The Johns Hopkins Musculoskeletal Center aims to streamline and improve access for diagnosis and treatment of conditions affecting muscles, bones and connective tissues. Each of the center’s locations feature a diverse group of physicians, therapists, and advanced practitioners who work together to bring you the right treatment at the right time.
DR. C REVIEWS MAJOR HEALTH AND TELEMEDICAL NEWS FOR THE WEEK ENDING SEPTEMBER 20, 2020.
ABDOMINAL (VISCERAL) FAT KILLS. The following post tells you how, and suggests what you might do to prevent this scourge, which is gradually becoming an epidemic in America.
OBESITY is an energy imbalance problem. MORE CALORIES ARE CONSUMED THAN ARE NEEDED AND CAN BE UTILIZED. A Good quality Diet, with lots of natural (rather than processed) foods, especially vegetables and fruits, have lots of FIBER that takes up space and makes you feel full.
Fiber also feeds the MICROBIOME. If the foods are DIVERSE, the microbiome will also be diverse and help utilize the calories you eat. A healthy Microbiome also contributes to your health by manufacturing neurotransmitters, vitamins, and other factors that are just starting to be appreciated. Diet QUALITY, as well as quantity, is important.
EXERCISE is critical for more than utilizing calories. It increases ADIPONECTIN which guides fat to fat stores where they belong, rather than to the liver, and IRISIN which favors the production of BROWN FAT, thus utilizing energy. The opposite of exercise, the SEDENTARY LIFESTYLE, is now considered a disease system in itself.
Lack of SLEEP favors obesity in a number of ways; at the very least, you can’t eat while asleep. Abdominal fat contains INFLAMMATORY cells which go directly to the Liver via the hepatic portal system to cause metabolic disruption. Insulin sensitivity falls, blood sugar, LDL and triglycerides rise. DIABETES and the METABOLIC SYNDROME result.
The excessive weight also causes back, hip and knee problems which contribute to the 10% increase in overall medical costs due to Obesity.
We have no photographs, abdominal, navel-level girth measurements, CTs, BMIs or death certificates to prove it, but it is highly unlikely that Paleolithic Humans suffered from excessive abdominal fat. They had no refrigerators, deliciously packaged snacks, sugary, fructose-containing soft drinks and candy, nor did they have cave-lighting to extend their daylight eating hours and disrupt their diurnal rhythm.
They had to walk or run long distances to obtain their meagre food supplies, which tired them out so that they most likely had a good night’s sleep. SLEEP, DIET and EXERCISE are built into our Metabolism by Darwinian Evolution. Paleolithic humans didn’t live long lives and succumb to cancer and heart disease.
They died most often by violence, which made Blood clotting a survival benefit, rather than the Risk factor for stroke and heart attacks that coagulation is to us now. It is not all our fault that OBESITY is steadily increasing over the last few decades.
CAPITALISM is driven to provide us with ever increasingly available and tasty food. Both consumers and purveyors scream when even the most logical political check on OVEREATING is legislated: Taxing of sugary, fructose-containing, nutritionless soft drinks was tried in Philadelphia to a chorus of complaints. To my knowledge the tax has survived, reduced sugary drink consumption, and was helpful in reducing the weight of Philadelphia residents. Not many cities were brave enough to follow suit.
GENETIC Influences can also conspire against weight control. The FTO gene, while relatively infrequent does have an influence, as shown in twin studies. And there seems to be a SET POINT in weight that makes it difficult to take off the pounds and keep them off. 2 years after almost all diets, the weight has returned. Eating HABITS, once established are hard to change.
BARIATRIC SURGERY has been shown to help Obesity, as well as Metabolic syndrome and Diabetes .I hope it will survive the test of time. Weight gain is easier to PREVENT than it is to treat. Somehow, society must get to the children, and keep them from gaining weight in the first place. Even children are now becoming obese.
INTERMITTENT FASTING can help contain Obesity. My own version is TIME-RESTRICTED EATING. I limit my eating to 6 hours a day, from Noon (usually 1PM) until 6PM. This has resulted in a modest weight loss from 142 pounds to 137 pounds. My son lost some 30 pounds in a 30 day, 1000 calorie “crash” diet to fend off advised Back Surgery. He exercised a lot of SELF CONTROL both to lose the weight, and to keep it off.
Unfortunately, Self Control is in short supply in our present SOCIETY OF EXCESS. Good luck in your quest, if you choose to embark on weight reduction. And good luck with your health if you don’t. I recommend “the secret life of fat” by Sylvia Tara in either case. Also, search for intermittent fasting in DWWR.
Water, the miracle molecule, proteins and fats are the very essence of life. Water does not dissolve fat, allowing for the cell membranes, and the compartmentalization of metabolic activity that allows life to happen.
FAT IS ESSENTIAL TO LIFE. Alas, all fats are not equally beneficial to nutrition, as the article stresses. Trans-fats, partially hydrogenated fatty acids produced mainly by industry, are the worst, acting to stimulate cholesterol synthesis, produce inflammation and damage the endoplasmic reticulum.
Their use has been banned in most countries. Saturated fat has been widely condemned, is not as good as the mono- and polyunsaturated fats, but not as bad as trans-fats. Some of life’s most delicious foods, such as cheeses, contain saturated fats, but it is best to keep down their consumption.
Remember that the first bite of something savory tastes the best; prevent habit from shoveling it down. Unsaturated fats are found in oily fish, which should be part of your diet.
Vegetables such as nuts, seeds, olives, and avocados are sources of “good fat” and should comprise 10-15% of your calories. Fats, compared to carbohydrates, contribute almost twice as many calories to your diet on a weight basis, and it’s easy to get carried away.
Total calories must be kept under control. STAY HEALTHY!
Do you have good or bad microbiome? Or do you have the microbiome you deserve?
Gut Microbiome, the new Open Access journal from Cambridge University Press and The Nutrition Society has published its first papers, including the animated abstract above from the paper: Hill, C. (2020) “You have the microbiome you deserve,” Gut Microbiome, Cambridge University Press, 1, p. e3.
Access the paper here: https://bit.ly/3bFOjc7
HARVARD MAGAZINE (SEPT – OCT 2020): From the book EXERCISED: Why Something We Never Evolved to Do Is Healthy and Rewarding by Daniel E. Lieberman, to be published on September 8, 2020 by Pantheon Books:
‘….many of the mechanisms that slow aging and extend life are turned on by physical activity, especially as we get older. Human health and longevity are thus extended both by and for physical activity.’
Exercise is like scrubbing the kitchen floor so well after a spill that the whole floor ends up being cleaner. The modest stresses caused by exercise trigger a reparative response yielding a general benefit.
In order to elucidate the links between exercise and aging, I propose a corollary to the Grandmother Hypothesis, which I call the Active Grandparent Hypothesis. According to this idea, human longevity was not only selected for but was also made possible by having to work hard during old age to help as many children, grandchildren, and other younger relatives as possible survive and thrive. That is, while there may have been selection for genes (as yet unidentified) that help humans live past the age of 50, there was also selection for genes that repair and maintain our bodies when we are physically active.
Daniel E. Lieberman is a paleoanthropologist at Harvard University, where he is the Edwin M Lerner II Professor of Biological Sciences, and Professor in the Department of Human Evolutionary Biology. He is best known for his research on the evolution of the human head and the evolution of the human body.
Daniel Lieberman, a Cultural Anthropologist from Harvard, makes the case that paleolithic hunter-gatherers Grandparents were helpful, in fact necessary to their families, and evolved to be active into old age. They did not evolve to sit in front of the TV, and modern men pay a penalty if they do.
INACTIVITY at ANY AGE is bad. If you put 20 year olds to bed, both weight and blood pressure go up. The book addresses a conundrum. Free radicals are bad. Exercise runs O2 through the mitochondria, which produces free radicals.
But EXERCISE REDUCES FREE RADICALS. A metaphor is introduced: you spill some tomato juice on the floor. But you clean it up, and the floor becomes cleaner than it was before. You exercise, the muscles suffer some microtears and injury. The REPAIR RESTORES the muscles to better than before, maybe with some extra mitochondria.
The Bodies MECHANISMS are MEANT TO BE USED. DIET is meant to supply the body energy and units for repair, EXERCISE is meant to use that energy, and keep the mechanism lubricated, and SLEEP is meant to allow for time to accomplish repair.
Sleep, Diet and Exercise can all be reconciled by recourse to Paleolithic man, whose activities imprinted our modern bodies.
Salt, so important to human health and disease, is also prominent in HUMAN HISTORY. Civilization has required it from earliest times. Cereal grains, the ‘Staff of life” is relatively low in SODIUM CHLORIDE, salt, making it a desirable food additive.
PRESERVATION of food before refrigeration required salt. Natron (Natrium is latin for salt, and Na is its chemical symbol) was the Egyptian city known for its salt. Salary was an income supplement to Roman Legionnaires for purchase of salt.
Salt, gold and slaves were prominent in north African trade, and salt was often as valuable, ounce for ounce, as gold. “Below the salt” in medieval times meant the “cheap seats” in Feasts; only the “high table” had salt.
SEA WATER was about 0.9% salt at the dawn of Life, and that is presently the salt concentration in EXTRACELLULAR FLUID.
TASTE BUDS are happy with salty foods, and one set is specialized to pick up salty favors. The 4 others are sweet, sour, bitter and umami. As you can see, these taste buds were pro-evolutionary in our paleolithic ancestors.
The extra salt, sugar, and fats that taste so good in our present modern, excessive society are over-generously supplied by capitalistic producers intent on enhancing sales. Portions keep getting ever larger to encourage us to eat more.
Salt supports BLOOD PRESSURE, and sometimes ER Patients in shock are given saline infusions. More commonly, HYPERTENSION is treated by salt restriction, as illustrated in the accompanying Infographic.
POTASSIUM is the most common cation in the INTRACELLULAR FLUID, just as Sodium is most common in the Extracellular fluid. Our bodies fastidiously defend narrow concentration limits of Sodium, Potassium and other electrolytes which are important constituents of the famous Milieu interieur.
It is interesting that the Sodium-Potassium ATP Pump requires a large percentage of the ENERGY used to keep us alive. This pump also keeps our cell membranes POLARIZED, so important in NERVE TRANSMISSION.
So eat a lot of NATURAL FOODS, high in potassium, and avoid the catsup, sauces and condiments that riddle our high sodium, Fast food, modern diets.
NEW ENGLAND JOURNAL OF MEDICINE (JULY 23, 2020): A large body of evidence suggests that consumption of caffeinated coffee, the main source of caffeine intake in adults in the United States, does not increase the risk of cardiovascular diseases and cancers. In fact, consumption of 3 to 5 standard cups of coffee daily has been consistently associated with a reduced risk of several chronic diseases.
Coffee and tea have been consumed for hundreds of years and have become an important part of cultural traditions and social life.5 In addition, people use coffee beverages to increase wakefulness and work productivity. The caffeine content of commonly used sources of caffeine is shown in Table 1. For a typical serving, the caffeine content is highest in coffee, energy drinks, and caffeine tablets; intermediate in tea; and lowest in soft drinks. In the United States, 85% of adults consume caffeine daily,6 and average caffeine intake is 135 mg per day, which is equivalent to about 1.5 standard cups of coffee (with a standard cup defined as 8 fluid oz [235 ml]).7 Coffee is the predominant source of caffeine ingested by adults, whereas soft drinks and tea are more important sources of caffeine ingested by adolescents,