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Obesity, why there is excess fat storage, and solutions
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What I sent a friend as an introduction: 

The best easy test for a fatty liver is a sonogram, the standard one is a liver biopsy.  Fatty liver (NAFLD) is the starting point.  It is caused by damage to the hepatocytes by fructose through the process of glycation.  That likely happened to me in 1969, when my weight went up 20 pounds.  I took it off in the spring of 1970 by reducing my meals and skipping breakfast.  Thereafter whenever I gained 5 pounds I would repeat the same fix.  If I hadn’t took the weight, after a year the adipose tissue through the hormone leptin--which adipose tissue produces--resets the normal weight to a higher point.  I think I have a fatty liver because of my abdomen isn’t youthful and I had to watch my weight.  If the regulatory system is properly working, the weight will season-after-season remain the same.  Paleo peoples don’t have to watch their weight—look at the old photos and watch the anthropology films.  The last 3 months I have been skipping breakfast 6-days a week, and I lost 4 pounds, hopefully 2 pounds from the liver.  I find it easy to skip breakfast and just drink tea with a tablespoon of lime juice.  

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Why short-term fasting cures obesity helped by a low carb, low fructose diet 8/9/16

Obesity is caused by a fat- metabolism-appetite regulatory system in which insulin has the greatest influence; thus to keep weight off fix the system.  We have 2 wrong messages 1) eat less fat thus more carbs and 2) eat less calories and exercise more. The first causes obesity if carbs includes too much sugar, and the second doesn’t work because if you are long-term overweight your regulatory system has been set to its current weight, and that doesn’t change with the calorie-restricted diet.  Insulin tells the cells to burn glucose and thus store fat. The fix is to maintain low insulin thus fat burning which starts when sleeping and continues with skipping breakfast (I drink 16 ounce tea with tablespoon of lime juice).  In the morning I have plenty of energy, thus feel good, am mentally sharp, in a good mood, and not very hungry. I do it every morning now, because I like the way I feel.  The body stores very little glucose, thus while sleeping there is no need for insulin to lower the blood glucose.  Without insulin, the cells switch to burning the stored fat.  Staying in fat burning longer allows the liver to ship out some of the excess fat it has stored.  The high sugar Western diet has mess up the liver to cause high insulin, also called insulin resistance.  Excess insulin causes excess fat storage in the liver, muscles, fat, and pancreas cells.  Proteins, like glucose. causes insulin secretion; thus fat storage.  Thus a low carb diet needs the help of from short-term fasting to fix the fatty liver.

Dr. Jason Fung in his clinic cures his patients with fasting and a low carb diet.  As a nephrologist in the clinic he gets the worse patients, end stage kidney failure from type-2 diabetes, on insulin injections, and thus they all are quite obese.  I have included in the attachment a link to his lecture on YouTube and 2 blogs saved as word documents.  Because of 3 years of full-time studies of diet related topics, I know that Dr. Fung is first among scholars in the areas of obesity, diabetes, and the science relevant to their causes and fixes (links at end of paper).  

Hopefully, I have been sufficiently convincing for you to open up the attachments and check out the evidence.  One paper is on what to eat and 5 diets depending upon the situation, a long version with many additional topics, a testimonial, and a Dr. Fung blog.  Corporations and the government that serves have been given us the wrong information on healthful diet since 1977, low fats which are replaced with a high in sugar (thus fructose) and other carbs.  On healthfully.org/rh are diet papers and much more.  Feedback is always appreciated. 

 Extra part in attachment along with links:

Note: if you need a sweetener, buy corn syrup (pure glucose).  Several grocery chains carry Karo syrup.  Table sugar and corn syrup were the 2 main sweeteners in the 1960s and before.  The obesity epidemic is caused by tripling the amount of fructose since the 1960s.  Fructose is found in fruits and is one-half of the disaccharide sucrose (table sugar), the other half is glucose.  Glucose can also form long types of chains (starches) that can be broken down into single glucose units.  These long-chain easily digestible carbohydrates are found in plants, with the highest concentration of them in grains, rice and potatoes.  Fructose the other half of sucrose is a net 15 times more reactive than glucose; it attaches to proteins in a process called glycation and this adversely affects the functions of that protein.  I have included links to documentaries by the national broadcast corporations of Canada and Australia on why too much sugar is poison—what U.S. corporate media won’t play—it is the fructose half of sucrose.  If you dig deeper you will find out in a longer paper of mine (attached) how through glycation on a high sugar diet fructose is the principle cause for all of the conditions associated with the western diet.  I have at the bottom of this paper links to my website pages and to a page with 130 links to YouTube documentaries and lectures on an assortment of health issues, each with a short description.  Using Google Chrome, I cast the YouTube to my television. 

What has happened to the liver

The problem driving weight gain is a fatty liver (see NAFLD in Wikipedia, non-alcoholic fatty liver disease).   Fatty liver is a sign that reactive fructose has damaged proteins in the liver and this resulted in raised insulin in the liver which caused excess fat storage in the liver—this could have happened decades ago.  Note without excessive glycation by fructose, the liver doesn’t become fatty.  The traditional oriental diets are very high in glucose (carbs); some are over 70%, yet their sugar which comes from fruits and vegetables averages 15 grams daily.  Their liver is fine, thus obesity and type-2 diabetes are very rare.  Add Western levels of fructose to their diet and they have the western health issues.  Our Western diet in 2001 had 152 pounds of added sweeteners per person per year according to the USDA (189 grams of added sugars a day).  Approximately half of that is fructose.  One sign of fatty liver is visceral fat, and it doesn’t have to be very much.  Some people through vigilant weight control put under 5 pounds around their middle (I am one of them).  As described above fructose goes to the liver, the only place it is metabolized.  However, it is 15 times more reactive than glucose and attaches to proteins in a process called glycation” (a bad thing).   It is estimated that 1/3rd of Europeans and Americans have NAFLD—I think the percentage is at least twice, that the bar set for NAFLD is too high.  NAFLD messes up the complex functions of the liver including several that raise the level of blood glucose, and thus cause the additional release of insulin from the pancreas to lower the blood glucose. This is known as insulin resistance.  Prolonged high level of insulin causes a gradual gain in weight.  And it gets worse, insulin also regulates leptin a hormone produced by adipose (fat cells) which plays a key role in regulating fat storage. With long-term weight gain this hormone adjusts to the larger fat cells, and it operates to maintain that new level of fat.  Thus when that person attempts to lose weight on a low calorie diet, at about 2 months leptin starts to lowers metabolism and increases hunger.  This effect of leptin will continue for years after the weight is loss to restore the lost weight.  With long-term weight, this leptin system resets to the new weight.  Thus energy restricted diets are doomed to fail (yo-yo diets) unless the liver is cleansed, and this requires either bariatric surgery or fasting.

Profits before people  

Do you wonder why this message about how fructose causes a fatty liver, the fasting fix, that high insulin causes  obesity, and the role of fructose in the assortment of conditions including cardiovascular disease, arthritis, type-2 diabetes, Alzheimer’s disease, macular degeneration, isn’t on everyone’s mind, yet this evidence is pushed in peer review journal articles?  The answer is simple, the media won’t offend its large advertisers, corporations to protect their market influence the production of information (Dr. Fung’s article on Coke a Cola (see attachment) and other companies fund nutritional conferences--one of many way they influence information.  Drug companies do similar funding for physicians, and our government is in bed with the corporate system that they once regulated to protect the public.  The evidence for all my claims is supported by a large body of journal articles on bad pharma; articles which meet the standards of peer review, yet the results are buried by big-bucks corporate influence, their tobacco-science articles, and the use of KOLs (key opinion leaders) for higher.  On my website I provide a few of the articles that support the claims I have made on diet, my papers on diet have links to supporting journal articles, and there is much more.  I have put 12 years of university training and many hours into http://healthfully.org/rg/, which has been up since 2004 and has over a thousand pages downloaded daily. 

Obesity and Type-2 Diabetes:  Healing, What To Do and Why

www.healthfully.org/rns/id6.html   7/23/16 (see first definitions on last page)

The systems and why it fails:  There are 2 main systems for producing the energy molecule ATP, one of burning glucose, the other of fats.  Obesity & T-2D result from a defect in the fat-weight-regulatory system.  All mammals have a complex regulatory system for appetite, rate of metabolism, and fat storage.  There are over eighty hormones involved in the systems.  The Western diet has 30% calories from sugars (788 calories), mostly from sucrose.  The most reactive sugar is fructose; it is one half of the disaccharide sucrose.  It accumulates in the liver because that is where it is metabolized.  There it damages the liver through the process of glycation.  Glycation is the process of a sugar and its metabolites randomly attaching to proteins.  This damage in the liver causes insulin resistance (IR) which entails a higher than normal level of insulin is necessary to promote the uptake of blood glucose by cells throughout the body.  Refined & also easily digested carbohydrates such as from rice and potatoes accelerate the process leading to insulin resistance and fatty liver disease (NAFLD) because they cause a very high blood glucose level.[1]  Insulin direct cells throughout the body to absorb blood glucose which the cells will burn (metabolize).  To promote glucose burning, insulin also signals cells to stop burning fat and thus STORE THE FAT.   Thus IR causes an excess in fat storage.   Some of that fat is stored in the liver, and in excess (2-3 pounds) this further damages the liver.  These stresses upon the liver (from glycation & excess fat) are what throws-out of balance the weight control system. Too much fat in the pancreas damages the pancreas causes T2D.  The US western diet with its average of 151 pounds yearly of sugar has caused through liver damage a health disaster. 

A few more pieces to the system:  more on what you need to know are the causes so that you will know how fasting and low sugar diet fixes the weight-regulatory system.  Fructose is a 7.5 times more reactive than glucose, and it takes twice as long as glucose to be cleared from the liver; thus it damages the liver at 15 times the rate of glucose. Experiments have shown that high fructose diet causes liver inflammation.  Galactose from milk sugar lactose is also very reactive.  Incretins are hormones produced in the stomach and duodenum in response to foods.  They stimulate the release of insulin by the pancreas.  This explains why all foods cause the release of insulin even the ones that don’t have glucose (carbs).  See Insulin Table at the end for the amounts.  It is another reason why a very low carb diet fails long-term, because the insulin in response to proteins prevents the clearance of fat from the liver and pancreas.  Insulin also regulates the hormone leptin.  Having IR will over time result in leptin resistance (excess leptin).  Leptin produced by fat (adipose) tissue and functions to maintain at a fixed level of fat through its affects upon appetite and metabolism.  When the fat level stored drops low it functions to both increase appetite and cause a major reduction in metabolism.  This leptin system with other hormones functions to restore weight, a good thing if you are thin, but a bad thing if you are long-term overweight.  This leptin production by fat tissues explains why it is so hard for some people to lose weight and keep it off—the yo-yo diets.  Western diet has through excess insulin made many of us overweight, obese, and diabetic.  Exercise more and eat less doesn’t fix the system.      

The fix:  Cleanse the fatty liver & pancreas through extended periods of low insulin.  At night after the food has been digested and blood glucose returns to the fasting level (which is what your doctor measures with blood work in the morning) the body is metabolizing fats, insulin is very low.  This period of fat burning, if frequent and long enough, will burn the excess fat in the liver and pancreas.  When on a low carb/sugar diet helped along by fasting, this will permit the liver and pancreas to heal and function normally:  the cure for NAFLD, IR and T2D.  Merely low carb or low calories will not keep insulin sufficiently low to allow the metabolism of the excess fat in the liver or to avoid the lipophilic effect of leptin to restore the fat by increasing appetite and lowering metabolism.   Remember that leptin is secreted in response to insulin.  Fasting enhanced by low carbs avoids the drop in metabolism that occurs through leptin to restore fat Cleansing the liver of fat prevents the yo-yo diet.  

What you probably won’t hear this from your doctors and corporate media:  Medical schools do not have a course in nutrition.  The influence of the pharma and food manufacturers also extends to clinical trials and who rises to be a key opinion leaders and what they teach.  Because it is not in their financial interest to fix the NAFLD and IR with diet and thereby prevent all the comorbidities, your doctor is taught that the ketogenic diet is dangerous, fasting doesn’t work, and he will advises you to eat less and exercise more.  The same message is taught dieticians and repeated in the corporate press.  They are taught the fix is to eat less and exercise more and for diabetes to tightly manage glucose with drugs, and that diabetes is a progressive disease.  It is tragic that industries are allowed in our corporatist state to pollute the evidence, corrupt medical education, and clinical practices. 

JK short fast (SF):  go on a 16 hour fast (7 PM until 11:00 AM) or longer, thus extending nighttime fat burning to midday.  At night because of not eating there is low glucose and thus low insulin.   If hunger becomes an issue, than drink tea or coffee without sweeteners or milk.  Yes, no artificial sweeteners[2].  If quite hungry then eat a little celery or like greens, preferable without cheese or peanut butter, or similar small snack.  If progress is slow than lower carbs more and progress to the alternate day fasting.  You can still delay your first meal on the non-fasting days.  Choose whichever fast has the best compliance, Dr. Fung prefers alternate day fasting, but uses either based upon compliance.     

The fat burning diet: It starts in the supermarket: buy low net carb foods (net carbs = total carbohydrates minus fiber content in grams), and clean out your cupboards and fridge.  It is easier to say “no” in the market then in the kitchen.  We are a social animal, thus enlist the support of your family and friends.  A positive vicarious social contact arises from watching the diet and diabetes documentaries and lectures on YouTube; and it enlists the support of the rational side of your brain.  An extensive list of YouTube videos with description is at http://healthfully.org/rh/id7.html.  Keep a log of your diet and fasting including how you feel.  Start the log a couple of weeks before starting your diet and fasting.  For some the gradual approach is best.  With this method you can reduce your carbs gradually and substitute corn syrup for sugar.  Karo is the leading brand; it is pure glucose (no fructose).  Biologically it is equivalent to rice and potatoes.  It took me 3 months to lose my craving for sweets; a year to reduce to 1/3rd refined carbs—and I have always been slim.   Right from the start I increased saturated fats (butter) to replace the reduction in carbs. Yes, fats are much better for you than refined carbs and yes, saturated fats are the best, followed by monounsaturated fats.  (See links section below for the science behind why saturated fats are much better than the cheap unhealthy processed polyunsaturated fats which food manufactures along with added sugars use).  To obtain the long periods of low insulin requires fasting.  An early, small dinner, low in carbs and high fat, moderate protein[3] entails more hours at night in the fat-burning state.  If short-term fasting isn’t working to cure T2D and obesity, then switch to alternate day fasting and continue to reduce the carbohydrates.

Additional good diet practices: 

Short-term fast, don’t eat after 7 PM and skip breakfast.  

To lower insulin spike when eating refined carbs include a liberal dose of fat and/or protein

Exercise prior to and subsequent to eating, thus lowering blood glucose and thus insulin

Smaller meals have lower insulin spike and quicker clearance from gastro-intestinal track

Preferentially buy carbs that are high in resistant starches (see /rh/id3.html) such as from legumes and/or fiber such as green-leafy vegetables

Increase saturated fats to supply the energy that carbs were supplying & greater satiety   

Avoid the products of the food manufactures; for they are have added sugar, refined carbs, polyunsaturated and trans-fats, and chemical additives 

At meal-time eat slowly and stop before stuffed

Have handy small low carb snacks to kill hunger pangs

LINKS: The best source on what to eat for health, for diet, and related topics is at Concise.  In the rh section are articles which lay out the evidence for what is found there and dja has journal articles on rancid fats, diet, etc.  Important are Part 5 on supplements, Part 6 which covers many of the topics here, and Part 10 on the New Atkins low-carb diet.  The large Videos library with brief descriptions has links to YouTube.  It confirms the claims here--and other health topic.  The links to ABC, CBC, BBC, ABC again national networks; they expose what U.S. media hides.  The leading authority with results is Dr. Fung of Toronto; his videos on YouTube are on fasting, T2D, fats, & insulin.   I highly recommend his book “The Obesity Code:  Unlocking The Secretes of Weight Loss” (a book on fasting is coming out in October of 2016).  For those with T2D, for a minimal fee your he will work with your doctor, click on the link to his clinic.

Definitions:  body & food basics 

Adipocytes (lipocytes) fat cells compose adipose tissue & secrete hormones resistinadiponectinleptin and apelin.  

ATP, Adenosine TriPhosphate (adenosine with 3 phosphate molecules (PO4) attached), transfers chemical energy within the cell through the loss of one of its phosphate groups.  In the mitochondria ADP returns to the high energy state ATP 3(PO4) through absorbing energy from the metabolism of carbohydrates & fats.  ATP provides the energy for over 90% of the biosynthesis:  for muscle contraction, hormones, collagen, etc. and for intra and intercellular active transport.

Cardiovascular disease (CVD) causes cigarettes and a high sugar diet which cause endothelial dysfunction of the artery walls.  These cells permit pathogens to colonize in the artery walls to cause inflammation, atherosclerosis, and CVD.

Carbohydrate (carb):  fiber, fructose, glucose-glycogen, starch, sucrose, lactose, net carbs (total carbs minus fiber):

Fiber, vegetable fiber, roughage, the carbohydrate component not broken down by digestive enzymes, but some is by gut bacteria.  Fiber has more than ten sugar units.  It lowers the insulin spike when consumed with refined carbs. 

Fructose (fruit sugar) a monosaccharide found in fruits.  Main sources are the disaccharide sucrose, fruits, and high   fructose corn syrup.  It is metabolized in the liver into either glucose, or fat which when insulin is stored there to cause fatty liver.  Also fructose is 7.5 more reactive then glucose and by glycation damages the liver, etc.

Glucose a monosaccharide is the main energy storage molecule for plants; in humans 1-2-lbs is stored as long-chain glycogen a backup energy source stored in muscles, fat, and liver cells.  Glucose is as one half of sucrose, and is also obtained from the hydrolysis of the digestible starches.  Glucose and fat are the main sources for production of ATP.

 Starch is long chains of glucose units.  This polysaccharide is produced mostly by green plants for energy storage. 

 Sucrose, table sugar, produced by plants; it is the readily hydrolyzed disaccharide consisting of fructose and glucose. 

Glycation:  a process where a monosaccharide (simple sugar) randomly attaches to proteins or lipid; this adversely affects their functions, thus glycation is a major cause of our chronic age-related diseases. 

Diabesity:  the combination of diabetes and obesity that afflicts those on the Western diet—a recently coined term. 

Fat (Free Fatty acids and triglycerides): up to 24 carbon molecules with an organic acid or glycerol molecule on end.

Incretin: class of hormones secreted by the stomach and intestines which causes insulin secretion and produces satiety.

Insulin: a gateway hormone is produced by the pancreas.  Its main function is to have cells absorb glucose and store fat.  Cells already loaded with glucose, to prevent toxic level resist the message by insulin to absorb more glucose.  Insulin also regulates other enzymes and hormones including leptin.  Low insulin is the cause of type 1 and 2 diabetes.  Insulin also promotes the storage in amino acid, and thus we secret insulin by the incretin system in response to proteins. 

Insulin resistance (IR):   a condition of higher than normal amount of blood insulin to lower blood glucose due to a diminished response to insulin by various tissues.  The pancreas then releases even more insulin to lower blood glucose.  IR is the condition which causes the fat accumulation in the liver and pancreas and obesity, and all their comorbidities.

Ketogenic diet (very low carbohydrate diet):  it forces the body to rely upon just fats to convert ADP to ATP to cause weight loss without restricting calories.  It is named refers to the ketones produced in this metabolic natural process.

Key Opinion Leaders (KOLs):  people who rise to top positions in their area of expertise.  In fields relevant to business some of these people violate the standards of science to produce and spread business-favorable spin, and are handsome rewarded for their services.  The term is used in that sense of bad conduct.  Pharma has used KOLs along with regulatory capture to produce a drug disaster while selling it to medical students, physicians, politicians, and the public as cutting edge science.   

Leptin:  produced by fat cells is in part regulated by insulin.  Leptin in the brain suppresses appetite and it also regulates metabolism.  Leptin is responsible for the 25% reduction in metabolism plus increased appetite that eventually occurs during an energy-restricted diet.  Leptin functions to maintain fat storage and to restore weight even years later.  

Lipids are a group of naturally occurring fat like molecules including waxes, sterols, fats, phospholipids, and others.

Metabolism in reference to diet refers to the metabolic use of mainly either fat or carbohydrate to convert ADP to the high energy molecule ATP mostly by the mitochondria.  During  starvation proteins also can be used to make ATP.

NAFLD (Non-Alcoholic Fatty Liver Disease):  the accumulation of fat by liver cells sufficient to significantly downgrade their various functions.  The NHANES survey 2011 found NAFLD in 30% of adult population—similar % for Europe. 

Type-2 diabetes (T2D): occurs when the pancreas fails to produce enough insulin to lower glucose to its normal range; it results from chronic IR and the accumulation of fat in the pancreas which eventually causes the decline in insulin.



[1] Note:  those who eat a very low sugar diet, such as the traditional diet of the Japanese do not develop IR or NAFLD, and therefore have a very low--compared to those on the Western diet—incidence of T2D, heart attack and obesity (sugar is only 14 grams a day).

[2] Artificial sweeteners have been shown to stimulate the production of the  signal the release of insulin because of their taste.

[3] Proteins in meats fish and poultry and an intermediate high insulin index number though they don’t have carbs because of the incretin system—see Insulin Index table at end.  This is why calorie restricted and very low carb diets for the long-term obese nearly always fail because they don’t cleanse the liver.  This requires fast.    

 

Health is essential for quality of life.  Given the proclivity for injurious behavior (the prime examples being obesity, tobacco, soldiering, and recreational drugs) I can only conclude that the rational function of the brain is primarily social, including the generation of reasons for what is inexcusable; and the rest of what we do is quite similar to the actions of our cats and dogs.  I wish that all people would develop a love of philosophy (the term in Greek means love of wisdom).  With such love there would be a commitment to hold beliefs in proportion to the evidence in support there of, and there would be a drive for to live a truly moral life. 

 

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Disclaimer:  The information, facts, and opinions provided here is not a substitute for professional advice.  It only indicates what JK believes, does, or would do.  Always consult your primary care physician for medical advice, diagnosis, and treatment. 

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