carbohydrates

The Many Lives of Carbohydrates

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Most people love carbohydrates. They taste good and we think because they taste good, they should be good for us. Popeye, the cartoon character from the 20th Century that millions of children grew up watching, was strong and full of energy because of eating spinach. Spinach is a carbohydrate. In later years children’s characters, such as the ones in Sesame Street (sesame is a carbohydrate) like Cookie Monster (a carbohydrate), and many others have also become advertisements for foods. Such cartoons can make a huge impression on children—and to some degree on adults as well.1

There are many questions people fail to ask about carbohydrates. For example, what exactly are carbohydrates? Are the following items all carbohydrates: a bowl of salad, a serving of tofu, a slice of sourdough bread, a bite of watermelon, a piece of 90% dark chocolate, almond butter, soy milk, coconut water, a throat candy, or a vitamin C gummy? If these are all carbohydrates—which they are—is there any difference between them? And if yes, how so, and if not, why not? Do we have to eat any carbohydrates to stay healthy? How does our body use carbohydrates? In this article, I examine carbohydrates and answer these questions.

What is a Carbohydrate?

Carbohydrates are sugars found in nature: glucose, fructose, galactose, sucrose, maltose, starch, lactose, and fiber.

  • Glucose is a monosaccharide, a simple sugar that is found in most plant-based foods and is a vital element in some human organs, such as the blood. Glucose easily ferments to alcohol.
  • Fructose is a hexose sugar found especially in honey and fruit. Fructose is not a sugar the human body can recognize as sugar. This creates a number of problems. Fructose is easily converted to alcohol by yeast. Fructose is much sweeter tasting than glucose, so sweeter fruits usually have higher fructose content.
  • Sucrose is what we call common table sugar. It is a disaccharide, a molecule composed of two monosaccharides: glucose and fructose in equal amounts.
  • High fructose (such as corn syrup or honey) is a disaccharide like sucrose, except the percentage of fructose is higher.
  • Galactose is a monosaccharide sugar that is about as sweet as glucose.
  • Starch is a polysaccharide made up of a large number of glucose molecules.
  • Maltose is a sugar produced by the breakdown of starch by, for example, enzymes found in our saliva. It is a disaccharide consisting of two linked glucose units.
  • Lactose is a combination molecule of glucose and galactose, which needs lactase enzymes to be broken apart. Those with lactose intolerance are unable to break apart lactose into glucose and galactose, causing gastric distress.
  • Fiber is a type of carbohydrate that the body cannot digest. Because fiber isn’t a sugar, it technically isn’t a carbohydrate. Our body cannot use it as fuel. However, since fiber is only available when attached to sugars our body can use, in the USA it was decided to consider fiber a carbohydrate. However, fiber is not considered to be a carbohydrate in all other countries. To get net carbohydrates, fiber is subtracted from the total carbohydrates, even in the USA.

Do We Need Carbohydrates?

The theoretical minimal level of carbohydrate … intake is zero, but [carbohydrate] is a universal fuel for all cells, the cheapest source of dietary energy, and also the source of plant fiber. In addition, the complete absence of dietary [carbohydrate] entails the breakdown of fat to supply energy (glycerol as a glucogneogenic substrate, and ketone bodies as an alternative fuel for the central nervous system (CNS))…2

Although the above quote provides a perfect answer, it is terse, so let me elaborate. There are three macronutrients that we can eat: carbohydrates, fats, and proteins. Of these, fats and proteins are essential, and carbohydrates are not essential. What makes a macronutrient essential is decided based on our body’s ability to make it. For example, while eating an apple provides glucose to the body for energy, that same amount of glucose can be created by our body as well, by converting protein to glucose—via gluconeogenesis. Therefore, if we have no carbohydrates available but we can eat protein, then carbohydrates become redundant (hence non-essential), since the body can make glucose from protein.

However, protein is an essential macronutrient. If we have no protein available to us, only carbohydrates, such as an apple, our body is unable to make protein from that apple. Our body must receive ample protein from our diet in order to synthesize protein for our body. Basically everything we see (skin, hair, nails) and also things we don’t see (blood, 50% of our bones, collagen, hormones, etc.,) are all made of proteins. I wrote about protein previously here. Therefore, protein is an essential macronutrient. Similarly, fat is an essential macronutrient. We must consume some types of fats. Some fat types our body can produce from carbohydrates but not all.

The essential fats we must consume are omega 3 (EPA/DHA) and omega 6 (linoleic) fatty acids. Our body is capable of making some fatty acids from fructose and glucose by the liver but not every kind.

What about fiber? Because fiber falls into the carbohydrates category and carbohydrates are nonessential, it follows that fiber is nonessential. Yet we continuously read/hear about the gut-brain connection, and that assumes that a diverse gut flora is essential, and gut flora lives on fiber. Why is fiber talked about as essential if carbohydrates are not essential?

As you can tell, there is a lot of confusions around nutrition, creating a seemingly intractable dilemma: “what food should we eat?”

Fuel Versus Nutrition

When we talk about carbohydrates, it is important to understand how it relates to nutrition. By this I mean: are carbohydrates fuel for energy or nutrition for growth and development? This is not a trivial question. Most people believe that children need carbohydrates for healthy growth and development. Is this a true assertion though?

The body can use two fuel types: carbohydrates and fats. The body can only use one nutrition type for growth and development: protein. The body can use two nutrition types for structural foundation: protein and fats. I repeat: carbohydrates cannot support growth and development of tissues and organs. It is important to understand that the body cannot even store carbohydrates as carbohydrates for fuel. The reason for this is complex, but in layman terms: glucose is toxic3. It is a highly combustible fuel that may cause major oxidative damage.  Carbohydrate oversupply will lead to storing the extra fuel as fat for future energy source. In other words, carbohydrates convert to fat4—triglycerides to be precise. We do not store carbohydrates in our body.

Do We Need Fiber?

There are two main fiber types: soluble and insoluble; there is a third kind, resistant starch, which is mostly man made by manipulating food. Soluble fibers dissolve in water and generate a gel-like texture that is known to reduce the speed with which glucose absorbs, whereas insoluble fibers only generate bulk (here). The conversion of resistant starch by human gut flora yields short chain fatty acids5 which are in the form of butyrate and acetone6, precursors of ketone bodies acetone, acetoacetic acid, and beta-hydroxybutyric acid. Ketone bodies are measurable in blood as β-Hydroxybutyrate, in the breath as acetone, and in the urine as acetoacetic acid, in those who are in ketosis by a metabolic change where ketones are used as fuel instead of glucose. Butyrate, and other short-chain fatty acids generated by gut flora, are not measurable by conventional methods.

The important point about short chain fatty acids generation by gut flora from resistant starch is that when we restrict the consumption of carbohydrates and enter ketosis, the body’s main fuel is ketone bodies. Thus, one need not eat fiber to receive short-chain fatty acids and ketones, and one also receives ketones while in the carbohydrate metabolic process. To learn more about the ketogenic diet, read my article here.

Did you know that even cows that chew grass (cellulose) all day long, end up with short chain fatty acids of butyrate, e.g. ketones7. Are cows seriously on the ketogenic diet? No, they are not in ketosis, however, they are not living off carbohydrates either. They live off of the nutrients created by their flora, such as butyrate. In short: cows live on fats and not carbs, though they eat grass all day—provided they eat grass. Cows fed with grain, such as corn, and wheat, and non-grains such as soy, have very different nutritional content in their meat from grass-fed cows8,9 to the detriment of cattle and human health.

While gut bacteria are believed to be essential for human survival and health, there is a caveat. Humans lack fermenting chambers and only have a single stomach. The opportunity for bacteria to ferment fiber from grains, leafy greens, nuts and seeds, and fruits, would require extensive fermentation ability. Since the only section in the human metabolic process where fermentation is possible is in the short gut, the amount of fermenting is very minimal. For this reason, in humans, the majority of fiber consumed acts only as bulk but not as nutrition. Therefore, the consumption of great quantities of fibrous foods are not to the advantage of the human metabolic process. Fiber provides very large volume but very low nutrition quality.

Eating High Volume and Low Nutrition

Eating more of poor quality but abundant forage to obtain these components generates too much energy, which may be stored in white adipocytes or dissipated by diet-induced thermogenesis. In other words, ‘burning off’’ excess energy can help to correct nutritional imbalances in …barely adequate diets, distilling out scarce nutrients including amino acids, essential fatty acids, vitamins and minerals from energy-rich but nutrient-poor foods…10

The above quote may be a bit complex, so let me elaborate. Eating a lot of food with few nutrients but lots of energy is a problem for the body. A macronutrient that meets this generalization is carbohydrates. As noted earlier, carbohydrates provide fuel and not nutrition. Therefore, in terms of nutrition they are poor quality but in terms of energy, they provide too much. Some of the energy burns off as heat. You may notice this when you eat carbohydrates; you feel hot. This is thermal energy dissipated as a result of getting too much energy for fuel, which cannot be stored. Additionally, since carbohydrates are poor in nutrition, the body has to distill out scarce nutrients with a lot of work. It does this as it converts the excess energy to fatty acids (triglycerides) and stores them for the future.

Micronutrients

There are micronutrients in carbohydrates that we only get in limited amounts from animal food sources, such as vitamin C and magnesium, for example. While both C and magnesium are considered to be essential, they are more essential in a diet full of carbohydrates. This may be counter-intuitive, but the consumption of excess carbohydrates, as a result of low nutrition value, increases glycation processes. Glycation is oxidation, and lots of free radicals are generated, causing damage. Free radicals need to be removed by antioxidants. Vitamin C is an antioxidant. Thus, in a high carbohydrate diet, vitamin C is essential and is “built in” so to speak, very handily, to help reduce free radicals. However, a diet low in carbohydrates has much less need for vitamin C, since glycation, and thereby free radicals, are greatly reduced. Magnesium is found in animal meat as well, and again, similarly to vitamin C, less is sufficient when the diet doesn’t contain carbohydrates.

However, if you are still concerned about vitamin C need, there are animal sources such as: liver, heart, and eggs11-13 with adequate amounts of vitamin C. Although the magnesium amount in meat and dairy is less than in green leafy vegetables, it is provided in sufficient amounts, given the higher absorption rate from animal products than from carbohydrates. Since magnesium management is done by the kidneys, more frequent urination, as a result of carbohydrate consumption, may reduce available magnesium in carbohydrate rich diets 13,14. This would suggest that a diet poor in carbohydrates and rich in meats may need less magnesium.

What Do Carbohydrates Offer?

With all the things I wrote about how carbohydrates are not essential, have low or no important nutrients, what do they have? Is there any reason to eat them? There is no research on what happens to the gut flora in humans when we stop eating plant matter. It is simply assumed that all humans eat plants, and thus, for all humans the gut flora must be able to work with plants. Even if we accept this as a potential point of importance, which in my opinion is highly unlikely, since those not eating an ounce of carbs do just fine with whatever gut flora they have, we still don’t have an answer: what nutrients do carbs offer? There must be some nutrient in plants that would make us want to eat carbohydrates.

In reality there is none. Moreover, carbohydrates are full of antinutrients. Antinutrients are chemicals that block the absorption of beneficial chemicals and/or cause harm themselves. Everything that is alive wants to evade its predators. Some animals can run away and those that cannot get away fast have poisons. Plants also cannot run away and so their tactic is to create chemicals that deter predators from eating them. This deterrence can be subtle, like bitter taste, or hot spice, or can be overwhelming and deadly, such as poisonous mushrooms or something as common as the seeds of apples—eating apple seeds can deliver a lethal dose. The list of poisonous plants is long. Here you find many. While we may not eat most of these poisonous plants or apple seeds, what about eating something more common, such as veggies, nuts, seeds, grains, and fruits sold in grocery stores for our eating pleasure? Do they also contain harmful toxins?

As it turns out, they do. A clever article describes many of them. There are also a couple of amazing documentary films you should watch. Here is one and here is another. In these two films you are introduced to a completely different world of plants, which will help you understand why plants do what they do. So let’s talk about some of the most common plant toxins.

Understanding Antinutrients

The term antinutrients may mean different things to different people. Antinutrients represent chemicals found in plants that supports the growth and survival of the plant itself, but which may cause harm for those eating plants. Since plants want to ensure their own survival, want to reproduce and provide their offspring a chance for survival as well, they have come up with a huge array of chemical protection against predators. These protective chemicals differ based on the part of the plant. Fruits were meant to be consumed because the seeds are propagated by the feces of the animals that consumed them, so it is in the interest of the plants to support those that eat their fruits. However, eating the leaves (such as leafy greens, drinking leaf teas, etc.,), the flowers (such as broccoli, cauliflower, etc.,), the seeds or nuts (such as legumes, almonds, peanuts, etc.,), the young shoots (green onions, asparagus, etc.,), or the roots (potatoes, tubers, onions, etc.,) are off limit as far as the plant is concerned. These parts of the plants are protected by chemicals that either cause harm directly (such as Allyl cyanide in cruciferous veggies such as broccoli, cabbages, cauliflower, and others) or indirectly by blocking nutrients from absorption (such as tannin, for example, which reduces the absorption of metals such as iron and zinc, they also inhibit digestive enzymes, and interfere with proteins. Below is a list of some of the most commonly found antinutrients in the carbohydrates humans eat.

Phytic Acid

Phytic acid is an important storage form of phosphorus and inositol, and is important in building bones, repairing nerves, and as antioxidants. Because of this, there is hardly a person who doesn’t believe that phytates are good and important. They are antioxidants after all, so we need them15… not so fast!

During the past years, attention has been focused on PA [Phytic Acid] as an antinutritional factor in the diet of humans because of their inability to utilize phytate. The low bioavailability of the minerals bound in the PA can lead to deficiencies in human populations where staples like wheat, rice and maize are the major or the only source of nutrition. (from here)

The problem is that phytic acid requires the digestive enzyme phytase to make it bioavailable in the body. While ruminants possess this enzyme and are able to break down phytate, humans (and animals that are not ruminants) lack this enzyme. Because we phytate is not bioavailable for humans, rather than help in nutrient absorption, phytates block it, and are thus, antinutrients. Food sources of phytates include grains, seeds, and nuts.

Goitrogens

As the name implies, this is a compound that attacks the thyroid, causing goiter. Plants that contain this chemical block iodine absorption. Most autoimmune thyroid degeneration is caused by goitrogens. Plants rich in goitrogens are soy, all crucifers—also everyone’s favorites like kale and broccoli.

Oxalates

Oxalates are in many plants and in some in very high amount. Oxalates are corrosive sharp crystals that can cause various problems for humans. Most well-understood are kidney stones, and UTIs16, and lesser understood but more common problems are discussed here. Oxalate rich foods are nuts—particularly almonds—some fruits—particularly mulberries and pomegranates—and many vegetables—particularly rhubarb and spinach. Chocolate is a high-oxalate food!

Tannins

One of the videos I linked to earlier is about tannins. Tannins are a bitter-tasting compound. For example, coffee, tea, dark chocolate, wine, etc., all are high in tannin as their bitter taste lets you know. Tannins interfere with iron and other metals absorption. Tannins are carcinogenic17.

Plant Sterols

Sterols are plant-form of cholesterol. While they have been believed to have lots of health effects because they lower cholesterol, research shows that they are harmful and end up causing heart disease.

EPA/DHA Fatty Acids

Up until this point, I have described all of the things that carbohydrates provide—good or bad. Now let’s look at what they don’t provide, which would be essential.

“More than half of the dry weight of the brain is lipid, a high proportion of which contains long-chain fatty acids derived from dietary essentials. So the metabolic bases of both these features require efficient digestion and internal distribution of dietary and synthesised lipid”18

Our brain is over 60% essential fatty acid in EPA/DHA form19. In plants only the ALA form of omega 3 fatty acid is available. The ALA form is not similar to EPA/DHA and the human body has an extremely low rate of conversion 20. Not eating sufficient EPA/DHA fatty acids can cause brain damage, while increased consumption of DHA is neuroprotective.

Insulin

Among the most important downsides of carbohydrates is their association with insulin release, because carbohydrates convert to glucose, which is toxic to humans. Glucose toxicity leads to insulin resistance 3 (type 2 diabetes) and neurotoxicity21 in humans.

Conclusion

Throughout this paper, I have discussed the negative effects of carbohydrates. I showed absolutely no positives. This is not a bias on my part. I love carbohydrates. We all do. Carbohydrates are addictive; I wrote about that before here. However, at one point we must accept that carbohydrates are not essential. They are harmful if we consume high quantities over the long term. They provide antinutrients, cause harm by providing too much glucose, and lack essential nutrients. We can safely assume that many humans (not all) have evolved to tolerate low quantity, mostly seasonal, carbohydrate intake. However, given the nearly zero amount of nutrients carbohydrates provide, it may be time to reduce our carbohydrate consumption and, instead, fill our tummies with essential nutrients of proteins and fats.

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Sources

1          Leonard, B., Campbell, M. C. & Manning, K. C. Kids, Caregivers, and Cartoons: The Impact of Licensed Characters on Food Choices and Consumption. Journal of Public Policy & Marketing 38, 214-231, doi:10.1177/0743915619827919 (2019).
2          Bier, D. M. et al. Report of the IDECG Working Group on lower and upper limits of carbohydrate and fat intake. European Journal of Clinical Nutrition 53, s177-s178, doi:10.1038/sj.ejcn.1600759 (1999).
3          Rossetti, L., Giaccari, A. & DeFronzo, R. A. Glucose Toxicity. Diabetes Care 13, 610-630, doi:10.2337/diacare.13.6.610 (1990).
4          Samuel, V. T. Fructose induced lipogenesis: from sugar to fat to insulin resistance. Trends in Endocrinology & Metabolism 22, 60-65, doi:10.1016/j.tem.2010.10.003 (2011).
5          Cummings, J. H. Cellulose and the human gut. Gut 25, 805-810 (1984).
6          Bourassa, M. W., Alim, I., Bultman, S. J. & Ratan, R. R. Butyrate, neuroepigenetics and the gut microbiome: Can a high fiber diet improve brain health? Neuroscience Letters 625, 56-63, doi:https://doi.org/10.1016/j.neulet.2016.02.009 (2016).
7          Rogers, J. A. & Davis, C. L. Rumen Volatile Fatty Acid Production and Nutrient Utilization in Steers Fed a Diet Supplemented with Sodium Bicarbonate and Monensin<sup>1</sup>. Journal of Dairy Science 65, 944-952, doi:10.3168/jds.S0022-0302(82)82295-9.
8          Li, Y. et al. Ruminal Transcriptomic Analysis of Grass-Fed and Grain-Fed Angus Beef Cattle. PLoS ONE 10, e0116437, doi:10.1371/journal.pone.0116437 (2015).
9          Daley, C. A., Abbott, A., Doyle, P. S., Nader, G. A. & Larson, S. A review of fatty acid profiles and antioxidant content in grass-fed and grain-fed beef. Nutrition Journal 9, 10-10, doi:10.1186/1475-2891-9-10 (2010).
10        CANNON, B. & NEDERGAARD, J. Brown Adipose Tissue: Function and Physiological Significance. Physiological Reviews 84, 277-359, doi:10.1152/physrev.00015.2003 (2004).
11        SEELIG, M. S. The Requirement of Magnesium by the Normal Adult: Summary and Analysis of Published Data. The American Journal of Clinical Nutrition 14, 342-390 (1964).
12        Pennington, J. A. T. Y., B.E.;. Total Diet Study nutritional elements, 1982-1989. Journal of the American Dietetic Association 91, 4 (1991).
13        Seo, J. W. & Park, T. J. Magnesium Metabolism. Electrolytes & Blood Pressure : E & BP 6, 86-95, doi:10.5049/EBP.2008.6.2.86 (2008).
14        Longo, D. L. et al. Harrison’s Manual of Medicine 18th Edition.  (McGraw Hill Medical, 2013).
15        Schlemmer, U., Frølich, W., Prieto, R. M. & Grases, F. Phytate in foods and significance for humans: Food sources, intake, processing, bioavailability, protective role and analysis. Molecular Nutrition & Food Research 53, S330-S375, doi:10.1002/mnfr.200900099 (2009).
16        Siener, R., Ebert, D. & Hesse, A. Urinary oxalate excretion in female calcium oxalate stone formers with and without a history of recurrent urinary tract infections. Urological Research 29, 245-248, doi:10.1007/s002400100198 (2001).
17        Chung, K.-T., Wong, T. Y., Wei, C.-I., Huang, Y.-W. & Lin, Y. Tannins and Human Health: A Review. Critical Reviews in Food Science and Nutrition 38, 421-464, doi:10.1080/10408699891274273 (1998).
18        Pond, C. M. in Adipose Tissue Biology   (ed Michael E.; Symonds)  (Springer Science+Business Media LLC, 2017).
19        Chang, C. K., DS; Chen, JY;. Essential fatty acids and human brain. Acta Neurologica Taiwanica 18, 10 (2009).
20        Gerster, H. Can adults adequately convert alpha-linolenic acid (18:3n-3) to eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3). International journal for vitamin and nutrition research 68, 14 (1998).
21        Tomlinson, D. R. & Gardiner, N. J. Glucose neurotoxicity. Nat Rev Neurosci 9, 36-45 (2008).

The Misguided Battle Against Dietary Fat and Cholesterol

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I was at my medical provider the other day waiting for my turn for an MRI test. I shared the lobby with over 100 people. As I looked around, for the first time I noticed something odd. About 80% of the people in the lobby were overweight. I found a seat, the only seat. It was a single small seat. Most of the seats now are double sized to allow the obese to sit. I am claustrophobic and was concerned about this on my way to the MRI machine. The nurse gave me a wink and smile and we walked into the room. I was nailed to the floor. I have never seen anything like this though I have been in MRIs many times before.

I recall having been pushed into a narrow tube many times before where I could not lift a hand, usually dimly lit with some wind blowing in my face and a terribly loud echoing hammering as the image slices were taken. Yet here I was, glided silently into an MRI machine that was almost big enough for me to sit up in. “Ah the benefits of having obese people” I thought as I entered this brightly lit giant tube that was so wide that even the noise was reduced, lacking the echo we all are familiar with and hate. The radiologist told me that all MRI scanners are being replaced. As I was scanned for 45 minutes, I had no claustrophobia at all and not too much noise to block my thinking. The time gave me a chance to pause about the obesity epidemic: how did we get here? Why are entire new industries created to cater to our new weight rather than help us become healthy? Why are so many of us overweight to begin with? What has gone wrong?

Coincidentally, for unrelated reasons, I was already researching the nutritional recommendations of the USDA for the past several months; reading all of the books and academic research papers available to me. The USDA recommendations sparked my interest because I run a migraine group full of glucose intolerant migraineurs. I merely wanted an answer to why migraineurs (like me) are glucose intolerant, when I came across the huge nutritional boxing ring with major academic fights in this arena. The real science was hid, even by the NIH, unpublished.

The obesity epidemic starts with the theory of Ancel Keys who in the mid 20th Century US decided that coronary heart disease (CHD) was the most important thing to focus on (Eisenhower just had a heart attack). He found support for his hypothesis that high cholesterol is caused by high dietary fat—in particular saturated animal fats—and those with high cholesterol will most certainly have CHD, will flip and die very soon. His findings were dubious at best, but still garnered support (Ancel Keys – Seven Countries Study)

Researchers all over the world presented conflicting evidence but they were not only not able to publish these data in reputable academic journals, they were ostracized for even trying. Eventually so many scientists lost their reputation as a result of trying to fight Keys’ hypothesis that many left academia or changed fields of research and gave up (1-3).

Nina Teicholz spent eight years digging up files never published and hidden in the archives of the NIH (3). The reason for not publishing? The findings did not support Keys’ theories. It was assumed that the results had to have been wrong and therefore could not be published. In scientific research the role of science is to try to refute the theory by proving it wrong. In the case of Keys’ theory, the law of science changed: a theory was accepted as truth and no one could publish anything unless they found supporting evidence to THAT theory. Thus, science moved backwards and has effectively stalled for decades where cholesterol and fat are concerned.

When nutrition research began in the early 20th Century, we did not have the all of the tools available that we have today. Today we know that cholesterol is not made from fat at all but from Acetyl CoA and Acetoacetyl CoA (source). So if cholesterol is not made from fat, what is the connection of eating saturated fat to CHD? Nothing actually—today we know but shhhhh… this still cannot be said loud!

Cholesterol Is Made from Acetyl CoA and Acetoacetyl CoA, Not Fat

Cholesterol is made from two molecules in a total of about 39 hard steps by our liver (or we can eat it like egg yolks). Would our body go through such hard work of creating something if it ended up causing our death? It is not even plausible that human evolution would have supported such counter mechanism.

A Primer on Metabolism

Acetyl CoA is

“an important biochemical molecule in cellular respiration. It is produced in the second step of aerobic respiration after glycolysis [the breakdown of glucose (think carbohydrates) by enzymes, releasing energy and pyruvic acid] and carries the carbon atoms of the acetyl group to the TCA cycle [Krebs cycle which is a chemical reaction used by all aerobic organisms] to be oxidized for energy production” (source)

and Acetoacetyl CoA is

“intermediate in the oxidation of fatty acids [fats] and in the formation of ketone bodies [fat burning energy bodies]” (source).

Note that neither is a fat but they together form fat (cholesterol) by oxidation. Cholesterol is a lipid (a naturally occurring molecule like fats, waxes, steroids, fat-soluble vitamins like vitamins A, D, E, and K, and also triglycerides). Triglycerides are ester derived from glycerol and three fatty acids – body fat, phospholipids (a major component of all cell membranes), and many other types of lipids. The main biological functions of lipids (such as cholesterol) are storing energy, signaling, and acting as structural components of cell membranes.

It is not the matter of eating fat and oops we now have cholesterol; rather it is a matter of “we must have cholesterol to survive.”

Where do these elements come from in the body to create cholesterol?

As noted above: carbohydrates (glucose is a carbohydrate) and an element that is an intermediate step in oxidizing fatty acid combined create cholesterol, which “then enters the citric acid cycle in the mitochondria…” (source) Note the key word here: carbohydrates. This is important because the “health-heart” movement of Ancel Keys’ “fat causes high cholesterol” is clearly not true if cholesterol is made from carbohydrates and not a fat. How did we end up thinking that cholesterol is made from fat? It certainly is fat but clearly is not made from fat.

Why do we need cholesterol?

Cholesterol is used by our mitochondria (not what we eat but what our mitochondria needs to create energy ATP). (source)

How much cholesterol is needed and what happens when we reduce cholesterol?

You would think that these questions were asked over the 80+ years but no reputable scientist dared asking. The moment such question was asked, the sticker “black sheep” went up the forehead so researchers just let it go. Thus we have no idea how much cholesterol we actually need. Everyone needs a different level: the thought that a 30-year old 7-foot-tall male Marathon runner needs the same cholesterol level as a little old lady, aged 95, in a wheelchair is just preposterous. Clearly each person needs a different level based on mitochondrial respiration intensity and frequency, which is age, gender, and activity related. A cookie-cutter approach just cannot work. What happens when we reduce cholesterol? As noted above, cholesterol stores energy, it is a signaling agent, and acts as structural components of cell membranes among other things. If we reduce cholesterol, we effectively reduce our body functions.

The Combustible Vegetable Oils

Since it was decided that fat creates cholesterol and thus saturated fats had to be removed from everyone’s diet, the research was about how to make vegetable oils, unsaturated or polyunsaturated, edible and digestible (the kind flies won’t eat in your garage). Hydrogenation could only produce dangerous fats, such as hydrogenated vegetable oils (trans fats) or partially hydrogenated vegetable oils, both of which were said to have randomly combusted in delivery trucks while being taken for cleaning and also while taken back to the restaurants after cleaning. Apparently the fumes vegetable oils create settle in the clothing (and the lungs of the chefs) and even after professional cleaning are still capable to burst into flame without any provocation (3). These vegetable oils have polyunsaturated fats that have the unfortunate “poly” (multiple) bonds. These bonds break easily, transforming fats into ugly sticky goo and free radicals. This goo replaces animal fats in human mitochondria, blocking the mitochondria from creating energy.

This makes a lot of sense: fats in vegetable oils are not the same chemical components as fats in animal bodies. There is a huge difference in how they work and to what they bond. Animal fats become energized by thermal heat referred to as internal combustion whereas vegetables use external energy (the sun) and in heat they disintegrate, oxidize, and become goo. They chemically change from being fats to something that cannot be used by the human body as fats (4). Olive oil does not combust but at higher temperatures oxidize, creating free radicals.

Fat provides a lot of energy, 9 Calories per gram as opposed to carbohydrates and proteins, each producing only 4 Calories per gram. This implies that by removing fat calories from our diet, a very large part of the daily calories needed to be made up by something other than fat. Since protein also contained fat (saturated fat in particular), the Food Pyramid and later “My Plate” both reduced the protein amount as well. Thus, what we were left with was increased carbohydrates in our diets. However, as noted above, carbohydrates are part of cholesterol creation. This has become a catch 22 that no one in the “heart-health” supporter group accepted or did not see or decided to ignore because it was too complex or decided to ignore because then they too would become black sheep.

The Catch 22

Perhaps most the most striking aspect of this misunderstanding, is that if we follow the steps, we inadvertently increase the very diseases that we would like to avoid. By increasing carbohydrate intake, we’re increasing cholesterol and inducing metabolic disorders.

reduce cholesterol ==> reduce fats ==> increase carbohydrates ==> increase cholesterol

So here we are today, 80+ years later. Today the Western Diet world has a nightmare of metabolic disorders to fight. Where do metabolic disorder lead to? CHD of course, the very thing Ancel Keys wanted to rid the society from. However, there is more to it than that.

Carbohydrates have some nasty properties—both simple and complex carbohydrates do:

  1. They are addictive; eight times more than cocaine or heroin (5, 6)
  2. Grains (complex carbohydrates we eat the most of) release morphine (7), another drug
  3. Carbohydrates spike insulin and create insulin resistance (8-10)
  4. Insulin in the blood makes us hungry
  5. The more carbohydrates we eat, the more insulin we release and the hungrier we get
  6. Insulin resistance turns into type 2 diabetes
  7. People with type 2 diabetes are at an increased risk of CHD
  8. Carbohydrates create triglycerides, the type of cholesterol that is know to cause CHD (11)

And so now not only are we back at trying to prevent CHD, where we started 80+ years ago, but we also have massive metabolic disorder epidemic and new diseases, such as cancer, that also appear to be connected to high carbohydrate consumption.

Yet, to this day, the nutrition guideline of the USDA for the American population, now called My Plate, does not even include dietary fat! I challenge you to find a baby food with more than 1% fat in it; babies are only eating carbohydrates.

Luckily there is a new movement toward a healthy diet that goes under a couple of different names: Low Carbohydrate High Fat (LCHF) or ketogenic diet. These types of diets are used now therapeutically for many health conditions; health conditions we could probably prevent if we simply added saturated animal fats back into our diet and dumped all that sugar and grain.

Sources

  1. Taubes G (2008) Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health (Anchor).
  2. Taubes G (2011) Why We Get Fat: And What to Do About It (Anchor) Reprint edition December 27, 2011 Ed p 288.
  3. Teicholz N (2015) The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet (Simon & Schuster; Reprint edition, New York) p 496.
  4. Browner WS, Westenhouse J, & Tice JA (1991) What if americans ate less fat?: A quantitative estimate of the effect on mortality. JAMA 265(24):3285-3291.
  5. Ahmed SH, Guillem K, & Vandaele Y (2013) Sugar addiction: pushing the drug-sugar analogy to the limit. Current Opinion in Clinical Nutrition & Metabolic Care 16(4):434-439.
  6. Lenoir M, Serre F, Cantin L, & Ahmed SH (2007) Intense Sweetness Surpasses Cocaine Reward. PLoS ONE 2(8):e698.
  7. Perlmutter D & Loberg K (2014) Grain Brain: The Surprising Truth About Wheat, Carbs, and Sugar – Your Brain’s Silent Killers (Hodder & Stoughton).
  8. DiNicolantonio JJ & Lucan SC (2014) The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart 1(1):e000167.
  9. Schaefer EJ, Gleason JA, & Dansinger ML (2009) Dietary Fructose and Glucose Differentially Affect Lipid and Glucose Homeostasis. The Journal of Nutrition 139(6):1257S-1262S.
  10. Stanhope KL (2015) Sugar consumption, metabolic disease and obesity: The state of the controversy. Critical Reviews in Clinical Laboratory Sciences:1-16.
  11. Gandotra P & Miller M (2008) The role of triglycerides in cardiovascular risk. Current Cardiology Reports 10(6):505-511.

Graphic credit: You shall be obese (picture ©Angela A. Stanton, Ph.D.)

Thanksgiving Dinner: Ideas for Diabetics, Vegetarians and Everyone in Between

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The holidays symbolize a joyous time of family, friends and food. As a big proponent of a plant-based diet, this time of year has usually served as a conundrum for me. While my family is carving the turkey and noshing on honey-baked ham, I have always found myself turning to the carbohydrate-heavy side dishes. I have decided I am done torturing myself and have taken to the Internet and vegan/vegetarian cookbooks for help in planning a healthy, plant-based holiday. Rather than turkey, I indulge in acorn squash stuffed with spinach and a bit of Gorgonzola (or, for my vegan audience, try a quinoa mushroom pilaf stuffing instead). The traditional turkey, stuffing and mashed potatoes is not necessary for a fulfilling holiday.  If you are curious about plant-based Thanksgiving dishes, I highly recommend sites such as The Post Punk Kitchen, Vegetarian Times or One Green Planet. For me, experimenting with new, healthier foods has been an exciting and challenging adventure.

Regardless of dietary status, it is important to recognize that the average person consumes anywhere between 5,000 to 6,000 calories throughout Thanksgiving Day. Such a deluge of food into the human body overworks our system. According to Joanna Gorman, a registered dietitian quoted in the Las Vegas Review Journal, insulin and the breakdown of fat kick into high gear and cause unnecessary strain and stress. For those among us who must monitor their insulin, there are a number of substitutions one can make on Thanksgiving, such as switching out potatoes for mashed rutabagas, parsnips or cauliflower for more fiber and lower carbs. Try sautéed green beans with garlic instead of casserole, which can be heavy with cheese and cream. Use whole-grain bread crumbs (or even brown rice) and double the veggies for your stuffing. The Mayo Clinic and dLife (a Diabetes resource site) both share a number of recipes and ideas for a healthful holiday.

The best way to avoid overeating for one big meal is to partake in smaller meals throughout the day. Portion control and light exercise is key; rather than sitting on the couch all day, maybe take a little walk around the block with a loved one instead. Listen to your body and don’t keep allowing yourself to eat out of boredom or based on the deliciousness of a particular dish. Not only should we keep ourselves from overeating, we shouldn’t push our loved ones to eat more when they are already sated either.

It is important to enter the holiday season armed with knowledge on how we can better care for each other and ourselves. Many choices we make during this time of year, such as overindulging in sweets or tripling our calorie count can be harmful to our bodies. I know I have made these mistakes many times and felt remorse and physical pain as a result of my overeating. I truly hope these resources will allow my readers to seek out new and interesting recipes and partake in a healthy and happy holiday season.