Big Sugar’s Secret Ally? Nutritionists by GARY TAUBES

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The first time the sugar industry felt compelled to “knock down reports that sugar is fattening,” as this newspaper put it, it was 1956. Papers had run a photograph of President Dwight D. Eisenhower sweetening his coffee with saccharin, with the news that his doctor had advised him to avoid sugar if he wanted to remain thin.

The industry responded with a national advertising campaign based on what it believed to be solid science. The ads explained that there was no such thing as a “fattening food”: “All foods supply calories and there is no difference between the calories that come from sugar or steak or grapefruit or ice cream.”

More than 60 years later, the sugar industry is still making the same argument, or at least paying researchers to do it for them. The stakes have changed, however, with a near tripling of the prevalence of obesity in the intervening decades and what the Centers for Disease Control and Prevention figures reveal to be an almost unimaginable 655 percent increase in the percentage of Americans with diabetes diagnoses. When it comes to weight gain, the sugar industry and purveyors of sugary beverages still insist, a calorie is a calorie, regardless of its source, so guidelines that single out sugar as a dietary evil are not evidence-based.

Surprisingly, the scientific consensus is technically in agreement. It holds that obesity is caused “by a lack of energy balance,” as the National Institutes of Health website explains — in other words, by our taking in more calories than we expend. Hence, the primary, if not the only, way that foods can influence our body weight is through their caloric content.

Another way to say this is that what we eat doesn’t matter; it’s only how much — just as the sugar industry would have us believe. A 2014 article in an American Diabetes Association journal phrased the situation this way: “There is no clear or convincing evidence that any dietary or added sugar has a unique or detrimental impact relative to any other source of calories on the development of obesity or diabetes.”

The absence of evidence, though, as the saying goes, is not necessarily evidence of absence. If the research community had been doing its job and not assuming since the 1920s that a calorie is a calorie, perhaps we would have found such evidence long ago.

The assumption ignores decades of medical science, including much of what has become textbook endocrinology (the science of hormones and hormone-related diseases) and biochemistry. By the 1960s, researchers in these fields had clearly demonstrated that different carbohydrates, like glucose and fructose, are metabolized differently, leading to different hormonal and physiological responses, and that fat accumulation and metabolism were influenced profoundly by these hormones. The unique composition of sugar — half glucose, half fructose — made it a suspect of particular interest even then.

The takeaway is that we should expect the consumption of different macronutrients to have differential effects on the hormonal milieu of our cells and so, among myriad other things, on how much fat we accumulate. These effects may be very subtle, but subtle effects can accumulate over a few years or decades into the anything-but-subtle phenomena of obesity and diabetes. In light of this research, arguing today that your body fat responds to everything you eat the exact same way is almost inconceivably naïve.

But don’t blame the sugar industry for perpetuating this view. Blame the researchers and the nutrition authorities.

The industry is in a perverse position: defending the core beliefs of nutrition and obesity research while simultaneously being accused by some of the prominent experts in these disciplines of following the tobacco-industry playbook and so acting as “merchants of doubt.” If this sounds like cognitive dissonance — well, it is.

I am a fierce critic of sugar and believe that it, in fact, may have prematurely killed more people than tobacco. The disorders for which it is the prime suspect — obesity and Type 2 diabetes — in turn elevate our risk of virtually every major chronic disease, from heart disease to cancer and Alzheimer’s. And yet on this issue, I think the sugar industry has a fair point in rejecting the comparison.

Cigarette companies are notorious for having worked to undermine the scientific consensus on tobacco, which was backed by compelling evidence. Tobacco executives knew as well as public health officials that nicotine was addictive and that smoking caused lung cancer. But the evidence implicating sugar as a unique cause of chronic disease has never been nearly so convincing. More to the point, the consensus among nutrition and obesity authorities has been completely aligned with sugar industry interests: Sugar advertisers have had to remind people only that what nutrition authorities believe to be true of all foods is therefore true of sugar as well.

So can we really blame sugar companies for seeking to rebut the contention of some nutrition researchers — that sugar might be a unique cause of diabetes and heart disease — by commissioning other mainstream nutritionists to make the opposite case? In the 1970s, when the industry paid Fred Stare, founder of the nutrition department at the Harvard School of Public Health, to exonerate sugar in a lengthy journal supplement, “Sugar in the Diet of Man, all Mr. Stare had to do was enlist as authors some of the very influential researchers who were convinced that dietary fat was the real enemy (the conventional wisdom of the time that has now been largely overturned). No confusion needed to be sown. Their task was simply to reinforce the consensus.

“The method of science,” as the philosopher of science Karl Popper once put it, “is the method of bold conjectures and ingenious and severe attempts to refute them.” In nutrition, the conjectures (their boldness is debatable) are that obesity is caused by lack of energy balance, and so a calorie is a calorie. But they have been accepted with such faith that attempts to refute them have been anything but ingenious and severe. That the attempts have failed may speak more to the quality of the science than the validity of the conjectures. To fully understand the dangers of consuming sugar, we need experiments, in humans, that can unambiguously test these 100-year-old conjectures. No matter how time consuming or expensive these studies are.

To the sugar industry, the nutritionists’ dogmatic belief that obesity is a calorie overconsumption problem and a calorie is a calorie has been the gift that keeps on giving. So long as nutrition and obesity authorities insist that this is true, then the sugar industry can rightfully defend its product on the basis that the calories from sugar are no better nor worse than those from steak or grapefruit or ice cream — perhaps even kale or quinoa. We can’t have it both ways.

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The Toxins That Threaten Our Brains, by James Hamblin

Leading scientists recently identified a dozen chemicals as being responsible for widespread behavioral and cognitive problems. But the scope of the chemical dangers in our environment is likely even greater. Why children and the poor are most susceptible to neurotoxic exposure that may be costing the U.S. billions of dollars and immeasurable peace of mind.

Forty-one million IQ points. That’s what Dr. David Bellinger determined Americans have collectively forfeited as a result of exposure to lead, mercury, and organophosphate pesticides. In a 2012 paper published by the National Institutes of Health, Bellinger, a professor of neurology at Harvard Medical School, compared intelligence quotients among children whose mothers had been exposed to these neurotoxins while pregnant to those who had not. Bellinger calculates a total loss of 16.9 million IQ points due to exposure to organophosphates, the most common pesticides used in agriculture.

Last month, more research brought concerns about chemical exposure and brain health to a heightened pitch. Philippe Grandjean, Bellinger’s Harvard colleague, and Philip Landrigan, dean for global health at Mount Sinai School of Medicine in Manhattan, announced to some controversy in the pages of a prestigious medical journal that a “silent pandemic” of toxins has been damaging the brains of unborn children. The experts named 12 chemicals—substances found in both the environment and everyday items like furniture and clothing—that they believed to be causing not just lower IQs but ADHD and autism spectrum disorder. Pesticides were among the toxins they identified.

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“So you recommend that pregnant women eat organic produce?” I asked Grandjean, a Danish-born researcher who travels around the world studying delayed effects of chemical exposure on children.

“That’s what I advise people who ask me, yes. It’s the best way of preventing exposure to pesticides.” Grandjean estimates that there are about 45 organophosphate pesticides on the market, and “most have the potential to damage a developing nervous system.”

Landrigan had issued that same warning, unprompted, when I spoke to him the week before. “I advise pregnant women to try to eat organic because it reduces their exposure by 80 or 90 percent,” he told me. “These are the chemicals I really worry about in terms of American kids, the organophosphate pesticides like chlorpyrifos.”

For decades, chlorpyrifos, marketed by Dow Chemical beginning in 1965, was the most widely used insect killer in American homes. Then, in 1995, Dow was fined $732,000 by the EPA for concealing more than 200 reports of poisoning related to chlorpyrifos. It paid the fine and, in 2000, withdrew chlorpyrifos from household products. Today, chlorpyrifos is classified as “very highly toxic” to birds and freshwater fish, and “moderately toxic” to mammals, but it is still used widely in agriculture on food and non-food crops, in greenhouses and plant nurseries, on wood products and golf courses.

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Alzheimer’s Dementia and the Reversal of Cognitive Decline by Mimi Guarneri, MD, FACC, ABIHM

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Alzheimer’s Dementia and the Reversal of Cognitive Decline

Introduction

I was excited to review a paper written by Dr. Dale Bredesen entitled Reversal of Cognitive Decline: A Novel Therapeutic Program. Dr. Bredesen’s article is open-access as a Priority Research Paper in Aging. If you consider Alzheimer’s Dementia (AD) to be entirely incurable or unmodifiable, this paper will offer you new insight into the metabolic facets of the condition and hope that influencing the course of the condition is possible.

AD by the Numbers

Early in the paper, he notes that, “In the absence of effective prevention and treatment, the prospects for the future are of great concern, with 13 million Americans and 160 million globally projected for 2050, leading to potential bankruptcy of the Medicare system. Unlike several other chronic illnesses, Alzheimer’s disease prevalence is on the rise, which makes the need to develop effective prevention and treatment increasingly pressing. Recent estimates suggest that AD has become the third leading cause of death in the United States.” Regarding the pharmaceutical landscape for AD, he starkly points out the reality that “there is not a single therapeutic that exerts anything beyond a marginal, unsustained symptomatic effect, with little or no effect on disease progression.”

System Outline

Inspired by successes with other chronic illnesses such as cardiovascular disease, cancer and HIV, all of which support the efficacy of multiple-component systems, Dr. Bredesen and his colleague developed a system for AD, and he outlines the basic tenets:

  1. The goal is not to simply normalize parameters, but to optimize them.
  2. Based on the hypothesis that AD results from an imbalance in an extensive plasticity network, the therapy should address as many of the network components as possible, with the idea that a combination may create an effect that is more than the sum of the effects of many mono therapeutics.
  3. Just as for other chronic illnesses such as osteoporosis, cancer, and cardiovascular disease, the underlying network features a threshold effect, such that, once enough of the network components have been impacted, the pathogenetic process would be halted or reversed.
  4. The approach is personalized, based on the contributory laboratory values affecting the plasticity network; and is computationally intensive, since many physiological data points are analyzed, interdependent network-component status is assessed, and many interventions are prioritized to determine the therapeutic program.
  5. The program is iterative, so that there is continued optimization over time.
  6. For each network component, the goal is to address it in as physiological a way, and as far upstream, as possible.

    MEND Program

    His MEND (Metabolic Enhancement for Neurodegeneration) program, as he shared with the Natural Supplements audience, is based on the state of the evidence for the pathophysiology of AD, combined with health restoring individualized interventions. Some of his most potent points included the following:

    1. What is referred to as “Alzheimer’s disease” is actually a protective response to 5 metabolic and toxic insults.
    2. AD is not a mysterious, untreatable brain disease—it is a reversible, metabolic/toxic, usually systemic illness with a relatively large window for treatment.
    3. The many molecular mechanisms of cognitive decline and AD are mapped onto a treatment protocol.
    4. The treatment includes dozens of interventions, beginning with diet, exercise, sleep and stress management, and extending to hormone optimization, nutrients, targeted herbs, brain stimulation, drugs, and other therapies.

    Results Summary

    Dr. Bredesen discusses the impact of his program on the first 10 patients (with memory loss associated with AD, amnestic mild cognitive impairment or subjective cognitive impairment) to ever experience it. Notably, nine of the ten had subjective or objective improvement, and all six of those whose cognitive decline had a major impact on job performance were able to return to work or continue work with no further difficulty.

    Needless to say, the potential benefit of this approach is staggering. Controlled clinical trials are necessary, of course, but Dr. Bredesen’s report shows us what is possible when we take a hard look at the science and combine it with an intelligent, comprehensive, individualized approach. I thank Dr. Bredesen for his groundbreaking work and look forward to the unfolding of his program as more of us learn about how to help improve cognitive outcomes when we address root causes of poor health.

    Blessings on your journey,
    Mimi Guarneri, MD, FACC, ABIHM       mimi_blog
    AIHM President

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