Diabetes risk persists in metabolically healthy adults without NAFLD


Among metabolically healthy adults with overweight or obesity, researchers observed an association between BMI and diabetes risk independent of nonalcoholic fatty liver disease, according to findings published in Obesity.

“Our findings indicate that excess adiposity is not a harmless condition and can induce the development of diabetes, even in [nonalcoholic fatty liver disease]-free subjects without any metabolic abnormalities,” Yoosoo Chang, MD, PhD, of the Center for Cohort Studies at Total Healthcare Center, Kangbuk Samsung Hospital and Sungkyunkwan University School of Medicine in Seoul, South Korea, and colleagues wrote.

Chang and colleagues analyzed data from 74,509 adults considered to bemetabolically healthy at baseline, defined in this study as adults without insulin resistance or any criteria for metabolic syndrome except for large waist circumference (31,221 men). Adults were participants in the Kangbuk Samsung Health Study, a cohort of Korean adults who underwent comprehensive annual or biennial exams with at least one follow-up visit between March 2005 and December 2013; exams included blood draws and abdominal ultrasounds.

During a mean follow-up period of 4.1 years, 472 adults developed diabetes (incidence rate, 1.5/1,000 person-years). Researchers found that, as BMI increased, the incidence of diabetes also increased in a dose-response manner, independent of the presence of nonalcoholic fatty liver disease (NAFLD).

In adults with overweight but without NAFLD, the HR incident diabetes vs. adults of normal weight was 1.29 (95% CI, 1-2.16) after multivariable adjustment; HR for those with obesity and without NAFLD was 1.57 (95% CI, 1.14-2.16). For adults with NAFLD and overweight, the adjusted HR for incident diabetes rose to 1.9 (95% CI, 0.95-3.8); the HR for those with obesity and NAFLD was 2.57 (95% CI, 1.32-5.02).

“Even in strictly selected metabolically healthy men and women, we observed a strong association between BMI and incident diabetes that was independent of NAFLD,” the researchers wrote. “Also, our study demonstrates that overweight and obesity both independently affect the risk of diabetes in a dose-response manner.” – by Regina Schaffer

NIH grants $1.8 million for gut microbiome research in obesity, metabolic syndrome


The National Institute of Diabetes and Digestive Kidney Diseases of the NIH has awarded a 4-year $1.8 million grant to a Georgia State researcher studying the role of the gut microbiome in the development of obesity and metabolic syndrome, according to a press release from the university.

“The overall goal of the project is to understand how alterations in bacteria in the intestine can promote low-grade inflammation and metabolic diseases, including obesity,” grant recipient Andrew Gewirtz, PhD, a professor in the Institute for Biomedical Sciences at Georgia State University, said in the press release. “Additionally, we’re going to be looking at how changes in diet can protect against obesity, especially how dietary fiber can alter gut bacteria in a beneficial way.”

Andrew Gewirtz, PhD

Andrew Gewirtz

The project has three main goals. First, Gewirtz will determine the strength of the associations between low-grade inflammation-driving alterations in gut microbiota and metabolic syndrome (high blood pressure, high blood sugar, insulin resistance, hyperlipidemia and hepatic steatosis). This study will be done in humans, in collaboration with Shanti Srinivasan, MD, of Emory University, to confirm previous findings from mice studies.

Second, he will seek to understand how gut microbiota alterations promote inflammation in mice, and how the liver can be protected against low-grade inflammation and non-alcoholic fatty liver disease.

Finally, he will explore how dietary fiber can impact the gut microbiome and protect against obesity, also in mice. This study will compare insoluble and soluble or fermentable fiber.

“Our preliminary results indicate that these have very different types of effects. Hopefully in the end we’ll have a better understanding of what type should be consumed, for fibers that are naturally in foods or as supplements,” Gewirtz said.

Metabolic adaptations in energy expenditure follow bariatric surgery


Weight loss after Roux-en-Y gastric bypass, sleeve gastrectomy and laparoscopic adjustable gastric band in patients with obesity may lead to metabolic adaptations in energy expenditure, recently published data show.

Eric Ravussin, PhD, Boyd professor and associate executive director of clinical sciences at Pennington Biomedical Research Center in Baton Rouge, Louisiana, and colleagues evaluated 30 adults (27 women; mean age, 46 years; mean BMI, 47.2 kg/m2) who self-selected bariatric surgery (Roux-en-Y gastric bypass [RYGB], n = 5; sleeve gastrectomy, n = 9; laparoscopic adjustable gastric band [LAGB], n = 7) or a low-calorie diet (n = 9). The low-calorie diet consisted of 800 kcal/day for 8 weeks followed by weight maintenance.

Eric Ravussin

Eric Ravussin

Researchers sought to compare the changes in energy expenditure and circulating cardiometabolic markers 8 weeks and 1 year after bariatric surgery or the low-calorie diet intervention.

Degrees of weight loss were similar between the RYGB and sleeve gastrectomy groups (33%-36%) and were 16% in the LAGB and 4% in the low-calorie diet group after 1 year.

From baseline to week 8 and 1 year, 24-hour energy expenditure and sleeping energy expenditure were reduced in all study groups (P < .05 for all), but 24-hour energy expenditure between baseline and 8 weeks was not significantly reduced in the low-calorie group. From baseline to 8 weeks, after adjustment for free fat mass and fat mass, 24-hour energy expenditure was significantly reduced in all groups (RYGB, –145 kcal/day; sleeve gastrectomy, –254 kcal/day; LAGB, –178 kcal/day; low-calorie diet, –82 kcal/day), but at 1 year the changes persisted only in the RYGB (–124 kcal/day) and sleeve gastrectomy groups (–155 kcal/day). Trends were similar for sleeping energy expenditure in all surgery groups from baseline to 8 weeks (RYGB, –87 kcal/day; sleeve gastrectomy, –275 kcal/day; LAGB, –181 kcal/day), and the changes were maintained at 1 year (RYGB, –134 kcal/day; sleeve gastrectomy, –255 kcal/day; LAGB, –220 kcal/day). Compared with the low-calorie diet group, sleep energy expenditure reductions were higher in all surgery groups at 1 year (P < .05 for all).

One year after RYGB or sleeve gastrectomy, plasma HDL and total and high molecular weight adiponectin were increased, whereas triglycerides and high-sensitivity C-reactive protein levels were reduced.

“We found that metabolic adaptation of [approximately] 150 kcal [per day] occurs up to 1 year after RYGB, [sleeve gastrectomy] and LABG surgery,” the researchers wrote. “Our findings in obese individuals after bariatric surgery extend those already available after diet-induced weight loss, suggesting that a deficit in energy adaptation may be a homeostatic mechanism encouraging weight regain. Future studies are required to examine whether these effects remain beyond 1 year and contribute to the metabolic benefits of bariatric surgery.” – by Amber Cox

What Happens to Your Body When You Eat Trans Fat?


There are a number of dietary links between dementia and heart disease. Excessivesugar/processed fructose, grains, and trans fat consumption are three factors that promote both.

Story at-a-glance

  • Preliminary findings reveal that trans fat is linked to a higher risk of memory impairment
  • Trans fats may act as a pro-oxidant, contributing to oxidative stress that causes cellular damage
    • Vegetable oils oxidize when heated, and when oxidized cholesterol and trans fat enter into your LDL particles, they become destructive, contributing to arterial plaque buildup in your brain

Not surprisingly, recent research1 has pointed out that heart disease also increases your odds of developing Alzheimer’s disease, which is a serious and deadly form of dementia.

According to the authors, vascular damage may predispose your brain to increased amyloid plaque buildup, which is a hallmark of this degenerative brain disease. Plaque buildup worsens with stiffer arteries, so preventing arterial plaque formation may be a critical factor in the prevention of dementia.

For decades, saturated fats have been demonized as the cause of heart disease. The food industry, responding to such health concerns replaced saturated fats with trans fats, and a whole new market of low-fat (but high-sugar) foods was born.

Americans’ health has plummeted ever since, and millions have been prematurely killed by this mistake… Making matters worse, genetically engineered soy oil, which is a major source of trans fats, can oxidize inside your body, thereby causing damage to both your heart and your brain.

Trans Fat Clogs Your Arteries, Not Saturated Fat

As it turns out, saturated fat was never the culprit in heart disease. That assumption was based on flawed research, the conclusions of which were entirely erroneous.

Dr. Fred Kummerow, author of Cholesterol Is Not the Culprit, has researched fats and heart disease for eight decades, and he was the first researcher to identify which fats actually cause clogged arteries.

Last December, The New York Times2 featured Dr. Kummerow’s research on fats, which shows that trans fats (found in partially hydrogenated vegetable oils) are to blame for rising heart disease rates. Dr. Kummerow was the first to publish a scientific article on this association, back in 1957.

Preliminary study findings3 presented at the American Heart Association’s Scientific Sessions 2014 also reveal that trans fat is linked to a higher risk of memory impairment. This isn’t surprising when you consider the links between dementia and heart disease. According to Time Magazine:4

“[T]rans fat intake was linked to worse memory in people under age 45, even after controlling for mind-influencing factors like age, depression and education. Every gram of trans fat eaten per day was linked to 0.76 fewer words recalled. Put another way? Those who ate the most trans fat remembered 11 fewer words.”

One of the authors, Dr. Beatrice Golomb, noted that since the average number of words correctly recalled was 86, a loss of about a dozen words represents “a pretty big detriment to function.”5

The research, while unable to establish cause and effect, suggests trans fats may act as a pro-oxidant, contributing to oxidative stress that causes cellular damage. This is similar to Dr. Kummerow’s earlier findings, which show that vegetable oils oxidize when heated, and when oxidized cholesterol and trans fat enter into your LDL particles, they become destructive.

Trans Fats 101

Dr. Kummerow, now 100 years old, is still an active researcher and writer. He published four papers in the past couple of years alone. Some of his most recent research6 shows that there are two types of fats in our diet responsible for the formation of heart disease:

1. Trans fat found in partially hydrogenated oil. Structurally, trans fats are synthetic fatty acids; 14 of them are produced during the hydrogenation process. (They are not present in either animal or vegetable fats.)

Trans fats prevent the synthesis of prostacyclin,7 which is necessary to keep your blood flowing. When your arteries cannot produce prostacyclin, blood clots form, and you may succumb to sudden death.

2. Oxidized cholesterol forms when polyunsaturated vegetable oils (such assoybean, corn and sunflower oils) are heated. This oxidized cholesterol (not dietary cholesterol in and of itself) causes increased thromboxane formation—a factor that clots your blood.

Two of Dr. Kummerow’s papers pertain to how these oils harden your arteries and play an important role in the development of atherosclerosis. As reported by The New York Times:8 “The problem, [Dr. Kummerow] says, is not LDL, the “bad cholesterol”… What matters is whether the cholesterol and fat residing in those LDL particles have been oxidized…

[He] contends that the high temperatures used in commercial frying cause inherently unstable polyunsaturated oils to oxidize, and that these oxidized fatty acids become a destructive part of LDL particles. Even when not oxidized by frying, soybean and corn oils can oxidize inside the body.”

You Need Saturated Fats for Healthy Brain Function

Our ancestral diet was very high in saturated fats and virtually void of sugar and non-vegetable carbohydrates. Today, not only do most of us eat excessive amounts of carbohydrates, these carbs are refined and highly processed.

In the last decade, we’ve also shifted over to genetically engineered (GE) grains and sugar (GE sugar beets and corn), the long-term health effects of which have never been established.

This mistaken fat phobia has undoubtedly played a significant role in the dramatic rise in dementia and other neurological disorders, because your brain cannot function properly without fats. In fact, most people benefit from up to 50-85 percent of their daily calories in the form of fats for optimal health (for listing of healthy fats, see end of article) while they are seeking to resolve their insulin resistance.

For comparison, the American Heart Association recommends limiting saturated fat to between five to six percent of total calories!9There’s no doubt in my mind that this grossly sub-optimal recommendation level is contributing to the poor health of Americans, and promoting both heart disease and dementia.

While trans fat consumption decreased by about one-third between 1980-2009,10 many are still getting far too much trans fat in their diet. The problem is that it’s oftentimes hidden. Even products boasting a “zero trans fat” label can contain trans fat, because food manufacturers are not required to list trans fat if it falls below a certain amount per serving. Using ridiculously tiny serving portion is a legal loophole that permits food manufacturers to mislead you about the trans fat in their products. As a general rule, to avoid trans fats, you need to avoid any and all foods containing or cooked in partially hydrogenated vegetable oil, so be sure to check the list of ingredients.

Two Additional Concerns: Cyclic Aldehydes and Acrylamide

Besides the damage from trans fats, vegetable oils such as peanut, corn, and soy oil degrade into highly toxic oxidation products called cyclic aldehydes when heated, and these byproducts may actually do more harm than trans fat. But because this is so new, very few are aware of this problem. In animals, even low levels of cyclic aldehydes oxidize LDL cholesterol and cause high levels of inflammation associated with heart disease. Cyclic aldehydes have also been shown to cause toxic shock in animals through gastric damage, which is consistent with the rise in immune problems and gastrointestinal-related diseases in the human population. To learn more about this, please listen to my interview with investigative journalist Nina Teicholz.11

Acrylamide12, 13 is another highly toxic byproduct produced when starchy or carbohydrate-rich foods such as potatoes and grains are fried or cooked at high temperatures. French fries, chips, cookies, crackers, and cereals tend to have some of the highest levels of acrylamide, courtesy of the processing they’ve been put through. Acrylamide is a known neurotoxin, and animal research has revealed clear evidence of carcinogenic activity.14

While there’s no official data on what cooking oils may contribute to or prevent acrylamide formation, I believe it’s quite clear that processed vegetable oils increase the health hazards of foods processed or cooked at high temperatures. Speaking of acrylamide, on November 7, the US Department of Agriculture (USDA) approved genetically engineered varieties of potato,15 engineered to generate less acrylamide when cooked than regular potatoes. In my view, this madness is only going to make matter worse.

The problem of trans fats and cyclic aldehydes can largely be addressed by reverting to using saturated fats like butter, coconut oil and lard—the latter two of which are very stable and excellent for high temperature cooking. The problem of acrylamide is solved by cooking foods at lower temperatures. This, of course, would be a severe blow to the processed food industry. So instead of making some much needed changes to our food system (such as reverting away from processed foods and promoting more whole foods), a potato is genetically engineered that will not develop as much acrylamide—this way the food industry can continue making chips and French fries cooked in heart-, brain-, and gut-damaging vegetables oils, most of which are also genetically engineered (corn, soy), while pretending—and probably boasting—that they’ve “done something” to make our foods safer…

Avoiding Processed Food Is the Easiest Way to Protect Your Health

According to Dr. Kummerow, your body can eliminate trans fats in about a month, which is encouraging. The tragic reality, of course, is that 95 percent of the food that most Americans eat is processed—and processed food is where all this trans fat lies—and the cyclic aldehydes, and the acrylamide, and the genetically engineered ingredients, and the pesticides… So, if you want to protect your health, particularly your heart, brain, and gut, you need to avoid as many processed foods (including most restaurant food) as much as possible, and start cooking at home, using fresh, whole, unadulterated ingredients. In summary, I recommend:

  1. Avoiding sugar, processed fructose, and grains if you are insulin and leptin resistant. This effectively means you must avoid most processed foods
  2. Eating a healthful diet of whole foods, ideally organic, and replacing the grain carbs with:
    • Large amounts of vegetables
    • Low-to-moderate amount of high quality protein (think organically raised, pastured animals)
    • As much highly quality healthy fat as you want (saturated and monounsaturated from animal- and tropical oil sources). Again, most people need upwards of 50-85 percent of their daily calories in the form of fat for optimal health until their insulin resistance is resolved. Sources of healthful fats to add to your diet include:
Avocados Butter made from raw grass-fed organic milk Raw dairy Organic pastured egg yolks
Coconuts and coconut oil Unheated organic nut oils Raw nuts, such as almonds, pecans, macadamia, and seeds Grass-fed meats

Additional Dietary Guidelines for Maintaining Healthy Brain Function

When it comes to protecting your brain and preventing memory loss and dementia, your diet and lifestyle are your most important allies. My optimized nutrition plan can set you on the right path in this regard. As explained by neurologist Dr. David Perlmutter, author of the book, Grain Brain, Alzheimer’s is a disease predicated primarily on lifestyle choices; the two main culprits being excessive sugar and gluten consumption.

You want to be especially wary of genetically engineered ingredients, as they are heavily contaminated with glyphosate—a herbicide thought to be worse than DDT, and DDT has already been linked to the development of Alzheimer’s. In terms of your diet and other lifestyle factors, the following suggestions may be among the most important for preserving your brain function as you age:

  • Avoid sugar and refined fructose. Ideally, you’ll want to keep your sugar levels to a minimum and your total fructose below 25 grams per day, or as low as 15 grams per day if you have insulin/leptin resistance or any related disorders
  • Avoid gluten and casein (primarily wheat and pasteurized dairy, but not dairy fat, such as butter). Research shows that your blood-brain barrier is negatively affected by gluten. Gluten also makes your gut more permeable, which allows proteins to get into your bloodstream, where they don’t belong. That then sensitizes your immune system and promotes inflammation and autoimmunity, both of which play a role in the development of Alzheimer’s
  • Optimize your gut flora by regularly eating fermented foods or taking a high-potency and high-quality probiotic supplement
  • Increase consumption of all healthy fats, including animal-based omega-3. Healthy fats that your brain needs for optimal function include organically-raised grass-fed meats, coconut oil, olives and olive oil, avocado, nuts, organic pastured egg yolks, and butter made from raw grass-fed milk. High intake of the omega-3 fats EPA and DHA are also helpful for preventing cell damage caused by Alzheimer’s disease, thereby slowing down its progression, and lowering your risk of developing the disorder. Most margarine and butter substitutes are not good sources of healthy fats.
  • Reduce your overall calorie consumption, and/or intermittently fast until insulin resistance resolves. Ketones are mobilized when you replace carbs with coconut oil and other sources of healthy fats. Intermittent fasting is a powerful tool to jumpstart your body into remembering how to burn fat and repair the inulin/leptin resistance that is also a primary contributing factor for Alzheimer’s. To learn more, please see this previous article.
  • Improve your magnesium levels. Preliminary research strongly suggests a decrease in Alzheimer symptoms with increased levels of magnesium in the brain.
  • Eat a nutritious diet, rich in folate. Vegetables, without question, are your best form of folate, and we should all eat plenty of fresh raw veggies every day. Avoid supplements like folic acid, which is the inferior synthetic version of folate.
  • Exercise regularly. It’s been suggested that exercise can trigger a change in the way the amyloid precursor protein is metabolized, thus, slowing down the onset and progression of Alzheimer’s. Exercise also increases levels of BDNF (brain derived neurotropic factor) and a protein PGC-1alpha. Research has shown that people with Alzheimer’s have less PGC-1alpha in their brains and cells that contain more of the protein produce less of the toxic amyloid protein associated with Alzheimer’s. I would strongly recommend reviewing the Peak Fitness Technique for my specific recommendations. 
  • Avoid and eliminate mercury from your body. Dental amalgam fillings, which are 50 percent mercury by weight, are one of the major sources of heavy metal toxicity, however you should be healthy prior to having them removed. Once you have adjusted to following the diet described in my optimized nutrition plan, you can follow the mercury detox protocol and then find a biological dentist to have your amalgams removed.
  • Avoid and eliminate aluminum from your body: Sources of aluminum include antiperspirants, non-stick cookware, vaccine adjuvants, etc. For tips on how to detox aluminum, please see my article, “First Case Study to Show Direct Link between Alzheimer’s and Aluminum Toxicity.”
  • Avoid flu vaccinations as most contain both mercury and aluminum, well-known neurotoxic and immunotoxic agents.
  • Avoid anticholinergics and statin drugs. Drugs that block acetylcholine, a nervous system neurotransmitter, have been shown to increase your risk of dementia. These drugs include certain nighttime pain relievers, antihistamines, sleep aids, certain antidepressants, medications to control incontinence, and certain narcotic pain relievers. Statin drugs are particularly problematic because they suppress the synthesis of cholesterol, deplete your brain of coenzyme Q10 and neurotransmitter precursors, and prevent adequate delivery of essential fatty acids and fat-soluble antioxidants to your brain by inhibiting the production of the indispensable carrier biomolecule known as low-density lipoprotein.
  • Take a health challenge. I’ve partnered with Naturally Savvy to create 10 health challenges. Try the Trans Fat Challenge to learn five different ways you can spot trans fats on a product label even when the Nutrition Facts Panel states “0 Trans Fats.”