http://www.youtube.com/watch?v=xrsHqIKtXNw

The Metabolic Sydrome
Engineering Root Cause…. and
Solution?
(Is it the Sugar/Carb or the Fat…..?)
Ivor Cummins BE (Chem)
October 11th 2013

2013 Ivor Cummins BE(Chem) MIEI

Introduction

Myself:

 UCD, BE Chemical Engineering (Biochemical Stream)
 5 Years Medical Device Manufacturing / R&D (hemodialysis & perfusion)
 1 Year Precision Machine Design (Coronary Stent Manufacture)
 16 Years here (Process, Product, Development…. Complex Problem-Solving focus)
 Currently R&D Manager (Gen I)

This Body of Work:
IS

IS NOT

My personal analysis of broad root cause

An aligned view in the orthodoxy…

An Engineering Analysis based on Data

A Medical Study or medical guidance

A study of the Biochemistry of Life

A study of Nutrition Stuff and latest fads

A personal experiment with N = 1

A Prospective Clinical Trial(!)

Leveraging a vast canon of expert’s work

My own experiments and trials (bar 1)

Based on established science and literature

Based on any of the BS books out there

A Selection of Experts from My Journey…
Robert H. Lustig: M.D. Professor of

Pediatrics in the Division of
Endocrinology at University of
California, San Francisco
Dr. Lustig is a Neuroendocrinologist,
with basic and clinical training relative
to hypothalamic development,
anatomy, and function
Dr Peter Attia: mechanical engineering
and applied mathematics at Queen’s
University.
Graduate Stanford Medical School; two
years as a post-doctoral fellow at NIH in
the National Cancer Institute as a surgical
oncology fellow, followed by surgical
residency
Kimber Stanhope: M.S. in Nutrition
Science and a Ph.D. in Nutritional Biology
from the University of California at Davis.
Project Scientist in the Department of
Molecular Biosciences.
20 years of nutrition research experience
working on over 150 projects

Dr. Neville Wilson M.D.

University of Cape Town Medical
School, The College of Medicine,
S.A.
After stints of service as Doctor
and Surgeon all over the world, he
is currently in charge of Medical
Services at Leinster Clinic Health
Services Maynooth.
Jeff S. Volek Ph.D., R.D.: associate
professor in The Human Performance
Laboratory at The University of
Connecticut, Storrs, CT. He is an R.D.
and has a Ph.D. in Kinesiology
(Pennsylvania State University). He
has published over 200 scientific
articles and chapters.
Andreas Eenfeldt M.D. Swedish
medical doctor specializing in family
medicine; his particular strength is in
comparing and contrasting
carbohydrate and fat metabolism in
their respective ability to drive the
diseases of modernity…he runs
DietDoctor.com

Root Cause Methodology
Our Engineering Practice
Problem Definition
Comparative Analysis (IS / IS NOT)

•What, When, Where, Extent + Trends

General / Other Disciplines
Problem Definition
Correlation Analysis

• Epidemiological Studies
•Loose application of Is / Is Not

Root Cause Analysis

•Cause Effect chain – Root Cause Diagram
•Physics based mechanism for all Linkages

Hypothesis Generation

Mechanistic Evidence

•Explore mechanisms
•Focus on suspected factors

•For / Against Analysis
•Generate Targeted Experiments

Design & Analysis Of Experiments

•Screening Experiments, then fractional
•Statistical Inference informs next steps

Experimentation

•Prospective Studies
•Statistical Inference


Root Cause Methodology
Our Engineering Practice

General / Other Disciplines

Problem Definition
Comparative Analysis (IS / IS NOT)

•What, When, Where, Extent + Trends

Problem Definition
Correlation Analysis

A

• Epidemiological Studies
•Loose application of Is / Is Not

B

Mechanistic Evidence

Root Cause Analysis

•Cause Effect chain – Root Cause Diagram
•Physics based mechanism for all Linkages

Hypothesis Generation

•Explore mechanisms
•Focus on suspected factors

•For / Against Analysis
•Generate Targeted Experiments

Design & Analysis Of Experiments

•Screening Experiments, then fractional
•Statistical Inference informs next steps

C

Experimentation

•Prospective Studies
•Statistical Inference


The Trends – Linear for Weight….
USA

Proportion Overweight

England
Australia

France

Korea

(OECD Data)


…and Exponential for Diabetes

Number with Diabetes

Number with Diabetes

Percent with Diabetes

Percent with Diabetes


So is it Simply the Calories?
Why are we consuming so much?
% Obese
kCal/d


Weight Control / Obesity is largely a
subset of

The Metabolic
Syndrome
To understand the drivers of both,
is the key to recovery…..

Metabolic Syndrome Cost Impact?


Metabolic Syndrome Cost Impact?

My back-of-the-envelope calculation suggests somewhere in the
region of $1 Trillion + per annum in the coming decade for the
top 20 GDP countries….

Metabolic Syndrome Definition:
Low HDL “Good
Cholesterol”
<1.0 mmol/L
Waist
>~38” Men
>~35”
Women
Blood Pressure
Elevated
>135/85 mmHg

High Blood
Triglycerides
>1.5 mmol/L

METABOLIC
SYNDROME
(3 or more of
the 5 factors)
High Blood
Sugar
>5.6 mmol/L

(Obesity)

Stroke

Atheroschlorosis
Coronory Heart
Disease
Gout
Type 2
Fatty Liver
Diabetes
Disease
Alzheimers
Arthritis
Asthma

Low HDL “Good
Cholesterol”
<1.0 mmol/L
Waist
>~38” Men
>~35”
Women
Blood Pressure
Elevated
>135/85 mmHg

High Blood
Triglycerides
>1.5 mmol/L

METABOLIC
SYNDROME
(3 or more of
the 5 factors)
High Blood
Sugar
>5.6 mmol/L

How many people have it then? It’s
not too common, right?

(Obesity)

Stroke

Atheroschlorosis
Coronory Heart
Disease
Gout
Type 2
Fatty Liver
Diabetes
Disease
Alzheimers
Arthritis
Asthma

Low HDL “Good
Cholesterol”
<1.0 mmol/L
Waist
>~38” Men
>~35”
Women
Blood Pressure
Elevated
>135/85 mmHg

High Blood
Triglycerides
>1.5 mmol/L

METABOLIC
SYNDROME
(3 or more of
the 5 factors)
High Blood
Sugar
>5.6 mmol/L

How does >50% of US population
strike you?

(Obesity)

Stroke

Atheroschlorosis
Coronory Heart
Disease
Gout
Type 2
Fatty Liver
Diabetes
Disease
Alzheimers
Arthritis
Asthma

20% of the
“Fat” are
“Fit”
40% of the
“lean” are
unhealthy

Low HDL “Good
Cholesterol”
<1.0 mmol/L
Waist
>~38” Men
>~35”
Women
Blood Pressure
Elevated
>135/85 mmHg

High Blood
Triglycerides
>1.5 mmol/L

Key
METABOLIC
SYNDROME
(3 or more of
the 5 factors)

(Obesity)

Stroke

Atheroschlorosis
Phenomenon:

INSULIN
RESISTANCE

High Blood
Sugar
>5.6 mmol/L

How does >50% of US population
strike you?

Coronory Heart
Disease
Gout
Type 2
Fatty Liver
Diabetes
Disease
Alzheimers
Arthritis
Asthma

20% of the
“Fat” are
“Fit”
40% of the
“lean” are
unhealthy

B

Mech

A Crash Course in Endocrinology 1…..

Insulin / Glucagon / Ghrelin /
Leptin – know your control
system hormones!

sugar / simple
carbohydrate
ingestion primarily
High Blood
Sugar

1. Insulin
and
Glucagon


B

Mech

A Crash Course in Endocrinology 2

• Ghrelin
and
Leptin


And so, The KEY to the Cycle of Disease
Insulin (The Master Hormone):

• Gets glucose into Liver/Muscle AND FAT(!)
• In healthy people, drives brain appetite drop but…
• If driven too hard by Sugar and Carb in diet, leads to
INSULIN RESISTANCE - “Body says NO!”
• Brain Insulin Resistance: Appetite dysfunction results!


The KEY to APPETITE CONTROL


# 1: Insulin
Resistance

And so, The KEY to APPETITE CONTROL


# 1: Insulin
Resistance

#2: Appetite
Dysfunction



Leptin:

• Is released by Fat Cells (Adipocytes)

• Signals brain that fat stores are fine – STOP EATING
• But Leptin Is Blocked by INSULIN RESISTANCE and…
• If driven too hard (Excess Fat) then LEPTIN RESISTANCE

# 1: Insulin
Resistance

#2: Appetite
Dysfunction



Leptin:



# 1: Insulin
Resistance

#2: Appetite
Dysfunction

#3 Leptin
Signal Block



Leptin:



# 1: Insulin
Resistance

#2: Appetite
Dysfunction

#3 Leptin
Signal Block

#4 Leptin
Resistance



Appetite


Leptin:



# 1: Insulin
Resistance

#2: Appetite
Dysfunction

#3 Leptin
Signal Block

Obesity
Inflammation
Fatty Liver
“Bad Cholesterol”
Atherosclerosis
Heart Disease
Diabetes
Alzheimers
Cancers etc

“The Diseases
of Modernity”

#4 Leptin
Resistance


B

Mech

Perhaps unsurprisingly, Insulin
Resistance Leads to the Metabolic
Maladies….


B

Mech

Maladies….

…..but, substantially, is it the chicken or the egg??


B

Mech

Maladies….

Excess Weight


B

Mech

Maladies….

Excess Weight

Self-Reinforce
Loop Warning!

Self-Reinforce
Loop Warning!

B

Mech

So, time to fix 4 decades of “Hypothesis
Resistance”, and move on…

Excessive Insulin Demand
exhausts Pancreatic Cells
Irrecoverable Cell Death


B

Mech

Greed +

}


B

Mech

Greed +

} + appetite
derangement


B

Mech

Greed +

SelfReinforce
Loop
Warning!

SelfReinforce
Loop
Warning!

} + appetite
derangement

SelfReinforce
Loop
Warning!



Metabolic Syndrome / Obesity
POTENTIAL ROOT CAUSE #1:

SUGAR


Fructose Vs Glucose Sources

Sucrose (Table Sugar):
50%glucose / 50% fructose

High Fructose Corn Syrup (HFCS):
55% fructose / 45% glucose

Glucose-glucose-glucose......chains
So-called ”Simple Carb”, added sugar too though..

Fruit: 4% to 8% Fructose
(but with lots of Fibre & Good Stuff!)

Metabolic Syndrome / Obesity

SUGAR

Fructose / HFCS
“Mega Sources”:

* Soft Drinks / Sports Drinks *
Most All Processed Food
Low Fat Products
Fruit Juices / Smoothies
Most Breakfast Cereals
Etc Etc Etc

A

Corr

From one of the best, 1957
DIET AND CORONARY THROMBOSIS
HYPOTHESIS AND FACT

*

JOHN YUDKIN
M.A., Ph.D., M.D. Camb., M.R.C.P., F.R.I.C.
1.
2.
3.
4.
5.

USA
Australia
Canada
Finland
New
Zealand
6. UK
7. Denmark
8. Sweden
9. Norway
10. Netherlands
11. Switzerland
12. W. Germany
13. France
14. Italy
15. Japan

PROFESSOR OF NUTRITION IN THE UNIVERSITY OF LONDON AT
QUEEN ELIZABETH COLLEGE

NO Significant Correlation for
Fat and Heart Disease Rates

R2 = 0.1, P > 0.05

Significant Correlation for
Sugar and Heart Disease Rates

R2 = 0.41, P < 0.05

A

Corr

Let’s get up to date here….

Sugar g/day
%BMI > 25
Diabetes

Sugar g/day: Composite, multiple sources
BMI/Diabetes Data: http://www.cdc.gov/nchs/data/hus/hus12.pdf#063


A

Corr

Another Longer Term View…


A

Corr
Obesity Trend

Welcome, to The
new age of Sugar
and Simple Carbs…

Carb
grams/day

B

Mech

Reminder first – Glucose Vs Fructose


B

Mech

And now, a Crash Course in
Fructose Metabolism…..
Grateful thanks to Dr. Robert Lustig for the following slides
which I have augmented somewhat for clarity
•Professor of Endocrinology / Pediatrics, UCSF
•Director of Weight Assessment for Teen and Child Health
Please do see him professionally deliver this content
more comprehensively in “Sugar, the Bitter Truth”
http://www.youtube.com/watch?v=dBnniua6-oM

120 kcal Glucose
24 kcal goes to liver
120 kcal Alcohol
94 kcal goes to liver

60 kcal
(+ 12 kcal
glucose)

120 kcal Sucrose
(50:50 Fruc/Gluc)
ALL Fructose
must go to liver

B

Mech

Glucose, Alcohol,
Fructose – One of
these things is not
like the others…..!

The Mitochondria Your Cellular Energy
Production Line

B

Mech

Production Line

Into Your Liver
goes the Fructose

B

Mech

Production Line

Initial conversion
and ATP depletion

B

Mech

MS #1:
Hypertension

Ramp Up the
Uric Acid
Production

Production Line

B

Mech

Ramp Up Krebs
Cycle and Citrate
Production

B

Mech

Kick Off unique
Xylulose-S-P
Production

B

Mech

Accelerate the Fat
Production Line

B

Mech

MS #3:
HDL Reduction

Welcome to DNL:
Elevated Blood
Triglyceride

MS #4:
Triglyceride

B

Mech

Add Hepatic Lipid
Production and
drive NAFLD

B

Mech

Add Blood FFA &
Insulin Levels / IR

MS #2:
Central Obesity

B

Mech

SelfReinforce
Loop
Warning!

Add Blood FFA &
Insulin Levels / IR

MS #2:
Central Obesity

B

Mech

Add Systemic
Inflammation

B

Mech

MS #5:
Sugar Control

Add Hepatic
Insulin Resistance

B

Mech

MS #5:
Sugar Control

SelfReinforce
Loop
Warning!

Add Hepatic
Insulin Resistance

B

Mech

MS #5:
Sugar Control

SelfReinforce
Loop
Warning!

SelfReinforce
Loop
Warning!

Add Hepatic
Insulin Resistance

B

Mech

SREBP1 and
increased Fat
Production

B

Mech

SelfReinforce
Loop
Warning!

SREBP1 and
increased Fat
Production

B

Mech

Spiked Insulin
Drives Fat Storage

MS #2:
Central/Genera
l Obesity

B

Mech

SelfReinforce
Loop
Warning!

Spiked Insulin
Drives Fat Storage

MS #2:
Central/Genera
l Obesity

B

Leptin
blocking

Mech

Appetite
Control

Appetite Dysfunction
and Increased
Consumption

MS #2:
Central/Genera
l Obesity

B

SelfReinforce
Loop
Warning!

Mech

Leptin
blocking

Appetite
Control

Appetite Dysfunction
and Increased
Consumption

MS #2:
Central/Genera
l Obesity

B

Mech

MS #1:
Hypertension
MS #5:
Sugar Control

MS #3:
HDL Reduction

Welcome to the
Metabolic Syndrome

MS #2:
Central/Genera
l Obesity

MS #4:
Triglyceride

C

Expt

And Sugar’s effect on your “Bad”
Cholesterol?


1965 – 1972, Excellent Engineering Style
Studies – Not easy to find now

Low Sugar

High Sugar

Low Sugar

Lower is Better in
all plotlines here

High Sugar

Expt

Normal Diet

C


1965 – 1972, Excellent Engineering Style
Studies – Not easy to find now

Low Sugar

High Sugar

Lower is Better
in all plotlines

Low Sugar

Expt

Normal Diet

C


Low Sugar

High Sugar

Normal Diet

All Candidates Same Trend……

C

Expt

2011: Fructose Drives Visceral Obesity
Glucose:
LOW
Visceral
Obesity

SAT =
Subcutaneous
Or “Safe”
Body FatFat
Body Type

Fructose:
HIGH
Visceral
Obesity

VAT =

Visceral
Or “Toxic”
Body Fat Type


2011: Fructose Drives Post-Prandial TG
Triglyceride (AUC)

Expt

Area
Under
Curve i.e.

The Common Fasting Trigs test :
Glucose > Fructose, but note
lower scale, ~0.18mmol/L

Average
Trig
Impact

Glucose Fructose

Sucrose

Triglyceride 22-24h

C

Glucose Fructose

Sucrose

Fructose:
HIGH (0.60 mmol/L)
Post-Meal Trigs….
where damage is done…


ΔFasting ApoB (g/L)

Expt

2011: Fructose Drives ApoB Lipoprotein
(“The real BAD Cholesterol”)

Glucose:
Low
ApoB

Glucose

Fructose:
HIGH
ApoB

Sucrose

Fructose

Sucrose

% ApoB/ApoA

C

Glucose

Fructose

Sucrose

Note: As can be seen, the sucrose (50% Fructose and 50% Glucose)
seems synergistic in effect; my assumption is that the simultaneous Insulin
response triggered by the Glucose exacerbates the issue – but this is TBD
– the research team noted and deferred an explanation too…..


C

Expt

Lots where this
came from….

tD
Sof

rink

oys
sb

an

s!
girl
d



FAT

Natural
????
A Topic for
another
Seminar(!)
Natural

Natural

Triglyceride – 3 Fatty Acids
with a Glycerol Backbone

A

Corr

Fat Versus Sugar: Correlative Data

FAT g/day
%BMI > 25
Diabetes

Fat/BMI/Diabetes Data: http://www.cdc.gov/nchs/data/hus/hus12.pdf#063

A

Corr

Fat Versus Sugar: Correlative Data

FAT g/day
%BMI > 25
Diabetes

SUGAR g/d
%BMI > 25
Diabetes

Fat/BMI/Diabetes Data: http://www.cdc.gov/nchs/data/hus/hus12.pdf#063

A

Corr

A little bit of history…..Ancel Keys


And His BAD Science Punishment?

A

Corr

What Keys could have chosen…..


A

Corr

The Contemporaneous Controversy…
DIET AND CORONARY THROMBOSIS
HYPOTHESIS AND FACT

*

JOHN YUDKIN
M.A., Ph.D., M.D. Camb., M.R.C.P., F.R.I.C.
1.
2.
3.
4.
5.

USA
Australia
Canada
Finland
New
Zealand
6. UK
7. Denmark
8. Sweden
9. Norway
10. Netherlands
11. Switzerland
12. W. Germany
13. France
14. Italy
15. Japan

PROFESSOR OF NUTRITION IN THE UNIVERSITY OF LONDON AT
QUEEN ELIZABETH COLLEGE

NO Significant Correlation for
Fat and Heart Disease Rates

Significant Correlation for
Sugar and Heart Disease Rates

R2 = 0.1, P > 0.05

R2 = 0.41, P < 0.05

A

Corr

And the Dreadful SATURATED Fat?
Increasing Heart
Disease with lower
fat

Orthodox
View
TrendLine
Eh, excuse
me?

An
Engineer’s
TrendLine
Decreasing
Heart Disease
with higher fat


A

Corr

Another Recommended Paper
Men from
studies who
had NO Heart
Attacks

Men from the
studies
Who HAD
Heart
Attacks

Michael Gurr, Ph.D., renowned expert on lipids and author of the
authoritative textbook on lipid biochemistry, criticizes:

”…the degree of self delusion in research workers wedded to
a particular hypothesis despite the contrary evidence”
Dietary lipids and coronary heart desease: Old evidence, new perspective Review Article
Progress in Lipid Research, Volume 31, Issue 3, 1992, Pages 195-243
Michael I. Gurr, Professor in Food Science & Technology, University of Reading, UK.
Professor in Human Nutrition, Oxford Brookes University, UK.

A

Corr

2010: The Metastudy of all studies
Meta-analysis of 21 prospective
cohort studies evaluating the
association of saturated fat with
cardiovascular disease
Conclusion: There is no

NO Effect of
Dietary
Saturated Fat
Seen Overall

significant evidence for
concluding that dietary
saturated fat is associated
with an increased risk of CHD
or CVD.
More data are needed to
elucidate whether CVD risks are
likely to be influenced by the
specific nutrients used to replace
saturated fat….(Ivor note: like
sugar or refined carb perhaps….)

B

Mech

Fat Mechanistic Data
• Let’s make up some time here
and move on to experimental –
go on, you know you want to!


C

Expt

FAT – Experimental – Krauss et Al 2008

Experiment Design: 3 weeks isocalorific,
remainder with -1000 calories per day (starve)

Trig Reduction
Serum Triglyceride –
Lower is Better


C

Expt



Lower is Better

l ohC ” doog“ L DH

Trig Reduction
Serum Triglyceride –

HDL –
Higher is Better


C

Expt



Tot Chol/HDL
TOTAL CHOL / HDL
Lower is Better


C

Expt



Apo B / Apo A

Tot Chol/HDL
TOTAL CHOL / HDL

ApoB / Apo A Lipoprotein

Lower is Better

Lower is Better


C

Expt


r et e mi D e ci tr a P L DL
a l

remainder with -1000 calories per day
(starve)

LDL Particle Diameter
Higher is Better


C

Expt

(starve)

a l

Ivor Conclusion:
• Low Sugar/Carb, high Fat diet
dramatically improves Key
MetS disease markers

Higher is Better


C

Expt

(starve)

a l

Ivor Conclusion:
• Low Sugar/Carb, high Fat diet
dramatically improves Key
MetS disease markers

Higher is Better

Study Author’s Conclusion:
• A LOW FAT diet with
restricted calories sort of kinda
gets within range of the High
Fat diet in Key MetS disease
markers….???
•Come again???
•Are you Serious – call an
engineer, please……..!

Can do this again
and again……
and again.
by Jeff S. Volek, Ph.D., R.D.

C

Expt


Obesity Trends over Several Decades


Concluding Material


Coup De Grace? 2013: The Rat Proxy…

“…this study aims to develop a rat model
which closely depicts MS in humans…”
“Replacing whole wheat with refined wheat flour in rat
chow in 60% fructose-fed Sprague-Dawley rats resulted
in:

hypertension (p 0.01)

hyperglycemia (p 0.03)

hyper-triglyceridemia (p 0.001)
HDL Reduction (p 0.002)


In only
FOUR Weeks!

Fiber-free white flour with fructose offers a better model of metabolic
syndrome:
Amin and Gilani Lipids in Health and Disease 2013 12:44
doi:10.1186/1476-511X-12-44

More Rat Tales….
In results published online Feb. 26 2010 by the journal Pharmacology,
Biochemistry and Behavior, the researchers from the Department of Psychology
and the Princeton Neuroscience Institute reported on two experiments
investigating the link between the consumption of high-fructose corn syrup and
obesity.
"When rats are drinking high-fructose corn syrup at levels well below those in
soda pop, they're becoming obese -- every single one, across the board. Even
when rats are fed a high-fat diet, you don't see this; they don't all gain extra
weight."
The second experiment -- the first long-term study of the effects of high-fructose
corn syrup consumption on obesity in lab animals -- monitored weight gain, body
fat and triglyceride levels in rats with access to high-fructose corn syrup over a
period of six months. “Compared to animals eating only rat chow, rats on a diet
rich in high-fructose corn syrup showed characteristic signs of a dangerous
condition known in humans as the metabolic syndrome, including abnormal
weight gain, significant increases in circulating triglycerides and augmented fat
deposition, especially visceral fat around the belly. Male rats in particular
ballooned in size: Animals with access to high-fructose corn syrup gained 48
percent more weight than those eating a normal diet.”

% Daily Calorific
Intake

Guidelines
Schmidelines…..

Make your minds
up guys…
25

X

Labelmania - What’s YOUR poison?

Brown sugar, Fruit juice concentrate, Lactose ,
Corn sweetener, Glucose, Malt syrup, Galactose,
Corn syrup, High-fructose corn, Rice Syrup,
Maltose, HFCS, Dextrose, Syrup, Honey,
Molasses, Fructose, Invert Sugar, Maltodextrin,
Raw sugar, etc, etc

Answer: All of it…welcome to
“Synynom Shenanigans”


But I don’t eat that much Sugar…?
That means 6/9 teaspoons TOTAL INTAKE
per day for a female/male human
- NOT 6/9 that you add yourself to existing
food or drink, which is often loaded already!

Brekky
Time!

80g

250 ml

250 ml

Cereal

OJ

Smoothi
e

Total
Spoons

~4

~6

~8

~19

=

Over 2-3 times your daily
AHA adult guidelines…..
and more than a dozen
times the estimated human
evolutionary intake of ~1.5
teaspoons/day)…..

before you leave the
breakfast table

C

Expt

And My N=1
Experiment?
July 2013 Singapore

C

Expt

Ivor the Laboratory Rat

112

530
Note: converted from mmol/L to
mg/dL to get ratio guidelines
< 2.0

1.47

< 1.5
mmol
/L

4.5
1.44
<4.0

0.92

< 200
approx

<35
approx
>1.00
mmol
/L

GGT

Ferritin

HDL

Trig

Trig/HDL

Tot
Chol


C

Expt


112

530
< 2.0

1.47

< 1.5
mmol
/L

4.5
1.44

42
<35
approx

<4.0

0.92

< 200
approx

35
>1.00
mmol
/L

GGT

Ferritin

HDL

Trig

Trig/HDL

Tot
Chol


C

Expt


112

530
< 2.0

1.47

<35
approx

4.5
1.44

230
42

< 1.5
mmol
/L

<4.0

0.92

< 200
approx

35
>1.00
mmol
/L

GGT

Ferritin

HDL

Trig

Trig/HDL

Tot
Chol


C

Expt


112

530
< 2.0

1.73

1.47

<35
approx

4.5
1.44

230
42

< 1.5
mmol
/L

<4.0

0.92

< 200
approx

35
>1.00
mmol
/L

GGT

Ferritin

HDL

Trig

Trig/HDL

Tot
Chol


C

Expt


112

530
< 2.0

1.73

1.47

<35
approx

4.5
1.44

230
42

< 1.5
mmol
/L

<4.0

0.92

< 200
approx

0.78

35
>1.00
mmol
/L

GGT

Ferritin

HDL

Trig

Trig/HDL

Tot
Chol


C

Expt


112

530
< 2.0

1.73

1.47

<35
approx

4.5
1.44

230
42

< 1.5
mmol
/L

<4.0

0.92

< 200
approx

0.78

1.03

35
>1.00
mmol
/L

GGT

Ferritin

HDL

Trig

Trig/HDL

Tot
Chol


C

Expt


112

530
< 2.0

1.73

1.47

<35
approx

4.5
1.44

230
42

< 1.5
mmol
/L

<4.0

0.92

< 200
approx

0.78

1.03

3.5

35
>1.00
mmol
/L

GGT

Ferritin

HDL

Trig

Trig/HDL

Tot
Chol


C

Expt

Continued….
95

28
35

145
95
<135
mmHg
<85
mmHg

Sys BP

Ideal
~82Kg

Dia BP

Avg of 20+ readings from same Equipment

Ideal
32”

Weight

5k run
time

Waist

C

Expt

Continued….
95

28
35

145
95
<135
mmHg

130

Sys BP

<85
mmHg

80

Dia BP


Ideal
~82Kg

Ideal
32”

Weight

5k run
time

Waist

C

Expt

Continued….
95

28
35

145
95
<135
mmHg

130

Sys BP

<85
mmHg

80

Dia BP


Ideal
~82Kg

82

Weight

Ideal
32”

5k run
time

Waist

C

Expt

Continued….
95

28
35

145
95
<135
mmHg

130

Sys BP

<85
mmHg

24.5

80

Dia BP


Ideal
~82Kg

82

Weight

Ideal
32”

5k run
time

Waist

C

Expt

Continued….
95

28
35

145
95
<135
mmHg

130

Sys BP

<85
mmHg

24.5

80

Dia BP


Ideal
~82Kg

82

Weight

Ideal
32”

5k run
time

32

Waist

B’fast

or

etc

or

or

Lunch
Snack
Dinner

or

+

+

85% !!

Supper

or

MINIMISE

IDEAL

B’fast

or

Lunch
Snack
Dinner

Supper

MINIMISE

etc

•Effectively NO Sugar
or
or
•Effectively NO Wheat
•Minimal Simple Carbs
•NO “Diet” Foods (sugar!)
•NO “Low Fat” stuff (sugar!)
•Olive not Vegetable Oils
•Butter not Margerine
•Plenty Healthy Meat and
Fish, leave the skin on!
•Loads of Veg with dinner
+
or
•Lots of eggs/cheese +
•Moderate Nuts
•Moderate Fruit
85% !!
•85% Choc, or Milk Choc
NO
•Olives, Avocados
•Tomatoes and salad veg

IDEAL


SUMMARY FINDINGS
•Excessive Dietary Sugar and simple carbs are the primary root
cause of the Metabolic Syndrome and associated “Diabesity”
Epidemic (i.e No Sugar, and stick to Vegetables only for your carb input)
•Excessive Sugar and simple carbs promote insulin response and
appetite dysfunction, creating multiple self-reinforcing loops
•Sugar / simple carbs are the primary development agent of Insulin
Resistance Syndrome through proven mechanisms, and are a
primary driver of Lipid Generation (“Bad Cholesterol”) and
eventual dyslipidemia
•The driven weight gain consists of adipose tissue (esp. Visceral)
which exacerbates Insulin Resistence, drives Leptin Resistance and
reinforces the disease process
•Natural Dietary Fat is NOT a core root cause of the metabolic
syndrome and associated disease/obesity – and it does NOT cause
“Bad Cholesterol” !!!! Time to end 40 years of Bad Science….

A Sample of Approachable Science
•

“Sugar, The Bitter Truth” Professor Robert Lustig
–

•

http://www.youtube.com/watch?v=dBnniua6-oM

“The Skinny on Obesity” (8 parts)
– http://www.youtube.com/watch?v=nOl5promItc

•

“High Sugar Diets and Disease” Dr. Kimber Stanhope
– http://www.youtube.com/watch?v=_AJka21yfyE

•

“Wheat Belly” Dr. William Davis
– http://www.youtube.com/watch?v=UbBURnqYVzw

•

“The Straight Dope on Cholesterol” Dr. Peter Attia
– http://www.youtube.com/watch?v=dAWdHYSrh7M

•

“How Bad Science and Big Business created the Obesity Epidemic” David
Diamond PhD
–

•

http://www.youtube.com/watch?v=3vr-c8GeT34

“The Blog of Dr. Neville Wilson”
– http://drnevillewilson.com/

Current Working Thesis:
1. Excessive Dietary Sugar (directly ingested or in as found in most processed
food/drinks) is the 1st order primary root cause of the Metabolic Syndrome and
associated “Diabesity” Epidemic through the following elements:
1.1 Insulin Resistance is the driving force of appetite dysfunction, excessive fat storage and the constellation
of metabolic disease.
1.2 Sugar is the primary aggravator of Insulin Resistance through proven mechanisms, and is a direct driver
of Lipid Generation and eventual dyslipidemia (Serum Triglyceride, VLDL etc)
1.3 An elevated proportion of simple, high-glycemic carbohydrate in the diet (Glucose rapidly released by
Amylase, no fibre to attenuate), works in tandem with the simple sugars to promote Insulin Resistance.
1.3 Fructose is particularly pathogenic thru many pathways – lack of satiety signalling, promotion of Hepatic
fat generation and hepatic IR, lack of Ghrelin suppression, impact to Leptin levels, etc
1.4 The driven weight gain consists of adipose tissue (esp. Visceral) which is itself an organ, releasing body
toxic cytokines and hormones, exacerbating Insulin Resistence and accelerating the disease process

2. The disproportionate / non-linear rise of disease relative to the increase in sugar consumption can
be attributed to amongst other things:
2.1 Gestational Insulin Resistance and predisposition towards obesity in the next generation (2 nd order effect)
2.2 Co-incident lowered level of physical activity in society exacerbates the high sugar / simple carb damage

3. Dietary Fat is NOT a core root cause of the metabolic syndrome, but excess sugar / simple carbs
through the action of the insulin elevation will drive dietary fat into storage (obesity) and further
negative pathways will result as seen

BACKUP


The Wisdom of the Past?

}

Aw, c’mon
now!

"Diabetic Cookery; Recipes and Menus" by Rebecca W Oppenheimer,
1917

The So-Called “Cholesterol”

http://www.slideshare.net/ancestralhealth/attia-ahs-talk-pcfriendly

"High triglycerides alone increased the risk of heart attack nearly three-fold.
And people with the highest ratio of triglycerides to HDL -- the "good"
cholesterol -- had 16 times the risk of heart attack as those with the lowest
ratio of triglycerides to HDL in the study of 340 heart attack patients and 340
of their healthy, same age counterparts.
The ratio of triglycerides to HDL was the strongest predictor of a heart attack,
even more accurate than the LDL/HDL ratio. (Harvard-lead study - Circulation
1997;96:2520-2525)."


Polyunsaturated Fun


The Super Healthy PUFA


http://www.youtube.com/watch?v=xrsHqIKtXNw

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