Christina Light Craigo MSN ACNP AACCLos Angeles Cardiology Associates

February 9, 2019

Dietary Sugars: Effects on Obesity and Metabolic Disease as a Basis for New Dietary Recommendations. Michael Goran, PhD.

Khera AV et al. N Engl J Med 2016; 375: 2349-2358.

¨ First proposed pyramid introduced in the 1980s featured fruits and vegetables heavily.

¨ Chart was reorganized to emphasized special interests such as grain, meat and dairy, industries all heavily subsidized by the USDA.¡ Luise Light, nutritionist hired by the Department of

Agriculture, “could lead to an epidemic of obesity and diabetes”.

1st USDA Dietary Guidelines for

Americans

¨ A single fast food meal can stiffen arteries within hours, cutting their ability to relax normally in half

¨ Endotoxins are not destroyed by cooking temperatures, stomach acid or digestive enzymes

¨ Many Americans are stuck in a state of chronic low grade inflammation

Jenkins, D. et al. The Garden of Eden – plant based diets, the genetic drive to conserve cholesterol and its implications for heart disease in the 21st century.Comparative Biochemistry and Physiology Part A 136 (2003) 141-151.

Plant Based Diet

Jenkins, D. et al. The Garden of Eden – plant based diets, the genetic drive to conserve cholesterol and its implications for heart disease in the 21st century. Comparative Biochemistry and Physiology Part A 136 (2003) 141-151.

Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults. Quanhe Yang, PhD; Zefeng Zhang, MD, PhD; EdwardW. Gregg, PhD;W. Dana Flanders, MD, ScD; Robert Merritt, MA; Frank B. Hu, MD, PhD

¨ High intake of carbohydrates¡ Raises plasma fasting

triglycerides primarily by enhancing hepatic synthesis of VLDL

¡ Reduces HDL¨ Greater intake of

starches with high glycemic indexes is associated with insulin resistance

¨ Over 7-8% added sugar in our diets (125 calories per day) causes a 3-fold increased risk of cardiovascular mortality.

¨ Diets high in sugar may induce elevated levels of glucose, insulin, uric acid, impaired glucose tolerance, insulin and leptin resistance, non-alcoholic fatty liver disease and altered platelet function

¨ High intake of sugar leads to cardiovascular disease, hypertension, obesity, diabetes, low HDL, high triglycerides, dementia

Bias or Science?

¨ Extracted from the Food and Drug Law Journal: The Dietary Guidelines Advisory Committee reports contained:

¨ No discussion at all of the scientific research on the health consequences of eating meat. If the Committee actually discussed this research, it would be unable to justify its recommendation to eat meat, as the research would show that meat increases the risks of chronic disease, contrary to the purposes of the Guidelines. Thus, by simply ignoring that research, the Committee is able to reach a conclusion that would otherwise look improper.

¨ AAFP corporate ties to coca cola¨ ADA produces nutrition fact sheets -¨ Doctors perceive that patients would feel

deprived of all the junk they’re eating¨ Physicians went from being bystanders of

smoking to leading the fight against tobacco¨ Plant-based diets are the nutritional equivalent

of quitting smoking.

Guasch-Ferré, M., et al. BMC Medicine, 2013; 11:164.

Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women. The A to Z weight loss study: A randomized Trial. Christopher Gardner, et al. JAMA March 7. 2007 – Vol 297, No. 9

¨ Regularly lowering insulin levels leads to improved insulin sensitivity, a reduction in DM and obesity

¨ Overeating suppresses growth hormone levels by as much as 80% (HGH is associated with anti-aging)

¨ The most potent natural stimulus to growth hormone secretion is fasting

¨ Increase in resting energy expenditure

Harvie, M. et.al. The effects of intermittent or continuous energy restriction on weight loss and metabolic disease risk markers: a randomised trial overweight women. Int J Obes (Lond). 2011 May; 35(5):714-727.

Intermittent Fasting: Effect on Insulin Sensitivity and Triglycerides

Bhutani, S. et al. Improvements in Coronary Heart Disease Risk Indicators by Alternate Day Fasting Involve Adipose Tissue Modulations. Obesity 2010. 18, 2152-2159.

Heilbronn, L et. al. Alternate-day fasting in nonobese subjects: effects on body weight, body composition, and energy metabolism. Am J ClinNutr 2005;81:69-73.

Lingvay, et. Al. Rapid Improvement in Diabetes after Gastric Bypass Surgery: Is it the Diet or Surgery? Diabetes Care. 2013 Sept; 36(9):2741-7.

¨ Improves mental clarity and concentration

¨ Induces weight and body fat loss

¨ Lowers blood sugar levels

¨ Improves insulin sensitivity

¨ Increases energy

¨ Improves fat-burning¨ Lowers blood

cholesterol¨ Prevents Alzheimer’s

disease ¨ Extends life¨ Reverses the aging

process¨ Decreases

inflammation

The food you eat can be either the safest most powerful form of medicine or the slowest form of poison.

-Ann Wigmore