The low-fat diet obsession of recent decades has enabled the global obesity epidemic. While fat was removed from foods and deemed unhealthy, sugar was added as a replacement to enhance palatability. However, sugar is metabolized in the liver into fat via de novo lipogenesis, leading to weight gain and insulin resistance. The overconsumption of added sugars from processed foods is the main driver of obesity worldwide, not fat intake. Reintroducing healthy fats and limiting sugar can help address the obesity and diabetes crises.
How the low fat obsession enabled the obesity epidemicPelouze Guy-André
With the best intention of curbing the obesity epidemic, public policies and agribusiness industry touted low fat. Contrary to their aim, they increased obesity all over the world. Low fat is not the solution and it is part of the problem.
The bottom line is that when it comes to belly fat, the answer is not in drugs or supplements. we will tell you and show you different method and what works and what don't works. https://linktr.ee/jnag1988 watch our short video guide.
12 tips to help you lose stubborn belly fatAhmed Habib
Are you intrigued by those Internet ads claiming to know "the secret to shedding belly
fat" or "the one trick to losing belly fat"? If so, you're not alone. Americans spend
countless hours and billions of dollars trying anything and everything to attain a flat
stomach.
But is there really a magic bullet — a fast and easy way to get rid of stubborn belly fat
— as so many ads and commercials claim?
If you don’t know what the Paleo diet is or you’ve never heard of it before, no worries – within this first chapter, we’re going to explore exactly what this way of eating is all about.
How the low fat obsession enabled the obesity epidemicPelouze Guy-André
With the best intention of curbing the obesity epidemic, public policies and agribusiness industry touted low fat. Contrary to their aim, they increased obesity all over the world. Low fat is not the solution and it is part of the problem.
The bottom line is that when it comes to belly fat, the answer is not in drugs or supplements. we will tell you and show you different method and what works and what don't works. https://linktr.ee/jnag1988 watch our short video guide.
12 tips to help you lose stubborn belly fatAhmed Habib
Are you intrigued by those Internet ads claiming to know "the secret to shedding belly
fat" or "the one trick to losing belly fat"? If so, you're not alone. Americans spend
countless hours and billions of dollars trying anything and everything to attain a flat
stomach.
But is there really a magic bullet — a fast and easy way to get rid of stubborn belly fat
— as so many ads and commercials claim?
If you don’t know what the Paleo diet is or you’ve never heard of it before, no worries – within this first chapter, we’re going to explore exactly what this way of eating is all about.
Struggling To See Results With Your Diet? Lose The Fat Forever By Learning The Secrets That Our Ancestors Knew To Maintain A Healthy And Fit Body!
Whether we like it or not, the health of our society is bad and getting worse. As technology continues to develop, convenience does as well and ordering food is literally as simple as the clicking of a button.
Long gone are the days of having to find your own food, let alone having to drive to a restaurant to get dinner.
Cooking dinner looks less and less appealing when compared to the food conveniences and choices amongst diners, catering services, fast food and takeout.
According to the Academy of Nutrition and Dietetics, diabetes is now the seventh leading cause of death, just in the United States alone.
The global prevalence of overweight and obesity as a public health concern is well established and reflects the overall lack of success in our ability to achieve and maintain healthy body weight. Being overweight and obese is associated with numerous comorbidities and is a risk factor for several of the leading causes of death, including cardiovascular disease, diabetes mellitus, and many types of cancer.
The foundation of treatment has been diet and exercise.
Struggling To See Results With Your Diet? Lose The Fat Forever By Learning The Secrets That Our Ancestors Knew To Maintain A Healthy And Fit Body!
Whether we like it or not, the health of our society is bad and getting worse. As technology continues to develop, convenience does as well and ordering food is literally as simple as the clicking of a button.
Long gone are the days of having to find your own food, let alone having to drive to a restaurant to get dinner.
Cooking dinner looks less and less appealing when compared to the food conveniences and choices amongst diners, catering services, fast food and takeout.
According to the Academy of Nutrition and Dietetics, diabetes is now the seventh Dieting cause of death, just in the United States alone.
Struggling To See Results With Your Diet? Lose The Fat Forever By Learning The Secrets That Our Ancestors Knew To Maintain A Healthy And Fit Body!
Whether we like it or not, the health of our society is bad and getting worse. As technology continues to develop, convenience does as well and ordering food is literally as simple as the clicking of a button.
Long gone are the days of having to find your own food, let alone having to drive to a restaurant to get dinner.
Cooking dinner looks less and less appealing when compared to the food conveniences and choices amongst diners, catering services, fast food and takeout.
According to the Academy of Nutrition and Dietetics, diabetes is now the seventh leading cause of death, just in the United States alone.
11 Proven Ways to Lose Weight Without
Diet or Exercise Sticking to a conventional diet and exercise plan can be difficult.
However, there are several proven tips that can help you eat fewer
calories with ease
This eBook has a content related to the healthy food for healthy life. Now a days health is not good because of our diet. we don't have an idea what we should to eat and when. This book tell you lots of things about the healthy food.
Give 1 hour from your 24 hour for your health.
Metabolism. There isn’t perhaps a more frequently used word
in the weight loss (and weight gain) vocabulary than this.
Indeed, it’s not uncommon to overhear people talking about
their struggles – or triumphs – over the holiday bulge or love
handles in terms of whether their metabolism is working, or not.
Doctors, too, often refer to metabolism when they try and
explain why starvation and water-loss diets aren’t scientifically of
medically responsible; since, alas, they do not influence or take
into account metabolism (there’s that word again!)
L’hôpital public_ une entreprise paralysée 23_11_2019.pptxPelouze Guy-André
French public hospitals are territorial administrations. Consequently they are managed by the state and obey to a huge regulatory system which hampers their adaptability and governance. Changes are proposed in order to improve their efficiency in an environment of continuous and fast innovation.
Pour sortir le système de soins de l'impasse actuellePelouze Guy-André
Le système de soins est bloqué par l'inorganisation, la bureaucratie, les coûts et l'immobilisme du monopole d'assureur de la sécurité sociale. Pourtant les Français paient des impôts et des cotisations obligatoires très élevés; ils doivent pouvoir choisir leur assureur maladie et le contrat qui leur convient. Ce choix permettra de dynamiser l'offre et de réguler la demande. Il faut l'assortir de deux garanties, chaque résident doit avoir au minimum un contrat socle qui garantit les soins pour les maladies essentielles et ceux qui ne peuvent économiquement l'acheter doivent bénéficier d'un chèque santé du montant moyen de ce contrat.
La dynamique du marché (qui fait défaut au système actuel) et les garanties sociales pour éviter les passagers clandestins ou bien le coût du contrat pour les économiquement faibles peuvent améliorer rapidement le système tant pour l'accès aux soins essentiels que pour mieux rémunérer les soignants.
Covid 19 - petit état des lieux de la pandémie après le variant BA.2.pdfPelouze Guy-André
The future of the pandemic is an epidemic that drags months or years. How to deal with it?
L'avenir de la pandémie est une épidémie qui traîne des mois ou des années. Comment y faire face?
Red meat, ancestral diet and environment are not to be solved with prohibitions. I describe in this opinion the biases of observational studies and the mistakes in environment issues.
Struggling To See Results With Your Diet? Lose The Fat Forever By Learning The Secrets That Our Ancestors Knew To Maintain A Healthy And Fit Body!
Whether we like it or not, the health of our society is bad and getting worse. As technology continues to develop, convenience does as well and ordering food is literally as simple as the clicking of a button.
Long gone are the days of having to find your own food, let alone having to drive to a restaurant to get dinner.
Cooking dinner looks less and less appealing when compared to the food conveniences and choices amongst diners, catering services, fast food and takeout.
According to the Academy of Nutrition and Dietetics, diabetes is now the seventh leading cause of death, just in the United States alone.
The global prevalence of overweight and obesity as a public health concern is well established and reflects the overall lack of success in our ability to achieve and maintain healthy body weight. Being overweight and obese is associated with numerous comorbidities and is a risk factor for several of the leading causes of death, including cardiovascular disease, diabetes mellitus, and many types of cancer.
The foundation of treatment has been diet and exercise.
Struggling To See Results With Your Diet? Lose The Fat Forever By Learning The Secrets That Our Ancestors Knew To Maintain A Healthy And Fit Body!
Whether we like it or not, the health of our society is bad and getting worse. As technology continues to develop, convenience does as well and ordering food is literally as simple as the clicking of a button.
Long gone are the days of having to find your own food, let alone having to drive to a restaurant to get dinner.
Cooking dinner looks less and less appealing when compared to the food conveniences and choices amongst diners, catering services, fast food and takeout.
According to the Academy of Nutrition and Dietetics, diabetes is now the seventh Dieting cause of death, just in the United States alone.
Struggling To See Results With Your Diet? Lose The Fat Forever By Learning The Secrets That Our Ancestors Knew To Maintain A Healthy And Fit Body!
Whether we like it or not, the health of our society is bad and getting worse. As technology continues to develop, convenience does as well and ordering food is literally as simple as the clicking of a button.
Long gone are the days of having to find your own food, let alone having to drive to a restaurant to get dinner.
Cooking dinner looks less and less appealing when compared to the food conveniences and choices amongst diners, catering services, fast food and takeout.
According to the Academy of Nutrition and Dietetics, diabetes is now the seventh leading cause of death, just in the United States alone.
11 Proven Ways to Lose Weight Without
Diet or Exercise Sticking to a conventional diet and exercise plan can be difficult.
However, there are several proven tips that can help you eat fewer
calories with ease
This eBook has a content related to the healthy food for healthy life. Now a days health is not good because of our diet. we don't have an idea what we should to eat and when. This book tell you lots of things about the healthy food.
Give 1 hour from your 24 hour for your health.
Metabolism. There isn’t perhaps a more frequently used word
in the weight loss (and weight gain) vocabulary than this.
Indeed, it’s not uncommon to overhear people talking about
their struggles – or triumphs – over the holiday bulge or love
handles in terms of whether their metabolism is working, or not.
Doctors, too, often refer to metabolism when they try and
explain why starvation and water-loss diets aren’t scientifically of
medically responsible; since, alas, they do not influence or take
into account metabolism (there’s that word again!)
Similar to How the low fat obsession enabled the obesity epidemic (16)
L’hôpital public_ une entreprise paralysée 23_11_2019.pptxPelouze Guy-André
French public hospitals are territorial administrations. Consequently they are managed by the state and obey to a huge regulatory system which hampers their adaptability and governance. Changes are proposed in order to improve their efficiency in an environment of continuous and fast innovation.
Pour sortir le système de soins de l'impasse actuellePelouze Guy-André
Le système de soins est bloqué par l'inorganisation, la bureaucratie, les coûts et l'immobilisme du monopole d'assureur de la sécurité sociale. Pourtant les Français paient des impôts et des cotisations obligatoires très élevés; ils doivent pouvoir choisir leur assureur maladie et le contrat qui leur convient. Ce choix permettra de dynamiser l'offre et de réguler la demande. Il faut l'assortir de deux garanties, chaque résident doit avoir au minimum un contrat socle qui garantit les soins pour les maladies essentielles et ceux qui ne peuvent économiquement l'acheter doivent bénéficier d'un chèque santé du montant moyen de ce contrat.
La dynamique du marché (qui fait défaut au système actuel) et les garanties sociales pour éviter les passagers clandestins ou bien le coût du contrat pour les économiquement faibles peuvent améliorer rapidement le système tant pour l'accès aux soins essentiels que pour mieux rémunérer les soignants.
Covid 19 - petit état des lieux de la pandémie après le variant BA.2.pdfPelouze Guy-André
The future of the pandemic is an epidemic that drags months or years. How to deal with it?
L'avenir de la pandémie est une épidémie qui traîne des mois ou des années. Comment y faire face?
Red meat, ancestral diet and environment are not to be solved with prohibitions. I describe in this opinion the biases of observational studies and the mistakes in environment issues.
Le gras dans la viande, le poisson ou les végétaux est bon pour la santé.
Les acides gras saturés sont neutres du point de vue du risque cardiovasculaire, certains polyinsaturés sont indispensables et les mono-insaturés sont goûteux comme les avocats, les olives ...
Le gras du lait est excellent.
Les seuls produits à supprimer sont ceux qui contiennent des acides gras trans résultant d'un process industriel d'hydrogénation. Ceci est important.
Perspectives de la TM cardiovasculaire. Définition, histoire, modalités et efficacité sont envisagés au regard de la littérature. Puis les questions économiques et les enjeux à la faveur d'un sondage récent de Medscape sont discutés.
Why Numerus clausus failed in France since 40 yearsPelouze Guy-André
Numerus clausus is the law in France since more than 40 years for the state universities which BTW are the only authorized to have a medical school.
This number is decided by the government and the results are now clear: a massive doctor shortage.
However the suppression of NC is not the solution to this shortage, innovation in teaching, complete autonomy of universities and other conditions are mandatory to solve this catastrophic situation.
Statines en France: éléments de preuves pour favoriser le bon usagePelouze Guy-André
La polémique sur les statines prend un tour dangereux: il y a les pour et les contre. C'est bien évidemment stupide. d'ailleurs ceux là même qui sont contre évite de parler des patienst athéromateux ayant fait un accident et ceux qui sont contre ne commentent jamais les résultats du régime méditerranéen...
Quelques questions essentielles sur votre famille qu'il vaut mieux poser avant d'aller consulter un médecin... et qui pourraient améliorer le cas échéant diagnostic et traitement.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
How the low fat obsession enabled the obesity epidemic
1. 16/01/2019 How the low-fat obsession enabled the obesity epidemic
https://www.europeanscientist.com/en/features/low-fat-obsession-enabled-obesity-epidemic/ 1/12
European Scientist
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Home » Article of the week » How the low-fat obsession enabled the obesity epidemic
- Article of the week -
How the low-fat obsession
enabled the obesity
epidemic
By Guy-André Pelouze & Alexandre Pelouze - 22.01.2018
Diabetes: the new panorama
There are some key facts crucial to an understanding of the current situation.
WHO de nitions of obesity reveal some of them. To date, obesity worldwide
has more than doubled since 1980. In 2014, more than 1.9 billion (39% of the
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2. 16/01/2019 How the low-fat obsession enabled the obesity epidemic
https://www.europeanscientist.com/en/features/low-fat-obsession-enabled-obesity-epidemic/ 2/12
population) adults were overweight. Of these over 600 million (13%) were
obese. 42 million children under the age of 5 were overweight or obese in
2013.
These numbers are of very great concern, suf cient to consider obesity an
epidemic, which should be treated as an international emergency for many
reasons. Firstly, most of the world’s population live in countries where
excessive weight and obesity kill more people than malnutrition. Secondly, the
cost of these illnesses will be “astronomical” according to Marion Nestle, PhD,
MPH, and Chair of the Department of Nutrition and Food Studies at New York
University. Unfortunately our current solutions to this huge health problem are
not even close to helping cure or avoid complications in any of those patients.
And one of the easiest ways of understanding why our strategies are so
ineffective is to examine what causes obesity according to the WHO. They
report that the “fundamental cause of obesity is an energy imbalance between
calories consumed and calories expended. There has been a worldwide
increase in intake of energy-dense foods that are high in fat, and an increase in
physical inactivity due to the increasingly sedentary nature of many forms of
work, changing modes of transportation and increasing urbanisation”. We
would judge that it is now absolutely clear that obesity is due to an imbalance
between food consumed and energy expended. Thanks to Robert H. Lustig
(M.D. Professor of Pediatrics in the Division of Endocrinology at University of
California, San Francisco, and Director of the Weight Assessment for Teen and
Child Health (WATCH) Program at UCSF) it is clear that the concept of calories
is wrong and cannot single-handedly explain obesity. It is also clear that the
increased intake of energy-dense foods that are high in fat is not solely
responsible for the obesity epidemic. We will examine here what seems to be
the real culprit. R. Lustig explained it well when he said that “the problem in
obesity is not excess weight, the problem with obesity is that the brain is not
seeing the excess weight”.
Signi cantly, one person dies every 6 seconds from type 2 diabetes on the
planet and we have seen an increase from 30 million diabetic people in the
1980’s to 415 million people today. Worldwide approximately 1 in 10 adults
has type 2 diabetes mellitus. In the United States 29 million adults (1 in 11)
have type 2 diabetes mellitus and another 86 million (over 1 in 3) have
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continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to
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3. 16/01/2019 How the low-fat obsession enabled the obesity epidemic
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prediabetes. Put simply, approximately 40 % of US adults already have some
degree of insulin resistance. Last November 14 was the World Diabetes Day
which WHO wanted to use as an opportunity to promote efforts to prevent
diabetes and ensure optimal disease management. But surprisingly sugar is
still not a target in any of the plans to ght diabetes.
Fat or sugar?
Nutrition is one of the most signi cant elds where patient behaviours are
central, as patients carry out their own purchase and consumption of food. As
a result they need to take responsibility and so need to be able to understand
all the ins and outs about food.
We have already explained elsewhere (1) why fat has long been considered
the culprit for what is known as the metabolic disease and we will now explain
why and how it has destroyed perfectly good food habits and ended up in
what we may well consider as the worst food epidemic ever known.
For well-known reasons given elsewhere, fat has been removed from our food.
The main subsequent problem was that low fat food is not palatable, so
changes had to be made to make the low-fat food into something more
appealing. For equally well-known reasons sugar was the cheapest and
easiest substitute. It is a very cheap solution, palatable, and with the additional
factor that it triggers a very strong reward response in the brain, resulting in
an addiction leading to increased purchase. As R. Lustig said “Sugar is cheap,
sugar tastes good, sugar sells, so companies will have little incentive to
change.”
We would now like to set out why sugar is the culprit and not fat. The main
reason is that your body fat also called endogenous fat is not made from
exogenous fat but exogenous sugar. In other words the sugar you eat makes
you fat.
th
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Considering that today added sugars are consumed in excess by a majority of
the population it is essential to explain here the effects of those sugars on our
metabolism. As we stated in our previous paper (2) fructose is the only sugar
we should focus on. From an evolutionary standpoint fructose was present in
fruits to confer a survival advantage (in the event of famine or for the winter
period). Our overconsumption of it is now killing us.
Metabolism of Sugars
We will now discuss the various stages of fructose metabolism to understand
why overconsumption is the main reason for our general metabolic
disturbance leading to obesity and diabetes, sometimes referred to as insulin
resistance syndrome.
The rst action of the metabolism pathway is absorption. As soon as you eat
food containing fructose as an added sugar or the simple monosaccharide
present in fruits, it is absorbed by a speci c transporter in your jejunum (Glut5)
and then taken up by your liver. It is important to note that this absorption
process has a threshold and that this absorption is also facilitated if fructose is
ingested with glucose (which is the case with most added sugars such as
HFCS: High Fructose Corn Syrup).
Fructose is metabolised in the liver. It is also important to note that only a very
small amount of fructose is transported in your blood for distribution to other
organs. This is the reason why we do not measure the fructose concentration
in your blood as we do for glucose (glycemia) for example. (Glycemia 5.5
mmol/l VS fructosemia 0.01 mmol/l) Other organs like the kidneys, muscles,
adipose tissue and brain cells can express Glut5 and therefore can make use of
fructose from the blood but as the concentration of fructose in the blood is so
low, the metabolism in the periphery is very poor.
In the liver, fructose follows a very well known pathway avoiding the main
control steps of glycolysis (breaking down of sugar mechanism). In the
interests of simplicity you should understand that this mechanism is an
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enzymatic process by which we transform a sugar (glucose or fructose) into a
metabolic product that will be used to produce energy.
Concerning glucose this enzymatic chain reaction is tightly controlled and
certain enzymes are regulated mostly by the energy status of the liver (if we
need energy the enzymes are free to work as much as required as they have a
substrate breaking down glucose into a metabolic product and then ATP
[adenosine triphosphate] )
With fructose the control steps are absent, which means that if there is a
substrate (fructose) then we will have a chain reaction and production of the
metabolic product. The reason why the control process is non-existent is clear,
during evolution we needed to make extra fat out of the ingested fructose in
order to have reserves of energy to be able to survive in periods when food
was scarce (winter/ famine).
Metabolic products of this chain reactions are dihydroxyacetone phosphate
and glyceraldehyde 3-phosphate (DHAP, GA-3P). After the glycolysis is
simple, it can either continue into the citric acid cycle in the mitochondria, the
anaerobic lactic acid formation, “de novo lipogenesis” pathway or undergo
gluconeogenesis to form glucose.
To simplify, we can either make energy for immediate usage as ATP molecules
or synthesise lipids in order to store it and use it later depending on the energy
state of the body. For instance any organism in a low energy state ( sedentary
humans) will prefer de novo lipogenesis because there mitochondria are not
working, and they don’t need so much ATP molecules.
Now that we understand the theory let’s see what happens in practice
when we consume sugar in our diet.
After fasting if we haven’t eaten for a long time, 50% of the fructose will be
transformed into glucose, a process needed to control glycemia and to
distribute glucose to the other organs in order to deliver a substrate for energy
formation.
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In the present set up of over and continuous consumption of sugar – which is
the case most of the time since we eat too often during the day and most of
our food contains added sugars – fructose now goes into the de novo
lipogenesis pathway in order to make fat. As explained earlier this pathway is
not regulated so the more fructose you consume the more fat is produced via
non regulated de novo lipogenesis. The greater potential of fructose to
stimulate de novo lipogenesis is the main reason why it has been portrayed as
particularly harmful.
The fat accumulated in the liver causes hepatic disturbances and global insulin
resistance leading to decreased hepatic function and diabetes. It has been
shown that a hypercaloric state rather than macronutrient composition is
signi cant for the accumulation of lipids in the liver meaning that too much
sugar as added sugars or carbohydrates induces accumulation of fat in the
liver leading to NAFLD (nonalcoholic fatty liver disease an alarming twin
epidemy with central obesity or T2D.).
After this long metabolic explanation it is time to propose solutions in order
to help you ght against obesity and diabetes.
One of the rst pieces of advice is straightforward: you should cut down your
intake of added sugars in order to reduce the amount of sugar you are eating.
As we explained previously (2), most of the sugar in your food is usually added
and hidden. As you probably remember we listed almost 40 different names
for added sugar, which makes it more complicated for you to read and
understand exactly which ingredients are sugars. One of the simplest ways to
avoid sugar is to not buy processed food and make the effort to eat mainly
whole fresh foods. One of the most recurrent FAQ is whether you can eat fruit
because of the presence of fructose. Remember that the concentration of
fructose in a peach is nothing compared to the quantity of added fructose in
processed food. So it is absolutely ok to eat fruits.
Secondly you should introduce fat into your diet; raw fats are healthy and
won’t make you fat!
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This is the most important point in our discussion, and we will try to explain
why fat does not make you fat and does not increase your cardiovascular risk.
First it is really hard to over-eat fat because fat is very satiating. The best way
for you to understand it is to try to eat raw fat like butter without any bread
(you will have a normal, rapid, instinctive stop re ex). Eating fat in a low
carbohydrate diet makes it easier to access fat for energy (2). To sum up, you
will eat less and make your fat storage more accessible for fat burning so you
might even lose weight.
The second important point is to understand that the fat you are eating (called
exogenous fat) is not the exact same fat you will nd in your arteries. It rst
has to be digested and absorbed then made soluble in the form of
chylomicrons and eventually transported in the blood to the different organs.
From there several factors are to be taken into consideration to evaluate the
cardiovascular risk. If your in ammatory status is elevated (a consequence of
over consumption of carbohydrates and sugar, stress, cigarette smoking and
obesity) the odds are high for you ending up with oxidized LDL that will have
to be removed from the artery and therefore enters the wall of your artery
forming atherosclerotic plaques. Eating fat will not increase your LDL particles;
instead it will increase your total cholesterol and HDL.
In conclusion, you should remember that you have the opportunity to decide
whether you will eat it or not despite hacking of your brain. Deciding not to
buy is deciding not to eat. If you quit your soda habit, the sugar in your
morning coffee, your bread addiction and start eating more unprocessed fats
(butter, olive oil, animal fats), your health will improve rapidly.
by Alexandre Jean Pelouze MD, Surgery resident, Geneva University Hospital,
Geneva Switzerland, and Guy-André Pelouze MD, Thoracic and
cardiovascular surgeon, St John’s hospital, Perpignan, France.
References:
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1. Fats: an inaccurate hypothesis
Guy-André Pelouze, Global oils and fats, Vol 13 issue 2 (Apr-Jun) 2016, 8-11
2. https://www.contexte.com/article/article/added-sugar-rather-than-fat-
endangers-public-health_42969.html
3. Journal of Nutrition and Metabolism, Volume 2015 (2015),
http://dx.doi.org/10.1155/2015/823081
Fructose Metabolism and Relation to Atherosclerosis, Type 2 Diabetes, and
Obesity, Astrid Kolderup and Birger Svihus
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cardiovascular risk diabetes diet Fat obesity sugar
GUY-ANDRÉ PELOUZE & ALEXANDRE PELOUZE
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