Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

http://www.youtube.com/watch?v=xrsHqIKtXNw

5,524 views

Published on

See the Seminar at http://www.youtube.com/watch?v=xrsHqIKtXNw
A comprehensive analysis of the Metabolic Syndrome, Diabetes and Obesity Epidemic, exploring causal factors of appetite control derangement and descent into obesity, diabetes and coronary heart disease.

Published in: Education
  • Doctor's 2-Minute Ritual For Shocking Daily Belly Fat Loss! Watch This Video ◆◆◆ http://ishbv.com/bkfitness3/pdf
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • I recovered from bulimia. You can too! learn more... ➤➤ http://tinyurl.com/yxcx7mgo
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • The 3 Secrets To Your Bulimia Recovery ♥♥♥ http://tinyurl.com/bulimia2recovery
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • The 3 Secrets To Your Bulimia Recovery ■■■ http://scamcb.com/bulimiarec/pdf
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • How can I lose weight fast without exercise in a week? ➤➤ https://tinyurl.com/y6qaaou7
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

http://www.youtube.com/watch?v=xrsHqIKtXNw

  1. 1. The Metabolic Sydrome Engineering Root Cause…. and Solution? (Is it the Sugar/Carb or the Fat…..?) Ivor Cummins BE (Chem) October 11th 2013 2013 Ivor Cummins BE(Chem) MIEI
  2. 2. Introduction Myself:  UCD, BE Chemical Engineering (Biochemical Stream)  5 Years Medical Device Manufacturing / R&D (hemodialysis & perfusion)  1 Year Precision Machine Design (Coronary Stent Manufacture)  16 Years here (Process, Product, Development…. Complex Problem-Solving focus)  Currently R&D Manager (Gen I) This Body of Work: IS IS NOT My personal analysis of broad root cause An aligned view in the orthodoxy… An Engineering Analysis based on Data A Medical Study or medical guidance A study of the Biochemistry of Life A study of Nutrition Stuff and latest fads A personal experiment with N = 1 A Prospective Clinical Trial(!) Leveraging a vast canon of expert’s work My own experiments and trials (bar 1) Based on established science and literature Based on any of the BS books out there 2013 Ivor Cummins BE(Chem) MIEI
  3. 3. A Selection of Experts from My Journey… Robert H. Lustig: M.D. Professor of Pediatrics in the Division of Endocrinology at University of California, San Francisco Dr. Lustig is a Neuroendocrinologist, with basic and clinical training relative to hypothalamic development, anatomy, and function Dr Peter Attia: mechanical engineering and applied mathematics at Queen’s University. Graduate Stanford Medical School; two years as a post-doctoral fellow at NIH in the National Cancer Institute as a surgical oncology fellow, followed by surgical residency Kimber Stanhope: M.S. in Nutrition Science and a Ph.D. in Nutritional Biology from the University of California at Davis. Project Scientist in the Department of Molecular Biosciences. 20 years of nutrition research experience working on over 150 projects Dr. Neville Wilson M.D. University of Cape Town Medical School, The College of Medicine, S.A. After stints of service as Doctor and Surgeon all over the world, he is currently in charge of Medical Services at Leinster Clinic Health Services Maynooth. Jeff S. Volek Ph.D., R.D.: associate professor in The Human Performance Laboratory at The University of Connecticut, Storrs, CT. He is an R.D. and has a Ph.D. in Kinesiology (Pennsylvania State University). He has published over 200 scientific articles and chapters. Andreas Eenfeldt M.D. Swedish medical doctor specializing in family medicine; his particular strength is in comparing and contrasting carbohydrate and fat metabolism in their respective ability to drive the diseases of modernity…he runs DietDoctor.com 2013 Ivor Cummins BE(Chem) MIEI
  4. 4. Root Cause Methodology Our Engineering Practice Problem Definition Comparative Analysis (IS / IS NOT) •What, When, Where, Extent + Trends General / Other Disciplines Problem Definition Correlation Analysis • Epidemiological Studies •Loose application of Is / Is Not Root Cause Analysis •Cause Effect chain – Root Cause Diagram •Physics based mechanism for all Linkages Hypothesis Generation Mechanistic Evidence •Explore mechanisms •Focus on suspected factors •For / Against Analysis •Generate Targeted Experiments Design & Analysis Of Experiments •Screening Experiments, then fractional •Statistical Inference informs next steps Experimentation •Prospective Studies •Statistical Inference 2013 Ivor Cummins BE(Chem) MIEI
  5. 5. Root Cause Methodology Our Engineering Practice General / Other Disciplines Problem Definition Comparative Analysis (IS / IS NOT) •What, When, Where, Extent + Trends Problem Definition Correlation Analysis A • Epidemiological Studies •Loose application of Is / Is Not B Mechanistic Evidence Root Cause Analysis •Cause Effect chain – Root Cause Diagram •Physics based mechanism for all Linkages Hypothesis Generation •Explore mechanisms •Focus on suspected factors •For / Against Analysis •Generate Targeted Experiments Design & Analysis Of Experiments •Screening Experiments, then fractional •Statistical Inference informs next steps C Experimentation •Prospective Studies •Statistical Inference 2013 Ivor Cummins BE(Chem) MIEI
  6. 6. The Trends – Linear for Weight…. USA Proportion Overweight England Australia France Korea (OECD Data) 2013 Ivor Cummins BE(Chem) MIEI
  7. 7. …and Exponential for Diabetes Number with Diabetes Number with Diabetes Percent with Diabetes Percent with Diabetes 2013 Ivor Cummins BE(Chem) MIEI
  8. 8. So is it Simply the Calories? Why are we consuming so much? % Obese kCal/d 2013 Ivor Cummins BE(Chem) MIEI
  9. 9. Weight Control / Obesity is largely a subset of The Metabolic Syndrome To understand the drivers of both, is the key to recovery….. 2013 Ivor Cummins BE(Chem) MIEI
  10. 10. Metabolic Syndrome Cost Impact? 2013 Ivor Cummins BE(Chem) MIEI
  11. 11. Metabolic Syndrome Cost Impact? My back-of-the-envelope calculation suggests somewhere in the region of $1 Trillion + per annum in the coming decade for the top 20 GDP countries…. 2013 Ivor Cummins BE(Chem) MIEI
  12. 12. Metabolic Syndrome Definition: Low HDL “Good Cholesterol” <1.0 mmol/L Waist >~38” Men >~35” Women Blood Pressure Elevated >135/85 mmHg High Blood Triglycerides >1.5 mmol/L METABOLIC SYNDROME (3 or more of the 5 factors) High Blood Sugar >5.6 mmol/L (Obesity) Stroke Atheroschlorosis Coronory Heart Disease Gout Type 2 Fatty Liver Diabetes Disease Alzheimers Arthritis Asthma
  13. 13. Metabolic Syndrome Definition: Low HDL “Good Cholesterol” <1.0 mmol/L Waist >~38” Men >~35” Women Blood Pressure Elevated >135/85 mmHg High Blood Triglycerides >1.5 mmol/L METABOLIC SYNDROME (3 or more of the 5 factors) High Blood Sugar >5.6 mmol/L How many people have it then? It’s not too common, right? (Obesity) Stroke Atheroschlorosis Coronory Heart Disease Gout Type 2 Fatty Liver Diabetes Disease Alzheimers Arthritis Asthma
  14. 14. Metabolic Syndrome Definition: Low HDL “Good Cholesterol” <1.0 mmol/L Waist >~38” Men >~35” Women Blood Pressure Elevated >135/85 mmHg High Blood Triglycerides >1.5 mmol/L METABOLIC SYNDROME (3 or more of the 5 factors) High Blood Sugar >5.6 mmol/L How many people have it then? It’s not too common, right? How does >50% of US population strike you? (Obesity) Stroke Atheroschlorosis Coronory Heart Disease Gout Type 2 Fatty Liver Diabetes Disease Alzheimers Arthritis Asthma 20% of the “Fat” are “Fit” 40% of the “lean” are unhealthy
  15. 15. Metabolic Syndrome Definition: Low HDL “Good Cholesterol” <1.0 mmol/L Waist >~38” Men >~35” Women Blood Pressure Elevated >135/85 mmHg High Blood Triglycerides >1.5 mmol/L Key METABOLIC SYNDROME (3 or more of the 5 factors) (Obesity) Stroke Atheroschlorosis Phenomenon: INSULIN RESISTANCE High Blood Sugar >5.6 mmol/L How many people have it then? It’s not too common, right? How does >50% of US population strike you? Coronory Heart Disease Gout Type 2 Fatty Liver Diabetes Disease Alzheimers Arthritis Asthma 20% of the “Fat” are “Fit” 40% of the “lean” are unhealthy
  16. 16. B Mech A Crash Course in Endocrinology 1….. Insulin / Glucagon / Ghrelin / Leptin – know your control system hormones! sugar / simple carbohydrate ingestion primarily High Blood Sugar 1. Insulin and Glucagon 2013 Ivor Cummins BE(Chem) MIEI
  17. 17. B Mech A Crash Course in Endocrinology 2 • Ghrelin and Leptin 2013 Ivor Cummins BE(Chem) MIEI
  18. 18. And so, The KEY to the Cycle of Disease Insulin (The Master Hormone): • Gets glucose into Liver/Muscle AND FAT(!) • In healthy people, drives brain appetite drop but… • If driven too hard by Sugar and Carb in diet, leads to INSULIN RESISTANCE - “Body says NO!” • Brain Insulin Resistance: Appetite dysfunction results! 2013 Ivor Cummins BE(Chem) MIEI
  19. 19. The KEY to APPETITE CONTROL Insulin (The Master Hormone): • Gets glucose into Liver/Muscle AND FAT(!) • In healthy people, drives brain appetite drop but… • If driven too hard by Sugar and Carb in diet, leads to INSULIN RESISTANCE - “Body says NO!” • Brain Insulin Resistance: Appetite dysfunction results! # 1: Insulin Resistance 2013 Ivor Cummins BE(Chem) MIEI
  20. 20. And so, The KEY to APPETITE CONTROL Insulin (The Master Hormone): • Gets glucose into Liver/Muscle AND FAT(!) • In healthy people, drives brain appetite drop but… • If driven too hard by Sugar and Carb in diet, leads to INSULIN RESISTANCE - “Body says NO!” • Brain Insulin Resistance: Appetite dysfunction results! # 1: Insulin Resistance #2: Appetite Dysfunction 2013 Ivor Cummins BE(Chem) MIEI
  21. 21. And so, The KEY to APPETITE CONTROL Insulin (The Master Hormone): • Gets glucose into Liver/Muscle AND FAT(!) • In healthy people, drives brain appetite drop but… • If driven too hard by Sugar and Carb in diet, leads to INSULIN RESISTANCE - “Body says NO!” • Brain Insulin Resistance: Appetite dysfunction results! Leptin: • Is released by Fat Cells (Adipocytes) • Signals brain that fat stores are fine – STOP EATING • But Leptin Is Blocked by INSULIN RESISTANCE and… • If driven too hard (Excess Fat) then LEPTIN RESISTANCE # 1: Insulin Resistance #2: Appetite Dysfunction 2013 Ivor Cummins BE(Chem) MIEI
  22. 22. And so, The KEY to APPETITE CONTROL Insulin (The Master Hormone): • Gets glucose into Liver/Muscle AND FAT(!) • In healthy people, drives brain appetite drop but… • If driven too hard by Sugar and Carb in diet, leads to INSULIN RESISTANCE - “Body says NO!” • Brain Insulin Resistance: Appetite dysfunction results! Leptin: • Is released by Fat Cells (Adipocytes) • Signals brain that fat stores are fine – STOP EATING • But Leptin Is Blocked by INSULIN RESISTANCE and… • If driven too hard (Excess Fat) then LEPTIN RESISTANCE # 1: Insulin Resistance #2: Appetite Dysfunction #3 Leptin Signal Block 2013 Ivor Cummins BE(Chem) MIEI
  23. 23. And so, The KEY to APPETITE CONTROL Insulin (The Master Hormone): • Gets glucose into Liver/Muscle AND FAT(!) • In healthy people, drives brain appetite drop but… • If driven too hard by Sugar and Carb in diet, leads to INSULIN RESISTANCE - “Body says NO!” • Brain Insulin Resistance: Appetite dysfunction results! Leptin: • Is released by Fat Cells (Adipocytes) • Signals brain that fat stores are fine – STOP EATING • But Leptin Is Blocked by INSULIN RESISTANCE and… • If driven too hard (Excess Fat) then LEPTIN RESISTANCE # 1: Insulin Resistance #2: Appetite Dysfunction #3 Leptin Signal Block #4 Leptin Resistance 2013 Ivor Cummins BE(Chem) MIEI
  24. 24. And so, The KEY to APPETITE CONTROL Insulin (The Master Hormone): Appetite • Gets glucose into Liver/Muscle AND FAT(!) • In healthy people, drives brain appetite drop but… • If driven too hard by Sugar and Carb in diet, leads to INSULIN RESISTANCE - “Body says NO!” • Brain Insulin Resistance: Appetite dysfunction results! Leptin: • Is released by Fat Cells (Adipocytes) • Signals brain that fat stores are fine – STOP EATING • But Leptin Is Blocked by INSULIN RESISTANCE and… • If driven too hard (Excess Fat) then LEPTIN RESISTANCE # 1: Insulin Resistance #2: Appetite Dysfunction #3 Leptin Signal Block Obesity Inflammation Fatty Liver “Bad Cholesterol” Atherosclerosis Heart Disease Diabetes Alzheimers Cancers etc “The Diseases of Modernity” #4 Leptin Resistance 2013 Ivor Cummins BE(Chem) MIEI
  25. 25. B Mech Perhaps unsurprisingly, Insulin Resistance Leads to the Metabolic Maladies…. 2013 Ivor Cummins BE(Chem) MIEI
  26. 26. B Mech Perhaps unsurprisingly, Insulin Resistance Leads to the Metabolic Maladies…. …..but, substantially, is it the chicken or the egg?? 2013 Ivor Cummins BE(Chem) MIEI
  27. 27. B Mech Perhaps unsurprisingly, Insulin Resistance Leads to the Metabolic Maladies…. …..but, substantially, is it the chicken or the egg?? 2013 Ivor Cummins BE(Chem) MIEI
  28. 28. B Mech Perhaps unsurprisingly, Insulin Resistance Leads to the Metabolic Maladies…. …..but, substantially, is it the chicken or the egg?? Excess Weight 2013 Ivor Cummins BE(Chem) MIEI
  29. 29. B Mech Perhaps unsurprisingly, Insulin Resistance Leads to the Metabolic Maladies…. …..but, substantially, is it the chicken or the egg?? Excess Weight Self-Reinforce Loop Warning! Self-Reinforce Loop Warning! 2013 Ivor Cummins BE(Chem) MIEI
  30. 30. B Mech So, time to fix 4 decades of “Hypothesis Resistance”, and move on… Excessive Insulin Demand exhausts Pancreatic Cells Irrecoverable Cell Death 2013 Ivor Cummins BE(Chem) MIEI
  31. 31. B Mech So, time to fix 4 decades of “Hypothesis Resistance”, and move on… Greed + } Excessive Insulin Demand exhausts Pancreatic Cells Irrecoverable Cell Death 2013 Ivor Cummins BE(Chem) MIEI
  32. 32. B Mech So, time to fix 4 decades of “Hypothesis Resistance”, and move on… Greed + } + appetite derangement Excessive Insulin Demand exhausts Pancreatic Cells Irrecoverable Cell Death 2013 Ivor Cummins BE(Chem) MIEI
  33. 33. B Mech So, time to fix 4 decades of “Hypothesis Resistance”, and move on… Greed + SelfReinforce Loop Warning! SelfReinforce Loop Warning! } + appetite derangement SelfReinforce Loop Warning! Excessive Insulin Demand exhausts Pancreatic Cells Irrecoverable Cell Death 2013 Ivor Cummins BE(Chem) MIEI
  34. 34. Metabolic Syndrome / Obesity POTENTIAL ROOT CAUSE #1: SUGAR 2013 Ivor Cummins BE(Chem) MIEI
  35. 35. Fructose Vs Glucose Sources Sucrose (Table Sugar): 50%glucose / 50% fructose High Fructose Corn Syrup (HFCS): 55% fructose / 45% glucose Glucose-glucose-glucose......chains So-called ”Simple Carb”, added sugar too though.. Fruit: 4% to 8% Fructose (but with lots of Fibre & Good Stuff!)
  36. 36. Metabolic Syndrome / Obesity POTENTIAL ROOT CAUSE #1: SUGAR Fructose / HFCS “Mega Sources”: * Soft Drinks / Sports Drinks * Most All Processed Food Low Fat Products Fruit Juices / Smoothies Most Breakfast Cereals Etc Etc Etc 2013 Ivor Cummins BE(Chem) MIEI
  37. 37. A Corr From one of the best, 1957 DIET AND CORONARY THROMBOSIS HYPOTHESIS AND FACT * JOHN YUDKIN M.A., Ph.D., M.D. Camb., M.R.C.P., F.R.I.C. 1. 2. 3. 4. 5. USA Australia Canada Finland New Zealand 6. UK 7. Denmark 8. Sweden 9. Norway 10. Netherlands 11. Switzerland 12. W. Germany 13. France 14. Italy 15. Japan PROFESSOR OF NUTRITION IN THE UNIVERSITY OF LONDON AT QUEEN ELIZABETH COLLEGE NO Significant Correlation for Fat and Heart Disease Rates R2 = 0.1, P > 0.05 Significant Correlation for Sugar and Heart Disease Rates R2 = 0.41, P < 0.05
  38. 38. A Corr Let’s get up to date here…. Sugar g/day %BMI > 25 Diabetes Sugar g/day: Composite, multiple sources BMI/Diabetes Data: http://www.cdc.gov/nchs/data/hus/hus12.pdf#063 2013 Ivor Cummins BE(Chem) MIEI
  39. 39. A Corr Another Longer Term View… 2013 Ivor Cummins BE(Chem) MIEI
  40. 40. A Corr Obesity Trend Welcome, to The new age of Sugar and Simple Carbs… Carb grams/day
  41. 41. B Mech Reminder first – Glucose Vs Fructose 2013 Ivor Cummins BE(Chem) MIEI
  42. 42. B Mech And now, a Crash Course in Fructose Metabolism….. Grateful thanks to Dr. Robert Lustig for the following slides which I have augmented somewhat for clarity •Professor of Endocrinology / Pediatrics, UCSF •Director of Weight Assessment for Teen and Child Health Please do see him professionally deliver this content more comprehensively in “Sugar, the Bitter Truth” http://www.youtube.com/watch?v=dBnniua6-oM
  43. 43. 120 kcal Glucose 24 kcal goes to liver 120 kcal Alcohol 94 kcal goes to liver 60 kcal (+ 12 kcal glucose) 120 kcal Sucrose (50:50 Fruc/Gluc) ALL Fructose must go to liver B Mech Glucose, Alcohol, Fructose – One of these things is not like the others…..! The Mitochondria Your Cellular Energy Production Line
  44. 44. B Mech The Mitochondria Your Cellular Energy Production Line Into Your Liver goes the Fructose
  45. 45. B Mech The Mitochondria Your Cellular Energy Production Line Initial conversion and ATP depletion
  46. 46. B Mech MS #1: Hypertension Ramp Up the Uric Acid Production The Mitochondria Your Cellular Energy Production Line
  47. 47. B Mech Ramp Up Krebs Cycle and Citrate Production
  48. 48. B Mech Kick Off unique Xylulose-S-P Production
  49. 49. B Mech Accelerate the Fat Production Line
  50. 50. B Mech MS #3: HDL Reduction Welcome to DNL: Elevated Blood Triglyceride MS #4: Triglyceride
  51. 51. C Expt
  52. 52. B Mech Add Hepatic Lipid Production and drive NAFLD
  53. 53. B Mech Add Blood FFA & Insulin Levels / IR MS #2: Central Obesity
  54. 54. B Mech SelfReinforce Loop Warning! Add Blood FFA & Insulin Levels / IR MS #2: Central Obesity
  55. 55. B Mech Add Systemic Inflammation
  56. 56. B Mech MS #5: Sugar Control Add Hepatic Insulin Resistance
  57. 57. B Mech MS #5: Sugar Control SelfReinforce Loop Warning! Add Hepatic Insulin Resistance
  58. 58. B Mech MS #5: Sugar Control SelfReinforce Loop Warning! SelfReinforce Loop Warning! Add Hepatic Insulin Resistance
  59. 59. B Mech SREBP1 and increased Fat Production
  60. 60. B Mech SelfReinforce Loop Warning! SREBP1 and increased Fat Production
  61. 61. B Mech Spiked Insulin Drives Fat Storage MS #2: Central/Genera l Obesity
  62. 62. B Mech SelfReinforce Loop Warning! Spiked Insulin Drives Fat Storage MS #2: Central/Genera l Obesity
  63. 63. B Leptin blocking Mech Appetite Control Appetite Dysfunction and Increased Consumption MS #2: Central/Genera l Obesity
  64. 64. B SelfReinforce Loop Warning! Mech Leptin blocking Appetite Control Appetite Dysfunction and Increased Consumption MS #2: Central/Genera l Obesity
  65. 65. B Mech MS #1: Hypertension MS #5: Sugar Control MS #3: HDL Reduction Welcome to the Metabolic Syndrome MS #2: Central/Genera l Obesity MS #4: Triglyceride
  66. 66. C Expt And Sugar’s effect on your “Bad” Cholesterol? 2013 Ivor Cummins BE(Chem) MIEI
  67. 67. 1965 – 1972, Excellent Engineering Style Studies – Not easy to find now Low Sugar High Sugar Low Sugar Lower is Better in all plotlines here High Sugar Expt Normal Diet C 2013 Ivor Cummins BE(Chem) MIEI
  68. 68. 1965 – 1972, Excellent Engineering Style Studies – Not easy to find now Low Sugar High Sugar Lower is Better in all plotlines Low Sugar Expt Normal Diet C 2013 Ivor Cummins BE(Chem) MIEI
  69. 69. Low Sugar High Sugar Normal Diet All Candidates Same Trend……
  70. 70. C Expt 2011: Fructose Drives Visceral Obesity Glucose: LOW Visceral Obesity SAT = Subcutaneous Or “Safe” Body FatFat Body Type Fructose: HIGH Visceral Obesity VAT = Visceral Or “Toxic” Body Fat Type 2013 Ivor Cummins BE(Chem) MIEI
  71. 71. 2011: Fructose Drives Post-Prandial TG Triglyceride (AUC) Expt Area Under Curve i.e. The Common Fasting Trigs test : Glucose > Fructose, but note lower scale, ~0.18mmol/L Average Trig Impact Glucose Fructose Sucrose Triglyceride 22-24h C Glucose Fructose Sucrose Fructose: HIGH (0.60 mmol/L) Post-Meal Trigs…. where damage is done… 2013 Ivor Cummins BE(Chem) MIEI
  72. 72. ΔFasting ApoB (g/L) Expt 2011: Fructose Drives ApoB Lipoprotein (“The real BAD Cholesterol”) Glucose: Low ApoB Glucose Fructose: HIGH ApoB Sucrose Fructose Sucrose % ApoB/ApoA C Glucose Fructose Sucrose Note: As can be seen, the sucrose (50% Fructose and 50% Glucose) seems synergistic in effect; my assumption is that the simultaneous Insulin response triggered by the Glucose exacerbates the issue – but this is TBD – the research team noted and deferred an explanation too….. 2013 Ivor Cummins BE(Chem) MIEI
  73. 73. C Expt Lots where this came from…. tD Sof rink oys sb an s! girl d 2013 Ivor Cummins BE(Chem) MIEI
  74. 74. POTENTIAL ROOT CAUSE #2: FAT Natural ???? A Topic for another Seminar(!) Natural Natural Triglyceride – 3 Fatty Acids with a Glycerol Backbone 2013 Ivor Cummins BE(Chem) MIEI
  75. 75. A Corr Fat Versus Sugar: Correlative Data FAT g/day %BMI > 25 Diabetes Sugar g/day: Composite, multiple sources Fat/BMI/Diabetes Data: http://www.cdc.gov/nchs/data/hus/hus12.pdf#063 2013 Ivor Cummins BE(Chem) MIEI
  76. 76. A Corr Fat Versus Sugar: Correlative Data FAT g/day %BMI > 25 Diabetes SUGAR g/d %BMI > 25 Diabetes Sugar g/day: Composite, multiple sources Fat/BMI/Diabetes Data: http://www.cdc.gov/nchs/data/hus/hus12.pdf#063 2013 Ivor Cummins BE(Chem) MIEI
  77. 77. A Corr A little bit of history…..Ancel Keys 2013 Ivor Cummins BE(Chem) MIEI
  78. 78. And His BAD Science Punishment?
  79. 79. A Corr What Keys could have chosen….. 2013 Ivor Cummins BE(Chem) MIEI
  80. 80. A Corr The Contemporaneous Controversy… DIET AND CORONARY THROMBOSIS HYPOTHESIS AND FACT * JOHN YUDKIN M.A., Ph.D., M.D. Camb., M.R.C.P., F.R.I.C. 1. 2. 3. 4. 5. USA Australia Canada Finland New Zealand 6. UK 7. Denmark 8. Sweden 9. Norway 10. Netherlands 11. Switzerland 12. W. Germany 13. France 14. Italy 15. Japan PROFESSOR OF NUTRITION IN THE UNIVERSITY OF LONDON AT QUEEN ELIZABETH COLLEGE NO Significant Correlation for Fat and Heart Disease Rates Significant Correlation for Sugar and Heart Disease Rates R2 = 0.1, P > 0.05 R2 = 0.41, P < 0.05 2013 Ivor Cummins BE(Chem) MIEI
  81. 81. A Corr And the Dreadful SATURATED Fat? Increasing Heart Disease with lower fat Orthodox View TrendLine Eh, excuse me? An Engineer’s TrendLine Decreasing Heart Disease with higher fat 2013 Ivor Cummins BE(Chem) MIEI
  82. 82. A Corr Another Recommended Paper Men from studies who had NO Heart Attacks Men from the studies Who HAD Heart Attacks Michael Gurr, Ph.D., renowned expert on lipids and author of the authoritative textbook on lipid biochemistry, criticizes: ”…the degree of self delusion in research workers wedded to a particular hypothesis despite the contrary evidence” Dietary lipids and coronary heart desease: Old evidence, new perspective Review Article Progress in Lipid Research, Volume 31, Issue 3, 1992, Pages 195-243 Michael I. Gurr, Professor in Food Science & Technology, University of Reading, UK. Professor in Human Nutrition, Oxford Brookes University, UK. 2013 Ivor Cummins BE(Chem) MIEI
  83. 83. A Corr 2010: The Metastudy of all studies Meta-analysis of 21 prospective cohort studies evaluating the association of saturated fat with cardiovascular disease Conclusion: There is no NO Effect of Dietary Saturated Fat Seen Overall significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat….(Ivor note: like sugar or refined carb perhaps….) 2013 Ivor Cummins BE(Chem) MIEI
  84. 84. B Mech Fat Mechanistic Data • Let’s make up some time here and move on to experimental – go on, you know you want to! 2013 Ivor Cummins BE(Chem) MIEI
  85. 85. C Expt FAT – Experimental – Krauss et Al 2008 Experiment Design: 3 weeks isocalorific, remainder with -1000 calories per day (starve) Trig Reduction Serum Triglyceride – Lower is Better 2013 Ivor Cummins BE(Chem) MIEI
  86. 86. C Expt FAT – Experimental – Krauss et Al 2008 Experiment Design: 3 weeks isocalorific, remainder with -1000 calories per day (starve) Lower is Better l ohC ” doog“ L DH Trig Reduction Serum Triglyceride – HDL – Higher is Better 2013 Ivor Cummins BE(Chem) MIEI
  87. 87. C Expt FAT – Experimental – Krauss et Al 2008 Experiment Design: 3 weeks isocalorific, remainder with -1000 calories per day (starve) Tot Chol/HDL TOTAL CHOL / HDL Lower is Better 2013 Ivor Cummins BE(Chem) MIEI
  88. 88. C Expt FAT – Experimental – Krauss et Al 2008 Experiment Design: 3 weeks isocalorific, remainder with -1000 calories per day (starve) Apo B / Apo A Tot Chol/HDL TOTAL CHOL / HDL ApoB / Apo A Lipoprotein Lower is Better Lower is Better 2013 Ivor Cummins BE(Chem) MIEI
  89. 89. C Expt FAT – Experimental – Krauss et Al 2008 r et e mi D e ci tr a P L DL a l Experiment Design: 3 weeks isocalorific, remainder with -1000 calories per day (starve) LDL Particle Diameter Higher is Better 2013 Ivor Cummins BE(Chem) MIEI
  90. 90. C Expt FAT – Experimental – Krauss et Al 2008 Experiment Design: 3 weeks isocalorific, remainder with -1000 calories per day (starve) r et e mi D e ci tr a P L DL a l Ivor Conclusion: • Low Sugar/Carb, high Fat diet dramatically improves Key MetS disease markers LDL Particle Diameter Higher is Better 2013 Ivor Cummins BE(Chem) MIEI
  91. 91. C Expt FAT – Experimental – Krauss et Al 2008 Experiment Design: 3 weeks isocalorific, remainder with -1000 calories per day (starve) r et e mi D e ci tr a P L DL a l Ivor Conclusion: • Low Sugar/Carb, high Fat diet dramatically improves Key MetS disease markers LDL Particle Diameter Higher is Better Study Author’s Conclusion: • A LOW FAT diet with restricted calories sort of kinda gets within range of the High Fat diet in Key MetS disease markers….??? •Come again??? •Are you Serious – call an engineer, please……..! 2013 Ivor Cummins BE(Chem) MIEI
  92. 92. Can do this again and again…… and again. by Jeff S. Volek, Ph.D., R.D. C Expt 2013 Ivor Cummins BE(Chem) MIEI
  93. 93. Obesity Trends over Several Decades 2013 Ivor Cummins BE(Chem) MIEI
  94. 94. Concluding Material 2013 Ivor Cummins BE(Chem) MIEI
  95. 95. Coup De Grace? 2013: The Rat Proxy… “…this study aims to develop a rat model which closely depicts MS in humans…” “Replacing whole wheat with refined wheat flour in rat chow in 60% fructose-fed Sprague-Dawley rats resulted in: hypertension (p 0.01) hyperglycemia (p 0.03) hyper-triglyceridemia (p 0.001) HDL Reduction (p 0.002) 2013 Ivor Cummins BE(Chem) MIEI In only FOUR Weeks! Fiber-free white flour with fructose offers a better model of metabolic syndrome: Amin and Gilani Lipids in Health and Disease 2013 12:44 doi:10.1186/1476-511X-12-44
  96. 96. More Rat Tales…. In results published online Feb. 26 2010 by the journal Pharmacology, Biochemistry and Behavior, the researchers from the Department of Psychology and the Princeton Neuroscience Institute reported on two experiments investigating the link between the consumption of high-fructose corn syrup and obesity. "When rats are drinking high-fructose corn syrup at levels well below those in soda pop, they're becoming obese -- every single one, across the board. Even when rats are fed a high-fat diet, you don't see this; they don't all gain extra weight." The second experiment -- the first long-term study of the effects of high-fructose corn syrup consumption on obesity in lab animals -- monitored weight gain, body fat and triglyceride levels in rats with access to high-fructose corn syrup over a period of six months. “Compared to animals eating only rat chow, rats on a diet rich in high-fructose corn syrup showed characteristic signs of a dangerous condition known in humans as the metabolic syndrome, including abnormal weight gain, significant increases in circulating triglycerides and augmented fat deposition, especially visceral fat around the belly. Male rats in particular ballooned in size: Animals with access to high-fructose corn syrup gained 48 percent more weight than those eating a normal diet.” 2013 Ivor Cummins BE(Chem) MIEI
  97. 97. % Daily Calorific Intake Guidelines Schmidelines….. Make your minds up guys… 25 X Labelmania - What’s YOUR poison? Brown sugar, Fruit juice concentrate, Lactose , Corn sweetener, Glucose, Malt syrup, Galactose, Corn syrup, High-fructose corn, Rice Syrup, Maltose, HFCS, Dextrose, Syrup, Honey, Molasses, Fructose, Invert Sugar, Maltodextrin, Raw sugar, etc, etc Answer: All of it…welcome to “Synynom Shenanigans” 2013 Ivor Cummins BE(Chem) MIEI
  98. 98. But I don’t eat that much Sugar…? That means 6/9 teaspoons TOTAL INTAKE per day for a female/male human - NOT 6/9 that you add yourself to existing food or drink, which is often loaded already! Brekky Time! 80g 250 ml 250 ml Cereal OJ Smoothi e Total Spoons ~4 ~6 ~8 ~19 = Over 2-3 times your daily AHA adult guidelines….. and more than a dozen times the estimated human evolutionary intake of ~1.5 teaspoons/day)….. before you leave the breakfast table 2013 Ivor Cummins BE(Chem) MIEI
  99. 99. C Expt And My N=1 Experiment? July 2013 Singapore
  100. 100. C Expt Ivor the Laboratory Rat 112 530 Note: converted from mmol/L to mg/dL to get ratio guidelines < 2.0 1.47 < 1.5 mmol /L 4.5 1.44 <4.0 0.92 < 200 approx <35 approx >1.00 mmol /L GGT Ferritin HDL Trig Trig/HDL Tot Chol 2013 Ivor Cummins BE(Chem) MIEI
  101. 101. C Expt Ivor the Laboratory Rat 112 530 Note: converted from mmol/L to mg/dL to get ratio guidelines < 2.0 1.47 < 1.5 mmol /L 4.5 1.44 42 <35 approx <4.0 0.92 < 200 approx 35 >1.00 mmol /L GGT Ferritin HDL Trig Trig/HDL Tot Chol 2013 Ivor Cummins BE(Chem) MIEI
  102. 102. C Expt Ivor the Laboratory Rat 112 530 Note: converted from mmol/L to mg/dL to get ratio guidelines < 2.0 1.47 <35 approx 4.5 1.44 230 42 < 1.5 mmol /L <4.0 0.92 < 200 approx 35 >1.00 mmol /L GGT Ferritin HDL Trig Trig/HDL Tot Chol 2013 Ivor Cummins BE(Chem) MIEI
  103. 103. C Expt Ivor the Laboratory Rat 112 530 Note: converted from mmol/L to mg/dL to get ratio guidelines < 2.0 1.73 1.47 <35 approx 4.5 1.44 230 42 < 1.5 mmol /L <4.0 0.92 < 200 approx 35 >1.00 mmol /L GGT Ferritin HDL Trig Trig/HDL Tot Chol 2013 Ivor Cummins BE(Chem) MIEI
  104. 104. C Expt Ivor the Laboratory Rat 112 530 Note: converted from mmol/L to mg/dL to get ratio guidelines < 2.0 1.73 1.47 <35 approx 4.5 1.44 230 42 < 1.5 mmol /L <4.0 0.92 < 200 approx 0.78 35 >1.00 mmol /L GGT Ferritin HDL Trig Trig/HDL Tot Chol 2013 Ivor Cummins BE(Chem) MIEI
  105. 105. C Expt Ivor the Laboratory Rat 112 530 Note: converted from mmol/L to mg/dL to get ratio guidelines < 2.0 1.73 1.47 <35 approx 4.5 1.44 230 42 < 1.5 mmol /L <4.0 0.92 < 200 approx 0.78 35 >1.00 mmol /L GGT Ferritin HDL Trig Trig/HDL Tot Chol 2013 Ivor Cummins BE(Chem) MIEI
  106. 106. C Expt Ivor the Laboratory Rat 112 530 Note: converted from mmol/L to mg/dL to get ratio guidelines < 2.0 1.73 1.47 <35 approx 4.5 1.44 230 42 < 1.5 mmol /L <4.0 0.92 < 200 approx 0.78 1.03 35 >1.00 mmol /L GGT Ferritin HDL Trig Trig/HDL Tot Chol 2013 Ivor Cummins BE(Chem) MIEI
  107. 107. C Expt Ivor the Laboratory Rat 112 530 Note: converted from mmol/L to mg/dL to get ratio guidelines < 2.0 1.73 1.47 <35 approx 4.5 1.44 230 42 < 1.5 mmol /L <4.0 0.92 < 200 approx 0.78 1.03 3.5 35 >1.00 mmol /L GGT Ferritin HDL Trig Trig/HDL Tot Chol 2013 Ivor Cummins BE(Chem) MIEI
  108. 108. C Expt Continued…. 95 28 35 145 95 <135 mmHg <85 mmHg Sys BP Ideal ~82Kg Dia BP Avg of 20+ readings from same Equipment Ideal 32” Weight 5k run time Waist 2013 Ivor Cummins BE(Chem) MIEI
  109. 109. C Expt Continued…. 95 28 35 145 95 <135 mmHg 130 Sys BP <85 mmHg 80 Dia BP Avg of 20+ readings from same Equipment Ideal ~82Kg Ideal 32” Weight 5k run time Waist 2013 Ivor Cummins BE(Chem) MIEI
  110. 110. C Expt Continued…. 95 28 35 145 95 <135 mmHg 130 Sys BP <85 mmHg 80 Dia BP Avg of 20+ readings from same Equipment Ideal ~82Kg 82 Weight Ideal 32” 5k run time Waist 2013 Ivor Cummins BE(Chem) MIEI
  111. 111. C Expt Continued…. 95 28 35 145 95 <135 mmHg 130 Sys BP <85 mmHg 24.5 80 Dia BP Avg of 20+ readings from same Equipment Ideal ~82Kg 82 Weight Ideal 32” 5k run time Waist 2013 Ivor Cummins BE(Chem) MIEI
  112. 112. C Expt Continued…. 95 28 35 145 95 <135 mmHg 130 Sys BP <85 mmHg 24.5 80 Dia BP Avg of 20+ readings from same Equipment Ideal ~82Kg 82 Weight Ideal 32” 5k run time 32 Waist 2013 Ivor Cummins BE(Chem) MIEI
  113. 113. B’fast or etc or or Lunch Snack Dinner or + + 85% !! Supper or MINIMISE IDEAL 2013 Ivor Cummins BE(Chem) MIEI
  114. 114. B’fast or Lunch Snack Dinner Supper MINIMISE etc •Effectively NO Sugar or or •Effectively NO Wheat •Minimal Simple Carbs •NO “Diet” Foods (sugar!) •NO “Low Fat” stuff (sugar!) •Olive not Vegetable Oils •Butter not Margerine •Plenty Healthy Meat and Fish, leave the skin on! •Loads of Veg with dinner + or •Lots of eggs/cheese + •Moderate Nuts •Moderate Fruit 85% !! •85% Choc, or Milk Choc NO •Olives, Avocados •Tomatoes and salad veg IDEAL 2013 Ivor Cummins BE(Chem) MIEI
  115. 115. SUMMARY FINDINGS •Excessive Dietary Sugar and simple carbs are the primary root cause of the Metabolic Syndrome and associated “Diabesity” Epidemic (i.e No Sugar, and stick to Vegetables only for your carb input) •Excessive Sugar and simple carbs promote insulin response and appetite dysfunction, creating multiple self-reinforcing loops •Sugar / simple carbs are the primary development agent of Insulin Resistance Syndrome through proven mechanisms, and are a primary driver of Lipid Generation (“Bad Cholesterol”) and eventual dyslipidemia •The driven weight gain consists of adipose tissue (esp. Visceral) which exacerbates Insulin Resistence, drives Leptin Resistance and reinforces the disease process •Natural Dietary Fat is NOT a core root cause of the metabolic syndrome and associated disease/obesity – and it does NOT cause “Bad Cholesterol” !!!! Time to end 40 years of Bad Science…. 2013 Ivor Cummins BE(Chem) MIEI
  116. 116. A Sample of Approachable Science • “Sugar, The Bitter Truth” Professor Robert Lustig – • http://www.youtube.com/watch?v=dBnniua6-oM “The Skinny on Obesity” (8 parts) – http://www.youtube.com/watch?v=nOl5promItc • “High Sugar Diets and Disease” Dr. Kimber Stanhope – http://www.youtube.com/watch?v=_AJka21yfyE • “Wheat Belly” Dr. William Davis – http://www.youtube.com/watch?v=UbBURnqYVzw • “The Straight Dope on Cholesterol” Dr. Peter Attia – http://www.youtube.com/watch?v=dAWdHYSrh7M • “How Bad Science and Big Business created the Obesity Epidemic” David Diamond PhD – • http://www.youtube.com/watch?v=3vr-c8GeT34 “The Blog of Dr. Neville Wilson” – http://drnevillewilson.com/
  117. 117. B’fast or Lunch Snack Dinner Supper MINIMISE etc •Effectively NO Sugar or or •Effectively NO Wheat •Minimal Simple Carbs •NO “Diet” Foods (sugar!) •NO “Low Fat” stuff (sugar!) •Olive not Vegetable Oils •Butter not Margerine •Plenty Healthy Meat and Fish, leave the skin on! •Loads of Veg with dinner + or •Lots of eggs/cheese + •Moderate Nuts •Moderate Fruit 85% !! •85% Choc, or Milk Choc NO •Olives, Avocados •Tomatoes and salad veg IDEAL 2013 Ivor Cummins BE(Chem) MIEI
  118. 118. Current Working Thesis: 1. Excessive Dietary Sugar (directly ingested or in as found in most processed food/drinks) is the 1st order primary root cause of the Metabolic Syndrome and associated “Diabesity” Epidemic through the following elements: 1.1 Insulin Resistance is the driving force of appetite dysfunction, excessive fat storage and the constellation of metabolic disease. 1.2 Sugar is the primary aggravator of Insulin Resistance through proven mechanisms, and is a direct driver of Lipid Generation and eventual dyslipidemia (Serum Triglyceride, VLDL etc) 1.3 An elevated proportion of simple, high-glycemic carbohydrate in the diet (Glucose rapidly released by Amylase, no fibre to attenuate), works in tandem with the simple sugars to promote Insulin Resistance. 1.3 Fructose is particularly pathogenic thru many pathways – lack of satiety signalling, promotion of Hepatic fat generation and hepatic IR, lack of Ghrelin suppression, impact to Leptin levels, etc 1.4 The driven weight gain consists of adipose tissue (esp. Visceral) which is itself an organ, releasing body toxic cytokines and hormones, exacerbating Insulin Resistence and accelerating the disease process 2. The disproportionate / non-linear rise of disease relative to the increase in sugar consumption can be attributed to amongst other things: 2.1 Gestational Insulin Resistance and predisposition towards obesity in the next generation (2 nd order effect) 2.2 Co-incident lowered level of physical activity in society exacerbates the high sugar / simple carb damage 3. Dietary Fat is NOT a core root cause of the metabolic syndrome, but excess sugar / simple carbs through the action of the insulin elevation will drive dietary fat into storage (obesity) and further negative pathways will result as seen 2013 Ivor Cummins BE(Chem) MIEI
  119. 119. BACKUP 2013 Ivor Cummins BE(Chem) MIEI
  120. 120. The Wisdom of the Past? } Aw, c’mon now! "Diabetic Cookery; Recipes and Menus" by Rebecca W Oppenheimer, 1917 2013 Ivor Cummins BE(Chem) MIEI
  121. 121. 2013 Ivor Cummins BE(Chem) MIEI
  122. 122. The So-Called “Cholesterol” http://www.slideshare.net/ancestralhealth/attia-ahs-talk-pcfriendly "High triglycerides alone increased the risk of heart attack nearly three-fold. And people with the highest ratio of triglycerides to HDL -- the "good" cholesterol -- had 16 times the risk of heart attack as those with the lowest ratio of triglycerides to HDL in the study of 340 heart attack patients and 340 of their healthy, same age counterparts. The ratio of triglycerides to HDL was the strongest predictor of a heart attack, even more accurate than the LDL/HDL ratio. (Harvard-lead study - Circulation 1997;96:2520-2525)." 2013 Ivor Cummins BE(Chem) MIEI
  123. 123. Polyunsaturated Fun 2013 Ivor Cummins BE(Chem) MIEI
  124. 124. 2013 Ivor Cummins BE(Chem) MIEI
  125. 125. The Super Healthy PUFA 2013 Ivor Cummins BE(Chem) MIEI

×