The cholesterol story leaves out significant facts in order to focus on the treatment of cholesterol with pharmaceuticals. While this is helpful in certain cases, it is not the only way to address arterial problems. One glaring omission is the fact that cholesterol is simply a “messenger” designed to repair the permeability of the lining of arteries in people who do not eat enough antioxidants. Think of oxidation-inflammation leading to “leaky arteries.” The American Heart Association advises to try a diet high in plant-based foods-which is likely to repair the leakiness, causing cholesterol to drop- for 6 months before trying a prescription medication. Along the same lines I recommend a close look at refined sugars. They also raise cholesterol by interfering with its processing in the liver and by exacerbating arterial permeability. Demonizing of fats in general has resulted in excessive consumption of sugars.
Hugo Rodier, MD
Many Studies assert how bad soda pop is for you. Here is a review of the ones most quoted:
- Swithers SE. Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements. Trends Endocrinol Metab. 2013;24:431-441
- Tate DF, Turner-McGrievy G, Lyons E, et al. Replacing caloric beverages with water or diet beverages for weight loss in adults: main results of the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial. Am J Clin Nutr. 2012;95:555-563
- de Ruyter JC, Olthof MR, Seidell JC, Katan MB. A trial of sugar-free or sugar-sweetened beverages and body weight in children. N Engl J Med. 2012;367:1397-1406
- Dyer J, Salmon KS, Zibrik L, Shirazi-Beechey SP. Expression of sweet taste receptors of the T1R family in the intestinal tract andenteroendocrine cells. Biochem Soc Trans. 2005;33:302-305
- Mace OJ, Affleck J, Patel N, Kellett GL. Sweet taste receptors in rat small intestine stimulate glucose absorption through apical GLUT2. J Physiol. 2007;582(Pt 1):379-392
- Margolskee RF, Dyer J, Kokrashvili Z, et al. T1R3 and gustducin in gut sense sugars to regulate expression of Na+-glucose cotransporter 1.Proc Natl Acad Sci U S A. 2007;104:15075-15080
- Brown RJ, Walter M, Rother KI. Ingestion of diet soda before a glucose load augments glucagon-like peptide-1 secretion. Diabet Care. 2009;32:2184-2185
- Fujita Y, Wideman RD, Speck M, et al. Incretin release from gut is acutely enhanced by sugar but not by sweeteners in vivo. Am J PhysiolEndocrinol Metab. 2009;296:E473-E479
- Jang HJ, Kokrashvili Z, Theodorakis MJ, et al. Gut-expressed gustducin and taste receptors regulate secretion of glucagon-like peptide-1. ProcNatl Acad Sci U S A. 2007;104:15069-15074
- Ma J, Bellon M, Wishart JM, et al. Effect of the artificial sweetener, sucralose, on gastric emptying and incretin hormone release in healthy subjects. Am J Physiol Gastrointest Liver Physiol. 2009;296:G735-G739
- Frank GK, Oberndorfer TA, Simmons AN, et al. Sucrose activates human taste pathways differently from artificial sweetener. Neuroimage. 2008;39:1559-1569
- Green E, Murphy C. Altered processing of sweet taste in the brain of diet soda drinkers. Physiol Behav. 2012;107:560-567
- Rudenga KJ, Small DM. Amygdala response to sucrose consumption is inversely related to artificial sweetener use. Appetite. 2012;58:504-507
- Ramirez I. Diet texture, moisture and starch type in dietary obesity. Physiol Behav. 1987;41:149-154
- Ramirez I. Feeding a liquid diet increases energy intake, weight gain and body fat in rats. J Nutr. 1987;117:2127-2134
- Ramirez I. Overeating, overweight and obesity induced by an unpreferred diet. Physiol Behav. 1988;43:501-506
- Cassady BA, Considine RV, Mattes RD. Beverage consumption, appetite, and energy intake: what did you expect? Am J Clin Nutr. 2012;95:587-593
- Kant AK, Graubard BI, Mattes RD. Association of food form with self-reported 24-h energy intake and meal patterns in US adults: NHANES 2003-2008. Am J Clin Nutr.2012;96:1369-1378
OK, too technical, but, what will it take to get you to quit diet soda? Perhaps the realization that soda is addictive, and that you are a coca-holic..
- Electronic cigarettes have been shown to be as effective as nicotine patches to quit smoking. But, the Utah Medical Association recently passed a resolution recommending that they not be sold to minors; they have been shown to be addictive enough to discourage their use in non-smokers, especially in our children.
- Reduce inflammation. It has been linked to practically all diseases in one form or another. In fact, chronic inflammation may preclude health aging. The question is, whence inflammation? Refined sugar and animal fat diets. Quit blaming your genes, ok? Other than changing your diet you may take supplements to lower inflammation; my favorite is Curcumin in tea form.
- “Health Benefits and Cost-effectiveness of a Hybrid Screening Strategy for Colorectal Cancer. US Preventive Task Force.” An annual or biennial fecal immunological test (FIT) beginning at age 50 years in combination with a single colonoscopy at age 66 years is as effective as current colorectal cancer (CRC) screening guidelines, that is, a colonoscopy every 10 years over age
- “Understanding the Role of Probiotics and Prebiotics (fiber) in Preventing Allergic Disease.”
- “Lactobacillus Probiotics May Prevent Recurrent UTIs in Postmenopausal Women.”
- The Society of General Internal Medicine (SGIM) Sep 13 2013 has recommended that internists avoid 5 common, but not always necessary, tests or procedures. The evidence-based recommendations, part of the Choosing Wisely campaign, are:
- Don’t recommend daily home finger glucose testing in patients with Type 2 diabetes mellitus not using insulin.
- Don’t perform routine pre-operative testing before low-risk surgical procedures.
- Don’t recommend cancer screening in adults with life expectancy of less than 10 years.
- Don’t place, or leave in place, peripherally inserted central catheters for patient or provider convenience.
- Don’t perform routine general health checks for asymptomatic adults.
No routine physicals?
No, not when the “prevention” generally practiced in those visits is geared to ordering questionable tests (other than mammogram and colonoscopy) and emphasizing pharmaceutical treatment for symptoms only. In other words, routine physicals have proven not to be worth it because they only cover 10% of the factors that affect a person’s health. If “routine physicals” were used to thoroughly cover the other 90%, that is, lifestyles, nutrition, emotional and environmental issues, then, these visits would be worth it, bringing considerable savings to the health care system, to say nothing about better health for the patient.
“Thoroughly” in my opinion means for the doctor to do the educating, including nutrition, which is what I do in my clinic. I know; this is not likely to happen in too many other clinics judging by the way things are going. OK, then: “don’t perform routine general health checks for asymptomatic adults.”
Another entrenched practice questioned: counting calories
The article “Science Reveals Why Calorie Counts Are All Wrong” validated my 30-years-worth of experience in the trenches counseling patients about their health in general and their nutrition in particular. Eating is a very psychological and even spiritual endeavor. It must be kept simple and doable. Counting calories involves too much micromanaging; it is not sustainable.
As you liberate yourself from counting calories, give up on measuring and/or tracking percentages of proteins, fats and carbohydrates while you are at it; it is just more unsustainable micromanaging. Just eat the glycemic index diet until satisfied. If one is able to forego of processed foods, the hunger signals will be correctly quenched so that you eat the right amount of food for your needs.
 “Very High Fructose Intake Increases Serum LDL-Cholesterol and Total Cholesterol: A Meta-Analysis of Controlled Feeding Trials,”
J. Nutrition 2013;143:1391
 European Respiratory Society (ERS) 2013 Annual Congress
 Canadian Medical Association J. Epub September 2013
 J. Clinical Gastroenterology and Hepatology 2013;11:1158
 J. Immunotherapy. 2013;5(8):869
 J. Evidence Based Medicine 2013;18(4):141
 “Bridging the divide between health and health care,” JAMA 2013;309:1121
 J. Scientific American Aug 28 2013