Recommended non-technical summations

Diet Recommendations, and its science

LDL functions as part of the immune system

see link below for the evidence

Concise Dietary Recommendations for health, and to fix/prevent IR, NAFLD, MeS, T2D, Obesity, AS, & CVD (Definitions in Section #4)   --    8/6/16 -- http://healthfully.org/rc/id21.html  short 1-4

Healthy Diet

Sugars without fructose:  barley malt, corn syrup (Karol), corn syrup solids, dextran, dextrose, diastatic malt, diatase, ethyl maltol, galactose, glucose, glucose solids, lactose, malt syrup, maltodextrin, maltose, & rice syrup.  For extensive foods recommendations use Fat Chance, pages 199-205 by Prof. Robert Lustig.

1.  FIVE DIETS

1) Healthy diet: For those in good health and normal weight without IR from the Western diet.  The goal is to keep fructose & insulin low, thus avoid added sugar.  Small meals, with fiber, fats, and proteins along with increased physical excursion keep serum glucose and thus insulin low.  Low rate of glycation requires very low fructose (see section 6, at).  Follow food recommendations above and take the short fast at least once a week, which promotes a healthy liver. 

2)  Fatty liver but no major weight issue, follow the above but do the short-term fast every morning.  This must continue until the few extra abdominal pounds are lost, and your middle has that youthful look, then gradually go off the diet and see if your weight has stabilized at the lower point; if not than go back to short-term fasting.  Expect to be fasting for 4 months or longer.   Increasing the time fasting, increases the duration of the low insulin phase.   

3) Weight loss diet of less than 20% and for those with IR:   Daily the jk short fast and 20% calories from carbs or less.  If progress is slow, then add the New Atkins Diet with moderate proteins. 

4) T2D diet on one drug, &/or obesity:  Daily JK short fast, keep lowering carbs, and if needed add new Atkins type diet.  Monitor plasma glucose so as to reduce dependence on drugs.  If after 6 month this hasn’t cured T2D then switch to full alternate-day fasting.  Watch Dr. Jason Fung explain the issues on insulin and diabetes and alternate day fasting diet.[13]  

5) Severe T2D and morbid obesity: Follow a very low carb diet with alternate-day fasting.  T2D is a progressive disease treated with drugs to lower glucose, then more drugs, & then insulin injections.  It is caused by diet and can be cured by diet.  The fast following bariatric surgery cures over 80% of T2D in the first few weeks, before major weight loss.

JK short fast:  go on a 16 hour fast (7 PM until 11:00 AM) or longer, thus extending nighttime fat burning to produce ATP (the energy molecule) to midday.  At night because of not eating there is low glucose and thus low insulin.   If hunger becomes an issue than eat green-leafy vegetables, black coffee or tea with lemon.  Lower carbs especially those high in sugar.  Keep lowering carbs if progress slows and extending the fast. 

Atkins maintenance phase:  Once weight target is reached, the daily intake of carbs is increased by 10 grams per day to find the level where weight is gained, then drop below that level.  Continue to limit refined carbs and foods with high glycemic index to small portions, limit sweets with fructose, & use the JK short fast weekly to maintain a healthy liver.  Vigorous exercise is a general health tonic and mood elevator. 

2.  Explanation of processes/fixes -- Outline of process at http://healthfully.org/rc/id23.html

The issue isn’t calories, but abnormally high level of insulin and its affect upon the weight-regulatory system.  Insulin causes fat storage.  A fatty liver causes IR, thus higher than normal levels of insulin with ever increasing store of fat. 

If you fall under situations 3 and 4 above, your metabolic system is mucked up from excess fat in the liver, and simply following the standard recommendations since the 1970s of “eat less and exercise more” will not work long term.  A population study found that 99.4% of those who were obese, were still obese or overweight 9 years later and for those morbidly obese 99.898% (situation 4 above)—those who had bariatric surgery were excluded, see British Medical Journal.  Moreover because of existing leptin resistance, when on an energy-restricted diet appetite is increased and metabolism is reduced by over 20% as the body attempts to preserve its fat store (there goes the desire to exercise).[14]  The energy restricted diet with carbs doesn’t cleanse these organs; thus the regulatory system will cause a gradual regain of weight (the yo-yo diet).[15]  The reason for the high long-term failure rate of diets is that obesity, IR, and T2D are the result of defects in the hormonal regulatory system.  Its main regulatory hormone is insulin.  The process leading to the regulatory defects starts with consuming over the years too much fructose (#4 below has definitions) and refined carbs that result in a high level of insulin.  With high insulin most of the fructose is converted to fat in the liver and the excess is stored there; this results in a fatty liver (NALFD), which mucks up the hormonal system, first by causing IR in the liver and then in other tissues.  With IR the pancreas must release more insulin than is normal to lower the amount of blood glucose.  Because insulin causes the cells to burn glucose and store fat, the excess in insulin causes an excess fat storage; viz., weight gain.  There are two main metabolic systems one for fats the other for glucose burning.  The very low carb Atkins type diet (called a ketogenic diet) causes the cells to switch to a fat-burning mode and stays on it.  Staying in this mode causes tissues to metabolize their stores of fat at a high rate, and thus to slowly cleanse the pancreas and liver of excess fat; this will cure IR, MeS,  NAFLD,T2D,¹² obesity, leptin resistance, and eventually for most to reset their weight regulatory system.  Without very low carbs and/or fasting this doesn’t happen, thus the so called yo-yo diet.  

3.  Net Carbs while on Atkins ketogenic diet—easy table by JK  

Net Carbs = total carbohydrates minus fiber content in grams (avoid those in red)

Also avoid refined carbs, high carbs, and like such as in chips, breads, pasta, soda, all juices and sweetened drinks, most deserts.  Since goal is low insulin, also avoid artificial sweetened foods, which through stomach stimulate insulin.

To calculate from the food label, simply subtract fiber from total carbohydrates

On the Atkins website (http://files.atkins.com/1501_CarbCounter_Online.pdf) is an extensive table of net carbs.  For simplicity the food label on products can be used, simply subtract fiber from carbohydrates to get an approximate value.  Remember that food manufacturers add sugar to nearly every product plus many of them have various forms of starch as filler and thickening agent (starch is pure glucose). 

Each portion of food contained 240 Calories—score relative to white bread which was set at 100

from http://graemethomasonline.com/wp-content/uploads/2010/06/Insulin-Index.pdf

Detail explanation of testing  http://www.janurky.sk/db/articles/20150703n0(kj_not_kj)/images/insulin_index.pdf

These figures are based on test results for an ideal group:  average age 22 and BMI of 23.  Foods needing preparation such as potatoes and pasta were boiled, stored overnight in the refrigerator then warmed the next day in a microwave.  Test score was based on the average insulin level over 120 minutes divided by that for white bread times 100.   There were 503 tests total test for the 36 listed foods.  Breakfast cereals were served with milk.  “Plasma insulin concentrations were measured in duplicate by using an antibody-coated tube radioinmmuonoassy kit (Coat-A-Count; Diagnostic Products Corporation, Los Angeles)”at 1997, p. 1295.  Samples of 1.5 to 2.5 mL. of blood were obtained at 15 minute intervals over the 2 hours test period.  Unfortunately this table lacks important foods of vegetables, milk, soda, diet soda, and fat (which I included from another source--Dr. Fung’s book The Obesity Code p 193).                                                                                                                                                                            

The goal is to maximize the rate of fat burning which requires a low insulin diet.  Insulin causes fat storage.   Since protein is needed to maintain muscle mass, it must be restricted but only somewhat.  The USDA dietary recommendations are high.  Thus I recommend cutting it to 35 grams women, and 45 grams men--for those of average body frame size.  This is sufficient to prevent muscle loss.[16]  The effect of protein upon insulin and thus fat storage explains why short-term and alternate day fasting make a very significant improvement upon the low carb ketogenic diet.[17]  For most on a ketogenic diet, after a couple of months the rate of weight loss will decline, the effect of insulin upon leptin.  Fasting prevents this phenomenon.

4. Diet-Food Basics

Adipocytes (lipocytes) fat cells compose adipose tissue & secrete hormones resistin, adiponectin, leptin and apelin.  

ATP, Adenosine TriPhosphate (adenosine with 3 phosphate molecules (PO4) attached), transfers chemical energy within the cell through the loss of one of its phosphate groups.  In the mitochondria ADP returns to the high energy state ATP 3(PO4) through absorbing energy from the metabolism of carbohydrates & fats.  ATP provides the energy for over 90% of the biosynthesis:  for muscle contraction, hormones, collagen, etc. and for intra and intercellular active transport.

Cardiovascular disease (CVD) causes cigarettes and a high sugar diet which cause endothelial dysfunction of the artery walls.  These cells permit pathogens to colonize in the artery walls to cause inflammation, atherosclerosis, and CVD.

Carbohydrate (carb):  fiber, fructose, glucose-glycogen, starch, sucrose, lactose, net carbs (total carbs minus fiber):

Fiber, vegetable fiber, roughage, the carbohydrate component not broken down by digestive enzymes, but some is by gut bacteria.  Fiber has more than ten sugar units.  It lowers the insulin spike when consumed with refined carbs. 

Fructose (fruit sugar) a monosaccharide found in fruits.  Main sources are the disaccharide sucrose, fruits, and high   fructose corn syrup.  It is metabolized in the liver into either glucose, or fat which when insulin is stored there to cause fatty liver.  Also fructose is 7.5 more reactive then glucose and by glycation damages the liver, etc.

Glucose a monosaccharide is the main energy storage molecule for plants; in humans 1-2-lbs is stored as long-chain glycogen a backup energy source stored in muscles, fat, and liver cells.  Glucose is as one half of sucrose, and is also obtained from the hydrolysis of the digestible starches.  Glucose and fat are the main sources for production of ATP.

 Starch is long chains of glucose units.  This polysaccharide is produced mostly by green plants for energy storage. 

 Sucrose, table sugar, produced by plants; it is the readily hydrolyzed disaccharide consisting of fructose and glucose. 

Glycation:  a process where a monosaccharide (simple sugar) randomly attaches to proteins or lipid; this adversely affects their functions, thus glycation is a major cause of our chronic age-related diseases. 

Diabesity:  the combination of diabetes and obesity that afflicts those on the Western diet—a recently coined term. 

Fat (Free Fatty acids and triglycerides): up to 24 carbon molecules with an organic acid or glycerol molecule on end.

Incretin: class of hormones secreted by the stomach and intestines which causes insulin secretion and produces satiety.

Insulin: a gateway hormone is produced by the pancreas.  Its main function is to have cells absorb glucose and store fat.  Cells already loaded with glucose, to prevent toxic level resist the message by insulin to absorb more glucose.  Insulin also regulates other enzymes and hormones including leptin.  Low insulin is the cause of type 1 and 2 diabetes.  Insulin also promotes the storage in amino acid, and thus we secret insulin by the incretin system in response to proteins. 

Insulin resistance (IR):   a condition of higher than normal amount of blood insulin to lower blood glucose due to a diminished response to insulin by various tissues.  The pancreas then releases even more insulin to lower blood glucose.  IR is the condition which causes the fat accumulation in the liver and pancreas and obesity, and all their comorbidities.

Ketogenic diet (very low carbohydrate diet):  it forces the body to rely upon just fats to convert ADP to ATP to cause weight loss without restricting calories.  It is named refers to the ketones produced in this metabolic natural process.

Key Opinion Leaders (KOLs):  people who rise to top positions in their area of expertise.  In fields relevant to business some of these people violate the standards of science to produce and spread business-favorable spin, and are handsome rewarded for their services.  The term is used in that sense of bad conduct.  Pharma has used KOLs along with regulatory capture to produce a drug disaster while selling it to medical students, physicians, politicians, and the public as cutting edge science.   

Leptin:  produced by fat cells is in part regulated by insulin.  Leptin in the brain suppresses appetite and it also regulates metabolism.  Leptin is responsible for the 25% reduction in metabolism plus increased appetite that eventually occurs during an energy-restricted diet.  Leptin functions to maintain fat storage and to restore weight even years later.  

Lipids are a group of naturally occurring fat like molecules including waxes, sterols, fats, phospholipids, and others.

Metabolism in reference to diet refers to the metabolic use of mainly either fat or carbohydrate to convert ADP to the high energy molecule ATP mostly by the mitochondria.  During  starvation proteins also can be used to make ATP.

NAFLD (Non-Alcoholic Fatty Liver Disease):  the accumulation of fat by liver cells sufficient to significantly downgrade their various functions.  The NHANES survey 2011 found NAFLD in 30% of adult population—similar % for Europe. 

Type-2 diabetes (T2D): occurs when the pancreas fails to produce enough insulin to lower glucose to its normal range; it results from chronic IR and the accumulation of fat in the pancreas which eventually causes the decline in insulin.

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5.  Fasting is easy and essential

I never had a protracted weight problem.  By chance I had used the short-term fast when.  I gained 20 pounds during the winter of 1969-70.  At the age of 26 my metabolism slowed down, and so I didn’t burn off rapidly the excess glucose and fructose.  I had developed a fatty liver, and thus was putting the pounds on.  It took 3 months of reduced meals and fasting to lose it.  It stayed off because it was short-term weight gain, my white adipose tissue through leptin had rest my weight to 170.  After that, whenever I gained 5 pounds, I simply cut back on portions, quit eating by 7 PM, and skipped breakfast several times a week.  The second change was exercise.  I moved from Winnipeg to southern California and became in 1975 a sports addict.  I started playing volley ball and cycling, then over the next 7 years I added moderate weight training and singles racquet ball.  In 1993 my diet changed for the worse:  following the lead of a very fit friend, I went on a very low fat (thus high carb) Western diet.  Fortunately I watched my weight, thus I never went more than 5 pounds above my youthful weight.  Skipping breakfast is easy.  In 2012 I watched Prof. Lustig lecture on YouTube, which had gone viral.  He explained why sugar was poison and I took notes.  In 2013 I researched his explanation of the diabesity epidemic.  In the spring of 2014, I reduced sugars including fruits, and carbs from grains, thus I increased fats. It took about 4 months before candy, fruit juices, ice cream, and sweet melons tasted way too sweet.  Though my weight remained for decades the same, I had 3 pounds more around the lower abdomen than when I was young.  It probably was a sign of a fatty liver, so I decided in the spring of 2016 to experiment with daily short fasting.  By July of 2016, 4 months later, I lost 4   pounds, waist shrunk 1 inch, and fasting glucose (a measure of IR) was lower.  I noticed that by skipping breakfast, I had reduced my total consumption of food.  I was less hungry especially at dinner time.  A big plus was that I experienced no decline in mental or physical energy in the morning, and avoided the decline following breakfast.[1]   After a couple of months of adjusting, I now like skipping breakfast.  Morning fasting and not eating at night has convinced me that weight control with short-term fasting is easy and pleasant, easier than an energy restricted diet.[2] 

The lack of sex hormones has been shown to play a significant role in weight gain.  Estradiol (the best of 4 estrogens) controls fat distribution, which is visually obvious as a girl develops during teen years.  Lack of estrogen cause women to gain abdominal weight following menopause.  The two sex hormones are nearly structurally identical, but for on functional group.  Testosterone makes a different for men past the age of 60 when they do sufficient amount to restore them to a youthful level, which is what I did.  Starting in 2004 was the use of natural testosterone[3] from a compounding pharmacy.  It made my weight control easy.  I stopped weighing myself once I realized that my weight regulatory system kept me between 161 and 165. 

Dr. Jason Chapter 20 “When to Eat” in his Obesity Code, 2016, p 235-251 covers the history and advantages of fasting; his opening words “LONG-TERM DIETING is futile”.  The reason is the major drop in metabolism due to leptin and it physical and emotional consequences; thus few are capable of going on a life-long energy restricted diet—there are numerous long-term studies which show that the obese gain back most or all of their lost weight.   “The body reacts to weight loss by trying to return to its original body set weight…  [because] our insulin level stays elevated” which is due to insulin resistance; thus leptin also is elevated.   Only fasting addresses IR.  His clinical experience and extensive research proves that fasting is both easy and works.   Here I stand upon his shoulders:  I shall present what I find of most value in that chapter, sometimes quoted and my additions will be in [brackets].  IR causes excess fat storage and leptin promote reduced metabolism and increased appetite.  [But it is not appetite/hunger exactly, rather the feeling that if I eat a bit more my energy and mental clarity will return to what it ought to be; this is the effect of leptin on energy.]   All foods promote the release of insulin; only not eating will keep blood insulin level low.   As Fung points in other chapters, incretin hormone system responds to digestion in the stomach and small intestine by stimulating the release of insulin from the pancreas [fats and fructose by far produce the least leptin response].  It explains why meat, fish, and poultry have a higher insulin index than boiled pasta.  Though Fung writes of 24 to 36 hour fast as curing IR, his clinic also uses the short-term fast.  “The term ‘breakfast’ is the meal that breaks the fast—which we do daily”--p 237.  Fasting has been involved used in most cultures and religions, and among the hunter-gatherer was forced by circumstance.  Hippocrates of Kos (c. 460-370) wrote; “instead of using medicine, better fast today; to eat when you are sick is to feed your illness” p 237.  Humans like most animals do not eat when sick.  Plato and Aristotle were staunch supporters of fasting.  “The body does not burn muscle until all fat store is gone” p 240.  “Blood glucose levels remain normal as the body switches over to burning fat for energy.  This effect occurs with fasting periods as short as twenty-four to thirty six hours.  Longer fasts reduce insulin even more dramatically…. Regular fasting has been shown to significantly improve insulin sensitivity.  This finding is the missing piece in the weight-loss puzzle.  Most diets don’t address insulin resistance,” p240.  One of the most potent stimuli of growth hormone {HGH] secretion is fasting.  Fasting promotes the use of fat as fuel and preserves muscle mass and bone density.  Adrenalin [and noradrenalin] levels go up with fasting,” p 241 they are the natural amphetamines- that create alertness and physical energy.  “Breakdown of muscle tissue happens only at extremely low levels of body fat—approximately 4 percent,” p242.  “The human body has evolved to survive episodic periods of starvation,” p 243.  “Caloric restriction diets do not allow the evolved adaptation that occurs during fasting,” p 244.  “Studies of eating a single meal per day found significantly more fat loss, compared to eating three meals per day, despite the same caloric intake” 243[4].  “Total energy expenditure is increased during a fast—in a 4-day fast by 12%,” p244.  “In our clinic experience showed that appetite decreased as duration of fasting increased.  The most astonishing aspect of this study [107 obese subjects unable to lose weight] was the ease with which prolonged starvation was tolerated.  These experiences echo our own clinical experience at the Intensive Dietary Management Clinic with hundreds of patients,” p245.  The more dangerous visceral fat is preferentially removed with fasting. There is reference to Dr. Michael Mosley (British on BBC) 5:2 diet, 5 days of full caloric and 2 days of 25% of calories at the end of a short-term fast.  In the trial that compared the 5:2 to the Mediterranean diet with a 25% reduction in calories.  At 6 months both groups lost about the same amount of weight, but the 5:2 group have lower insulin and less IR, at p247.  The short term fasting made this important difference.  Fasting because it corrects insulin resistance is essential for long-term dieting success. 

For those who want to know more of the science behind fasting, I highly recommend that you read my “Evidence of Alternate Day Fasting—Cures Type-2 Diabetes”  and Fung’s book on fasting that is scheduled for release October 2016.  For a concise refresher as to the details of what has caused the weight control system to crash click on link.  My own experience and others whom I have talked has convinced me that short-term fasting is easy, and the scientific literature confirms that longer periods are also easy; this is because our body has evolved a system to burn the fat reserve and to keep us alert and full of energy so that we more likely to hunt and gather foods.   

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