of them we interact with in our environment on a daily basis. Air, water, various proteins, minerals, countless plant and animal proteins… It is mind-boggling how many things we come in contact with each day. So why do some of these substances make our bodies desire more and more of them, while the other we interact with without so much as a thought?

As it turns out, the properties of a substance that makes it addictive all boil down to the interaction of the substance with very particular portions of the brain. It is the neurotransmitter, hormonal and chemical responses by the brain to the substance which make a substance either innocuous or addictive. All addictive substances share many similarities with how they interact with the brain and the conditions that they produce in the brain. The following section is going to be a little technical and “science-ey”, so I apologize in advance for any headaches caused. I do promise to keep the technical jargon down to an absolute minimum, but I feel that it is important to explain the science behind addiction in some detail to give you a clearer picture of what is really going on in your body.

Brain Physiology:The Mesolimbic System

The part of the brain which is most involved in an addictive response to a substance is named the mesolimbic system. This “system” is actually more a collection of several distinct neural structures located in the cortex region of the brain. The primary constituent structures of the limbic system are the amygdala, hippocampus, septal nuclei, and anterior nucleate gyrus, and maybe the most important and well-known brain structure in regards to addiction is the nucleus accumbens. My intention certainly is not to overwhelm you with scientific terms or technical jargon. The real message is that the brain is incredibly complex, and that these structures have many diverse functions to carry out for the body. The hippocampus, for example, is responsible for the development of long-term memories. The piriform cortex has a significant role in the physiological process of smelling. The functions don’t necessarily relate to one another. But it is the reward and pleasure response functions of this system that we are interested in for our purposes. For simplicity’s sake, I will limit our discussion to the three portions of the mesolimbic system which are most prominently involved in addiction… the nucleus accumbens and the amygdala. I don’t want you to misunderstand, the reward center of the brain certainly is not the only player in the game when we talk about the physiology of addiction. Other systems, hormones, and neurotransmitters influence the reward pathway as well. But for our purposes an examination of the amygdala and nucleus accumbens show us the “beating heart” of the addiction response.

The Amygdala

The amygdala are two small, nodule-like structures situated deep in the middle of the brain. They are highly connected to several important parts of the brain such as the hypothalmus, trigeminal nerve the ventral tegmental area (VTA). It has a few rather diverse jobs in the grand scheme of things for the body, but the function that we are most concerned about with our subject is its role in positive learning. It forms memories of positive events (and substances) that you come into contact with and remembers that substance is a “positive” thing for some future time. This makes the amygdala very important in the process because it is essentially where the memory of the “good feeling” starts and ends. This has been shown conclusively in animal studies. When mice have their amygdala damaged, they no longer pursue the positive behaviors that other mice do.

Nucleus Accumbens

The nucleus accumbens is the structure of the brain most famous for being labeled the “pleasure center”. When we have a pleasurable experience in life, whatever it may be, chances are the nucleus accumbens is in a very active state. This little structure also connects to several other structures in the brain, including the amygdala and VTA. The actual biology is way beyond the scope of this article, but a simple explanation is that when you have a pleasurable experience, several other structures in the stimulate a release of the neurotransmitter dopamine in the nucleus acumbens. This dopamine then interacts with the nucleus accumbens, activating it and producing the “good feeling” that we experience.

When it is functioning like it was designed to, it is a fascinating process. Nature has designed this chemical reaction specifically to put us in favorable positions as frequently as possible. This is because the things we experience in nature which cause this effect on our brain are generally good for us in a biological sense. Our bodies and the natural environment thus perform a beautifully precise dance with the substances it provides.

In order for this process to happen a substance is produced by the plant to heighten this pleasure response in our brain. As time passed through history, the plants who developed greater attractive substances ( sweeter fruit, caffeine, nicotine) thrived and dominated. Over the years, nature produced some very potent substances through this process of natural selection which exert a very high dopamine response in the nucleus accumbens. The end result? Addictive substances were born.

So the question is, if addiction is a natural process, then where did biology go wrong? Well, biology didn’t go wrong….mankind intervened in nature and did what we do time and time again…made a giant mess.

The truth is, these natural compounds in their native state aren’t particularly harmful or addictive. For instance, when taken in its natural form the coca leaf isn’t a terribly bad thing and only modestly addictive. However when man isolated, condensed, and purified the addictive substance contained in the coca leaf (cocaine), a highly addictive and terrible substance was born which enslaves many people to its effects. The same can be said for poppy seeds (opium, heroin), and many other drugs of addiction.

If you take an MRI of the brain of a heroine addict, a crack addict, and an alcoholic while they are in the midst of a binge of their substance of choice, the brain activity is nearly identical. They all have extremely active nucleus accumbens with surging dopamine levels in that part of their brain. So, how does this tie in to our dietary woes?

Brain Scans of Various Addicts vs. Normal Brains. Notice the similar level of activity (yellow vs. red).

It just so happens that we use the same system of condensing and purifying for sugar. It has been proven in a multitude of studies that sugar effects the brain in an identical manner as the common drugs of addiction. When ingested, sugars stimulate a rapid and very high level of dopamine secretion in the nucleus accumbens. This is the exact condition which we believe triggers addiction in all its forms. So where is the real-world evidence?

Heavy sugar consumers, be it junk food junkies or high carbohydrate marathoners, display significant withdrawal symptoms when the sugar content of their diet is drastically reduced or eliminated. Heaches, diarrhea, nausea, fatigue, low grade fever, and shivering are the most common symptoms of sugar withdrawal. You have probably experienced these symptoms yourself if you have tried to crash diet, or simply suddenly went from being a couch potato to a strict diet overnight. These symptoms are hallmarks of addictive drug withdrawal.

Proof of Sugar’s Addictive Properties. This Bird Has Been Whacked Out of His Mind on Sugar Since I was a Child

Of course, the one big difference between sugar and other addictive substances (alcohol excepted) is that sugar just happens to also contain calories. When you are addicted to sugar and the good feeling of contentment that it brings to you, you are also packing in tremendous amounts of caloric energy which must be accounted for. Thanks to sugar’s unique metabolic properties, these calories are particularly harmful and quite useless to a healthy human body. We will discuss sugar’s specific metabolic problems in next month’s installment, but for now just know that sugar calories are bad for you… with a capital B.

It is my belief that addiction to sugar in all of its permutations ( table sugar, high fructose corn syrup, etc.) is the beating heart of our obesity epidemic. I contend that only by recognizing sugar as an addictive substance instead of just a source of calories and then treating it as such in our diets will we begin to understand its effects on our physiology, psychology and corpulence.

There is one group in our society who has been clued in to the sugar and addiction relationship for years. Food manufacturers, over the past 30 years, have added high fructose corn syrup to everything they produce. You may not have even realized this unless you consciously read ingredients in your everyday food items. Do you think this is an accident? Of course it is not. They are well aware they are lacing their products with an addictive substance to ensure a heightened attraction to their products. Can you think of another reason they would put corn syrup in bread? Pretzels? Saltine crackers? Lunch meats? All of these products existed for an eternity without added sugars. Do you feel duped yet?

These Guys Have Known About This Science for Decades

The one point that I hope that you take home from this article is to begin viewing the food you eat not as energy, but as biologically active substances. You could even call them drugs, and in the final analysis that may be the most descriptive word for our food. They cause particular and measurable biological and biochemical responses to their ingestion. Many components of food target specific receptors in the body ( just like contemporary pharmaceuticals). Hippocrates once wrote, “Let food be thy medicine, and medicine be thy food.” I think he had it figured out 2000 years ago. The point I am trying to make is, don’t underestimate your food. To think of it as mere energy is to do your health and body composition a great disservice.

Where Do We Go From Here?

So sugar is an addictive substance, and you are an addict. So, where do we go from here? We will begin addressing how to deal with your dependence on sugar in the next installment, but your homework is two-fold:

Read the labels of the food in your kitchen this week to see how many products you have been eating have hidden additive sugars

At each meal, instead of thinking “how many calories is this?” think “how is this going to interact with my body?”

Until next time!

TAGS: Nutrition

Reconstructing the Anabolic Diet- Part 2

June 19th, 2012

4 responses

Matt Poteet, Pharm.D.

In part 1 of the series, we looked at the Anabolic Diet’s low carbohydrate, ketogenic weekday phase. We discussed the general premises of the diet, and I explained the modifications that I would make in order to make the diet more effective for body composition changes and much healthier in the long-term. In part 2, we will examine everyone’s favorite part of the diet- the weekend carb load. We will examine the potential shortcomings of the original plan, the most common pitfalls in the carb load and how to avoid them, and I will provide a more detailed and targeted plan to accomplish the goals of the carb load which, in my opinion, will provide both superior body composition results and a better overall health profile for the dieter.

As we discussed in part 1, the biggest issue with Dr. Dipasquale’s original recommendations are again lack of specificity and quality. This problem gets compounded on the weekend carb load, due to the much higher amount of food and the very pronounced hormonal response that the weekend foods illicit. In fact, far from being the gluttonous period of gastronomic debauchery that so many Anabolic Diet practitioners see it as, the weekend phase is actually quite hormonally and biochemically complex. What was originally marketed as “anything you want for 36-48 hours is really best broken down into three distinct phases which correspond to the body’s continually changing hormonal environment in response to the weekend foods. In order to really get the most out of the Anabolic Diet in physique development, careful attention should be paid to these phases. I will break down each phase, explain what you need to eat in the phase, why, and how long it needs to be. We will then put it together for a comprehensive overview of the weekend.

Phase 1

If there is a period that most closely resembles the original Anabolic Diet’s weekend recommendations, it is the period I call Phase 1. In this phase, your body has the most favorable hormonal and biochemical environment possible for utilization of carbohydrate. This is entirely due to the previous five days of low-carbohydrate, high- fat eating and training. These days:

Exhaust hepatic and muscular glycogen stores
Potentiate GLUT4 receptor activity
Stimulate AKT2 activity

Basically the body is almost out of immediately-usable energy stores, and it knows it. Since being low on energy is generally bad for surviving things which may arise, there is a compensation which takes place. The body gets exceptionally efficient at up-taking glucose from the bloodstream. Conversely, the environment for fat storage and converting glucose into triglyceride is very poor. Enzymes such as lipoprotein lipase, which is responsible for the uptake of triglyceride into the fat cells, are down-regulated. The liver is also in “storage mode”. The various enzymes which convert sugars into triglyceride are inhibited, while the enzymes responsible for glycogenolysis and storage are activated and hyper-sensitive. This “perfect storm” of biochemistry is what enables the consumption of all manner of junk food on the diet without adversely affecting the physique. Nothing is really off-limits in this period, even the dreaded high fructose corn syrup. In fact, this is the one time where fructose can serve a useful purpose as it is extremely efficient at replenishing liver glycogen in while the body is in this depleted state. Unfortunately this little phase doesn’t last forever, in fact it doesn’t last very long at all. All of these phases are very transient, and the physiological environment begins changing in response to the high levels of sugar immediately. Once you take that first bite of whatever decadent, sinful food you decide to eat first on your carb load, the clock starts. So the big question is….how long does it last? The answer is very individualized, but in general a person with normal body fat levels and normal insulin resistance will last about 6 hours in this phase before conditions change. The better shape you are in, the longer the phase 1 environment can last. Some elite athletes and bodybuilders can stay in phase 1 for an entire 24 hour period.

Even for the elite though, there comes a time when phase 1 ends. It is then time to begin thinking again before you shove that food in your pie-hole. For purposes of rapid fat loss, for those who are not in great shape and are just beginning this type of diet, and for those who have very poor insulin sensitivity and/or borderline diabetic phase 1 may be all that can be handled for the weekly carb load. The hormonal environment, insulin sensitivity, and intracellular glycogen stores are just not great enough yet to handle more than that. After a period of time on the diet this will change for the better and allow the individual to improve his baseline insulin sensitivity and to move on to phase two, where the majority of glycogen supercompensation takes place.

Phase 2

After you have driven back home from Dairy Queen and called an end to phase 1, an assessment of what is going on in your body is warranted. You now have a high to very high level of circulating insulin, while simultaneously continuing to hold on to good insulin sensitivity. This is a very advantageous phase for those who look to increase muscle mass on this diet. In fact this phase is essential of if the the greatest amount of muscle mass and performance is an objective. Due to the full liver however, special consideration must be taken when selecting the carbohydrate sources in this phase. This is essentially where I diverge from Dipasquale’s recommendations. Whereas he would have you eating pizza and ice cream the rest of the carb load, I believe in turning attention to the quality of carbohydrate in order to produce the most effective glycogen super-compensation in the skeletal muscle. We also need to keep one eye on our long term health as well. While a six hour free-for-all sounds unhealthy, I doubt that there are any long term health consequences to such an eating pattern. The total weekly time is simply too low and the calories which are able to be ingested too small a percentage of the weekly calories to make a difference. Once we get into phase 2, the period starts stretching into a day-long affair and the implications are greater for poor food choices.

Recommendations for the carbohydrate source in this phase are for predominantly long chain amylopectin and amylose-containing foods. Rice (white or brown), potatoes, pastas, oats are all fine choices. The key in carbohydrate selection in this phase is the elimination of fructose-containing carbohydrates. Why? Well, that has to do with our biological processing of fructose. Essentially, fructose cannot participate in glycogen loading when the liver is full of glycogen. It is 100% metabolized by the liver, and in this scenario the vast majority of fructose will be converted into triglyceride. This is not what we want or need in any phase of our dieting life, and we certainly don’t want to be eating a large portion of our carbohydrate during a carbohydrate load which cannot participate in making glycogen. The length of phase two can certainly vary based on all of the individual physiological differences that we talked about with phase 1.

I generally recommend phase 2 at that way. roughly twice as long as phase 1. In the scenario of the typical dieter mentioned above, this would be a 12 hour phase. Those with exceptional physiology could extend this though. Phase 2 accomplishes the real leg work of the carbohydrate load on the Anabolic Diet. Once completed, glycogen stores should very well be close to topped off. Some people will say that, once this happens, you should go immediately back to low-carbohydrate eating. This is certainly one way to do it, and there may be some positives to doing it that way. I have found through experimentation that a phase 3, or “transition” provides an even greater glycogen supercompensation while making the transition back to ketosis easier on Sunday and Monday.

Phase 3

The purpose of phase 3 is two-fold; to provide additional carbohydrates in order to complete the super-compensation and to provide slightly more dietary fat back in to the diet in order to transition back into a “fat-fuel” metabolism. This phase is short- it is comprised of two meals over roughly 4-6 hours. For carbohydrate sources, complex carbohydrate with lots of dietary fiber is the goal. This is the time for Ezekiel-type breads, steel-cut oats, quinoa, and similar foods. High dietary fiber will limit absorption and coupled with the dietary fat slow gastric emptying. This provides a perfect “bridge” back to low-carb land. We are essentially tapering off of carbohydrate (and thus insulin), treating it as the powerful pharmacological substance that it is.

Putting it All Together

So, how does it all fit together in the real world? And the larger question, is DIpasquale’s diet most attractive trait, its livability, preserved? Let’s look at it in totality. Instead of the 36-48 hour free-for-all we have:

6 hour “free-for-all”
12-18 hour glycogen supercompensation period
4-6 hour transition

How does this translate into “livability”? Well, let us assume you go start the weekend at dinnertime on Friday night. Friday night will be the “hang out” night. You can go to the ice cream social at the local senior living center, go out with the guys for some drinks, eat your corn dog and cotton candy at the fair. Do whatever you feel like doing, whenever you feel like doing it. You then stumble home with an insulin hangover and go to bed. Getting up the next day, its whole wheat waffles, French toast, rice krispies for breakfast, a trip to the sushi buffet for lunch, and spaghetti for dinner on date night. And as day turns into evening, eat a couple of smaller meals before bed for your phase 3. Things like a small bowl of oatmeal with peanut butter, Ezekiel toast with bacon and eggs would fit the bill.

Conclusion

So that’s the weekend. Hopefully I have stimulated you to think a little deeper in regards to carbohydrate type, frequency, and duration. In part 3, we will wrap things up looking at supplementation and tying the entire diet into a comprehensive training system which takes full advantage of the Anabolic Diet’s cyclical properties.

TAGS: Healthy Living

June Nutraceutical of the Month – Maca Root

June 11th, 2012

Matt Poteet, Pharm.D.

Maca Root ( Lepidium meyenii )

Do you feel tired? Despite the copious amounts of caffeine and other stimulants you scarf down throughout the day, do you find youself feeling like you just don’t have the energy left in the tank to complete all of the day’s tasks? Before you turn to harsh ( and usually harmful ) stimulant medications, more caffeine, or gimmicky energy drinks why not try a natural solution for a change?

Maca root has been used for hundreds of years by the ancient south american cultures to combat lack of energy and vitality. It was given to their warriors in preparation for battle or strenuous work, like building giant neolithic stone monuments. If it could power the building of giant stone cities, I think it just might also be useful in getting you through the 2 PM “sleepy time” and on to finishing that proposal by 5 PM. The mechanism of action isn’t well understod, but it possibly potentiates the thyroid gland to work more efficiently in the conversion of thyroid hormone to its active form. Try 1000 mg three times a day for a few weeks. Who knows….you may be so productive your boss will give you a raise. Maybe not, but we can dream can’t we?

TAGS: Healthy Living

I Should Be Dead!

June 2nd, 2012

2 responses

Matt Poteet, Pharm.D.

For the past six weeks I’ve been experimenting with a very high fat diet where I’m getting 65% of my calories from fat. No, that’s not a misprint. The vast majority of my calories are coming fat, and a good chunk of that has been saturated fat. The very same fat you’ve been told to avoid for decades because it would “damage your heart, build up in your arteries, increase your risk of cancer and even lead to obesity.” Curious about how this was affecting my body, I scheduled a full blood panel with our doctor. After seeing the results of that blood work, I shared with my doctor the details of my diet and how I teach people that fat is actually beneficial. She warned me that while this diet may be working for me, I may be the exception to the rule.

Gary Taubes, in his ground-breaking book “Good Calories, Bad Calories”, dug through TONS of research and found something surprising. Fat, touted as harmful for your diet, is a lie. And it’s a lie that has been covered up and repeated so many times, it’s been accepted as truth. We all know what that’s like – we all have that one friend whose stories are so far out of whack but so often heard, that we begin to believe them. I was guilty of thinking this way too; most of us at some point have been. However, not only did Taubes discover studies that uncover the truth about saturated fat and cholesterol – both wrongly put on the “naughty list”, but new studies are now showing just how beneficial they really are[i].

One study centered on coconut oil, which is a fantastic oil to use for cooking and baking, in shakes, and when topically applied, is a detoxifying agent for skin. Coconut oil is very heavy in saturated fat. It has higher saturated fat content than red meat, which by the way, has more monounsaturated fat than it does saturated. Yet, thanks to the misguided war on red meat and saturated fat, we’ve come to believe that red meat is loaded in this stuff. But I digress. A Brazilian study showed that when middle-aged women replaced their intake of canola oil with the EXACT number of calories from coconut oil, an interesting thing happened. Their HDL (good cholesterol) increased, triglycerides lowered, and they lost abdominal fat. By including more saturated fat from coconut oil in the diet, regardless of the calorie content, several markers for heart health and diabetes risk drastically decreased. I’ll bet they looked younger and more vibrant as well.

It’s unfortunate. We’ve been told for decades to avoid these foods and build our diet around “good” carbohydrates. Yet, sadly, a high carbohydrate diet can promote weight gain for most people, decrease their HDL, and increase their triglycerides; this is in complete opposition to what conventional dietary wisdom says will happen. And yet we wonder why our children are obese at such young ages, and why our health across the nation is worse than ever. Even my doctor wonders why the vast majority of her male patients don’t have HDL numbers as good as mine.

Personally, I don’t believe it’s “simply” a matter of will-power, or one of individual responsibility. There are tens of thousands of people who spend hours at gyms and fitness clubs throughout the country, but who are frustrated that the pounds just won’t come off. I see it every single day. These folks tell me they’re eating healthy foods, have cut back on saturated fat and cholesterol, and are increasing their whole grain consumption. Are you seeing the pattern yet? This is NOT WORKING. Living a lifestyle with these parameters only causes us to avoid the foods – the REAL foods – that help to control our appetites, our weight, and lower our risk of disease.

So, how has a diet of high fat and high cholesterol worked out for me? Below is a picture of my results. Look specifically at the numbers circled in red.

These numbers squash claims that saturated fat and cholesterol are the “bad guys”. We’ve been told that red meat, eggs, and bacon increase our blood cholesterol. But I eat these foods along with coconut oil everyday and it looks like I’m doing just fine. In fact, I’m doing better than a lot of people. The studies I’ve mentioned prove that though your total cholesterol may go up, but it’s your HDL that’s holding the torch, and the LDL that’s struggling to catch up. When my doctor saw my HDL of 71, her eyes widened, “I almost never have guys with levels that high.”

If you’re not familiar with triglycerides, they are another piece of the puzzle that can clue us into our health status. When levels get above 150, doctors will get worried that you are at a higher risk of heart or diabetes issues. Mine clocked in at a low 45. My high fat, low-carbohydrate diet looks like it is keeping my triglycerides nice and low, which is further backed by numerous studies. My daily shot of fish oil doesn’t hurt either.

How can you predict the future of your heart health? Take your triglycerides and divide them by your HDL. This is your triglyceride to HDL ratio (TG:HDL). The ratio of triglycerides to HDL was the strongest predictor of a heart attack, even more accurate than the LDL/HDL ratio (Circulation 1997;96:2520-2525). As your ratio creeps above 3.0 and nearing the 4.0 range, the risk of heart problems is increased. Ideally you want to shoot for 2.0 or lower. My TG:HDL ratio is a svelte .63.

I also requested my physician order an NMR cholesterol test for me. This is a relatively new test and not all doctors will be aware of it. But, the cool thing with this test is that it measures the size of your cholesterol particles. While this topic is another article in of itself, essentially the NMR test gives you further input about the sizes of your LDL particles and can clue you into whether or not you have the fluffy “good” LDL (yes, I’m saying right now LDL is not bad cholesterol as you’ve been lead to believe) or if you have more small dense LDL that can be problematic for our health.

Here are my NMR numbers which were taken three weeks after my first cholesterol test. Take note that some of my numbers changed within only a few weeks. I’ll let Dr. Matt Poteet chime in on this section of the article to give his input on my readings.

LDL-P – 1,111

HDL – 63

Triglycerides – 32

Small LDL-P 390

LDL Size – 20.7

As we mentioned in the first part of our cholesterol series, both particle size and particle number are very important to extrapolate useful information from a lipid profile. Some of these levels will look completely foreign to the reader, due to the fact that mainstream medicine has yet to embrace them as a metric for cardiovaclar health. Mark’s test shows the strong trend toward increased LDL particle size, lower LDL particle number, increased HDL, and very low triglyceride which are all hallmarks of an excellent lipid profile. Every physician in America would be ecstatic to see their patients with these numbers, yet Mark produced these numbers eating a diet very high in tropical oils and animal fat which have been deemed terrible for you by the mainstream for decades. This is proof positive that there is much more to the story of heart disease than what we have been told through the years. For a little more information on the NMR test, click here. Interested in taking the NMR test? See this website.

-Matt

At this point, I should note that genetics are not on my side. Heart disease runs rampant on both sides of my family, affecting both parents at an early age as well as my father’s parents. As the saying goes, “genetics load the gun, lifestyle pulls the trigger.” By steering clear of the lifestyle habits on which I was raised, I was able to avoid that smoking gun. High blood pressure also runs in my family and mine is usually “normal” at 120-125/80-85. While on this low-carb diet my blood pressure has only improved and is now usually at 110-115/65-75. No surprise here as a high carb diet will elevate insulin levels which in turn will raise blood pressure. Plus, you retain more water on a high carb diet which will also increase pressure. If anything, I’ve been adding more salt to my diet lately because I’m eating more vegetables. It’s no wonder so many people have high blood pressure these days. They’re just following conventional dietary wisdom.

The American Dietetics Association still supports the idea that saturated fat plays a role in increasing our odds of Type 2 diabetes. Yet, if we look at my A1C levels above, which is an average of blood sugar over the past three months, I’m well below the pre-diabetic category, let alone the diabetic one. Some health practitioners believe that 4% is ideal, so personally I’d like to see my number even lower. But after six weeks of this lifestyle, I’ve been able to bring down my fasting blood sugar by almost 10 points.

These recommendations of antiquity, in my opinion, immensely contributed to the obesity epidemic we see today. In fact, many of us don’t see it at all; we take it as the norm. But our “norm” shouldn’t be to expect heart disease, Type 2 diabetes, cancer, and Alzheimer’s as inevitable. Regular physical activity and REAL food will heal your body and your mind; which may give your doctor a stroke, metaphorically, of course.

So, eat up America! Red meat (from pasture/grass-fed cows), organic/local eggs (yes, yolk included), and organic bacon is back on the menu. Skip the stuff that comes in packages and anything that has a shiny and colorful “healthy” sticker on it. Remember this: health doesn’t come packaged like a toy in a cereal box, or down the chip isle at the organic store. All we have to do is eat REAL FOOD.

Stay tuned for the next article where we can look at another case study of someone who is following a diet a bit lower in fat than mine, but more strictly Paleo. You know, still full of all that stuff we’ve been told is bad for us.

[i]Study Links

http://www.ajcn.org/content/91/3/535

https://www.ncbi.nlm.nih.gov/pubmed/20071648

https://www.ncbi.nlm.nih.gov/pubmed/19751443

https://www.ncbi.nlm.nih.gov/pubmed/20354806

https://www.ncbi.nlm.nih.gov/pubmed/20683785

https://www.ncbi.nlm.nih.gov/pubmed/21951982

TAGS: Healthy Living

Carrie’s Knockout Chili

May 23rd, 2012

Matt Poteet, Pharm.D.

Submitted by Carrie Padgett

Everybody loves chili. Most people view chili as a “cold weather” food. If you only eat chili when its cold outside, you miss an incredible opportunity to use fresh garden ingredients, which gives this traditional american meal a subtle but noticable flavor jolt. This is a very quick and easy stove top version.It has no beans ( shout out to Texas) and minimizes other carb-heavy ingredients without sacrificing taste. The tomato paste thickens it rathar than corn starch or flour that many chili recipes call for.

Ingredients:

2tbsp butter

5oz (1/2 large) white onion- diced

2 cloves garlic, minced

1 fresh jalapeno, minced

2.5lbs ground beef

4tbsp tomato paste

2c homemade beef stock

2 c diced fresh tomato

3tbsp chili powder

1/2tsp cayenne pepper

2tsp paprika

1tbsp ground cumin

1tsp salt

Directions:

In a large pot, melt butter, then add onion, jalapeno, and garlic. Cook until onions are soft and translucent, about 5 minutes. Add ground beef, cook until browned. Add remaining ingredients, stir thoroughly and let simmer 20-30 min. Top with shredded sharp cheddar, sour cream, and sliced avocado.

TAGS: Recipes

Our Modern Food Addiction

May 21st, 2012

Matt Poteet, Pharm.D.

There have been many books on the subject of diet written in the past 30 years, and it feels like I have read them all. I am sure that you have read nearly as many as I have. Most of these books view our society’s weight problem as a problem of consumption. The various plans either try to solve the problem hormonally, through the suppression of insulin via a lowered carbohydrate intake, or through portion control of various means. These books have all met with varying degrees of success, and some are scientifically sound. But one thing keeps happening over and over again; people keep writing more diet books. Our problem with obesity has not been fixed, and as you know has only gotten worse. The First Lady of the United States has made it her personal crusade while in the White House to try to influence our society and specifically our children, to eat healthy and exercise. I applaud her for her effort, but I do not see it making much of a dent in the statistics.

All of the books, the First Lady, the celebrity weight loss shows have one thing in common; they look at our obesity problem as a defect in our behavior. They say “If you establish healthy behaviors you will defeat obesity” and “ People need to make better food choices”. All of this is predicated on the belief that people are willingly making bad choices, see an alternative, and can physically make a different choice. You do see some success stories. There is the occasional very large weight loss, or the middle-aged guy who finally rids himself of those 20 pounds he has held on to around his midsection for the last 15 years with a diet of meat and cheese. But the rarest of all the weight-loss storybook endings just happens to be the “and kept it off permanently” variety. It is truly a sad fact of our modern dietary experience that re-gaining previously lost weight is much more common than keeping the weight off. In fact, a recent study indicated that 31 percent of all dieters regain the entire amount of weight lost on any diet within 6 months of the cessation of that diet. That is simply a staggering statistic.

These facts bring up the proverbial million dollar question: If obesity is simply a behavior problem, and if we can correct that behavior problem for a significant period of time (lose our desired weight), then why do such a large percentage of people re-gain the weight that they lost? Why would an individual suffer through several months of dieting, restricting his calories or fat or carbohydrates through behavior modification just to turn around and adopt those same poor behaviors again, regain the weight and basically waste all of the effort they expended over that period of time? You and I both know that they would not willingly do this. Something more is at play here. Something that really takes the behavior choices out of the hands of the individual. That something is addiction.

It will be my objective, over the course of time, to lay out a case for food addiction as the primary reason for the increase in our society’s obesity over the past 30 years. In particular, it is addiction to sugar which is to blame. Chronic consumption of sugar causes numerous physiological changes in our brain which are synonymous with the changes caused by drugs of abuse. I will also show how sugar is metabolically different from other sources of carbohydrates, proteins, or dietary fat and how that difference makes it a physiological disaster to your long term health and well being. I will also show that, the reason for the rise in obesity over the past 30 years happens to coincide exactly with the increase in sugar and sugar additives in our food supply in the same time period. The increase being a financial boon for certain industries in our country and how the low fat craze of the late 70’s and early 80’s actually opened the door for this abuse to take place.

I will then share with you a plan to truly address the problem of sugar addiction. A program not unlike the one which has been used for years in treating patients who are victims of other substances of abuse. This program will provide an assessment of your current level of sugar consumption, a plan to easily taper down from that level, and a program to successfully transition you to the natural diet which we were intended as a species to survive and thrive on.

How I Got Here

I began to look at the problem of obesity at a very young age. I didn’t do this out of any intellectual curiosity at the time ( thanks to Indiana Jones I wanted to be an archaeologist when I was 12), but rather out of the necessities of my world. I was a fat kid. My mother was a child of the late Depression era in rural Appalachian East Tennessee. She grew up mostly hungry as a child, and even as a young adult her and my father sometimes struggled to put enough food on the table for my older two siblings. By the time my little brother and I came along in the late 1970s, my father had a good stable job on the railroad. In our little town, it was one of the best jobs to be had. So we never had to go without. Unfortunately my mother just happened to be the first sugar addict that I met in my life. Her eyes still light up like Christmas morning at the mentioning of a cake or chocolate pinwheel cookies. Needless to say, sweets were in great abundance in my childhood home.

There wasn’t a whole lot of structure to the kids acquiring them either. We didn’t have to sweep the floor or mow the grass or take out the garbage to earn a piece of candy, we simply ate one…or three. No one saw anything wrong with eating a lot of sugar. I certainly didn’t see a Saturday Morning Schoolhouse Rock telling me to avoid eating snack cakes because I would become as big as a house. There was an occasional comment that eating sugar would “give you diabetes” by my mother, but it was just a comment. My pediatrician also said nothing to my mother about my diet or obesity. She had plenty of opportunity, as I visited her quite frequently due to stomach pains and other gastrointestinal complaints that she passed off as a “nervous stomach”. ( I would later discover these ailments were diet-related) She would follow the allopathic medical script religiously; write me a prescription for the symptoms and send me home. this continued as long as I went to her.

I say all of this not to try to say that there was anything wrong or deficient with my upbringing. My mother is the greatest, kindest women I have ever known. Had she known the dangers of the diet she was feeding her children, she would have stopped it immediately. I bring up my childhood diet and its problems because it is absolutely typical in our society. Parents feed their children poorly and the pediatricians are disconnected from that part are the child’s health. Limiting dietary fat is their only general nutritional macronutrient recommendation for children older than two.

As I grew up I was an active and extremely happy child. I participated in every sport, even excelling in some, and had many friends. Despitte all of this activity, I was still very overweight. When adolescence came around and females started to be noticed, the weight around my belly became an issue. The slim among us have no idea what a deterrent a big belly is to securing a date to the school dance. After being turned down for the first couple of dances, I made the connection between the ice cream, my belly, and the rejection of the pretty girl in the corner. I decided I must do something about it. I went on a simple diet, mostly eliminating the sweets, and lost the weight I needed to lose right in time for high school. But as time went on I continually battled with sugar and weight gain.

It was in high school where I began having a real interest in the science of nutrition. It was the early 1990’s, during the height of the low fat craze that swept the world. I recall one of my good friends older sister being very overweight and frustrated to the point of tears that no matter what she did, the weight just wouldn’t come off. As she talked further she mentioned that she ate no fat and that she had even substituted her regular candy bars with fat free devil’s food snack cookies and the weight wouldn’t budge. Even as a teenager with zero scientific knowledge or training, this perked my ears up. I remember thinking that there is something more going on than just the general public consensus that dietary fat was unhealthy and made you fat. So I stored that little curiosity away in the back of my mind and moved on. Throughout high school and undergraduate training, I began developing a deep interest in nutrition while training for the sports such as weightlifting and bodybuilding that I became involved in. I read whatever popular information there was at the time about nutritional science, soaking up everything I could. But no matter what, I continued to struggle with my own weight fluctuations. It seems I would always be gaining and losing the same 20 pounds year after year. I became a master of losing weight and getting into great condition. I could get down to single digit bodyfat levels right on schedule for a competition or for summer vacation. It was tedious work, but I knew almost exactly how many weeks it would take me eating my monotonous low calorie, low fat diet and exercising before I reached my target bodyfat level. But just like clockwork, when I came off of the strenuous fat loss diet I would regain the 20 pounds. Of course this was extremely frustrating but I accepted it as just part of life. My body simply would not maintain a weight that was so low.

The most interesting part of these diet episodes was, when beginning these dieting periods, I noticed that for the first four to seven days that I would feel absolutely terrible. I would have terrible headaches, my eyes became sensitive to light, I would have a lot of trouble sleeping, and I had one thought constantly on my mind; sugar. Getting my mouth on a cake, pie, or candy bar was almost all that I thought about. The feeling was the most intense for the first week, but lingered on in the background of my mind for three or four weeks. Then, I was fine if I made it through those first few weeks. Several times I did not. I gave in and ate the sugar, and ate a lot of it. When I did, all was right with the world. The headache disappeared, I slept like a baby, and I felt calm and relaxed during the waking hours. I thought about this at length through undergraduate training and it was then that I started thinking that the sugar itself may have some addictive properties and what I was experiencing was withdrawal.

I had always been very interested in the science of addiction. My family, like many others, have had several family members who have struggled constantly with substance abuse. I have witnessed first hand the power that substances have over the life of an addict; from the personality changes during a binge, the negative effect that it has on the family structure, and the price that the addict pays to society when his addiction becomes more than he can contain inside their self. I have also witnessed the effects of withdrawal on the health of my loved ones. I have seen the discomfort, heard about the headaches, watched as nights of sleep were lost. Addiction influenced my decisions as an adult in many ways. When I became a pharmacist, I did so in large part because of the curiosity I had in pharmaceuticals and their therapeutic uses which I first took an interest in from seeing the harm that they could cause by being used inappropriately. In a way, I wanted the deepest understanding of pharmacology that I could achieve so that I might understand my personal life better. Many professionals I have heard speak on their career choices have stated a similar reasoning for their choices.

Pharmacy school was the vehicle which allowed me to really fill out the science behind addiction. The physical and chemical properties of the pharmaceutical agents became de-mystified. I was able, as a clinician, to see the ghost in the machine of addiction. After three years of didactic (classroom) training in pharmacy school, a candidate completes a a fourth year of clinical rotations. These clinical rotations are largely of your choosing and are very diverse in their scope. When it came time for me to select my elective rotations, I jumped at the chance to do a rotation in substance abuse. The setting was an outpatient substance abuse clinic in metropolitan Atlanta. There were individuals addicted to just about every substance you can think of that can be abused in that clinic; an 18 year old addicted to sniffing paint, a heroin addict in recovery, crack addicts from the inner city, and alcoholics. All were in various stages of the recovery process and for the most part they were all very physically different from one another. The one thing they had in common was their lives were dramatically affected by a substance.

It was right around this time that I began to see the connection between the pharmaceutical agents that were crippling the members of the abuse clinic and the substance was causing me and many of the people that I knew so much grief with our waistline and health. I began looking into the science behind sugar addiction and found that there is compelling evidence already in the scientific literature. I applied these scientific principles to my own diet and have completely and permanently cured myself of the affliction of the addiction to sugar. In doing so I developed a program that I believe is the easiest, quickest way for sugar-addicted individuals in our modern society to forever cast off the shackles of yo-yo dieting, weight fluctuations, and low self esteem that comes with not living up to your own expectations.

I am sure some of you are already asking yourself “what is the point of all of this? Why is this pharmacist equating a substance that we all know and love as a harmless treat with a disease as serious as addiction?” It is a difficult realization for all of us. Aside from a few forward-thinking scientists and medical doctors, there really is no one in our society who is even giving serious consideration to this subject. After all, sugar is a natural substance which we have used in one form or another for thousands of years. We received it as a reward for washing the dishes or taking out the trash as a child. We give it to our on children when they do the same. We put it in our coffee in the morning to make it taste better. The word “sugar” has a completley positive connotation in our language. Where I am from in the south, calling someone “sweet”, “sugar”, or “honey” is a positive affirmation for how you feel about that person. How can it possibly be, with all of our history and positive associations with this substance, that sugar is actually both harmful to our health and addictive by itself?

As with most problems in our modern society, the reason this natural substance has been transformed from sweet treat to dangerous substance lies with what we in our infinite wisdom and hubris have transformed the natural substance in to. Our modern processing has made it possible to extract this substance from seemingly unpalatable crops such as corn and beets, concentrate it down into its purest chemical form, and then put it in nearly every commercial product that we consume today. Nature never intended for sugar to be eaten in the form that we eat it now. And for all the thousands of years of our history on this earth our bodies were only familiar with sugar when it came packaged in a large vegetable or fruit. A fruit or vegetable, it turns out, that also contained other substances which aid in the digestion and metabolism of the sugar. We threw all of that out and kept the sugar. We kept the substance that nature created to attract us to consume the fruit, the substance that nature made addictive on purpose, and threw the rest in the nutritional trash heap. Thus, sugar’s addictive properties are free to run rampant in much the same way that other purified substances do, with the natural governor taken off by us.

I hope to make a compelling case for sugar addiction in our modern society. I will attempt to show you how it started, why it started, what it is, and most importantly what to do about it. I hope that, through this knowledge, you will be able to understand the problems and pitfalls of our modern nutritional system, how to eliminate your dependence on sugar through a safe and proven program, and how to eat for the rest of your life free of the concerns and health problems that the sugar addiciton causes. This first part of the series was admittedly a long set up. But I felt it necessary to explain the background to my thinkin gon the subject in order to fully address the issue. The next part of this series we will dive deeply into the science behind addiction, and how it ties in to our modern diet of processed foods from a biological standpoint. So put your thinking caps on and get ready!

TAGS: ChildhoodDiabetesModern DietaryObesitySugar Addiction

Eggplant Parmesan

May 14th, 2012

Matt Poteet, Pharm.D.

Lasagna’s poor little cousin rarely gets press in mainstream society. But it has one huge benefit over lasagna…. It can be made with all-natural ingredients very easily. Techinically, due to my inclusion of meat, my version isn’t eggplant parmesan. The pork adds a great taste bud twist to the usual recipe, as well as some much needed protein! It can easily be made meat-free and is equally delicious, for those in the vegetarian camp. Give this grain free version a try and see what you think. I would bet even Garfield will approve.

Ingredients

2 Eggplants

1 container of parmesan cheese

16 oz high quality marinara sauce

1 pound ground pork or nitrate-free sausage

2 cups almond meal

4 eggs- beaten

½ cup fresh basil

kosher salt

black pepper- freshly ground

2 tsp oregano

1 tsp sage

1 clove garlic- minced

Extra virgin olive oil

Directions:

Pre-heat oven to 350 degrees. Cut eggplants lengthwise into slices roughly 1/8 inch thick. Place in colander and sprinkle lightly with kosher salt. Let sit in sink for 30 minutes to sweat excess moisture out of slices. While slices are sweating, crumble and cook ground pork in skillet with 2 tsp black pepper and the minced garlic. Combine almond meal, oregano, sage, and 2 tsp kosher salt and blend together and place on plate. Beat eggs and place in separate container. Heat skillet with olive oil to medium heat. Begin dipping slices of eggplant in egg wash, dredging in flour mixture, and frying in olive oil on both sides until light brown. Once finished, begin layering mixture into 9 x 11 baking dish. Place a layer of eggplant on bottom, followed by a layer of marinara, then a layer of pork, a dusting of cheese and fresh basil. Repeat until complete, topping with a layer of cheese. Bake until cheese is melted and top is lightly brown (around 30 minutes.) Wait 15 minutes before serving. Serves 8.

TAGS: Recipes

Mark’s Paleo Experience

May 13th, 2012

Mark Shields

Experimenting With The Paleo Diet

During the last month I’ve been experimenting with the Paleo Diet. I have however made some changes that are detailed below. I wanted to see firsthand what the hype is about. In fact, to actually call my trial run as a Paleo Diet may not be fair… its more like a Paleo template. Having known some of the specifics of the diet for a while, I felt no need to dive further into the details. Rather than endlessly researching, why not actually give it a trial run. If you’re not familiar with the Paleo Diet you will soon as it starts to go mainstream. Essentially, the key components are to avoid grains, legumes and dairy. At this point many people will start to feel a little uncomfortable. Give up bread, milk and beans? Well, no one is really sad to give up beans. However, peanuts are a legume, so no peanut butter, that part kind of sucks. At least there are alternatives though.

Paleo Diet – Not A Typical “Diet”

Some call it just another “fad” diet. But I don’t think the Paleo Diet has fallen victim to false advertising; in fact, it’s full of scientifically and logically-based principles. Anytime the word “diet” is attached to something, it leaves a bad taste in my mouth. A “diet” often means a few short-lived habits that can’t be sustained, containing numerous nutritional myths.

Dr. Loren Cordain, author of two of the most notable Paleo Diet books including “The Paleo Answer”, made numerous valid points about health and the potential benefits of excluding dairy, grains, and legumes. His views inspired me to dig a little deeper into my own habits and give Paleo a shot. As a wellness professional, I’d already cut wheat out of my own diet, and for some time I already knew of the unsettling distress dairy has on my digestive system.

Adjusting The Paleo Diet To Fit You

But as a naturally thin guy, I’d hit an impasse. The Paleo Diet emphasizes the inclusion of pasture-raised meats, seafood, veggies, nuts, seeds, some oils, and fruit. While this does provide a variety of food options, someone like me might have difficulty gaining weight with these choices. So, I began following a slightly modified Paleo plan.

To get those extra calories, I’ve reintroduced small amounts of low-lactose dairy, or Kefir, and fortunately I haven’t felt any digestive stress. I include a “wheat-like” product once a week, and through some great Paleo recipe blogs I’ve even found ways to satisfy my cookie addiction! So it’s important to understand that though Paleo has some tight guidelines, it can be the foundation to finding the perfect nutrition lifestyle that’s right for you. Rest assured the Paleo Diet won’t make you feel like you need to sacrifice your favorite foods.

As a Precision Nutrition Fitness Nutrition Coach, I’ve been putting my clients on a modified version of the Paleo Diet even before I knew what Paleo entailed, and often they’d complain of having too much food to eat; they were stuffed but kept losing weight. There’s so much power in not feeling deprived, and actually nourishing your body with the nutrients it needs. Should you make the switch to Paleo?

Research shows that when we try to change too many habits at once, the rate of actual success is abysmal. Thus, for the vast majority of clients, I ask them to make one nutritional change at a time. But there are always exceptions, and such a case involved a senior client who had suffered from acid-reflux and IBS for years. Several specialists tried to help her, and the medications they prescribed not only didn’t work, but they also led to other health issues. After only three weeks of following a modified Paleo approach eliminating wheat and limiting carbs, her symptoms were almost completely gone. And after six weeks, completely gone.

Something to consider when following a Paleo Diet that restricts grains, is that there are people who do not react negatively to all grains, and in proper quantities and timing won’t necessarily lead to weight gain. Amaranth or wild rice for example can still be part of a well-rounded nutritional approach, but probably should be limited in quantity. It’s also important to take into account how those grains are prepared, which we’ll dive into the details in a later article. What about bread? It’s my belief that the vast majority of people who do eliminate “healthy whole wheat”, are actually able to avoid many of the common diseases wheat-eaters suffer from.

Perhaps the biggest challenge for me now, aside from getting enough calories to gain weight, is the elimination of protein powder. I haven’t completely eliminated it, but I have relied on these supplements too much in the past. Protein powder does shake my long-held beliefs about avoiding all processed foods; but there is new research showing benefits to some whey protein consumption in relation to cancer prevention.

Overall, my body is responding extremely well to a diet that many “experts” would say is not optimal because it excludes some foods that are promoted as “healthy”. I’ve modified the diet in a way that fits my lifestyle, goals, and preferences so I know I can stick with it. It’s more important to follow the reliable nutritional habits of the Paleo lifestyle, than it is to sign up with the latest fad diet and fall off the wagon after only a few weeks. The Paleo Diet can be your ticket out of the classic diet rut. If you adjust the Paleo Diet to your comfort levels, you can finally feel good in your body.

Stay tuned for Part 2 where I’ll share the results of my blood work. What are the results internally of a Paleo style diet? Is my doctor going to say she told me so?

TAGS: DietPaleo Diet

Citrus Honey Porterhouse Chops

May 5th, 2012

Matt Poteet, Pharm.D.

Who says steaks should have all the fun? Ask your butcher for a “porterhouse” pork chop cut next time you are at the grocery and see what you’ve been missing! I came up with this little recipe while searching for something “a little sweet, a little salty, and a little spicy”. I think its a winner. Try it out!

Ingredients:

1 TBSP Cracked Black Pepper

2 tsp kosher salt

3 TBSP raw honey

Juice from 1/2 orange

1/2 tsp ground ginger

1 TBSP apple cidar vinegar

1 clove minced garlic

2 tsp Sriracha hot chile sauce

2 bone-in porterhouse pork chops, thick cut

Preparation:

1) Preheat the grill to 450 F.

2) Dust chops with black pepper and kosher salt

3) Prepare the citrus honey glaze by combining remaining ingredients in smll bowl. Honey may need to be heated slightly if too thick to stir in.

4) Liberally glaze each chop with the mixture before placing on grill. Re-glaze while cooking.

5) Enjoy!

TAGS: Recipes

Cholesterol Made Easy- Part 1

May 5th, 2012

2 responses

Matt Poteet, Pharm.D.

Cholesterol Made Easy Part 1
By John Meadows CSCS, CISN and Matt Poteet, Pharm.D.

It seems kind of funny to say “made easy” and cholesterol in the same sentence. The truth is that many facets of cholesterol are actually extremely complicated and beyond the scope of our knowledge by a long shot. Cholesterol synthesis is one such facet. There are at least 12 steps to get 2 acety Co-A to its end form of cholesterol, and there are a ton of big words through these steps like, geranyl pyrophosphatase, squalene, and other words that give me a headache. Knowing the terms and complex biochemical reactions are completely unnecessary for the average guy or gal who simply wants to be be healthy, have a great life, and someday bounce their grandchildren on their knee. Seeing the need for both clarity and simplicity in the subject of cholesterol, we decided to write an article where 95% of the technical and medical jargon is thrown out. Only the bare necessities are here in easily digestible, but physiologically sound form. By the time we finish we hope to have presented cholesterol in the clearest and simplest manner possible in a way everyone can both understand and utilize.

We will attempt demystify the things that you usually hear associated with cholesterol though like “good” and “bad” cholesterol. We will talk about the basics, and also talk about what tests are out there in regards to cholesterol and what they really mean. I think you’ll enjoy this part, as it’s fairly easy to understand, and you’ll very quickly realize how the information that is out there, is mostly incorrect. So hang on tight, and get ready for some cholesterol truth!

How many kinds of cholesterol are there?

There are at least 2 right? Good and bad? WRONG. There is only one kind of cholesterol. It is inheritantly good, and it looks like this.

Riveting pic, I know. Exactly what does cholesterol do in the body? Why is it so important?

It is the beginning structural building block for sex hormones like testosterone
It is very important for cell membrane integrity and fluidity. No cholesterol would mean your cells would be like mini blobs with no rigidity
It is a crucial component of Vitamin D synthesis, with a little help from the sun of course.
It is a primary structural component of your brain and CNS, comprising up to 60% of its overall dry weight. In fact, the highest concentrations of cholesterol in your entire body are in your brain and nervous system.
It is used to make bile acids which are crucial in digestion and absorption of fatty acids and fat soluble vitamins.

So it goes without saying, we need cholesterol. So far so good, we have established that there is only kind of cholesterol, and it’s very important.

Lipoproteins

When someone is speaking of their “cholesterol” levels, what they are actually talking about is a group of molecules called lipoproteins. These lipoproteins act as the carriers of cholesterol. They make it possible for very oily components such as triglycerides and cholesterol to travel through the water-based body. Oil and water don’t mix except with the help of lipoproteins! There are many numerous types of lipoproteins known to us today. Medical science are constantly subdividing them based upon various factors such as size, density, and constituency.But there are five main types which we will discuss today. The first three you may not know much about, but hang tight for the cool stuff.

Chylomicrons – In size, chylomicrons are the largestof the lipoproteins. They are created in the small intestine in response to eating a meal, and their main “job” is to be filled with the dietary fat (triglyceride) and cholesterol after you eat a meal (mostly triglyceride), and then transport these substances to the liver, muscle, and other body components which need them. Once the chylomicron has finished delivering its triglyceride packages to the various body addresses, it is much smaller than when it started. It then travels back to the liver where it is broken down, and possibly reassembled into other lipoproteins like VLDL…
VLDL (Very Low Density Lipoprotein) – VLDL is the second largest in size of the five lipoprotein classes. It is manufactured in the liver and has a similar role in transporting oily substances through the body. But while the chylomicron’s job is to transport the oily substances that you eat, VLDL’s job is to transport the oily substances which are already in your body from place to place. In comparison to chylomicrons, the triglyceride content is usually a little lower, while the cholesterol content is usually a little higher. As VLDL moves about in the body delivering its packages to the various organ systems, an enzyme called LPL (lipoprotein lipase) removes triglyceride for use by the body. As VLDL gradually loses the triglyceride, it becomes smaller and changes in to….
IDL (Intermediate Density Lipoprotein) – By the time VLDL changed into IDL it is usually carrying about half cholesterol and half triglyceride. IDLs are further acted upon by enzymes (hepatic lipase), lose more triglyceride and turn into LDL. Ah finally. We made it to something familiar…LDL..the bad stuff!

I know what you are thing, so Matt and John, that’s cool and all, but what does this have to do with anything???

Well remember we said there is only one kind of cholesterol, and you probably thought if there is only one kind, then what exactly are HDL (good), and LDL (bad) cholesterol?

As we said previously, cholesterol does not dissolve in water (thus not blood either). To get from point A to point B it must move through these lipoprotein carriers. I feel that this situation calls for an analogy. Imagine a road with delivery trucks traveling to and fro with passengers. The trucks are the lipoproteins, the people cholesterol, and the packages in the back are triglycerides. The “HDL” trucks are carrying “cholesterol” people on the road to the Liver Station (your liver). Going the opposite direction are “LDL” cars carrying “cholesterol” people from Liver Station to other places such as Heart City. Keep this fresh in your mind because we are going to return to this analogy often in this discussion.

LDL (Low Density Lipoprotein) – By the time we get to LDL, we only have a few packages left. They are sliding back and forth on the floor. I hope they aren’t fragile! We now have a molecule carrying about 90% cholesterol and 10% triglyceride. When a cell needs some cholesterol, it hangs out a vacancy sign ( in the form of an LDL receptor) The delivery driver is tired of hearing these cranky passengers by now. They have been saying “are we there yet?” for the past 3 hours! So the LDL whips into the LDL recpetor and is transported into the cell. His job is done. Aha, you say. Now it will wreak havok! Well not so fast. More on this later.
HDL (High Density lipoprotein) – Of course we have to mention these carriers too. They are the taxis of the body, stopping along the way to pick up straggling cholesterols who may have had too long of a night out on the town. They head back to the liver hopefully not running too many red lights. There the excess will be removed by the body as bile or broken down and re-allocated to other places in the body for other tasks.

Now that we have laid some groundwork for what is truly going on with cholesterol in your body, lets address a few of the more common myths in our society about cholesterol.

MYTH #1 – Eating fat will raise LDL levels. BUSTED- As was described above, dietary fat (yes even the saturated kind) is shuttled via chylomicrons from your intestines to the rest of the body. This does nothing to the LDL level in your blood. The amount of dietary fat that reaches the liver also has little to do with the level of total cholesterol production. We know that in general if you eat less fat, your liver makes more cholesterol, you eat more fat, and your liver makes less due to the fact that there are more chylomicrons circulating. Your body is extremely efficient at regulating itself.

Probably a Bad Idea

So take a step back, where does the LDL come from? It originally comes from the VLDL once it has some fat removed from it. Now remember that VLDL’s job was to transport oily substances which were already in the body, not the dietary fat we have eaten (chylomicrons job). So what raises VLDL? Not dietary fat. Think excess carbohydrates. Excess carbohydrate turns into triglyceride very efficiently in the liver, and since it is already IN the body it is the responsibility of VLDL and ultimately LDL to transport it through the body. It is actually proven that generally a lower carb and higher fat diet LOWERS VLDL level. So eating fat will lower VLDL, and in turn the harmful types of LDL. Oh, there are different types of LDL? Absolutely. We will get to the different types of LDL in just a minute.

We didn’t think of this on our own I am sad to say, the American Journal of Medicine did (Seshadri et all, A randomized study comparing the effects of a low carbohydrate diet and a convention diet on on lipoprotein subfractions and C-reactive protein levels in patients with severe obesity. Amercian Journal Of medicine 117 (5) 2004 pages 398-405), as they were trying to prove the Atkins diet was bad for you. Oops.

Also, in November 2002 studies were published espousing lower carbohydrates for improvement in cholesterol levels. In one study Duke researchers found that “after six months, participants on the Atkins diet had lost 31 pounds, had an 11 percent increase in HDL (good cholesterol) and a 49 percent drop in their tryglyceride levels. Atkins dieters had a 49% reduction in VLDL levels, versus 17% for those on the low-fat group”.

Ok back to your regularly scheduled programming.

How Big is Your Truck?

Slowly but surely the word is getting out that LDL comes in various sizes. Larger particles are more buoyant and fluffy, and don’t lodge into endothelium as easy as smaller particles do. So if this is true, then the semi trucks, and Escalades on the road carrying it’s passengers (cholesterol) are less likely to crash and do damage. They just sort of bounce off the guardrails and keep moving.

The smaller delivery cars, the freaking Miatas, and especially those dang Dodge Darts have the potential to wreak some havoc. They can get stuck under the guardrails (endothelial cells) when they crash. When they get stuck, tons of emergency vehicles have to come to try and get them out of the mess. (Circulation 2002; 106: 3143-3421). And that is when things get messy and very dangerous through plaque formation and ultimately cardiovascular disease.

How Many Cars Can Be On the Road?

So we know that having smaller cars on the road is bad, but what about having so many cars you have a traffic jam regardless of whether they are big or small? Yes that is also an important factor in this discussion. This is called particle concentration. High LDL particle concentration is also considered a player in increased cardiovascular events. El Harchaoui K et al. Value of Low Density particle Number and Size as Predictors of Coronoary Artery Disease in Apparently Healthy Men and Women. J Am Coll Cardiol 2007;49:547-53.

This area is a little grey, but at some point if you just get overloaded with particles bad things are going to happen.

MYTH BUSTER #2 – The myth is that if you have an in range LDL reading (< 100) you are good to go. This is not always certain. LDL readings in standard blood tests only measure the amount of LDL cholesterol (the number of delivery vehicles)! There is no biological rule that all cars have to be full of people/cholesterol. In some of us, we might have trucks that are only partially full of people, but have a lot more trucks. So think of it this way if this still doesn’t make sense. You can have 10 containers each containing 1 lb of mag 10, or you could have 20 contains that each contain .5 lbs of mag 10. It’s still 10 lbs total, but you have more containers in the second example.

If this sounds far-fetched let me explain. When you eat a lot of sugary food, such as HFCS , your LDL carriers/trucks will fill up with excess triglyceride leaving less room for cholesterol, which requires more delivery trucks to be made and put on the road. The lesson is sugary crap in your diet will give you a higher particle number or concentration that could lead to heart disease and diabetes.

Summary

Key points from part 1:

There is only one kind of cholesterol, and it is inherently good for us
In order to transport oily substances like cholesterol and triglycerides, there must be carrier molecules called lipoproteins. There are five major types of lipoproteins, with HDL and LDL the most well-known.
Common LDL lab tests only show the percentage of total cholesterol that is LDL. It does not show how big the LDL is, or how many particles there are.
Larger, more “fluffy” LDL particles seem less likely to cause CV issues down the road.
Smaller LDL particles are much more dense and lodge more easily into endothelial tissue, becoming stuck and oxidized, causing an inflammatory response, and leading ultimately to cardiovascular disease.

Stay tuned for Part 2 where we will discuss:

LDL pattern B. How its really the villain in the story and why we produce it
How modern commercial food preparation, not dietary fat, is to blame for heart disease
Dietary strategies to correct a bad cholesterol test like low HDL, high LDL, and high triglyceride.

TAGS: CholesterolDietHeart DiseaseLow Carb