By Effective Prevention, the lowest cost approach

Joe Anderson, Fall 2011

About Joe Anderson: I have graduate school level studies in Biophysics,

Biochemistry and Physiology plus Systems Engineering.

My views are not the result of conventional education in Nutrition, Public Health or Medicine

I’ve extensively studied Nutrition-Health and Glycochemistry for the last 9 years, over 5,000 hours invested.

Reviewed over 2,000 scientific articles. Have been an R&D Engineer most of my career. Have no financial interests in any nutrition, food or

medical activities or companies. This is a pro bono presentation to further the Greater

Good.

Taboos and Sacred Cows

There is a huge body of nutritional/health orthodoxy based on outdated ’50s-’70s knowledge.

Much of this orthodoxy is not only outdated, but damaging to public health.

Correction of this situation is very slow because of food politics.

It takes 20-40 years for research to become incorporated into public knowledge.

Employee Health Plans have a way to help short circuit this health tragedy.

Open Minds, Please MOST nutrition/public health advice is based on

epidemiological research. Nearly every epidemiological study has errors in

design, analysis and/or interpretation. Confusion and conflicts result. Are eggs good for you? Epidemiology can only show correlation (linkage) NOT

causation or mechanism. Laboratory and clinical trials, using a control group and

controlled parameters, can demonstrate causation and mechanisms. It’s still difficult.

This presentation will report unorthodox information based on non-epidemiological, cross-disciplinary, research.

Cross-Disciplinary?Scientific reductionism

Medicine• Cardiology• Oncology• Diabetology• more

NutritionPaleoanthropologyBiochemistryPhysiologyBotanyPhysiologymore

Medicine• Cardiology• Oncology• Diabetology• more

NutritionPaleoanthropologyBiochemistryPhysiologyBotanyPhysiologymoreIntegrative Concepts

Simple, well-nuanced, science-based nutritional rules and guidelines for optimal

health

King County Employee Health Insurance Plan

King County, WA, Plan emphasizes personal responsibility, interventions and financial rewards.

Substantial savings result. IT WORKS An ideal platform for improved interventions. Improved interventions can further increase

savings, possibly a lot! KC is attracting attention and may become a

popular model, increasing its importance.

Some Basics:

Biochemistry is extraordinarily complex.

This diagramshows how fructose, a simple sugar is metabolized in the liver.

First reported in 2008!

Lustig, R, Fructose: Metabolic, Hedonic, and Societal Parallels with Ethanol, doi: 10.1016/j, jada.2010.06.008

Basics: Biochemistry is like “zippers” separating & mating or

precise “snipping” operations by enzymes at exact locations in molecules.

Enzymes open a moving oval window to the middle of the helix, then close it when the replication is complete.

DNA (simplified model)

DNA Replication (simplified model)

Basics:The “zipping” and “snipping” by enzymes depends on: Fully functional enzymes

Not glycated (more coming) Enzyme coding errors are

common genetic errors Adequate supply of the right

molecules for new protein. Adequate molecules Right atoms in the molecules

being added. Right shape to fit

Proper folding and function of proteins depends on everything.

Adequate nutrient supply, no deficiencies. Metabolically unusual molecules, with even one atom

out of place, perhaps changed by heat, chemistry or “foreign,” don’t “zip,” “snip” or fold well, so are often long-term toxic.

Basics, Sugars: Many sugar types in food. (mannose, sucrose,

lactose, fructose, levulose, maltose, glucose, more)

All carbohydrates digest to sugars. Sugars are “fuel” and, like any fuel, are

dangerous due to their inherent energy content.

After digestion only 3 simple sugars are absorbed into the bloodstream. (glucose, galactose and fructose)

Fructose is unique in molecular structure (a 5

atom ring instead of a 6 atom ring), chemical activity and glycation potential (~10X higher than glucose).

Basics, Sugars:Continued: Sugars are like “kindling.” Fats and ketone bodies, our other fuel, are like

efficient, long-burning fuel “logs.” Fats and ketone bodies are more efficient and create

less “smoke” (oxidizing molecules and other byproducts of metabolism) plus are non-glycating.

Sugars are consumed before fats and ketone bodies; an evolutionary adaptation to reduce their damage to the body.

Red blood cells are the only cells in the body that require a sugar, glucose.

This puts a lower limit on glucose concentration ~60 mg/dl.

Basics, Glycations

Glycations result from a sugar bonding without an enzyme to proteins and/or fats, thereby forming “foreign” molecules.

Follow-on effects of glycations: Formation of toxic molecules (formaldehyde & more)

Formation of oxidizing and carbonyl molecules, (hydrogen peroxide & more)

Activation of Receptors for AGEs (RAGES)(inflammatory & autoimmune disorders)

Glycations are a primary cause of dysfunction and aging.

Basics, Glycations Glycations cause:

Oxidative and carbonyl stress from intermediate reactions (whole body damage)

Cross linking of proteins increases stiffness and decreases strength. (wrinkling, aneurysms, hypertension, cirrhosis, lens rigidity, kidney disease)

Reduced/blocked enzyme action (digestive, replication and hormonal errors/insufficiency)

Browning of fats and proteins that is similar to the brown components of tobacco smoke both chemically and damage-wise. (heart disease, cancer)

Basics, Glycations Continued:

Auto-immune disorders (neuropathic diseases such as loss of sight, hearing, feeling, Lupus, Parkinson’s and more)

Inflammatory disorders(rheumatoid arthritis, asthma, allergies)

DNA mutations and cleavage (fructose only)(Birth defects, cancers)

Mineral sequestration leading to calcium, copper, chromium and other deficiencies. (osteoporosis, depression, ADD)

Glycations are little understood by public, high damage causing, good intervention targets

Basics: Models of Disease Modern medicine is highly effective for

acute illnesses and trauma such as:

Modern medicine is ineffective for chronic illnesses such as:

Tuberculosis

Typhoid

polio

Atheroscleosis & CHD

Diabetes

Dementias

Diphtheria

Whooping Cough

Anthrax

Yellow Fever

Skeletal Injuries

more

Losses of sight, hearing

Cancers

Obesity

Cataracts

Strokes

more

For these, modern medicine provides few answers or cures. WHY?

Basics, Models of Disease Modern medicine concentrates on the “magic”

pills and procedures to cure single-cause, acute illnesses.

Chronic diseases are multi-modal and follow other models: Telomere shortening Advanced Glycation Endproduct (AGE) accumulation Time dependent mutation accumulation Long term toxic damage Long term nutritional deficiencies Inherited genetic errors (digestion, enzymes mostly) Oxidative and carbonyl stress (whole body damage) More

High Complexity, but some simple solutions are possible for high value interventions.

Basics, Nutrition: Biochemistry, hormones, enzymes, genetics

and more are extraordinarily complex and evolved over millions/billions of years.

Life and humans evolved in the natural world, not in the recently created civilized world.

In the civilized diet we now know there are good and bad of each macronutrient: fats, carbohydrates and proteins.

Simplistic nutritional guidelines based on macronutrient ratios are completely inadequate guides to nutrition needs.

Much more finely tuned guides are needed.

US Gov’t Dietary Guidelines (DGs)

Rough draft, published in 1977, advised a low fat, high carbohydrate diet based on heart disease mortality only.

DGs are premised on the Seven Countries Study, Ancel Keys primary author.

Keys was a long-time low-fat diet proponent (1957 publication) and excellent debater.

There was significant controversy over Keys’ theory at the time, with others claiming that sugars were the root cause of most chronic illnesses.

US Gov’t Dietary Guidelines (DGs)

The Seven Countries Study is deeply flawed. In fact, the primary conclusion, that dietary fat causes heart disease, is probably wrong.

No significant study confirms it yet. Flaws in this study include:

Neglect of relevant variables - Poor design, excessive simplification, inability to separate variables

Data from only 7 of 22 countries was used - Cherry picking

Incomplete statistical analysis - Investigator

bias.

US Gov’t Dietary Guidelines The last issue of the DGs, in 2010,

reemphasized the same old things. Diets, on average, have moved to the DGs. Age-related chronic diseases and health costs

have soared since 1980. Increased disability and illness with more

expensive, but non-curative, pills and procedures have resulted.

Health costs soared since issue of the DGs. DGs fail to warn against long term toxins and

nutritional deficiencies AND give outdated, harmful advice.

US Gov’t Dietary Guidelines

DGs are simplistic and do not provide needed detailed guidance.

Continuing the DGs as-is seems to be increasing chronic diseases.

All of us are unwitting subjects in a long-term experiment without confirmed research.

It would probably have been better to do nothing.

Lack of a control group has allowed standards and perceptions to drift away from our genetic heritage of good health, even into old age.

Isolated Traditional Peoples, Our Only “Control Groups”

Our ancient ancestors ate fresh, whole, naturally organic, minimally processed foods.

Traditional diets provided superior mental, moral and physical health

“Modern”Kitavans:

60 Years Old

95 Years Old

Our genetic heritage is robust health

Kitavan’s diet by calories: 69% carbohydrates

Mostly starches, very low fructose 21% fats

Mostly from coconuts(highly saturated)

Seafood provides 4 g fats/day (omega 3s)

10% protein Exercise only slightly above US NO heart disease, obesity,

strokes, diabetes or other chronic diseases.

70% smokers!

Genetics/Diet MismatchQuotes: In the United States and most Western countries, diet-

related chronic diseases represent the single largest cause of morbidity and mortality. These diseases are epidemic in contemporary Westernized populations and typically afflict 50–65% of the adult population, yet they are rare or nonexistent in hunter-gatherers and other less Westernized people.

…Industrial era foods (dairy products, cereals, refined cereals, refined sugars, refined vegetable oils, fatty meats, salt, …

…the ultimate factor underlying diseases of civilization is the collision of our ancient genome with… the nutritional qualities of recently introduced foods.

Loren Cordain, et al, Origins and evolution of the Western diet: health implications for the 21st century, American Journal of Clinical Nutrition, Vol. 81, No. 2, 341-354, February 2005

Genetics-Diet Mismatch Humans can be robustly healthy on full meat

diets (Eskimos) to plant-rich omnivory (Kitavans). No traditional peoples studied are exclusively

vegetarian, though Kitavans are mostly so. NO traditional diet utilizes significant amounts of

processed foods, including flour, refined sugars, grains or vegetable oils.

Arguably our modern diet has changed drastically in the last 200 years which is 0.01% of a 2 million plus year genetic adaptation to a hunter-gatherer diet.

Chronic disease rates with good traditional diets are 10X to 1000x lower.

Why Are We So Sick?

Commercialization of HFCS circa 1980-2000; total fructose intake increased roughly 20% and obesity nearly doubled.

FIGURE 1. Availability of total fructose in relation to obesity prevalence (x) in the United States.

http://www.ajcn.org/content/80/4/1090.long

Why Are We So Sick? Increased fructose intake. The average diet very nearly reached the Dietary

Guidelines over the same period, increasing carb intake and lowering fat intake

Processed foods, dietary AGEs, additives and other long term toxin intakes also increased.

Endemic deficiencies were not addressed. All of the above probably contributed to chronic

disease increases. It can’t be genetics; traditional peoples adopting

our diet get sick, too, within months. Increased fructose intake is thought to be the

most important contributor.

Toxins we are poorly adapted for

Tobacco Alcohol Fructose Browned Foods

(dAGEs and MRPs)

The last two are the big hitters for cost savings/health improvement.

Well known, somewhat adequate interventions

Becoming known, inadequate interventions

Unknown, inadequate interventions

Browned Foods

Over the last 30-40 years, the dietary Advanced Glycation Endproduct (dAGE) load has increased significantly.

Why? Increased use of: Barbecue grills, fried foods Sugars in foods (dAGE formation) Gourmet cooking (seared/blackened/etc) Additions to processed foods

Strong, tasty flavors Semi-addictive (“bet you can’t eat just one”)

Fructose Promotes: Heart Disease High Blood Pressure Obesity Non Alcoholic Fatty Liver Disease Insulin Resistance

Type 2 Diabetes Early menarche (~17 years to 11 or 12) Narrowed dental palate (orthodontia) Narrowed pelvis (increased Caesarian births) Myopia More

Cancers Dementias, including Alzheimer’s More

Lustig, R, Fructose: Metabolic, Hedonic, and Societal Parallels with Ethanol, doi: 10.1016/j, jada.2010.06.008Cordain, L, Hyperinsulinemic diseases of civilization: more than just Syndrome X; PMID: 14527633

Fructose? HOW can a single substance cause such a

variety of diseases????? Claiming fructose causes so many diseases

may seem nonsensical at first because we are so used to the standard, modern-medicine, single-activator, infectious model of disease.

Chronic diseases are multi-modal, long-term nutritional deficiency/toxicity issues.

ALSO, these disease are caused by many different mechanisms which are buried in the research papers of many disciplines.

Fructose? Fructose is found in:

Table sugar, sucrose, 50% High fructose corn syrup (HFCS), 42% & 55% Fruits, root vegetables (least damaging form) Processed foods and beverages

Average daily fructose consumption: ~90 grams = 25 teaspoonfuls! The damage is in the dose!

Beverages, processed and snack foods are loaded.

Fructose is a very active glycation-former, 10x glucose

Fructose? Continued: Fructose is a plant sugar we are poorly

adapted to eat in quantity, 24/7/365. Glucose, a universal sugar and Lactose, a

mammalian sugar, do not cause problems nearly as severely.

Fructose is addictive for many, with action similar to opioids, making it difficult to quit.

Thus, fructose is a high-value, opportune target for interventions.

Quick effects for most quitting fructose:

Blood pressure down to normal within weeks to a few months (stroke, kidney and heart disease risk)

Dyslipidemia corrected to normal within weeks (heart and liver disease risk)

Fasting blood glucose down to normal within months (T2 Diabetes risk)

Overweight reduced significantly within weeks to years (osteoarthritis, more)

Fructose costs us the most Almost exclusively liver metabolism. Fructose metabolites are virtually identical to alcohol

and similarly promote many age-related chronic diseases.

Small Dense LDL is a direct result of hepatic fructose metabolism. (atherosclerosis)

All sugars cause glycations, but Fructose’s glycation potential is ~10x higher than glucose.

Glycations are similar to tobacco smoke chemically and damage-wise.

Fructose’s effects in the body mimic BOTH alcohol and tobacco smoke PLUS it has other, unique, damaging mechanisms.

Fructose costs us the most

Starches, which digest exclusively to glucose, are much less damaging than sucrose and HFCS which digest to glucose + fructose.

No other single molecule approaches fructose’s damage potential.

This gives interventions based on reducing fructose consumption a lot of leverage

Common Deficiencies: Long chain omega 3s (DHA, EPA from fish oil)

Omega 6s are significantly over supplied by vegetable oils, contributing to omega 3 deficiency since both compete for 1 enzyme

Other fats are synergistic with omega 3s, necessary.

Vitamin D Copper, chromium and other minerals

depleted from soils of factory farms. Unknowns – little research done for 60 years.

Omega 3 Deficiency Increases in rates of: ADD and other attention/learning disorders Autism spectrum disorders Depression Bipolar disorder Schizophrenia Migraines & seizure disorders Autoimmune (Lupus, asthma, arthritis, more) Strokes Cancer More

Learn more: http://www.naturalnews.com/016353_omega-3_fatty_acids_mental_health.html#ixzz1ZalSR3Fk

Omega 3 Deficiency Omega 3 supplementation in recent studies

has shown: Risk of all-cause mortality reduced 47-

87% by long chain omega 3s. Improved IQ and learning ability. Depression reduced/cured. Improved vision MoreOmega 3 is a heavy hitter for interventions

Learn more: http://www.naturalnews.com/016353_omega-3_fatty_acids_mental_health.html#ixzz1ZalSR3Fk

Vitamin D3Is known to affect: Heart disease Stroke Osteoporosis (rickets if severe) Depression Seasonal Affective Disorder Type 1 Diabetes More Reduces risk 50-80% for: Cancer SchizophreniaVit D3 is a heavy hitter, synergistic with omega 3s.

Learn more: http://www.naturalnews.com/003069.html http://www.naturalnews.com/027580_vitamin_D_heart_disease_prevention.html

Cost Effective Interventions:Examples: Cooking-nutrition-lifestyle classes covering

cost & time-effective techniques and recipes for low fructose, low AGEs, high omega 3 and low inflammation meals.

Education on supplements: Vitamin D3, omega 3s, more

Support for fructose quitting and withdrawal phases with needs possibly identified from classes.

More

Summary Highly important, long-term deficiencies and

toxics are neglected by orthodox nutritionists/public-health policies and MDs

Chronic diseases are complex, but treatable with simple, long-term nutrition/lifestyle interventions to correct root causes.

The King County Employee Health/Insurance program is an ideal model.

Updating diet recommends to current modern research will greatly improve outcomes for Employees

The End, For Now.

Thank you for listening!

Questions? Follow ups?