Tag Archive for: obesity

Sugar vs. Sweetener Research: Meaningless in the Real World

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I’m in a slight disadvantage in evaluating this study; I was able to read only the convention-session abstract and the press release. There were no recordings of the presentation that I could find, so there are details I don’t know. I have questions about the process, not the results, so here are my thoughts.

The In-Vitro Study

If you’re not familiar with the lingo, time to learn. In vitro is Latin, meaning literally “in glass.” An in-vitro study is conducted in a Petri dish, a test tube, or some location outside of an entire animal or human.

In this study, researchers exposed endothelial cells from the rats’ arteries to sugars and artificial sweeteners. We know there were changes in proteins; what we didn’t know is whether the change in protein genes that were activated in response to the artificial sweeteners mimicked a pattern we might see in a rat that’s diabetic. That’s an important question.

It would have been more meaningful if they examined a pattern of protein responses that occurred in the endothelial cells of rodents that already had diabetes. Just because something is activated in response to a stimulus, in this case sugars or artificial sweeteners, that doesn’t necessarily mean it’s a bad thing. It just means it happened.

The In-Vivo Study

In vivo is also Latin and means within a live animal or human. I have several issues with the rodent part of the study. First they gave high levels of sugar to the rats as well as high levels of artificial sweeteners. It would seem to me that it would be beneficial to get an estimate of what humans actually consume on a daily basis, dose it down to the appropriate amount for a rat, and start with that. Then you can compare your test results to a “normal” level. Next you can begin increasing the amount to see when the negative effects begin.

Second they used the DR/BB rat; DR stands for diabetes resistant and BB stands for biobreeding. This type of rodent is often used for research on type 1 diabetes because although it’s diabetes resistant, it has an underdeveloped immune system. It will respond to environmental insults differently than normal rats. Excess levels of sugar and artificial sweeteners may create an insult to the immune system to cause type 1 diabetes in this breed of rat.

The reason for doing the study was to see if artificial sweeteners may be contributing to the obesity and diabetes epidemic—type 2 diabetes, not type 1. Using this breed of rat seems like it would muddy the results. The changes they found in the blood of these rats fed excessive amounts sugar and artificial sweeteners would have been expected. The question is whether this is related directly to the research hypothesis or not. In my opinion, no.

To make this study pertinent to humans, we would need a similar pattern found in humans. Perhaps people under excessive stress and whose immune systems were compromised might show some relationship. But we’re not talking about susceptibility to type 1 diabetes. We’re talking about type 2 diabetes, and although they share a name, they’re vastly different diseases.

What we have is a study in test tubes on protein genes that are activated in response to artificial sweeteners and a second study on rodents with some dysfunction in over 200 different protein genes in response to sugar and artificial sweeteners. We may have people who use excessive amounts of artificial sweeteners everyday. We may have specific but as yet unknown gene patterns that may make people more susceptible to type 2 diabetes, but we haven’t identified what those genetic patterns are at this point or even if they exist at all.

The Bottom Line

So what does this study mean? This basic research shows that there may be a pattern to protein synthesis that’s different in high-sugar versus artificial-sweetener intake. But that does not resemble in any way what the authors of the study suggested in the press release. This study is relatively meaningless in the real world. Maybe we’ll know more about how all this impacts humans in another 5–10 maybe even 20 years. But as of today, it’s just provocative headlines. And we get far too many of those already.

Use artificial sweeteners or do not; that’s your choice. But don’t change based on this study. Use the old adage: everything in moderation including moderation.

What are you prepared to do today?

Dr. Chet

 

Reference: EB 2018. The Influence of Sugar and Artificial Sweeteners on Vascular Health during the Onset and Progression of Diabetes Board # / Pub #: A322 603.20.

 

What They Got Right in the Sugar and Artificial Sweetener Research

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Whether it’s a new form of treatment, a new medication, or even examining a phytonutrient for potential benefits, it all starts with basic research. That’s what the study I began talking about Tuesday is all about: basic research. I like it because this is the way all research has to begin. This is where test-tube studies are appropriate.

In this case they used epithelial cells from the vascular system of the rodents, exposed them to high amounts of sugars and artificial sweeteners, and then looked at specific changes in proteins that are involved in various types of cell action. In other words, they were looking for dysfunction in the way the genes for the proteins responded after exposure to the sugars and artificial sweeteners.

Were there differences? Yes. The important thing that they discovered was that the proteins inside these epithelial cells responded differently when exposed to sugar than when exposed to artificial sweeteners.

The question is this: was any of this meaningful in the real world? I’ll let you know what I think on Saturday.

What are you prepared to do today?

Dr. Chet

 

Reference: EB 2018. The Influence of Sugar and Artificial Sweeteners on Vascular Health during the Onset and Progression of Diabetes Board # / Pub #: A322 603.20.

 

Artificial Sweeteners, Obesity, and Diabetes

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Last week, you may have seen headlines that said something like “Artificial Sweeteners May Cause Obesity and Type 2 Diabetes!” Just about every news organization picked up a press release from the Experimental Biology meeting. In the press release, researchers gave some of the results of a paper that was presented at a scientific session, including comments by the lead author, Dr. Brian R. Hoffman.

The purpose for doing the study, he said, was because of the epidemic of obesity and diabetes in the U.S. While there’s little question that excessive sugar intake, combined with excess calories over years, does contribute to obesity and type 2 diabetes, no one has really examined the role artificial sweeteners may play.

In these studies, he and his research team examined the effect of high levels of sugars, aspartame, and acesulfame potassium on epithelial cells taken from rodents in a test-tube study. Then using another group of rodents, they overfed them sugars and the same artificial sweeteners for three weeks. The objective was to see what changes occurred in proteins and metabolites that were produced in cardiovascular epithelial cells in the test-tube study and the blood of the rodents.

They found that there were modifications in proteins under both conditions, which may have led to changes in the products they produced. But is this meaningful research or not? I’ll tell you what I liked about the study in Thursday’s memo.

What are you prepared to do today?

Dr. Chet

 

Reference: EB 2018. The Influence of Sugar and Artificial Sweeteners on Vascular Health during the Onset and Progression of Diabetes Board # / Pub #: A322 603.20.

 

Does a Little Extra Weight Keep You Alive?

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The Rotterdam Study was begun in 1991 to investigate the risk factors of cardiovascular, neurological, ophthalmological, and endocrine diseases in people 55 and older (1). The study is still ongoing, but periodically subsets of subjects are examined to find out which characteristics are associated with these diseases. In a study published in 2001, researchers reported on a group of subjects who were diagnosed with heart failure at the beginning of the study and followed for an average of six years—181 out of over 5,000 subjects. By the end of five years, 85 subjects had died. One of the observations that researchers noted was that a higher BMI was associated with reduced mortality; in plain terms, the heavier people were more likely to stay alive.

It didn’t stop there. In 2013, a study was published that directly examined the relationship between BMI and mortality (2). This meta-analysis included 97 studies and examined more than 2.88 million participants and more than 270,000 deaths. They reported that while grades 2 and 3 obesity (grade 2: BMI of 35-39.9; grade 3: BMI more than 40) were associated with increased mortality, grade 1 (BMI of 30-34.9) was not, and the overweight category (BMI of 25-29.9) actually showed a reduced risk of dying. (How do you rate? Check your BMI here.)

Is this true? Is body weight not associated with an increased risk of death? Have we been trying to lose weight for no reason? I’ll finish this on Saturday.

What are you prepared to do today?

Dr. Chet

 

References:
1. European Heart Journal (2001) 22, 1318–1327.
2. JAMA. 2013 January 2; 309(1): 71–82.

 

What Is the Obesity Paradox?

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Did you ever hear something that didn’t seem to make sense? That seemed to go against everything you thought to be true? One example of this is something called “The Obesity Paradox.” I’ve seen a few headlines this week that have talked about it, so it’s time to address it in the Memo.

One of the variables that we would think is related to the development of cardiovascular disease would be body weight. It seems logical: as weight increases, so does the strain on pumping the blood through the additional blood vessels required to feed the extra fat and muscle. People who are overweight may eat the wrong foods, consume too much food, and move too little.

But since the early 2000s, several studies have been published seeming to show that body weight wasn’t necessarily a risk factor for CVD or an early death. They showed that those who were overweight, a BMI between 25.0 and 29.9, had lower mortality rates than those who were normal weight. Some showed that stage-one obesity, a BMI between 30.0 and 34.9, was also not related to mortality. Thus the term “The Obesity Paradox” was coined. But is it true? We’ll take a look at the research the rest of the week.

What are you prepared to do today?

Dr. Chet

 

A New Commitment

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The numbers are in and the U.S. is fatter than ever: 39.6% of all adults over 20 years old are obese based on the Body Mass Index. That’s a rise of close to 2% since 2015, the last time the statistics were released. This isn’t affecting only adults; children 2–19 are also fatter than ever with 18.5% now considered obese. If we throw in those who are overweight, more than 70% of the population is fatter than ever.

I could review the causes, from refined carbohydrates to chemicals with estrogenic properties. I could talk about all the diets that could help. I could talk about supplements that may help to give people an edge. I’ve done that all before. There’s no single diet nor exercise program nor supplement that works for everyone. We all just have to find our own way. Instead, I’m going to tell you a story and issue you a challenge.

One of my best friends for the past 30 years, Dick Heller, died last week; he’d fought off cancer several times, but it finally got him just before his 80th birthday.

Dick and I were professors together in Buffalo. He was an excellent swimming coach and a competitive swimmer throughout his life. He was also a great teacher, especially when it came to helping people change their habits; he would help people identify what they wanted to achieve in the health and fitness classes he taught, have them write it down, develop a plan, and track the progress. Their grade was not based on how they compared to others; it was based on the goals they set.

To honor Dick, Paula and I are going to use that approach as we continue to improve our diet. Getting enough vegetables is a particular problem so we’re going to add at least one serving per day, every day, until it becomes a new habit.

Here’s my challenge to you. Pick one small health habit you want to improve, write it down, and start doing it every day until it becomes a new habit. Whatever small habit, if done repeatedly, that will help you achieve your goal. It may be related to your weight because, like I said, 70% of us are overweight or obese. It may be a different health goal. If people you know have died because of a health challenge, do it to honor them.

Identify. Write it down. Plan. Execute. Evaluate. I can’t think of a better tribute to Dick than that.

What are you prepared to do today?

Dr. Chet

 

Reference: https://www.cdc.gov/nchs/products/databriefs/db288.htm.

 

The Bottom Line on Loneliness

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Loneliness is a terrible thing. My father-in-law missed my mother-in-law from the day she died until the day he did. He was never without people in the assisted-living residences where he lived; the staff was wonderful and we visited him often, but he was terribly lonely. He lived to 94 and it was a good life, but the last three were unarguably his worst—even getting shot at in World War II was better. One of the reasons I shed no tears when he died was because I knew he was finally where he wanted to be: with his Ruthie.

For those of us still alive and in no hurry to leave this world soon, loneliness, social isolation, and living alone are things we may have to confront. The longer we live, as Dad did, the greater the possibility we might have to face these issues. But how great is the risk? Let’s take a look.

 

The Studies

The critical thing to understand is that meta-analyses can tell us something about a large group of people, but they can’t tell us anything about ourselves. While the total number of subjects is impressive, there are no hard comparable numbers to examine. Not reported was how they assessed loneliness and social isolation in each of the 70 studies. This was a presentation, not a paper. When it becomes a peer-reviewed paper, that may help us examine details, but for now we just don’t know.

One thing they didn’t assess due to the nature of the study was the risk for people who were lonely, isolated, and obese. If the logic holds true, they should be at the highest risk.

These studies raise questions. One of the commentaries suggested that this study hadn’t considered the effect of mobile devices. Does it make people feel part of a social group to be interacting on Facebook and Twitter, as well as texting? Or does that make them feel more alone?

 

The Bottom Line

While the science is not the strongest, it raises some significant issues. What will happen to your social fabric as you age? Most people prepare for financial wellness, but how about social wellness? Where are you going to be and who might be with you? Should you move to your retirement destination or into assisted living earlier so you’ll have more energy to make friends before your health deteriorates? Is staying in your home the best option? My mother-in-law was much happier after moving into a nursing home because she finally had a big group of friends and lots of activities—and of course Dad visited almost every day.

And this is an issue for younger people as well. If you feel lonely and isolated, it’s time to reach out; reconnect with family and friends and find new activities that will help you meet new people.

Just as you eat well and exercise for your body, it may be time to prepare your mind for your social situation as you get older. It’s also an important issue to explore with your parents. I’ll keep doing my part to get and keep you healthy, and I’ll continue to be in touch three times a week.

What are you prepared to do today?

Dr. Chet

 

Reference: www.sciencedaily.com/releases/2017/08/170805165319.htm.

 

Loneliness Is Worse than Obesity

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Let’s take a look at the second study on loneliness by the same research group and presented at the 2017 American Psychological Association Convention. In this study, researchers analyzed 70 studies in a meta-analysis; simply put, it’s a way of combining data from many studies to get a more robust statistical look at an issue. In this case, the number of subjects was over three million from countries all over the world.

What they found was that social isolation, loneliness, and living alone were all independently associated with early mortality similar to obesity and other physical risk factors. The researchers called for more research to find out how to address these factors. Their concern was that as the population of the world ages, this could become a greater public health issue.

How at risk are you? Is this a real concern? What can you do about? I’ll finish this up on Saturday.

What are you prepared to do today?

Dr. Chet

 

Reference: www.sciencedaily.com/releases/2017/08/170805165319.htm

 

The Link Between Loneliness and Mortality

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Have you ever felt alone even though you were surrounded by dozens of people? That can happen to anyone at times but when it happens on a regular basis, can it impact your health? Could it even be worse than being obese? Recent research suggests that it just might be.

Before we get to the studies, let’s define some terms.

  • Social isolation is a physical lack of contact with other human beings.
  • Loneliness is a subjective feeling of being lonely no matter how many people are around.
  • Living alone is just what it says: you live alone. Up to 25% of the adult population lives alone in the U.S.

Researchers did two meta-analyses on the relationship between social isolation, loneliness, and living alone. In the first study, people with more social connections had up to a 50% reduction in early mortality. That in and of itself is interesting, but it’s what they reported in the second study that was more profound. I’ll cover that on Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: www.sciencedaily.com/releases/2017/08/170805165319.htm

 

Obesity: A Global Problem

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The overwhelming conclusion by the Global BMI Mortality Collaboration is that the rate of mortality linked with the degree of obesity follows the same pattern in the entire world with one exception: South Asia. If you look at the graphs of the mortality rate per BMI category, they’re virtually identical in North America, Europe, Australia, New Zealand, and East Asia. One of the reasons that South Asia might be different was that only three studies were included in the analysis.

We are not alone in our fight to lose weight and get healthier. Actually, that’s a completely different . . .

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