Continuing my theft of Dr. Tim Noakes' excellent post on South African
blogger Marika Sboros’s FOODMED.NET,
Dr. Noakes relates how “more support for Gerald Reaven’s unifying hypothesis of
chronic disease has come from an unexpected source – from those doctors,
hepatologists, who specialize in…diseases of the liver.”
Dr. Noakes continues, “It has been
known for some time that the added risks associated with obesity depend, in
part, on where that extra fat is stored in the body. Thus fat that
accumulates under the skin – subcutaneous fat – is far less unhealthy than
is fat that accumulates within and between the organs in the abdomen, so-called
visceral obesity.
“The hepatologists have now gone
one step further to show that the real killer in visceral obesity is the fat
that accumulates within the liver
causing NAFLD, a disease that is now reaching epidemic proportions.
“Their work shows that it is NAFLD
and not obesity per se that produces the abnormal metabolic state – the
atherogenic dyslipidemia (Table 2) – that causes heart disease in those with
insulin resistance and the metabolic syndrome.
“Table 2: The metabolic features of
atherogenic dyslipidemia present in those with NAFLD and insulin resistance
●
Elevated blood
glycated hemoglobin (HbA1c) levels
●
Elevated fasting
blood insulin levels
●
Elevated fasting
blood glucose levels
●
Hyperinsulinemia and
hyperglycemia (elevated blood glucose levels) in response to carbohydrate
ingestion
●
Low blood
HDL-cholesterol concentrations
●
High blood
triglyceride concentrations
●
Elevated numbers of
small dense LDL-particles
●
Elevated blood Apo
lipoprotein B concentrations
“The absolutely key point is
that dietary carbohydrates and not dietary fat cause NAFLD. For when the
insulin resistant eat excess carbohydrates including fructose found in sugar
and fruits, they must convert into fat any extra carbohydrate they cannot
either use as a fuel or store immediately as carbohydrate in liver or muscles.
“Note that all these options are
severely reduced in those with insulin resistance. Instead under the
action of insulin – the fat-building hormone – that fat is stored,
initially as fat in the liver. But as NAFLD develops, insulin resistance
worsens, hyperinsulinemia increases, atherogenic dyslipidemia deteriorates and
the seeds for the chronic diseases of obesity, diabetes, heart disease, NAFLD
and perhaps cancer and dementia are sown.
“Thus it is that dietary
carbohydrates and not dietary fat are the direct cause of this group of chronic
diseases in those with insulin resistance.
“Summary:
●
The work of Dr Gerald Reaven is as revolutionary to the
understanding of medicine as were the works of Newton, Galileo and Darwin to
their disciplines.
●
By producing
a unifying theory for perhaps six chronic diseases and by presenting the
initial evidence that these conditions are initiated by high carbohydrate diets
in those with insulin resistance, he has fundamentally changed our
understanding of how these conditions develop and how best they should be
treated. And also how they might be prevented.
Our challenge is to incorporate this new understanding
into our teaching and practice of medicine.”
No comments:
Post a Comment