Repost: : Syndrome X "New Scientist" 1 Sept 2001

Question:

This post not CC’d by email >HI Quentin… >Well that certainly sounds like me. >So are we also saying that letting the insulin do the work of >regulating our blood sugar levels isn’t good either?

G’day G’day Martin,   We need insulin to transfer glucose into many tissue cells.  There are exceptions. The brain manages to get glucose without requiring insulin.  The levels of glucose in the eye respond to the fluctuating levels in the blood.  Some nerve cells are similarly affected.   When cells become insulin resistant the levels of insulin required to put glucose into the cells requiring insulin to do the job increases. The pancreas cranks out more insulin. It is sort of like driving a car with a foot heavy on the accelerator pedal because the car is dragging a parachute behind it.  Eventually the motor overheats. > It seems that diet is the only thing that really is important.

Avoid a sedentary lifestyle is also important. > I suppose that is >the message that we have had drummed into us in the UK all our lives. >A sensible balanced diet with only a little meat and lots of veggies. >Try and get the majority of our calories from complex carbs!

That is pretty close to it.  One could emphasize the importance of fish.  The short answer is often a short fish … sardines or anchovies. >Is there a direct link between the level of obesity and insulin >resistance and high triglycerides?

I think so.   >What about the plant estols(?) such as Benecol.. do they really work?

Yes.  They work.  Some people think they shouldn’t work because the liver makes more cholesterol than is absorbed from most diets.  Since the phytosterols block the absorption of cholesterol these people reason phyotesterols should have little effect.  What they are overlooking is cholesterol is dumped by bile into the gut and it is the RE-absorption that the phytosterol prevent.  When not reabsorbed, the waste cholesterol talks to the big white telephone. For phytosterols to work efficiently they require fat.  That is the reason phytosterols are added to margarine and not say bread.  Fat improves there efficiency ten fold.   Phytosterols are naturally occurring. One of the sad historical jokes of dietary misinformation occurred when some people stopped eating avocados because the crude chemical tests available at the time found sterols in avocados and the idiot brigade thought it was cholesterol. >Is there a diet sheet that lists foods good for syndrome x sufferers?

Here are the general principles. 1. Avoid refined carbs 2. Eat foods in as natural a state as possible. 3. Use non-starchy vegetables as your primary source of carbs. 4. Keep the amounts of carb dense foods low or moderate depending on health.   5. Avoid soft drinks and fruit juices.   6. Avoid vegetable oils.      Replace them with fruit oils eg olive, avocado. 7. Avoid hydrogenated oils like the plague. The news on this got worse. It was thought that below a couple of percent of calories was OK. Some recent research suggests there is no safe limit for the common contaminant of hydrogenated oils elaidic acid, a trans fatty acid. 8. Eat fish preferably salmon, mackerel, sardines etc. They really are good for brain function.  As the details of choline, pyroglutamate, EPA, DHA, DMAE etc become clearer … the answer is a short fish. 9. Have protein at all meals.   >Thanks for the repost. >Martin.

– Quentin Grady       ^  ^  / New Zealand,       >#,#< [                     / /     "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin

Response:

- Hide quoted text -- Show quoted text - >This post not CC'd by email >>There are researchers who are of the opinion that fructose in >>combination with fat is also unhealthy.   >So I believe. But if you don't add refined, hydrogenated, or other >fats to your diet and only eat the 25 to 30% that is unavoidable in >eating a whole food diet, and you don't eat refined flour, or refined >sugars, then you can't go wrong. Fruit (fructose) is excellent even >for diabetics. >G'day G'day Joe, >  Sometimes people give up when confronted with a barrage of commonly >held believes.  The long sentences seem to refer to refined fats and >carbs. That is the barrage. > The point we are supposed to believe is contained in the short >sentence, "Fruit (fructose) is excellent even for diabetics" >OK.  What is a refined fat?  

Fat extracted and purified from the produce in which it occurs >Is lard a refined fat?

Yep, it is concentrated from the meat eaten. >How about coconut oil?

Yep, coconut meat/milk is the way to go to get it more unrefined - Hide quoted text -- Show quoted text ->The answers are unimportant as most readers have knee jerk response to >the word "refined"    There are IMHO many reasons to select less >processed source of fats eg if one eats whole nuts one gets the full >range of natural tocopherols ie the Vit E that works. There are also >phytosterols etc. >Even hydrogenated is not as simple as it seems.   When fully >hydrogenated the transfats disappear.  Unfortunately most of the solid >cooking compound used for deep frying still contain trans fats. >It is also hard to argue with whole food.  Most people here advocate >whole food.  Some on general principles. Some because it works. >That brings us to the >Fruit (fructose) is excellent even for diabetics. >How would YOU know?  As I understand it you are not a diabetic.

Well I listen to the research done by my daughter's diabetes clinic. And I look at the GI and carb content of many readily available fruit. How do you know? Other than perhaps extrapolating your own idiosyncratic responses onto everyone else? >The people who post here for the most part have a lot to lose by >getting things wrong.

Do you believe I don't know this? >It is not some idle argument for them.  

Nor for me. >The >reality  for most posters is "excellent" doesn't describe their >relationship with fruit.  

Some type 2s, perhaps, but I would be certain that many type 2s and all type 1s would find some fruit excellent for them if they take the oft repeated advice to try a little and test, test, test. Do you think ALL fruit should be regarded as off-limits for all diabetics? Notwithstanding the fact that my original sentence was referring to the fructose in these fruits. >While fruit has desirable qualities and I am >one of their strongest advocates the word "excellent" doesn't describe >the situation as most people here see.  

Excellent to me means enjoyable and nutritious. What does it mean to you? (Of course if you have an idiosyncratic response to some fruits at some times of the day, then they aren't excellent for you, but I thought this was obvious. Sorry, I must be more careful in my observations. >"Discretion" figures more >prominently.  

For everybody, when they are trying them out, at first. If they have no adverse reaction, then they are excellent YMMV, IMHO. >Tropical fruit tends to spike many people.

Because they have more glucose, less fructose. I seem to recall someone advocating mango, but from the GI tables, this would not be a likely candidate for an excellent food for some diabetics. Of course so much depends on what you eat it with and test, test, test. > People tend >to limit themselves to what they find works for them eg two serves a >day or eating only berries or subtropical fruit.  

Highly recommended. As I said previously, there is some ongoing research here that looks like loosening some of the previous restrictions on fruit. When I hear, I will post. >Always the emphasis >in on discretion, not blanket advocacy of fruit.  

See above. Blanket advocacy of any food is surely not an underlying rule of coping with diabetes. I thought this was understood. Sorry. >Secondly, you have in other posts advocated fructose as a sweetener >for diabetics.

In preference to the same quantity of glucose. But never have I advocated adding any "sugar" IIRC. >IMHO that is very dangerous advice.  

More dangerous than using glucose? That's what you are saying. >Fruit does not >equate to fructose.  

No, but it contains most of that which we should be eating. Your postulate is that it is a dangerous substance that should be avoided, No? >Most fruit has fructose only because it contains >sucrose or fructose and glucose in the same proportions as sucrose.  

Or because it has fructose in it?  :) jl

Response:

- Hide quoted text -- Show quoted text - >This post not CC'd by email >I just did a Google on trans fats and came across the Mercola site >with a Dr Enig. >A sentence that stood our was: >"Americans eat too much fat (especially partially hydrogenated >vegetable oils) and not enough fruits and vegetables." >Seems to say it all, really. IMHO.  Well at least most of it  :) >G'day G'day Joe, >  Which part seems to say it all?   >Dr Enig is (in)famous for her politicizing of "The oiling of America." >She is not so famous for doing peer reviewed research.  To put it >mildly she is/was considered a bit of an out caste from the mainstream >of nutritional  research.  Her basic premise is that saturated fats >have been taking the bad rap for trans monounsaturated fats that are >accidentally produced in the partial hydrogenation of the seed oils eg >canola, corn, sunflower. For her saturated fats are fine and trans >fats evil. Further more she alleges all manner of cover ups for >example in estimating the amount of trans fat in the US diet.  

Yes, I thought the Mercola site seemed a bit shonky, but I asked in a few places a while ago and got no response, so I just went with my gut feeling (pun intended). No, the only bit that says it all for me was the sentence I quoted, nothing else. >That doesn't make the opinion quoted less true.   >As it happens it is a statement I could have written myself, since it >represent my beliefs pretty well.   It just means if you wish to quote >authorities it pays to know the reputation of the authority, if you >wish to take the stance of presenting the mainstream view.

Agree, I was just mentioning the site that I saw it on, during a search for trans fats. Thanks for your confirmation of my suspicions. The sentence could have been written by any sensible commentator. jl

Response:

This post not CC'd by email >Quentin, this point of view is also supported in the recent edition of >Nutrition Action newsletter, which is published by the Center for >Science in the Public Interest.  This edition is an overview of fats, >based upon the most recent research.  Good information there.  A couple >of nice charts ... one showing sources of Omega 3 fats, another with a >breakdown of 18 different fats according to percentage saturated, >monounsaturated, polyunsaturated (linoleic acid and alpha-linoleic) and >other.  Be glad to scan an email any of this if it interests you. >Richard

Thank you Richard,   One of the reasons I persist is the hope that I will learn more, especially that what I thought was true because "everyone" believes it needs revising.  Mark Twain summed it up something like this, "It ain't what you know but what you know that isn't so that bites ya." My apologies to S. Clements and all his descendants for any misquotation that may materially alter what he said. -- Quentin Grady       ^  ^  / New Zealand,       >#,#< [                     / /     "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin

Response:

This post not CC'd by email >Yep that's it.  Five times the input. >Five times the production of triglycerides. >No, half the quantity of fructose, and glucose in excess will go to >tgs as well as fructose (well almost) >See, I think we are talking at cross purposes. I'm talking about the >naturally occurring fructose in fruits, whereas you are talking about >what I would call gross excesses of its consumption.

G'day G'day Joe,   This is often at the crux of things.  It is a matter of audience. Readers here fall into a number of categories.  Here are a couple. There are those who have been here for a while.  For the most part it won't matter what either of us say.  They are doing whatever works well enough for them they aren't prepared to change.  The gains as they see it a less than the perceived rewards.   There are those who are new.  Some of them are desperately looking for a fix ... preferably a quick fix.   Many of them are habituated to diets that are high in processed sugars and fats.  It is part of the lifestyle.  There is nothing that many of them would like more than to retain that lifestyle with minimal changes eg replace refined sucrose with refined fructose.  My point is it won't change their existing patterns of consumption though they will appear to be doing better because their bg meter tells them so.   > Fats, proteins >and carbohydrates will all cause problems if consumed in excess, and >fructose is little different from all the others. Bit slower absorbed, >so less likely to cause a bg spike in a diabetic, but every 4 calories >in excess will add a gram of fat to the spare tyre  :)

-- Quentin Grady       ^  ^  / New Zealand,       >#,#< [                     / /     "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin

Response:

--snip-- >   Which part seems to say it all? > Dr Enig is (in)famous for her politicizing of "The oiling of America." > She is not so famous for doing peer reviewed research.  To put it > mildly she is/was considered a bit of an out caste from the mainstream > of nutritional  research.  Her basic premise is that saturated fats > have been taking the bad rap for trans monounsaturated fats that are > accidentally produced in the partial hydrogenation of the seed oils eg > canola, corn, sunflower. For her saturated fats are fine and trans > fats evil. Further more she alleges all manner of cover ups for > example in estimating the amount of trans fat in the US diet. > That doesn't make the opinion quoted less true.

Quentin, this point of view is also supported in the recent edition of Nutrition Action newsletter, which is published by the Center for Science in the Public Interest.  This edition is an overview of fats, based upon the most recent research.  Good information there.  A couple of nice charts ... one showing sources of Omega 3 fats, another with a breakdown of 18 different fats according to percentage saturated, monounsaturated, polyunsaturated (linoleic acid and alpha-linoleic) and other.  Be glad to scan an email any of this if it interests you. Richard

Response:

This post not CC'd by email >I just did a Google on trans fats and came across the Mercola site >with a Dr Enig. >A sentence that stood our was: >"Americans eat too much fat (especially partially hydrogenated >vegetable oils) and not enough fruits and vegetables." >Seems to say it all, really. IMHO.  Well at least most of it  :)

G'day G'day Joe,   Which part seems to say it all?   Dr Enig is (in)famous for her politicizing of "The oiling of America." She is not so famous for doing peer reviewed research.  To put it mildly she is/was considered a bit of an out caste from the mainstream of nutritional  research.  Her basic premise is that saturated fats have been taking the bad rap for trans monounsaturated fats that are accidentally produced in the partial hydrogenation of the seed oils eg canola, corn, sunflower. For her saturated fats are fine and trans fats evil. Further more she alleges all manner of cover ups for example in estimating the amount of trans fat in the US diet.     That doesn't make the opinion quoted less true.   As it happens it is a statement I could have written myself, since it represent my beliefs pretty well.   It just means if you wish to quote authorities it pays to know the reputation of the authority, if you wish to take the stance of presenting the mainstream view. -- Quentin Grady       ^  ^  / New Zealand,       >#,#< [                     / /     "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin

Response:

This post not CC'd by email >There are researchers who are of the opinion that fructose in >combination with fat is also unhealthy.   >So I believe. But if you don't add refined, hydrogenated, or other >fats to your diet and only eat the 25 to 30% that is unavoidable in >eating a whole food diet, and you don't eat refined flour, or refined >sugars, then you can't go wrong. Fruit (fructose) is excellent even >for diabetics.

G'day G'day Joe,   Sometimes people give up when confronted with a barrage of commonly held believes.  The long sentences seem to refer to refined fats and carbs. That is the barrage.  The point we are supposed to believe is contained in the short sentence, "Fruit (fructose) is excellent even for diabetics" OK.  What is a refined fat?   Is lard a refined fat? How about coconut oil? The answers are unimportant as most readers have knee jerk response to the word "refined"    There are IMHO many reasons to select less processed source of fats eg if one eats whole nuts one gets the full range of natural tocopherols ie the Vit E that works. There are also phytosterols etc. Even hydrogenated is not as simple as it seems.   When fully hydrogenated the transfats disappear.  Unfortunately most of the solid cooking compound used for deep frying still contain trans fats. It is also hard to argue with whole food.  Most people here advocate whole food.  Some on general principles. Some because it works. That brings us to the >Fruit (fructose) is excellent even for diabetics.

How would YOU know?  As I understand it you are not a diabetic. The people who post here for the most part have a lot to lose by getting things wrong. It is not some idle argument for them.  The reality  for most posters is "excellent" doesn't describe their relationship with fruit.  While fruit has desirable qualities and I am one of their strongest advocates the word "excellent" doesn't describe the situation as most people here see.   "Discretion" figures more prominently.   Tropical fruit tends to spike many people.  People tend to limit themselves to what they find works for them eg two serves a day or eating only berries or subtropical fruit.  Always the emphasis in on discretion, not blanket advocacy of fruit.   Secondly, you have in other posts advocated fructose as a sweetener for diabetics. IMHO that is very dangerous advice.  Fruit does not equate to fructose.  Most fruit has fructose only because it contains sucrose or fructose and glucose in the same proportions as sucrose.   -- Quentin Grady       ^  ^  / New Zealand,       >#,#< [                     / /     "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin

Response:

- Hide quoted text -- Show quoted text - >This post not CC'd by email >There's a bit of that, but I've heard personally from experts I've >talked to, that the fructose thing is still up in the air. >In the last day or so, I got to have a chat with a >biochemist/dietician and a diabetic centre dietician. >G'day G'day Joe, >  I don't have access to friendly biochemists locally though from time >to time people doing research write to me. So I guess it is up to me >to take up this side of the discussion without the benefit of pocket >authorities.   >   Let's take the statements one by one. > They both >explained that fructose and glucose were pretty equal in the blood. >OK so in their opinion one gram of fructose and one gram of glucose in >the blood has pretty much the same consequences.  The exceptions might >be important but for the moment lets assume they are not.   >What would be the consequence if that statement was true? >That is our question for the moment. >  If people weigh their foods and follow a diet as they might if >taking the advice of diabetic centre dietician then yes things could >be equal.  One gram of excess fructose would put on as much fat as one >gram of excess glucose.  However alt.support.diabetes is the land of >statistical weirdness for diabetics, many people here eat by their >blood glucose meters.  Whatever the case is in Australia or elsewhere, >in New Zealand most people use a meter which is specific to glucose. >Clinistix are only commonly used for urine testing.  AFAIK urine >glucose testing is uncommon amongst T2s.   >OK so let us assume, so that we can pursue at least some points to a >conclusion, that one eats to the meter, assessing safety of carb >intake by one hour and two hour post prandial blood glucose readings. >IMHO with glucose and starches the blood glucose reading gives a >reasonably  honest estimate of carb intake.  With fructose and its GI >of 19 (Rick Mendosa's site average value) those who assess safety of >carb intake will eat FIVE times as much fructose as glucose.

No they won't. Glucose and fructose are isocaloric, and so both will be restricted, and as fructose is more then twice as sweet as glucose, it can be arguest that only half will be consumed for one tenth of the glycemic effect. >The advantage of fructose was it got there much more slowly. >Yes excess fructose caused the liver to produce triglycerides, just >like excess glucose. That's it. >Yep that's it.  Five times the input. >Five times the production of triglycerides.

No, half the quantity of fructose, and glucose in excess will go to tgs as well as fructose (well almost) See, I think we are talking at cross purposes. I'm talking about the naturally occurring fructose in fruits, whereas you are talking about what I would call gross excesses of its consumption. Fats, proteins and carbohydrates will all cause problems if consumed in excess, and fructose is little different from all the others. Bit slower absorbed, so less likely to cause a bg spike in a diabetic, but every 4 calories in excess will add a gram of fat to the spare tyre  :) > Now they follow the latest research, >and have seen nothing to change their long held opinion of fructose. >It is the preferred sugar for diabetics, but a gram of it still has >four calories, and this must be always taken into account. >When someone says "It is the preferred sugar ... " that speech pattern >includes a lost performative.  The person and criteria used to make >the assessment are not explicitly stated.  

Fair enough. Bad expression, although it gives me the pip when Microscrote tries to convert everything from passive to active. What I mean is simply better -- more advantages than the comparison. >I can assume you are referring to the people you have talking to.

Nope, see above. >That would be reasonable ... however it would be pure mind reading to >guess on what basis they are making their assessment.  

The properties they expressed about these two sugars. Isocaloric, equally damaging in excess, but fructose trickle into the blood one fifth the rate that glucose does. They did mention that fructose in high levels cause liver anomalies, but this rarely happens with a good diet, whatever that means exactly, although I have my own ideas from reading the biochemist's book >An assessment based on assumptions of equal intake could be quite >different from assessments based on assumptions of equal post prandial >blood glucose outcomes.

Not sure here. Sucrose, and honey and many fruits are roughly 50:50 glucose:fructose. I have heard that high fructose corn syrup (hfcs) is also about 50:50 despite its name. Neverthless, on an unamended diet, the worst you could do would be a roughly isocaloric intake of g&f. This will cause a spike from the glucose component,and a very slow curve from the fructose component. >You might like to share this post with them >and discuss it with them.  If nothing else it will jolly up their >morning coffee/tea break conversations.

I'm sure it will. jl

Response:

This post not CC'd by email >There's a bit of that, but I've heard personally from experts I've >talked to, that the fructose thing is still up in the air. >In the last day or so, I got to have a chat with a >biochemist/dietician and a diabetic centre dietician.

G'day G'day Joe,   I don't have access to friendly biochemists locally though from time to time people doing research write to me. So I guess it is up to me to take up this side of the discussion without the benefit of pocket authorities.      Let's take the statements one by one. > They both >explained that fructose and glucose were pretty equal in the blood.

OK so in their opinion one gram of fructose and one gram of glucose in the blood has pretty much the same consequences.  The exceptions might be important but for the moment lets assume they are not.   What would be the consequence if that statement was true? That is our question for the moment.   If people weigh their foods and follow a diet as they might if taking the advice of diabetic centre dietician then yes things could be equal.  One gram of excess fructose would put on as much fat as one gram of excess glucose.  However alt.support.diabetes is the land of statistical weirdness for diabetics, many people here eat by their blood glucose meters.  Whatever the case is in Australia or elsewhere, in New Zealand most people use a meter which is specific to glucose. Clinistix are only commonly used for urine testing.  AFAIK urine glucose testing is uncommon amongst T2s.   OK so let us assume, so that we can pursue at least some points to a conclusion, that one eats to the meter, assessing safety of carb intake by one hour and two hour post prandial blood glucose readings. IMHO with glucose and starches the blood glucose reading gives a reasonably  honest estimate of carb intake.  With fructose and its GI of 19 (Rick Mendosa's site average value) those who assess safety of carb intake will eat FIVE times as much fructose as glucose. >The advantage of fructose was it got there much more slowly. >Yes excess fructose caused the liver to produce triglycerides, just >like excess glucose. That's it.

Yep that's it.  Five times the input. Five times the production of triglycerides. > Now they follow the latest research, >and have seen nothing to change their long held opinion of fructose. >It is the preferred sugar for diabetics, but a gram of it still has >four calories, and this must be always taken into account.

When someone says "It is the preferred sugar ... " that speech pattern includes a lost performative.  The person and criteria used to make the assessment are not explicitly stated.   I can assume you are referring to the people you have talking to. That would be reasonable ... however it would be pure mind reading to guess on what basis they are making their assessment.   An assessment based on assumptions of equal intake could be quite different from assessments based on assumptions of equal post prandial blood glucose outcomes. You might like to share this post with them and discuss it with them.  If nothing else it will jolly up their morning coffee/tea break conversations. Best wishes, -- Quentin Grady       ^  ^  / New Zealand,       >#,#< [                     / /     "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin

Response:

>Wow!  That was a nicely waged argument!  Ok now for the biggie.. >I'm a t2 and imo huge.  How does this affect me?  What should I be >eating not too much of?

Everything  :) Sorry, but I reckon the biggest problem is excess weight. I don't like this fact, personally, but I believe it is the truth. Apart from that, avoid foods that spike you, and highly refined carb foods (white flour, sugar etc) and cutting down on fat is how I attack calorie restriction - it's easier. You might find as a type 2, that you can increase yout protein and fat intake a little so you can reduce your carbohydrates. IMO, fructose should not be avoided in moderation, it's somewhat better for a type 2 than glucose, but as I said in the beginning, cut all of it down. jl

Response:

- Hide quoted text -- Show quoted text - >This post not CC'd by email >>>>>Syndrome X is the silent precursor of T2 diabetes and CHD. >>>See above, parents, food and work. >>Perhaps you are suggesting these are the only factors.  That could >>represent you belief.  It would form part of mine but not all of it. >Not sure what you have in mind for any other causes. I thought this >triumvirate covered all bases. It's the interconnection that is a >little confused. Chicken and egg. >G'day G'day Joe, >  Expressed as parents, food and work it probably does.  However at >one stage food was more closely defined as eating too much.  IMHO >consumption of calories in excess is a major part of the problem but >not the whole problem.  Some part of the problem is eating the wrong >sort of foods.  People have differing views on what the wrong sort of >food might be.  However there are some large scale studies that indict >specific foods eg the Nurses' study specifically indicts trans fats >not finding other fats to be causative in isocaloric diets.

I just did a Google on trans fats and came across the Mercola site with a Dr Enig. A sentence that stood our was: "Americans eat too much fat (especially partially hydrogenated vegetable oils) and not enough fruits and vegetables." Seems to say it all, really. IMHO.  Well at least most of it  :) >There are researchers who are of the opinion that fructose in >combination with fat is also unhealthy.  

So I believe. But if you don't add refined, hydrogenated, or other fats to your diet and only eat the 25 to 30% that is unavoidable in eating a whole food diet, and you don't eat refined flour, or refined sugars, then you can't go wrong. Fruit (fructose) is excellent even for diabetics. >My point here is simple, it >isn't only genetics plus the total calories input vs output that >determines whether or not one gets diabetes.  

It obviously contributes a Hell of a lot. Aboriginal people and Westerners didn't have the epidemic of diabetes until they started to overconsume, and under-exercise. Cars and manufactured foods. When I was a kid, we mowed the grass with a hand push mower. >Some of the effects with >people making a transition from subsistence diets to Western diets >have significant maternal effects that can look for all the world like >genetic effects.  

Yep, I'm sure this is part of it, but how big a part? There are many folk who can survise the Western lifestyle with elan. >The ... its all excess calories, insufficient >exercise and genetics summary ... needs to be treated cautiously.

OK, fair comment. Howsabout "Mostly excess calories, insufficient exercise and genetics" >At the very least believing it uncritically blinds one to the >possibility of discovering other facets.

I agree strongly. I have however not seen any evidence of any problem not easily put at the door of excessive consumption. My diet isn't perfect. It is excessive. It contains too much meat. When my overseas visitors naff off home, We will be reducing meat consumption for health and cost factors, and reducing consumption overall, and increasing exercise -- my orthopaedic injuries will be back to my pre-accident status. We eat NO spreads (butter, marg etc) (except a smear of low fat cheese spread on the dry wholegrain toast for breakfast) We use very little olive oil. And skim milk in out tea. We bake our own whole grain bread. It will get perfecter and perfecter. There will be no "trans" fats, and the same amount of fructose as out cave dwelling fourbears jl     [hopefully]

Response:

This post not CC’d by email >>>>Syndrome X is the silent precursor of T2 diabetes and CHD. >>See above, parents, food and work. >Perhaps you are suggesting these are the only factors.  That could >represent you belief.  It would form part of mine but not all of it. >Not sure what you have in mind for any other causes. I thought this >triumvirate covered all bases. It’s the interconnection that is a >little confused. Chicken and egg.

G’day G’day Joe,   Expressed as parents, food and work it probably does.  However at one stage food was more closely defined as eating too much.  IMHO consumption of calories in excess is a major part of the problem but not the whole problem.  Some part of the problem is eating the wrong sort of foods.  People have differing views on what the wrong sort of food might be.  However there are some large scale studies that indict specific foods eg the Nurses’ study specifically indicts trans fats not finding other fats to be causative in isocaloric diets. There are researchers who are of the opinion that fructose in combination with fat is also unhealthy.  My point here is simple, it isn’t only genetics plus the total calories input vs output that determines whether or not one gets diabetes.  Some of the effects with people making a transition from subsistence diets to Western diets have significant maternal effects that can look for all the world like genetic effects.  The … its all excess calories, insufficient exercise and genetics summary … needs to be treated cautiously. At the very least believing it uncritically blinds one to the possibility of discovering other facets. — Quentin Grady       ^  ^  / New Zealand,       >#,#< [                     / /     "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin

Response:

Wow!  That was a nicely waged argument!  Ok now for the biggie.. I'm a t2 and imo huge.  How does this affect me?  What should I be eating not too much of? regards Martin.

- Hide quoted text -- Show quoted text ->  I attempted to summarize an article in New Scientist.  It could be >tempting to interpret that article.  Whatever the cause the essential >point being made is that T2 diabetes, elevated triglycerides and high >blood pressure are metabolic disorders that are often somehow related. >If choosing wrong parents, eating too much and not exercise enough is >a factor in T2 diabetes then it is also likely to be a factor in >elevated triglycerides and high blood pressure. > Of course. It seems to be unclear as to what causes what. Overweight > seems to cause blood fat aberrations, hypertension, and IR, but then > there is apparently some evidence that may point to these being the > *result* of something, not the cause. >>>>It is called Syndrome X. >>>>While it is a YMMV thing the three underlying features are >>>>1. high triglycerides, >>>>2. high blood pressure, >>>>3. insulin resistance. >>>>Syndrome X is the silent precursor of T2 diabetes and CHD. >>See above, parents, food and work. >Perhaps you are suggesting these are the only factors.  That could >represent you belief.  It would form part of mine but not all of it. > Not sure what you have in mind for any other causes. I thought this > triumvirate covered all bases. It's the interconnection that is a > little confused. Chicken and egg. >>>>The "New Scientist" article 1 Sept 2001 is worth the read if you can >>>>find a copy.  It has some colour diagrams that make the concepts >>>>expressed in the article even clearer. >>From your summary, it appears that this work has been pushed by Zammit >>for a decade or more. >>Many apparently disagree with him. >Since the issue is of importance I am not only interested in who >disagree with him but in why they disagree.  The only argument worth >winning for any of us is how to live with this condition. > Exactly. And the caution message that I get, is not to be too extreme > in any lifestyle choice, but to perhaps take a middle road, unless > there is clear, incontrovertable agreement that some things should be > followed, like reducing high BGs. >>>>Insulin normally STOPS the liver from releasing fats escorted around >>>>the blood stream as VLDL after a meal.  This is important because the >>>>enzymes that would remove the fats are busy dealing with fats from the >>>>meal.  If this doesn't happen then follow on processes lead to >>>>arterial blockages. >>>>Zammit's rat research shows the OFF switch fails when the diet >>>>contains frequent high energy snacks.  Insulin now PROMOTES fat >>>>release from the liver. >>>>It is as though the wiring for the fat release switch has been >>>>reversed. >>>>That begins a vicious cycle. >>>>High circulating fats make muscle cells insulin resistant. >>>>More insulin is produced. >>>>Eventually the adipose cells where fat gets stored get insulin >>>>resistant as well.  The excess circulating fat kills off insulin >>>>secreting pancreatic cells, insulin drops and that is how many of us >>>>arrived at alt.support.diabetes or misc.health.diabetes >>Nice theory, but who agrees with it? >I assume the question is rhetorical. > Just really a comment that much of the "ways" are still up in the air. >>>>Fructose is SELECTIVELY shunted towards the liver and the formation of >>>>fats. >>Just like glucose. >OK.  That is not how I understood things to be. My understanding is >that the liver deals with fructose in preference to glucose. > Perhaps, but by how much? If fructose is trickled into the bloodstream > so slowly.... > Bodyfat is made out of ingested triglycerides and glucose in the huge > majority. Any excess hexoses are converted to triglycerides. > Does it really matter whether fructose goes first or glucose does? >Perhaps >there is a better way of expressing this but high blood glucose levels >occur whereas high blood fructose levels don't. > Well that seems good, as frutosylation of proteins is less likely to > occur. If the diet is maintenance or less, then fructose will be > absorbed into cells and used for metabolic energy. > Glucose quick, fructose slow. Just what a body chased by sabre-toothed > tigers require, I would have thought. >This could be accounted for by the slow absorption of fructose >relative to glucose but personally I think there is another factor >operating. > I wouldn't be at all surprised. I just wish someone could point me to > it. I've read and looked and so far found little (except in bloody > Turkish >IMHO the liver preferentially gets rid of fructose.  It >seems to be what Zammit is saying.  I am interested in what other >active researchers in the field are saying. > Me too. It is clear from my readings that fructose is passively > absorbed into the bloodstream from the small intestine, as opposed to > glucose and galactose's active transport across this barrier. > What this has to do with speed of absorption, I am only guessing. > Fructose, when it is absorbed can be converted to glucose (and I think > much is) or absorbed directly (as fructose 6-phosphate) into the cells > as energy. Galactose cannot be used thus and all of it must be > converted to glucose where glucose 6-phosphate can be absorbed into > the body cells for energy. > Any excess glucose or fructose may be stored temporarily in the liver > as glycogen, and then converted to triglycerides for more longterm > storage in fat cells. This tg production is carried in the > bloodstream, affecting blood lipids, and thus it is excess input over > energy needs that are primarily responsible. IMO so far  :) >>>It provides one of the building blocks for triglycerides ie >>>>fats. >>But most tg fat not from ingested fatty acids is made from excess >>glucose in the liver. >The statement refers to fructose as ONE of the building blocks ... > Well all excess energy will end up round the tum eventually. > Glucose, fructose, same thing, and I don't know why it is important > which goes first. >>>>Fructose also directly stimulates the liver to release >>>>triglycerides. >You don't seem to be disagreeing with this statement. > I don't know. Are you saying that it "stimulates" without being > converted to triglycerides? Doesn't glucose "stimulate" tg production > by being turned into it? >>Amongst other things. The beauty of fructose is that it only arrives >>in a trickle. >When you use the word "beauty" I have to recognise that you have an >opinion about fructose. > Nah, it's probably just my trans-Tasman propensity for hyperbole and > understatement  :) > I really just mean "a possible advantage". Sorry. >This is where our discussions are important. >My opinion that while fructose has a low GI it isn't necessarily safe >for T2 diabetics is well known to any regular reader. > This is only very recent. Frucose is well documented in older > reference books as "a very sweet sugar suitable for diabetics" > Many "experts still hold to this. Are they wrong? I don't know. Some > say yes, and some say no. > [the experts I have so recently asked about this say that nothing has > changed] >Here it appears >you have taken a different position. > Purely agnosticism, with a bit of Devil’s Advocate thrown in. > I’m wary of apparent divergences from long-held knowledge without some > solid convincing — must be getting old and conservative  :) >That is OK so long as we thrash >out what we can regarding the truth of each and any of our >assumptions. > Great. That’s what this forum is so good for. I’m learning heaps. >To put the issues bluntly here is how I think we are polarized. >Quentin: Fructose is more dangerous than glucose. >Joe:     Fructose is less dangerous than glucose. > That’s probably a succinct statement of out positions. >If your opinion differs from the one stated please correct the >statement. >Perhaps you are playing devil’s advocate.  That’s cool. > There’s a bit of that, but I’ve heard personally from experts I’ve > talked to, that the fructose thing is still up in the air. > In the last day or so, I got to have a chat with a > biochemist/dietician and a diabetic centre dietician. They both > explained that fructose and glucose were pretty equal in the blood. > The advantage of fructose was it got there much more slowly. > Yes excess fructose caused the liver to produce triglycerides, just > like excess glucose. That’s it. Now they follow the latest research, > and have seen nothing to change their long held opinion of fructose. > It is the preferred sugar for diabetics, but a gram of it still has > four calories, and this must be always taken into account. >>>>John Bantle, University of Minnesota. >>>>Two dozen healthy volunteers were fed a diet with 17% of calories as >>>>fructose and then a diet nearly devoid of fructose.  The effects were >>>>worse for men. They turned out to be more sensitive to fructose than >>>>women. >>He did this in Nov 1992, I believe. Why have we heard nothing much >>since. >Oh.  There have been some regarding the benefits of fruit.  Fruit >consumption seems to be beneficial for women but not for men. > According to ongoing research here, fruit is fine for diabetics, so > long as it is spread out at least two hours between tennis ball sized > portions. The research is saying that this may be relaxed, apparently. > [type 1 only AFAIK] >What >the real

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This post not CC’d by email >For myself the take home message is cut the snacks. > >>>Eat regular meals. >By this I presume to cut the cakes, bikkies and ice-cream from in >between meals and not the "Jan Diet"

G’day G’day Jan,   There is often discussion about what people evolved to eat.   I find it easier to recognise what they didn’t evolve to eat. It is hard to imagine a scenario where primitive people had access to large amounts of sugar and fat at the same time eg as in icecream, confectionery, energy bars.   IMHO it is artifact of the industrial age.   Here are some US dietary figures for the source of carbs in their diet, (USDA National Food Review 1987). Sugar         40% Grains        36% Fruits         7% Dairy          6% Potatoes       5% Vegetables     4% Legumes&nuts   2% Without the rolling mills to crush the sugar cane or clever chemists using enzymes to convert corn syrup into high fructose corn syrup sweetener the top item of the list disappears. The percentage of fructose as a contributed to carbs backs off from something like 20% to say 5%.  At that level there is some evidence it is beneficial compared to straight glucose substrates like starch. Best wishes, — Quentin Grady       ^  ^  / New Zealand,       >#,#< [                     / /     "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin

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http://www.faqs.org/faqs/diabetes/ > doesn't address personal responsibility for preventing T2 from > happening to others, especially the innocent others namely children.

Yes, especially when there are kids already with the genetic background.  Like my kids.  Both parents, a bunch of grandparents, great grandparents and great aunts and uncles in the lineage.  Or my little Jasmine. People with Down syndrome have a higher risk of developing diabetes than the average population.  She also has asthma, sometimes needing steroids which makes her little bg's soar! Poor child has a triple whammy as well as not having the mental capacity to understand why she can't have as much food as she wants.  We have quite the battles sometimes.

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>  I attempted to summarize an article in New Scientist.  It could be >tempting to interpret that article.  Whatever the cause the essential >point being made is that T2 diabetes, elevated triglycerides and high >blood pressure are metabolic disorders that are often somehow related. >If choosing wrong parents, eating too much and not exercise enough is >a factor in T2 diabetes then it is also likely to be a factor in >elevated triglycerides and high blood pressure.  

Of course. It seems to be unclear as to what causes what. Overweight seems to cause blood fat aberrations, hypertension, and IR, but then there is apparently some evidence that may point to these being the *result* of something, not the cause. >>>It is called Syndrome X.   >>>While it is a YMMV thing the three underlying features are >>>1. high triglycerides, >>>2. high blood pressure, >>>3. insulin resistance. >>>Syndrome X is the silent precursor of T2 diabetes and CHD. >See above, parents, food and work. >Perhaps you are suggesting these are the only factors.  That could >represent you belief.  It would form part of mine but not all of it.

Not sure what you have in mind for any other causes. I thought this triumvirate covered all bases. It's the interconnection that is a little confused. Chicken and egg. >>>The "New Scientist" article 1 Sept 2001 is worth the read if you can >>>find a copy.  It has some colour diagrams that make the concepts >>>expressed in the article even clearer. >From your summary, it appears that this work has been pushed by Zammit >for a decade or more. >Many apparently disagree with him. >Since the issue is of importance I am not only interested in who >disagree with him but in why they disagree.  The only argument worth >winning for any of us is how to live with this condition.

Exactly. And the caution message that I get, is not to be too extreme in any lifestyle choice, but to perhaps take a middle road, unless there is clear, incontrovertable agreement that some things should be followed, like reducing high BGs. - Hide quoted text -- Show quoted text ->>>Insulin normally STOPS the liver from releasing fats escorted around >>>the blood stream as VLDL after a meal.  This is important because the >>>enzymes that would remove the fats are busy dealing with fats from the >>>meal.  If this doesn't happen then follow on processes lead to >>>arterial blockages. >>>Zammit's rat research shows the OFF switch fails when the diet >>>contains frequent high energy snacks.  Insulin now PROMOTES fat >>>release from the liver.   >>>It is as though the wiring for the fat release switch has been >>>reversed. >>>That begins a vicious cycle.   >>>High circulating fats make muscle cells insulin resistant. >>>More insulin is produced. >>>Eventually the adipose cells where fat gets stored get insulin >>>resistant as well.  The excess circulating fat kills off insulin >>>secreting pancreatic cells, insulin drops and that is how many of us >>>arrived at alt.support.diabetes or misc.health.diabetes >Nice theory, but who agrees with it? >I assume the question is rhetorical.

Just really a comment that much of the "ways" are still up in the air. >>>Fructose is SELECTIVELY shunted towards the liver and the formation of >>>fats.   >Just like glucose. >OK.  That is not how I understood things to be. My understanding is >that the liver deals with fructose in preference to glucose.  

Perhaps, but by how much? If fructose is trickled into the bloodstream so slowly.... Bodyfat is made out of ingested triglycerides and glucose in the huge majority. Any excess hexoses are converted to triglycerides. Does it really matter whether fructose goes first or glucose does? >Perhaps >there is a better way of expressing this but high blood glucose levels >occur whereas high blood fructose levels don't.  

Well that seems good, as frutosylation of proteins is less likely to occur. If the diet is maintenance or less, then fructose will be absorbed into cells and used for metabolic energy. Glucose quick, fructose slow. Just what a body chased by sabre-toothed tigers require, I would have thought. >This could be accounted for by the slow absorption of fructose >relative to glucose but personally I think there is another factor >operating.

I wouldn't be at all surprised. I just wish someone could point me to it. I've read and looked and so far found little (except in bloody Turkish >IMHO the liver preferentially gets rid of fructose.  It >seems to be what Zammit is saying.  I am interested in what other >active researchers in the field are saying.  

Me too. It is clear from my readings that fructose is passively absorbed into the bloodstream from the small intestine, as opposed to glucose and galactose's active transport across this barrier. What this has to do with speed of absorption, I am only guessing. Fructose, when it is absorbed can be converted to glucose (and I think much is) or absorbed directly (as fructose 6-phosphate) into the cells as energy. Galactose cannot be used thus and all of it must be converted to glucose where glucose 6-phosphate can be absorbed into the body cells for energy. Any excess glucose or fructose may be stored temporarily in the liver as glycogen, and then converted to triglycerides for more longterm storage in fat cells. This tg production is carried in the bloodstream, affecting blood lipids, and thus it is excess input over energy needs that are primarily responsible. IMO so far  :) >>It provides one of the building blocks for triglycerides ie >>>fats.   >But most tg fat not from ingested fatty acids is made from excess >glucose in the liver. >The statement refers to fructose as ONE of the building blocks ...

Well all excess energy will end up round the tum eventually. Glucose, fructose, same thing, and I don't know why it is important which goes first. >>>Fructose also directly stimulates the liver to release >>>triglycerides. >You don't seem to be disagreeing with this statement.

I don't know. Are you saying that it "stimulates" without being converted to triglycerides? Doesn't glucose "stimulate" tg production by being turned into it? >Amongst other things. The beauty of fructose is that it only arrives >in a trickle. >When you use the word "beauty" I have to recognise that you have an >opinion about fructose.  

Nah, it's probably just my trans-Tasman propensity for hyperbole and understatement  :) I really just mean "a possible advantage". Sorry. >This is where our discussions are important. >My opinion that while fructose has a low GI it isn't necessarily safe >for T2 diabetics is well known to any regular reader.  

This is only very recent. Frucose is well documented in older reference books as "a very sweet sugar suitable for diabetics" Many "experts still hold to this. Are they wrong? I don't know. Some say yes, and some say no. [the experts I have so recently asked about this say that nothing has changed] >Here it appears >you have taken a different position.  

Purely agnosticism, with a bit of Devil’s Advocate thrown in. I’m wary of apparent divergences from long-held knowledge without some solid convincing — must be getting old and conservative  :) >That is OK so long as we thrash >out what we can regarding the truth of each and any of our >assumptions.  

Great. That’s what this forum is so good for. I’m learning heaps. >To put the issues bluntly here is how I think we are polarized. >Quentin: Fructose is more dangerous than glucose. >Joe:     Fructose is less dangerous than glucose.

That’s probably a succinct statement of out positions. >If your opinion differs from the one stated please correct the >statement. >Perhaps you are playing devil’s advocate.  That’s cool.

There’s a bit of that, but I’ve heard personally from experts I’ve talked to, that the fructose thing is still up in the air. In the last day or so, I got to have a chat with a biochemist/dietician and a diabetic centre dietician. They both explained that fructose and glucose were pretty equal in the blood. The advantage of fructose was it got there much more slowly. Yes excess fructose caused the liver to produce triglycerides, just like excess glucose. That’s it. Now they follow the latest research, and have seen nothing to change their long held opinion of fructose. It is the preferred sugar for diabetics, but a gram of it still has four calories, and this must be always taken into account. >>>John Bantle, University of Minnesota. >>>Two dozen healthy volunteers were fed a diet with 17% of calories as >>>fructose and then a diet nearly devoid of fructose.  The effects were >>>worse for men. They turned out to be more sensitive to fructose than >>>women.   >He did this in Nov 1992, I believe. Why have we heard nothing much >since. >Oh.  There have been some regarding the benefits of fruit.  Fruit >consumption seems to be beneficial for women but not for men.  

According to ongoing research here, fruit is fine for diabetics, so long as it is spread out at least two hours between tennis ball sized portions. The research is saying that this may be relaxed, apparently. [type 1 only AFAIK] >What >the real reason for this is I don’t know but it does fit with the idea >that men are more sensitive to fructose than women.

Sorry, sensitive in what way? Is it absorbed faster in men? – Hide quoted text — Show quoted text ->>>The order of sensitivity to fructose is rats, men and lastly women. >>>Draw your own conclusions on that one.  <grin> >>>The high fructose diet increased triglycerides by 32% in men and worse >>>the liver spewed them out after meals when fat would normally be high. >>>Put simply the after dinner fat spike damages the arteries. >>>(As an aside, the average American diet has 40% calories from sugar >>>and high fructose corn syrup. That means

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>For myself the take home message is cut the snacks. >>>Eat regular meals.

By this I presume to cut the cakes, bikkies and ice-cream from in between meals and not the "Jan Diet"

Response:

This post not CC’d by email – Hide quoted text — Show quoted text -> This post not CC’d by email > Since the issue is of importance I am not only interested in who > disagree with him but in why they disagree.  The only argument >worth > winning for any of us is how to live with this condition. >(All else snipped to comment on this particular insight). >I wish all the people who get interested in these kind of research >questions would keep in mind what the bottom line is, as you so >obviously do, Quentin. Sadly, some seem to get more interested in >winning the "argument" or point scoring than the original purpose >for which this research is supposed to be intended, i.e. to raise >the health levels of the general population in regard to Syndrome X >and T2 DM. >I am selfish enough to want to live a longer and more productive >life, but the lately  the focus is shifting to the alarming increase >in children (under 20 years of age) who are being dx’d with T2.  (I >recently discussed this with a person who attended the conference in >China, at which leading health professionals, whose interest is in >diabetes, and were from all over the globe,  rated this as the most >urgent problem relating to diet at the moment. )  She called it an >"explosion" of T2 in children.

G’day G’day Annette, Thank you for reminding me of this.  When I said "The only argument worth winning for any of us is how to live with this condition." that doesn’t address personal responsibility for preventing T2 from happening to others, especially the innocent others namely children. Frankly I find shouldering that responsibility overwhelming.  Or least that is how it feels.  I know only to well that I intended to get the issue of trans fats in fast food in New Zealand on the political agenda for the upcoming elections.   The election is on Saturday and political awareness of this issue is zip.   An official US statement rated one soft drink per day as sufficient to raise the risk of obesity in teenagers by 60%.  When one considers the influence of advertising and peer pressure those who consider holding back the tide have to realise what they are up against. >The US is not the only country so afflicted.  This is an issue that >is affecting a lot of developed nations.

An in a lot less affluent countries who will be less able to "fix" the problems with high tech solutions like laser eye surgery etc. >It is trite, but true – >children are our future.  We better get it right, and soon. >Annette

Thanks Annette, — Quentin Grady       ^  ^  / New Zealand,       >#,#< [                     / /     "… and the blind dog was leading." http://homepages.paradise.net.nz/quentin

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> This post not CC’d by email > Since the issue is of importance I am not only interested in who > disagree with him but in why they disagree.  The only argument worth > winning for any of us is how to live with this condition.

(All else snipped to comment on this particular insight). I wish all the people who get interested in these kind of research questions would keep in mind what the bottom line is, as you so obviously do, Quentin. Sadly, some seem to get more interested in winning the "argument" or point scoring than the original purpose for which this research is supposed to be intended, i.e. to raise the health levels of the general population in regard to Syndrome X and T2 DM. I am selfish enough to want to live a longer and more productive life, but the lately  the focus is shifting to the alarming increase in children (under 20 years of age) who are being dx’d with T2.  (I recently discussed this with a person who attended the conference in China, at which leading health professionals, whose interest is in diabetes, and were from all over the globe,  rated this as the most urgent problem relating to diet at the moment. )  She called it an "explosion" of T2 in children. The US is not the only country so afflicted.  This is an issue that is affecting a lot of developed nations. It is trite, but true – children are our future.  We better get it right, and soon. Annette

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This post not CC’d by email – Hide quoted text — Show quoted text ->G’day G’day Folks, >  In a thread on glycemic index Joe asked if I could repost a summary >I made of an article in New Scientist.   Here it is, >>  From time to time posters express surprise that their triglycerides >>or blood pressure is high.   >They chose the wrong parents, eat too much, and don’t exercise enough.

G’day G’day Joe,   I attempted to summarize an article in New Scientist.  It could be tempting to interpret that article.  Whatever the cause the essential point being made is that T2 diabetes, elevated triglycerides and high blood pressure are metabolic disorders that are often somehow related. If choosing wrong parents, eating too much and not exercise enough is a factor in T2 diabetes then it is also likely to be a factor in elevated triglycerides and high blood pressure.   >>As if having insulin resistance and a >>diagnosis of T2 diabetes isn’t enough there are these other issues to >>deal with.  Well in one sense they are all part of the same syndrome. >>It is called Syndrome X.   >>While it is a YMMV thing the three underlying features are >>1. high triglycerides, >>2. high blood pressure, >>3. insulin resistance. >>Syndrome X is the silent precursor of T2 diabetes and CHD. >See above, parents, food and work.

Perhaps you are suggesting these are the only factors.  That could represent you belief.  It would form part of mine but not all of it. >>The "New Scientist" article 1 Sept 2001 is worth the read if you can >>find a copy.  It has some colour diagrams that make the concepts >>expressed in the article even clearer. >From your summary, it appears that this work has been pushed by Zammit >for a decade or more. >Many apparently disagree with him.

Since the issue is of importance I am not only interested in who disagree with him but in why they disagree.  The only argument worth winning for any of us is how to live with this condition. – Hide quoted text — Show quoted text ->>What I’d like to do is present a summary of what is said in the >>article.   >>There are moments when I have had to rethink my beliefs and times when >>the writers confirm what I have read elsewhere and come to believe.   >>I have vigorously summarized the points of view. >>They are not literal quotes. >>Victor Zammit, head of cell biochemistry Hannah Research Institute. >>High levels of dietary saturated fats are bad. >>Under some circumstances the liver pours out saturated fats. >>Grazing pattern eating is a likely culprit. >As triglycerides are the method of longer term energy storage and a >source of some energy requirements, it is reasonable that the liver >shunts them around the place. Some are unavoidable in foods. >>Insulin normally STOPS the liver from releasing fats escorted around >>the blood stream as VLDL after a meal.  This is important because the >>enzymes that would remove the fats are busy dealing with fats from the >>meal.  If this doesn’t happen then follow on processes lead to >>arterial blockages. >>Zammit’s rat research shows the OFF switch fails when the diet >>contains frequent high energy snacks.  Insulin now PROMOTES fat >>release from the liver.   >>It is as though the wiring for the fat release switch has been >>reversed. >>That begins a vicious cycle.   >>High circulating fats make muscle cells insulin resistant. >>More insulin is produced. >>Eventually the adipose cells where fat gets stored get insulin >>resistant as well.  The excess circulating fat kills off insulin >>secreting pancreatic cells, insulin drops and that is how many of us >>arrived at alt.support.diabetes or misc.health.diabetes >Nice theory, but who agrees with it?

I assume the question is rhetorical. >>What is to be done about it? >>Christina Koutsari and Adrianne Hardman, University of Loughborough. >>Moderate daily exercise reduces circulating fats. >>Zammit again. >>1  Eat less often. Leave 4 or 5 hours between meals. >>2  More alcohol than 2 glasses of wine per day causes the liver to >>churn out fats. >>3. Foods high in fructose eg table sugar could be a bad as saturated >>fat and alcohol. >Note the COULD. I’m not disagreeing, but it’s one researcher’s theory.

Agreed. >>Fructose is SELECTIVELY shunted towards the liver and the formation of >>fats.   >Just like glucose.

OK.  That is not how I understood things to be. My understanding is that the liver deals with fructose in preference to glucose.  Perhaps there is a better way of expressing this but high blood glucose levels occur whereas high blood fructose levels don’t.   This could be accounted for by the slow absorption of fructose relative to glucose but personally I think there is another factor operating. IMHO the liver preferentially gets rid of fructose.  It seems to be what Zammit is saying.  I am interested in what other active researchers in the field are saying.   >It provides one of the building blocks for triglycerides ie >>fats.   >But most tg fat not from ingested fatty acids is made from excess >glucose in the liver.

The statement refers to fructose as ONE of the building blocks … >>Fructose also directly stimulates the liver to release >>triglycerides.

You don’t seem to be disagreeing with this statement. >Amongst other things. The beauty of fructose is that it only arrives >in a trickle.

When you use the word "beauty" I have to recognise that you have an opinion about fructose.   This is where our discussions are important. My opinion that while fructose has a low GI it isn’t necessarily safe for T2 diabetics is well known to any regular reader.  Here it appears you have taken a different position.  That is OK so long as we thrash out what we can regarding the truth of each and any of our assumptions.   To put the issues bluntly here is how I think we are polarized. Quentin: Fructose is more dangerous than glucose. Joe:     Fructose is less dangerous than glucose. If your opinion differs from the one stated please correct the statement. Perhaps you are playing devil’s advocate.  That’s cool. >>John Bantle, University of Minnesota. >>Two dozen healthy volunteers were fed a diet with 17% of calories as >>fructose and then a diet nearly devoid of fructose.  The effects were >>worse for men. They turned out to be more sensitive to fructose than >>women.   >He did this in Nov 1992, I believe. Why have we heard nothing much >since.

Oh.  There have been some regarding the benefits of fruit.  Fruit consumption seems to be beneficial for women but not for men.  What the real reason for this is I don’t know but it does fit with the idea that men are more sensitive to fructose than women. – Hide quoted text — Show quoted text ->>The order of sensitivity to fructose is rats, men and lastly women. >>Draw your own conclusions on that one.  <grin> >>The high fructose diet increased triglycerides by 32% in men and worse >>the liver spewed them out after meals when fat would normally be high. >>Put simply the after dinner fat spike damages the arteries. >>(As an aside, the average American diet has 40% calories from sugar >>and high fructose corn syrup. That means the average American diet has >>at least 20% of calories by fructose.  The Okinawans have a much lower >>fructose diet though reasonably high carb diet. Mostly this is because >>they eat vegetables fish, rice, noodles, tofu and much less sugar and >>fruit than Americans.) >>David Barker University of Southhampton >>Genetic susceptibility to Syndrome X varies though the genes >>responsible have yet to be tracked down. Undernourishment of the fetus >>and in early infancy can predispose people to Syndrome X later in >>life.

You will notice that the article address the issue of genetics but makes the point that choosing your mother’s diet is also significant. – Hide quoted text — Show quoted text ->>How much fructose are you getting? >>Teaspoon of sugar     2 grams >>Teaspoon of honey     2 grams >>Can of cola (330 ml) 15 grams >>Chocolate bar (100g) 25 grams >>Bowl of cereal        3 grams >>Serving of carrots    0.25 gram. >>Len Storlein >>Instead of struggling to reduce fat overall, switch to olive oil, >>marine fish oil. These suppress the liver’s release of triglycerides.   >But of course these are triglycerides themselves. >They must travel about in the bloodstream until they are either burnt >or stored.

Does that mean marine oils doesn’t suppress the liver’s release of triglycerides? >>Eating low GI foods is more controversial.  (Some foods get their low >>GI from fructose.   >Because it moves from the gut to the bloodstream so slowly?

And because the conversion of fructose to glucose is inefficient. The blood glucose tests pick up glucose not fructose. >Where the low GI is attributable to the slowly >>digestible starch amylose rather than amylopectin, low GI helps.)   >Allowing the slow transfer of glucose from the gut to the bloodstream. >>Best wishes, >>Hope this helps clarify some issues that have clearly worried some >>people.  For myself the take home message is cut the snacks. >>Eat regular meals. >Seems reasonable, but then there is good evidence that snacking or >many meals has advantages for some. >jl

– Quentin Grady       ^  ^  / New Zealand,       >#,#< [                     / /     "… and the blind dog was leading." http://homepages.paradise.net.nz/quentin

Response:

>HI Quentin… >Well that certainly sounds like me. >So are we also saying that letting the insulin do the work of >regulalting our blood sugar levels isn’t good either?  It seems that >diet is the only thing that really is important.  I suppose that is >the message that we have had drummed into us in the UK all our lives. >A sensible balanced diet with only a little meat and lots of veggies. >Try and get the majority of our calories from complex carbs! >Is there a direct link between the level of obesity and insulin >resistance and high triglycerides?

I believe so. The most important quality of diet is excess calories over expenditure over a long period, unless you are diabetic or on the way. jl

Response:

HI Quentin… Well that certainly sounds like me. So are we also saying that letting the insulin do the work of regulalting our blood sugar levels isn’t good either?  It seems that diet is the only thing that really is important.  I suppose that is the message that we have had drummed into us in the UK all our lives. A sensible balanced diet with only a little meat and lots of veggies. Try and get the majority of our calories from complex carbs! Is there a direct link between the level of obesity and insulin resistance and high triglycerides? What about the plant estols(?) such as Benecol.. do they really work? Is there a diet sheet that lists foods good for syndrome x sufferers? Thanks for the repost. Martin.

– Hide quoted text — Show quoted text -> G’day G’day Folks, >   In a thread on glycemic index Joe asked if I could repost a summary > I made of an article in New Scientist.   Here it is, >  From time to time posters express surprise that their triglycerides >or blood pressure is high.  As if having insulin resistance and a >diagnosis of T2 diabetes isn’t enough there are these other issues to >deal with.  Well in one sense they are all part of the same syndrome. >It is called Syndrome X. >While it is a YMMV thing the three underlying features are >1. high triglycerides, >2. high blood pressure, >3. insulin resistance. >Syndrome X is the silent precursor of T2 diabetes and CHD. >The "New Scientist" article 1 Sept 2001 is worth the read if you can >find a copy.  It has some colour diagrams that make the concepts >expressed in the article even clearer. >What I’d like to do is present a summary of what is said in the >article. >There are moments when I have had to rethink my beliefs and times when >the writers confirm what I have read elsewhere and come to believe. >I have vigorously summarized the points of view. >They are not literal quotes. >Victor Zammit, head of cell biochemistry Hannah Research Institute. >High levels of dietary saturated fats are bad. >Under some circumstances the liver pours out saturated fats. >Grazing pattern eating is a likely culprit. >Insulin normally STOPS the liver from releasing fats escorted around >the blood stream as VLDL after a meal.  This is important because the >enzymes that would remove the fats are busy dealing with fats from the >meal.  If this doesn’t happen then follow on processes lead to >arterial blockages. >Zammit’s rat research shows the OFF switch fails when the diet >contains frequent high energy snacks.  Insulin now PROMOTES fat >release from the liver. >It is as though the wiring for the fat release switch has been >reversed. >That begins a vicious cycle. >High circulating fats make muscle cells insulin resistant. >More insulin is produced. >Eventually the adipose cells where fat gets stored get insulin >resistant as well.  The excess circulating fat kills off insulin >secreting pancreatic cells, insulin drops and that is how many of us >arrived at alt.support.diabetes or misc.health.diabetes >What is to be done about it? >Christina Koutsari and Adrianne Hardman, University of Loughborough. >Moderate daily exercise reduces circulating fats. >Zammit again. >1  Eat less often. Leave 4 or 5 hours between meals. >2  More alcohol than 2 glasses of wine per day causes the liver to >churn out fats. >3. Foods high in fructose eg table sugar could be a bad as saturated >fat and alcohol. >Fructose is SELECTIVELY shunted towards the liver and the formation of >fats.  It provides one of the building blocks for triglycerides ie >fats.  Fructose also directly stimulates the liver to release >triglycerides. >John Bantle, University of Minnesota. >Two dozen healthy volunteers were fed a diet with 17% of calories as >fructose and then a diet nearly devoid of fructose.  The effects were >worse for men. They turned out to be more sensitive to fructose than >women. >The order of sensitivity to fructose is rats, men and lastly women. >Draw your own conclusions on that one.  <grin> >The high fructose diet increased triglycerides by 32% in men and worse >the liver spewed them out after meals when fat would normally be high. >Put simply the after dinner fat spike damages the arteries. >(As an aside, the average American diet has 40% calories from sugar >and high fructose corn syrup. That means the average American diet has >at least 20% of calories by fructose.  The Okinawans have a much lower >fructose diet though reasonably high carb diet. Mostly this is because >they eat vegetables fish, rice, noodles, tofu and much less sugar and >fruit than Americans.) >David Barker University of Southhampton >Genetic susceptibility to Syndrome X varies though the genes >responsible have yet to be tracked down. Undernourishment of the fetus >and in early infancy can predispose people to Syndrome X later in >life. >How much fructose are you getting? >Teaspoon of sugar     2 grams >Teaspoon of honey     2 grams >Can of cola (330 ml) 15 grams >Chocolate bar (100g) 25 grams >Bowl of cereal        3 grams >Serving of carrots    0.25 gram. >Len Storlein >Instead of struggling to reduce fat overall, switch to olive oil, >marine fish oil. These suppress the liver’s release of triglycerides. >Eating low GI foods is more controversial.  (Some foods get their low >GI from fructose.  Where the low GI is attributable to the slowly >digestible starch amylose rather than amylopectin, low GI helps.) >Best wishes, >Hope this helps clarify some issues that have clearly worried some >people.  For myself the take home message is cut the snacks. >Eat regular meals. > — > Quentin Grady       ^  ^  / > New Zealand,       >#,#< [ >                     / / > "… and the blind dog was leading." > http://homepages.paradise.net.nz/quentin

Response:

>G’day G’day Folks, >  In a thread on glycemic index Joe asked if I could repost a summary >I made of an article in New Scientist.   Here it is, >  From time to time posters express surprise that their triglycerides >or blood pressure is high.  

They chose the wrong parents, eat too much, and don’t exercise enough. >As if having insulin resistance and a >diagnosis of T2 diabetes isn’t enough there are these other issues to >deal with.  Well in one sense they are all part of the same syndrome. >It is called Syndrome X.   >While it is a YMMV thing the three underlying features are >1. high triglycerides, >2. high blood pressure, >3. insulin resistance. >Syndrome X is the silent precursor of T2 diabetes and CHD.

See above, parents, food and work. >The "New Scientist" article 1 Sept 2001 is worth the read if you can >find a copy.  It has some colour diagrams that make the concepts >expressed in the article even clearer.

From your summary, it appears that this work has been pushed by Zammit for a decade or more. Many apparently disagree with him. >What I’d like to do is present a summary of what is said in the >article.   >There are moments when I have had to rethink my beliefs and times when >the writers confirm what I have read elsewhere and come to believe.   >I have vigorously summarized the points of view. >They are not literal quotes. >Victor Zammit, head of cell biochemistry Hannah Research Institute. >High levels of dietary saturated fats are bad. >Under some circumstances the liver pours out saturated fats. >Grazing pattern eating is a likely culprit.

As triglycerides are the method of longer term energy storage and a source of some energy requirements, it is reasonable that the liver shunts them around the place. Some are unavoidable in foods. – Hide quoted text — Show quoted text ->Insulin normally STOPS the liver from releasing fats escorted around >the blood stream as VLDL after a meal.  This is important because the >enzymes that would remove the fats are busy dealing with fats from the >meal.  If this doesn’t happen then follow on processes lead to >arterial blockages. >Zammit’s rat research shows the OFF switch fails when the diet >contains frequent high energy snacks.  Insulin now PROMOTES fat >release from the liver.   >It is as though the wiring for the fat release switch has been >reversed. >That begins a vicious cycle.   >High circulating fats make muscle cells insulin resistant. >More insulin is produced. >Eventually the adipose cells where fat gets stored get insulin >resistant as well.  The excess circulating fat kills off insulin >secreting pancreatic cells, insulin drops and that is how many of us >arrived at alt.support.diabetes or misc.health.diabetes

Nice theory, but who agrees with it? >What is to be done about it? >Christina Koutsari and Adrianne Hardman, University of Loughborough. >Moderate daily exercise reduces circulating fats. >Zammit again. >1  Eat less often. Leave 4 or 5 hours between meals. >2  More alcohol than 2 glasses of wine per day causes the liver to >churn out fats. >3. Foods high in fructose eg table sugar could be a bad as saturated >fat and alcohol.

Note the COULD. I’m not disagreeing, but it’s one researcher’s theory. >Fructose is SELECTIVELY shunted towards the liver and the formation of >fats.  

Just like glucose. >It provides one of the building blocks for triglycerides ie >fats.  

But most tg fat not from ingested fatty acids is made from excess glucose in the liver. >Fructose also directly stimulates the liver to release >triglycerides.

Amongst other things. The beauty of fructose is that it only arrives in a trickle. >John Bantle, University of Minnesota. >Two dozen healthy volunteers were fed a diet with 17% of calories as >fructose and then a diet nearly devoid of fructose.  The effects were >worse for men. They turned out to be more sensitive to fructose than >women.  

He did this in Nov 1992, I believe. Why have we heard nothing much since. – Hide quoted text — Show quoted text ->The order of sensitivity to fructose is rats, men and lastly women. >Draw your own conclusions on that one.  <grin> >The high fructose diet increased triglycerides by 32% in men and worse >the liver spewed them out after meals when fat would normally be high. >Put simply the after dinner fat spike damages the arteries. >(As an aside, the average American diet has 40% calories from sugar >and high fructose corn syrup. That means the average American diet has >at least 20% of calories by fructose.  The Okinawans have a much lower >fructose diet though reasonably high carb diet. Mostly this is because >they eat vegetables fish, rice, noodles, tofu and much less sugar and >fruit than Americans.) >David Barker University of Southhampton >Genetic susceptibility to Syndrome X varies though the genes >responsible have yet to be tracked down. Undernourishment of the fetus >and in early infancy can predispose people to Syndrome X later in >life. >How much fructose are you getting? >Teaspoon of sugar     2 grams >Teaspoon of honey     2 grams >Can of cola (330 ml) 15 grams >Chocolate bar (100g) 25 grams >Bowl of cereal        3 grams >Serving of carrots    0.25 gram. >Len Storlein >Instead of struggling to reduce fat overall, switch to olive oil, >marine fish oil. These suppress the liver’s release of triglycerides.  

But of course these are triglycerides themselves. They must travel about in the bloodstream until they are either burnt or stored. >Eating low GI foods is more controversial.  (Some foods get their low >GI from fructose.  

Because it moves from the gut to the bloodstream so slowly? >Where the low GI is attributable to the slowly >digestible starch amylose rather than amylopectin, low GI helps.)  

Allowing the slow transfer of glucose from the gut to the bloodstream. >Best wishes, >Hope this helps clarify some issues that have clearly worried some >people.  For myself the take home message is cut the snacks. >Eat regular meals.

Seems reasonable, but then there is good evidence that snacking or many meals has advantages for some. jl

Response:

G’day G’day Folks,   In a thread on glycemic index Joe asked if I could repost a summary I made of an article in New Scientist.   Here it is, – Hide quoted text — Show quoted text – >  From time to time posters express surprise that their triglycerides >or blood pressure is high.  As if having insulin resistance and a >diagnosis of T2 diabetes isn’t enough there are these other issues to >deal with.  Well in one sense they are all part of the same syndrome. >It is called Syndrome X.   >While it is a YMMV thing the three underlying features are >1. high triglycerides, >2. high blood pressure, >3. insulin resistance. >Syndrome X is the silent precursor of T2 diabetes and CHD. >The "New Scientist" article 1 Sept 2001 is worth the read if you can >find a copy.  It has some colour diagrams that make the concepts >expressed in the article even clearer. >What I’d like to do is present a summary of what is said in the >article.   >There are moments when I have had to rethink my beliefs and times when >the writers confirm what I have read elsewhere and come to believe.   >I have vigorously summarized the points of view. >They are not literal quotes. >Victor Zammit, head of cell biochemistry Hannah Research Institute. >High levels of dietary saturated fats are bad. >Under some circumstances the liver pours out saturated fats. >Grazing pattern eating is a likely culprit. >Insulin normally STOPS the liver from releasing fats escorted around >the blood stream as VLDL after a meal.  This is important because the >enzymes that would remove the fats are busy dealing with fats from the >meal.  If this doesn’t happen then follow on processes lead to >arterial blockages. >Zammit’s rat research shows the OFF switch fails when the diet >contains frequent high energy snacks.  Insulin now PROMOTES fat >release from the liver.   >It is as though the wiring for the fat release switch has been >reversed. >That begins a vicious cycle.   >High circulating fats make muscle cells insulin resistant. >More insulin is produced. >Eventually the adipose cells where fat gets stored get insulin >resistant as well.  The excess circulating fat kills off insulin >secreting pancreatic cells, insulin drops and that is how many of us >arrived at alt.support.diabetes or misc.health.diabetes >What is to be done about it? >Christina Koutsari and Adrianne Hardman, University of Loughborough. >Moderate daily exercise reduces circulating fats. >Zammit again. >1  Eat less often. Leave 4 or 5 hours between meals. >2  More alcohol than 2 glasses of wine per day causes the liver to >churn out fats. >3. Foods high in fructose eg table sugar could be a bad as saturated >fat and alcohol. >Fructose is SELECTIVELY shunted towards the liver and the formation of >fats.  It provides one of the building blocks for triglycerides ie >fats.  Fructose also directly stimulates the liver to release >triglycerides. >John Bantle, University of Minnesota. >Two dozen healthy volunteers were fed a diet with 17% of calories as >fructose and then a diet nearly devoid of fructose.  The effects were >worse for men. They turned out to be more sensitive to fructose than >women.   >The order of sensitivity to fructose is rats, men and lastly women. >Draw your own conclusions on that one.  <grin> >The high fructose diet increased triglycerides by 32% in men and worse >the liver spewed them out after meals when fat would normally be high. >Put simply the after dinner fat spike damages the arteries. >(As an aside, the average American diet has 40% calories from sugar >and high fructose corn syrup. That means the average American diet has >at least 20% of calories by fructose.  The Okinawans have a much lower >fructose diet though reasonably high carb diet. Mostly this is because >they eat vegetables fish, rice, noodles, tofu and much less sugar and >fruit than Americans.) >David Barker University of Southhampton >Genetic susceptibility to Syndrome X varies though the genes >responsible have yet to be tracked down. Undernourishment of the fetus >and in early infancy can predispose people to Syndrome X later in >life. >How much fructose are you getting? >Teaspoon of sugar     2 grams >Teaspoon of honey     2 grams >Can of cola (330 ml) 15 grams >Chocolate bar (100g) 25 grams >Bowl of cereal        3 grams >Serving of carrots    0.25 gram. >Len Storlein >Instead of struggling to reduce fat overall, switch to olive oil, >marine fish oil. These suppress the liver’s release of triglycerides. >Eating low GI foods is more controversial.  (Some foods get their low >GI from fructose.  Where the low GI is attributable to the slowly >digestible starch amylose rather than amylopectin, low GI helps.)   >Best wishes, >Hope this helps clarify some issues that have clearly worried some >people.  For myself the take home message is cut the snacks. >Eat regular meals.

– Quentin Grady       ^  ^  / New Zealand,       >#,#< [                     / /     "… and the blind dog was leading." http://homepages.paradise.net.nz/quentin

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