It is well known that obesity in the United States is in epidemic proportions. It is also well known that it presents a risk for metabolic disease, the most common being diabetes. Books have been written about various diets and appetite curbing pills are legion. It is, of course, obvious that the type of diet consumed by so many people is responsible. What has not been understood is the exact mechanism.
Obesity and the Brain
Fat is stored in cells called adipocytes (from Latin adep, fat) these cells are capable of producing a hormone called leptin. This circulates in the blood until it comes to the part of the brain known as the hypothalamus. The message that leptin delivers to this organ tells it that the fat stores in the body are full and food intake should be curtailed. It is an important mechanism of appetite control. It is not generally appreciated that it is the brain, not the stomach, that is responsible for the sensations of hunger and satiety, thus controlling appetite.
As usual in basic science research, leptin was discovered in mice. By injecting it into fat mice that were made to be leptin deficient experimentally, appetite control resulted in reduction in body weight to normal proportions. It was concluded that this would be the obvious treatment for obese humans. Clinical trials with leptin treatment in obese humans failed to make any difference. It was then found that these humans already had plenty of circulating leptin but the hypothalamus was insensitive to its message. Adipocytes were doing their part but the hypothalamus was unresponsive. The question then was why the hypothalamus was insensitive and not responding to this important mechanism. The next phase of research was published in a scientific journal called Cell. This is read only by a group of scientists that are studying the properties of the cells that make up the body. It will be a long time before this research reaches clinicians and it also has the disadvantage of having been performed in mice. The message is so transparent, I undertook to report it here because we can use it now.
Of Mice and Men
When mice were fed on a high-fat diet, a mechanism was found in the hypothalamus. A “master switch” that controls inflammation in the body was turned on. This switch normally remains inactive throughout life in healthy animals. However, with it turned on, the mice gained weight and became resistant to insulin and leptin. By using genetic engineering, the researchers were able to turn off the master switch and they were then protected from becoming obese, even on a high-fat diet. It has been known for a long time that obese people develop inflammatory disease. The mechanisms involved are extremely complex but the simple message is one that is timeless “don’t overeat, particularly high calorie junk foods”. It has also been long known that calorie restriction in experimental animals is the only way to extend their longevity. Hungry animals fed this way not only live longer than those fed with enough food to give satiety, they also remain much more active into old age. We are obviously not required to remain permanently hungry, only to reach satiety with the right food. It is therefore not surprising that “junk food” eaters are always hungry.
Diet Basics: Eat Real Food
If this research is true for humans, it may be that it is actually a protective factor as long as we obey the rules of diet that have been with us for thousands of years. It is only recently that we drive a two ton machine to a store to buy food in a variety of boxes packaged by a food industry that depends entirely on their products being purchased. We would not require anti-inflammatory drugs or even a special diet. All we would need is self discipline and a full recognition that the only food we should ingest is the natural food that I used to tell all my patients is “made by God”. The high calorie man-made foods, many of which are simple carbohydrates, should be rejected completely. This is, of course, advice that is bound to be ignored by the majority because our sense of sweet taste that provides so much pleasure is perceived by our brains. Also, natural food is expensive. Taste buds on the tongue send a sensory input signal to the brain where it is interpreted. Reducing it to first principles, so much of our diet is hedonistic. As the old saying goes, we live to eat rather than eating to live.
Sugar on the Brain
Sugar extracted from its natural source is more of a drug than a food. This is because censors on the tongue send an input message to the brain where the sensation of sweet taste is perceived and interpreted. I remember that several physicians wrote letters to medical journals to state that the sweetener, aspartame, was responsible for a number of symptoms in their patients identical to those induced by sugar, including migraine headaches. The manufacturers responded by performing a study in which aspartame was given to experimental subjects in the form of capsules that they swallowed, thus bypassing the sweet taste mechanism. The study showed that there was no evidence for migraine or any other symptoms as a result of administration of this chemical sweetener by this method, suggesting that its effects are produced by the sensory input from tongue to brain. I am personally highly sensitive to sugar. The ingestion of one cookie gives me whole-night insomnia. Since I am not unique, I wonder how many people are taking sleeping pills because of chronic insomnia induced by their innocent consumption of sugar.
Artificial Sweeteners: Chemical Cocktails
Aspartame breaks down in the body to formaldehyde (used to pickle bodies), formic acid (used by bees to sting) and wood alcohol (that makes people go blind). Irrespective of the chemical content of artificial sweeteners, however, they are no substitute for sugar since they are likely to do the same thing. The only escape is to break the sweet taste craving by “cold turkey” withdrawal. I have seen many people get well by doing this. Sometimes it only takes a very small intake of sweet taste to cause relapse and reappearance of the previous symptoms. To back up my conclusion that this is a drug effect, I have seen many people that cannot resist sugar, even though they know perfectly well that they will suffer for it. In fact, animal studies have shown that sugar is more addictive than cocaine.
Doctors and Self-Discipline
Doctors therefore have the responsibility to educate patients about how their God-given health can be maintained. We know now that our genes are drastically changed by poor diet and lifestyle and we therefore can produce diseases in ourselves. The choice is ours to make.
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