Document

The Metabolic SydromeEngineering 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

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

IntroductionMyself: 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:


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

Robert H. Lustig: M.D. Professor of Pediatrics in the Division of Endocrinology at University of California, San FranciscoDr. Lustig is a Neuroendocrinologist, with basic and clinical training relative to hypothalamic development, anatomy, and function

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

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.

A Selection of Experts from My Journey…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.

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


General / Other DisciplinesOur Engineering Practice

Root Cause Methodology

Problem Definition

Comparative Analysis (IS / IS NOT)•What, When, Where, Extent + Trends

Root Cause Analysis•Cause Effect chain – Root Cause Diagram•Physics based mechanism for all Linkages

Hypothesis Generation•For / Against Analysis•Generate Targeted Experiments

Problem Definition

Correlation Analysis• Epidemiological Studies•Loose application of Is / Is Not

Mechanistic Evidence•Explore mechanisms•Focus on suspected factors

Experimentation•Prospective Studies•Statistical Inference

Design & Analysis Of Experiments•Screening Experiments, then fractional•Statistical Inference informs next steps


General / Other DisciplinesOur Engineering Practice

Root Cause Methodology

Problem Definition

Comparative Analysis (IS / IS NOT)•What, When, Where, Extent + Trends

Root Cause Analysis•Cause Effect chain – Root Cause Diagram•Physics based mechanism for all Linkages

Hypothesis Generation•For / Against Analysis•Generate Targeted Experiments

Problem Definition

Correlation Analysis• Epidemiological Studies•Loose application of Is / Is Not

Mechanistic Evidence•Explore mechanisms•Focus on suspected factors

Experimentation•Prospective Studies•Statistical Inference

Design & Analysis Of Experiments•Screening Experiments, then fractional•Statistical Inference informs next steps

A

B

C


The Trends – Linear for Weight….

(OECD Data)


Australia

Pro

po

rtio

n O

verw

eig

ht

USA

England

France

Korea

…and Exponential for Diabetes

Percent with Diabetes

Number with Diabetes

Per

cen

t w

ith

Dia

bet

es

Nu

mb

er w

ith

Dia

bet

es


So is it Simply the Calories?Why are we consuming so much?


% Obese

kCal/d

To understand the drivers of both, is the key to recovery…..


Weight Control / Obesity is largely a subset of

The Metabolic Syndrome

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….


Metabolic Syndrome Cost Impact?

Metabolic Syndrome Definition:

METABOLIC SYNDROME

(3 or more of the 5 factors)

Low HDL “Good Cholesterol” <1.0 mmol/L

High Blood Triglycerides >1.5 mmol/L

Waist >~38” Men

>~35” Women

High Blood Sugar

>5.6 mmol/L

Blood Pressure Elevated

>135/85 mmHg

Atheroschlorosis

Coronory Heart Disease

(Obesity)

Fatty Liver Disease

Gout

Arthritis

Type 2 Diabetes

Stroke

Alzheimers

Asthma


METABOLIC SYNDROME



How many people have it then? It’s not too common, right?


Waist >~38” Men

>~35” Women

High Blood Sugar

>5.6 mmol/L


>135/85 mmHg

Atheroschlorosis


(Obesity)

Fatty Liver Disease

Gout

Arthritis

Type 2 Diabetes

Stroke

Alzheimers

Asthma


METABOLIC SYNDROME




How does >50% of US population strike you?


Waist >~38” Men

>~35” Women

High Blood Sugar

>5.6 mmol/L


>135/85 mmHg

Atheroschlorosis


(Obesity)

Fatty Liver Disease

Gout

Arthritis

Type 2 Diabetes

Stroke

Alzheimers

Asthma

20% of the “Fat” are “Fit”

40% of the “lean” are unhealthy


METABOLIC SYNDROME




How does >50% of US population strike you?


Waist >~38” Men

>~35” Women

High Blood Sugar

>5.6 mmol/L


>135/85 mmHg

Atheroschlorosis


(Obesity)

Fatty Liver Disease

Gout

Arthritis

Type 2 Diabetes

Stroke

Alzheimers

Asthma

Key Phenomenon: INSULIN

RESISTANCE

20% of the “Fat” are “Fit”

40% of the “lean” are unhealthy

A Crash Course in Endocrinology 1…..Insulin / Glucagon / Ghrelin /

Leptin – know your control system hormones!

sugar / simple carbohydrate

ingestion primarily

BMech

1. Insulin and

Glucagon

High Blood Sugar


A Crash Course in Endocrinology 2


BMech

• Ghrelin and

Leptin

And so, The KEY to the Cycle of DiseaseInsulin (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!


The KEY to APPETITE CONTROLInsulin (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


And so, The KEY to APPETITE CONTROLInsulin (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!



#2: Appetite Dysfunction


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









#3 Leptin Signal Block







#4 Leptin Resistance







#4 Leptin Resistance

Appetite

ObesityInflammationFatty Liver

“Bad Cholesterol”AtherosclerosisHeart Disease

DiabetesAlzheimersCancers etc

“The Diseases of Modernity”

Appetite

ObesityInflammationFatty Liver

“Bad Cholesterol”AtherosclerosisHeart Disease

DiabetesAlzheimersCancers etc

“The Diseases of Modernity”

Perhaps unsurprisingly, Insulin Resistance Leads to the Metabolic Maladies….


BMech


…..but, substantially, is it the chicken or the egg??


BMech




BMech


Excess Weight



BMech


Excess Weight


Self-Reinforce Loop Warning!

Self-Reinforce Loop Warning!


BMech

So, time to fix 4 decades of “Hypothesis Resistance”, and move on…

Excessive Insulin Demand exhausts Pancreatic CellsIrrecoverable Cell Death


BMech



Greed +


}

BMech



+ appetite derangement

Greed +


}

BMech



+ appetite derangement

Greed +


}Self-

Reinforce Loop

Warning!

Self-Reinforce

Loop Warning!

Self-Reinforce

Loop Warning!

BMech

Metabolic Syndrome / ObesityPOTENTIAL ROOT CAUSE #1:

SUGAR


Glucose-glucose-glucose......chainsSo-called ”Simple Carb”, added sugar too though..

High Fructose Corn Syrup (HFCS): 55% fructose / 45% glucose

Sucrose (Table Sugar):50%glucose / 50% fructose

Fruit: 4% to 8% Fructose(but with lots of Fibre & Good Stuff!)

Fructose Vs Glucose Sources

Metabolic Syndrome / ObesityPOTENTIAL ROOT CAUSE #1:

SUGAR


Fructose / HFCS “Mega Sources”:

* Soft Drinks / Sports Drinks *Most All Processed Food

Low Fat ProductsFruit Juices / SmoothiesMost Breakfast Cereals

Etc Etc Etc

From one of the best, 1957ACorr

DIET AND CORONARY THROMBOSISHYPOTHESIS AND FACT *

JOHN YUDKINM.A., Ph.D., M.D. Camb., M.R.C.P., F.R.I.C.

PROFESSOR OF NUTRITION IN THE UNIVERSITY OF LONDON ATQUEEN ELIZABETH COLLEGE

NO Significant Correlation for Fat and Heart Disease Rates

R2 = 0.1, P > 0.05

1. USA2. Australia3. Canada4. Finland5. New

Zealand6. UK7. Denmark8. Sweden9. Norway10. Netherlands11. Switzerland12. W. Germany13. France14. Italy15. Japan

Significant Correlation for Sugar and Heart Disease Rates

R2 = 0.41, P < 0.05

Let’s get up to date here….

Sugar g/day: Composite, multiple sourcesBMI/Diabetes Data: http://www.cdc.gov/nchs/data/hus/hus12.pdf#063

ACorr


Sugar g/day

%BMI > 25Diabetes

Another Longer Term View…A

Corr


Welcome, to The new age of Sugar

and Simple Carbs…

ACorr

Obesity Trend

Carb grams/day

Reminder first – Glucose Vs FructoseBMech


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

BMech

60 kcal(+ 12 kcalglucose)

120 kcal Glucose24 kcal goes to liver

120 kcal Alcohol94 kcal goes to liver

120 kcal Sucrose (50:50 Fruc/Gluc)ALL Fructose must go to liver

The Mitochondria -Your Cellular Energy Production LineGlucose, Alcohol,

Fructose – One of these things is not like the others…..!

BMech

The Mitochondria -Your Cellular Energy Production Line

Into Your Liver goes the Fructose

BMech


Initial conversion and ATP depletion

BMech

Ramp Up the Uric Acid

Production

MS #1: Hypertension


BMech

Ramp Up Krebs Cycle and Citrate

Production

BMech

Kick Off unique Xylulose-S-P Production

BMech

Accelerate the Fat Production Line

BMech

Welcome to DNL: Elevated Blood

Triglyceride

MS #3: HDL Reduction

MS #4: Triglyceride

BMech

CExpt

Add Hepatic Lipid Production and

drive NAFLD

BMech

Add Blood FFA & Insulin Levels / IR

MS #2: Central Obesity

BMech

Add Blood FFA & Insulin Levels / IR

MS #2: Central Obesity

BMech

Self-Reinforce

Loop Warning!

Add Systemic Inflammation

BMech

Add Hepatic Insulin Resistance

MS #5: Sugar Control

BMech



BMech

Self-Reinforce

Loop Warning!



BMech

Self-Reinforce

Loop Warning!

Self-Reinforce

Loop Warning!

SREBP1 and increased Fat

Production

BMech

SREBP1 and increased Fat

Production

BMech

Self-Reinforce

Loop Warning!

Spiked Insulin Drives Fat Storage

MS #2: Central/General Obesity

BMech

Spiked Insulin Drives Fat Storage


BMech

Self-Reinforce

Loop Warning!


Appetite Dysfunction and Increased Consumption

BMech

Appetite Control

Leptinblocking


Appetite Dysfunction and Increased Consumption

BMech

Appetite Control

Leptinblocking

Self-Reinforce

Loop Warning!


Welcome to the Metabolic Syndrome

BMech


MS #3: HDL Reduction

MS #4: Triglyceride

MS #1: Hypertension

And Sugar’s effect on your “Bad” Cholesterol?

CExpt


1965 – 1972, Excellent Engineering Style Studies – Not easy to find now

CExpt

No

rmal

Die

t

Hig

h S

ug

ar

Lo

w S

ug

ar

Hig

h S

ug

ar

Lo

w S

ug

ar


Lower is Better in all plotlines here

1965 – 1972, Excellent Engineering Style Studies – Not easy to find now

CExpt

No

rmal

Die

t


Lower is Better in all plotlines

Hig

h S

ug

ar

Lo

w S

ug

ar

Lo

w S

ug

ar

All Candidates Same Trend……

No

rmal

Die

t

Hig

h S

ug

ar

Lo

w S

ug

ar

2011: Fructose Drives Visceral ObesityCExpt


Glucose:LOW

VisceralObesity

Fructose:HIGH

VisceralObesity

SAT = Subcutaneous

Or “Safe” Body Fat

SAT = Subcutaneous

Or “Safe” Body Fat Type

VAT =

VisceralOr “Toxic”

Body Fat Type

2011: Fructose Drives Post-Prandial TG C

Expt


FructoseGlucose Sucrose

Trig

lyce

ride

(AU

C)


Trig

lyce

ride

22-2

4h

AreaUnder

Curve i.e.

AverageTrig

Impact

The Common Fasting Trigs test :Glucose > Fructose, but note

lower scale, ~0.18mmol/L

Fructose: HIGH (0.60 mmol/L)Post-Meal Trigs….

where damage is done…

2011: Fructose Drives ApoB Lipoprotein(“The real BAD Cholesterol”)

CExpt

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…..


Glucose:Low

ApoB

Fructose:HIGHApoB

Sucrose


ΔF

astin

g A

poB

(g/

L)


% A

poB

/Apo

A

Lots where this came from….


CExpt

Soft Drinks boys and girls !

POTENTIAL ROOT CAUSE #2:

FAT

Triglyceride – 3 Fatty Acids with a Glycerol Backbone

2013 Ivor Cummins BE(Chem) MIEI Natural

Natural

Natural????

A Topic for another

Seminar(!)

Sugar g/day: Composite, multiple sourcesFat/BMI/Diabetes Data: http://www.cdc.gov/nchs/data/hus/hus12.pdf#063

Fat Versus Sugar: Correlative DataACorr


FAT g/day

%BMI > 25Diabetes

Sugar g/day: Composite, multiple sourcesFat/BMI/Diabetes Data: http://www.cdc.gov/nchs/data/hus/hus12.pdf#063

Fat Versus Sugar: Correlative DataACorr


SUGAR g/d

%BMI > 25Diabetes

FAT g/day

%BMI > 25Diabetes

A little bit of history…..Ancel KeysA

Corr


And His BAD Science Punishment?

What Keys could have chosen…..A

Corr


The Contemporaneous Controversy…ACorr

DIET AND CORONARY THROMBOSISHYPOTHESIS AND FACT *

JOHN YUDKINM.A., Ph.D., M.D. Camb., M.R.C.P., F.R.I.C.

PROFESSOR OF NUTRITION IN THE UNIVERSITY OF LONDON ATQUEEN ELIZABETH COLLEGE

NO Significant Correlation for Fat and Heart Disease Rates

R2 = 0.1, P > 0.05

1. USA2. Australia3. Canada4. Finland5. New

Zealand6. UK7. Denmark8. Sweden9. Norway10. Netherlands11. Switzerland12. W. Germany13. France14. Italy15. Japan

Significant Correlation for Sugar and Heart Disease Rates

R2 = 0.41, P < 0.052013 Ivor Cummins BE(Chem) MIEI

And the Dreadful SATURATED Fat?ACorr

OrthodoxView

TrendLineEh, excuse

me?

AnEngineer’sTrendLine


Increasing Heart Disease with lower

fat

Decreasing Heart Disease with higher fat

Another Recommended PaperACorr

Dietary lipids and coronary heart desease: Old evidence, new perspective Review ArticleProgress in Lipid Research, Volume 31, Issue 3, 1992, Pages 195-243Michael I. Gurr, Professor in Food Science & Technology, University of Reading, UK.Professor in Human Nutrition, Oxford Brookes University, UK.

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”

Men from the studies

Who HAD Heart

Attacks

Men from studies who

had NO HeartAttacks


2010: The Metastudy of all studiesA

Corr

Meta-analysis of 21 prospective cohort studies evaluating the association of saturated fat with cardiovascular disease

Conclusion: There is no 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….)


NO Effect of Dietary

Saturated Fat Seen Overall

• Let’s make up some time here and move on to experimental – go on, you know you want to!

Fat Mechanistic DataB

Mech


FAT – Experimental – Krauss et Al 2008

Trig Reduction

Experiment Design: 3 weeks isocalorific, remainder with -1000 calories per day (starve)

CExpt


Serum Triglyceride –

Lower is Better


Trig Reduction


CExpt

HD

L “g

ood”

Cho

l


Serum Triglyceride –

Lower is Better

HDL –

Higher is Better

FAT – Experimental – Krauss et Al 2008Experiment Design: 3 weeks isocalorific, remainder with -1000 calories per day (starve)

CExpt

Tot Chol/HD

L


TOTAL CHOL / HDL

Lower is Better


CExpt

Tot Chol/HD

L

Apo B / Apo A


TOTAL CHOL / HDL

Lower is Better

ApoB / Apo A Lipoprotein

Lower is Better


CExpt

LDL

Parti

cle

Dia

met

er


LDL Particle Diameter

Higher is Better


CExpt

LDL

Parti

cle

Dia

met

er



Higher is Better

Ivor Conclusion:• Low Sugar/Carb, high Fat diet dramatically improves Key MetS disease markers


Ivor Conclusion:• Low Sugar/Carb, high Fat diet dramatically improves Key MetS disease markers

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……..!


CExpt

LDL

Parti

cle

Dia

met

er



Higher is Better

Can do this again and again……

and again.

by Jeff S. Volek, Ph.D., R.D.

CExpt


Obesity Trends over Several Decades


Concluding Material


Coup De Grace? 2013: The Rat Proxy…

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

“…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)

HDL Reduction (p 0.002)

hyper-triglyceridemia (p 0.001)In only

FOUR Weeks!

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.”


25

X

Make your minds up guys…

Guidelines Schmidelines…..

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”


% D

aily

Cal

orifi

c In

take

But I don’t eat that much Sugar…?

250 ml250 ml

Cereal OJ Smoothie Total Spoons

~4 ~6 ~8 ~19

80g

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

Brekky

Time!

=2013 Ivor Cummins BE(Chem) MIEI

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!

And My N=1 Experiment?

CExpt

July 2013 Singapore

Ivor the Laboratory Rat

HDL

1.47

GGT

112

Trig

0.92

Trig/HDL

1.44

Tot Chol /HDL

4.5

CExpt

530

Ferritin

>1.00mmol

/L

< 200approx

<4.0

<35approx

< 1.5mmol

/L

< 2.0

Note: converted from mmol/L to mg/dL to get ratio guidelines



HDL

1.47

GGT

112

Trig

0.92

Trig/HDL

1.44

Tot Chol /HDL

4.5

CExpt

530

Ferritin

>1.00mmol

/L

< 200approx

<4.0

<35approx

< 1.5mmol

/L

< 2.0



42

35


HDL

1.47

GGT

112

Trig

0.92

Trig/HDL

1.44

Tot Chol /HDL

4.5

CExpt

530

Ferritin

>1.00mmol

/L

< 200approx

<4.0

<35approx

< 1.5mmol

/L

< 2.0



42

35

230


HDL

1.47

GGT

112

Trig

0.92

Trig/HDL

1.44

Tot Chol /HDL

4.5

CExpt

530

Ferritin

>1.00mmol

/L

< 200approx

<4.0

<35approx

< 1.5mmol

/L

< 2.0



42

35

230

1.73


HDL

1.47

GGT

112

Trig

0.92

Trig/HDL

1.44

Tot Chol /HDL

4.5

CExpt

530

Ferritin

>1.00mmol

/L

< 200approx

<4.0

<35approx

< 1.5mmol

/L

< 2.0



42

35

230

1.73

0.78


HDL

1.47

GGT

112

Trig

0.92

Trig/HDL

1.44

Tot Chol /HDL

4.5

CExpt

530

Ferritin

>1.00mmol

/L

< 200approx

<4.0

<35approx

< 1.5mmol

/L

< 2.0



42

35

230

1.73

0.78


HDL

1.47

GGT

112

Trig

0.92

Trig/HDL

1.44

Tot Chol /HDL

4.5

CExpt

530

Ferritin

>1.00mmol

/L

< 200approx

<4.0

<35approx

< 1.5mmol

/L

< 2.0



42

35

230

1.73

0.781.03


HDL

1.47

1.73

GGT

112

42

Trig

0.78

0.92

Trig/HDL

1.03

1.44

Tot Chol /HDL

3.5

4.5

CExpt

35

530

230

Ferritin

>1.00mmol

/L

< 200approx

<4.0

<35approx

< 1.5mmol

/L

< 2.0



Continued….

Weight

95

5k run time

28

Waist

35

Sys BP

145

Dia BP

95

CExpt

Ideal ~82Kg

Ideal 32”

<85mmHg

<135mmHg

Avg of 20+ readings from same Equipment2013 Ivor Cummins BE(Chem) MIEI

Continued….

Weight

95

5k run time

28

Waist

35

Sys BP

130

145

Dia BP

80

95

CExpt

Ideal ~82Kg

Ideal 32”

<85mmHg

<135mmHg


Continued….

Weight

95

5k run time

28

Waist

35

Sys BP

130

145

Dia BP

80

95

CExpt

Ideal ~82Kg

Ideal 32”

<85mmHg

<135mmHg


82

Continued….

Weight

95

5k run time

28

Waist

35

Sys BP

130

145

Dia BP

80

95

CExpt

Ideal ~82Kg

Ideal 32”

<85mmHg

<135mmHg


82

24.5

Continued….

Weight

82

95

5k run time

24.5

28

Waist

32

35

Sys BP

130

145

Dia BP

80

95

CExpt

Ideal ~82Kg

Ideal 32”

<85mmHg

<135mmHg


B’fast

Lunch

Snack

Dinner

Supper

MINIMISE2013 Ivor Cummins BE(Chem) MIEI

+or

oror etc

+

or

or

85% !!

IDEAL

B’fast

Lunch

Snack

Dinner

Supper


+or

oror etc

+

or

or

85% !!

IDEAL

•Effectively NO Sugar•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•Lots of eggs/cheese•Moderate Nuts•Moderate Fruit•85% Choc, NO Milk Choc•Olives, Avocados•Tomatoes and salad veg

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….


• “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/

A Sample of Approachable Science

B’fast

Lunch

Snack

Dinner

Supper


+or

oror etc

+

or

or

85% !!

IDEAL

•Effectively NO Sugar•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•Lots of eggs/cheese•Moderate Nuts•Moderate Fruit•85% Choc, NO Milk Choc•Olives, Avocados•Tomatoes and salad veg

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 (2nd 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


BACKUP


The Wisdom of the Past?

"Diabetic Cookery; Recipes and Menus" by Rebecca W Oppenheimer, 1917

Aw, c’mon now!}



The So-Called “Cholesterol”http://www.slideshare.net/ancestralhealth/attia-ahs-talk-pc-

friendly


"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)."

Polyunsaturated Fun



The Super Healthy PUFA


Education

Document