See the Big Picture: Blind Men, Nutrition & Elephants

Dr. Sears' Blog: New Solution or Simply Admitting Failure?

In today’s nutritional world of super-foods, magic diets, and dietary villains, everyone seems to be an expert on obesity. In reality, these dietary experts are more like a group of blind men trying to describe an elephant; they are all partially correct in their descriptions of the causes of obesity, but they are all describing a different part of the elephant and aren’t describing the whole picture. Many times, they reach the wrong conclusions about what constitutes a healthy diet.

Describing the Elephant’s Tail

Many secrets we are told are actually myths, or only tell part of the story:

  • Calories don’t count – Yes, they do. If you take in more calories than you need at a meal your body has to do something with them, such as store them. This causes oxidative stress especially in the hypothalamus and this disrupts your appetite control center. The bottom line is that you should eat the least number of calories at a meal possible so you aren’t hungry or tired for the next five hours. That’s about 300 calories for a female and no more than 400 calories for a male. The only way to restrict calories this much is to make sure the proteins, carbs and fats are balanced enough to generate the appropriate hormonal responses that suppress appetite.
  • Fat is good – It’s true that you need some fat to supply essential fatty acids, but any extra fat that enters into the blood simply reduces the need to release stored excess fat from the adipose tissue needed to provide “high-octane fuel” for the mitochondria to make ATP. Furthermore, a high-fat diet is one that is usually either rich in inflammatory fat consisting of saturated fat (palmitic acid being the worst) or omega-6 fatty acids or both. You need some fat, but most of it should be coming from monounsaturated fat like olive oil, and you still have to use it in moderation.
  • Carbs are bad – It is true that there are no essential carbohydrates needed for human nutrition, but it is a different story for the microbes that live in our guts. They require fermentable fiber to survive. If you are not going to supply them enough fermentable fiber to eat, they will start digesting the mucus layer that protects your gut lining since that mucus layer is rich in carbohydrates. This is the first step that leads to a leaky gut. Leaky gut allows food particles to escape the digestive system and enter the blood stream. The body sees these as foreign invaders and mounts an inflammatory response to fight off the invaders. This eventually leads to obesity.
  • Insulin makes you fat – Actually, it is insulin resistance that makes you fat. Insulin resistance occurs when the pancreas produces excess insulin because insulin can’t communicate correctly with its target tissues. Insulin resistance is not caused by excess carbs. It is actually caused by excess inflammation. The excess insulin in the blood caused by insulin resistance can make you fat because it increases the uptake of fatty acids into the fat cells and also prevents the release of fat for energy production. This lack of energy production makes you hungry. However, insulin in the brain (the hypothalamus) shuts down hunger. If you have insulin resistance, the ability of the hypothalamus to sense insulin is compromised and you are always hungry. If you eat more calories than you need, you gain weight.

Describing the Heart of the Elephant

There is a different part of the elephant that is not discussed by most experts because it is hard to find. Asking a blind man to describe the heart of an elephant is impossible because he can neither see it nor feel it. It’s not obvious, so it gets overlooked. These things include:

  • Endocannabinoids – One of the most common effects of smoking marijuana is increased appetite (i.e. the munchies). This is because the active ingredient in marijuana is THC that can activate endocannabinoid receptors in the brain that make you ravenous. There are other drugs that block those sites and cause weight loss. Unfortunately, their side effects were severe enough to take those drugs off the market. A better way to lower endocannabinoid levels in the brain is to take a lot of fish oil because endocannabinoids are derived from omega-6 fatty acids and high-dose fish oil which contains omega-3s has been shown to reduce endocannabinoid levels.
  • Metabolic endotoxemia – When large amounts of bacteria enter the bloodstream it causes sepsis and usually causes death. When small amounts of bacteria enter the bloodstream, it causes inflammation and you get fat. About half the bacteria in your gut carry fragments such as lipopolysaccharide (LPS) that activate toll-like receptors on the surface of your cells. This activation causes cellular inflammation. The more fat you eat (especially saturated or trans fats), the easier it is for the LPS molecules to enter into the bloodstream since they can piggyback on the surface of chylomicrons formed by dietary fat upon absorption from the gut.
  • Resolution of inflammation – If it was simply inflammation that makes you fat, then taking anti-inflammatory drugs should make you thin. It doesn’t work that way. You have to resolve inflammation, not simply inhibit it. To accomplish that goal you have to generate large amounts of hormones known as resolvins. These can only be made from EPA and DHA. If you don’t have enough EPA and DHA in your diet, then you will always have excess cellular inflammation and that will make you fat by causing insulin resistance.
  • Polyphenols as gene activators – Polyphenols (in therapeutic levels) are powerful activators of anti-oxidative, anti-inflammatory, and anti-aging genes. Without adequate levels of polyphenols in the diet, the genes needed to control weight gain will remain silent. You either have to eat a lot of non-starchy vegetables and fruits to get adequate levels of polyphenols or take a lot of polyphenol supplements to activate these key genes that prevent weight gain.
  • Hypothalamic inflammation makes you fat – Obesity actually starts with inflammation in the hypothalamus. Reduce that inflammation in the hypothalamus and you will be less likely to eat excess calories. If you eat fewer calories, you lose weight.

Describing the Trunk of the Elephant

Finally, there are the more well-known parts of the elephant that are exciting enough for experts to focus on and are sometimes made into common dietary villains. These don’t always stand up to science but often become popular and trendy. Just as people think of an elephant’s trunk as the distinguishing feature that makes an elephant stand out from other animals, these dietary villains become trendy because they are easy to describe. They still don’t give the entire picture. These include such concepts as:

  • Fructose makes you fat – Excess fructose, like excess calories or an excess of any nutrient, will make you fat. But if you consume adequate levels of polyphenols, even excess fructose has no effect on making you fat because the polyphenols are activating the genes that make you thin. This is why an apple (rich in fructose) a day keeps the doctor away. It’s the polyphenols.
  • Gluten makes you fat – Gluten supposedly makes you fat by causing inflammation. That’s only possible if you have a leaky gut so large fragments of any protein can enter into the bloodstream to cause an inflammatory response. If you have an inflamed gut the usual suspects are either metabolic endotoxemia, lack of fermentable fiber, excess inflammatory fat (saturated fats, trans fats, and omega-6 fats), excess calories causing oxidative stress, or all of the above. Work on removing the usual suspects first before declaring gluten to be the “evil one.”

All of these concepts have complex relationships with the diet that are rarely discussed by the experts. Until they are, our obesity epidemic and its consequences, diabetes and Alzheimer’s, will be here to stay. Nutrition is a lot more complicated than we are led to believe and focusing on describing just parts of an elephant doesn’t tell us enough about the entire animal. An elephant can’t work properly without all its parts and neither can nutrition.

How do you eat an elephant? One bite at a time. How do you learn about nutrition? One concept at a time.

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About Dr. Barry Sears

Dr. Barry Sears is a leading authority on the impact of the diet on hormonal response, genetic expression, and inflammation. A former research scientist at the Boston University School of Medicine and the Massachusetts Institute of Technology, Dr. Sears has dedicated his research efforts over the past 45 years to the study of lipids. He has published 40 scientific articles and holds 14 U.S. patents in the areas of intravenous drug delivery systems and hormonal regulation for the treatment of cardiovascular disease. He has also written 14 books, including the New York Times #1 best-seller "The Zone". His books have sold more than 6 million copies in the U.S. and have been translated into 22 different languages.

Comments

  1. Dr. Arcadio P. Sincero

    Dr. Sears,

    As I mentioned to you before, I have read several of your zone books (the latest: The Mediterranean Zone). And, I tell you that they are all excellent books, very scientific. But there is one thing that I have not gotten the answer of. And this is about how old people get their bodies to synthesize good eicosanoids, particularly, with respect to the effect of D6D.

    The enzyme D6D is inhibited by age (the old people I mentioned above). Assuming their diet is not supplemented with GLA (which is normally the case in America), how will their body obtain good eicosanoids if D6D is inhibited by age to convert linolenic acid to GLA?

    As always, thank you very much.

    Reply
    • Dr. Barry Sears

      The synthesis of GLA is an obligatory first step to make AA. Although age may decrease D6D activity, increased insulin levels stimulates it. Therefore getting adequate levels of GLA is not the problem, but its continued metabolism into AA is. Any GLA that is fomed from linoleic acid is rapidly transformed into DGLA, which is the building block of anti-inflammatory eicosanoids such as PGE1. However, DGLA can be be readily further metabolized into AA by the activity of delta-5-desatuase (D5D), which is also stimulated by insulin. The increased levels of AA generate more pro-inflammatory eicosanoids. Therefore the key is modulating the activity of both D6D and D5D by controlling the levels of insulin. That was the rationale behind developing the Zone Diet to modulate insulin levels on a lifetime basis.

      Reply
        • Barry Sears

          Any decrease in D6D activity by age can be easily overwhelmed by an increase in insulin levels induced by increased insulin resistance. Unfortunately this increases the likelihood that DGLA will be further metabolized into AA thus increasing the overall production of pro-inflammatory eicosanoids.

          Reply
          • Dr. Arcadio P. Sincero

            Now, Dr. Sears, I am confused. What do you mean by overwhelmed in “Any decrease in D6D activity by age can be easily overwhelmed…”. Do you mean that when the decrease in D6D activity is overwhelmed, its activity will be increased because the decrease is overwhelmed?

            Sorry for my ignorance.

  2. Zolari Avalon

    I take fermented cod liver oil and Krill. Is that sufficient to get my Omegas?
    Or should i be taking regular fish oil?

    Reply
      • James Pou

        Many reputable doctors in the nation have written articles, including well known Cardiologist Dr Sinatra that state the need to intake more DHA than EPA because its DHA that is specifically helpful to the heart and the body has to convert EPA to DHA to be able to use it.

        Yet for years you continue to have your liquid fish oil formula contain double EPA than DHA. Do you know something that the other doctors don’t know? If so I would like to see you write an article rebutting this information that is being widely spread on a daily basis by reputable professionals.

        Dr Sinatra has in his formula Calamarine oil that has naturally more DHA than EPA
        a ratio which he claims is the correct natural ratio.

        Please address this topic that continues to be discussed more freely by many professionals and they both can’t be right.

        I take your oil and are very concerned if I’m doing the wrong thing.
        Thanks.

        Reply
        • Dr. Barry Sears

          I would refer you one of my earlier blogs on the differences of EPA and DHA (http://www.zonediet.com/blog/what-are-the-real-differences-between-epa-and-dha/).

          Furthermore, EPA and DHA make completely different types of resolvins (the hormones necesasry for the resolution of inflammation) that have unique receptors and physiological actions. This is why you need both EPA and DHA. Having been involved in basic research in EPA and DHA for the past 40 years, I strongly believe that EPA has greater anti-inflammatory actions than DHA so that is why I maintain the EPA and DHA at a 2:1 ratio. My peer-reviewed research publications using a 2:1 ratio of EPA and DHA in treating severe brain trauma and macular degeneration would confirm my hypothesis.

          Reply
  3. Patrice

    I’m a petite woman. I weigh 122 lbs.
    I have been taking the zone omega 3 for a few months now.
    Should I take the four omega 3 pills or just 3?

    Size matters, probably for my protein intake also.
    I would be grateful for guidance.

    Reply
    • Barry Sears

      I usually recommend 2.5 grams of EPA and DHA as a minimum. To get that level, you would would require four capsules per day. The levels of omega-3 fatty acids you need should be based on your blood levels. In particular, the ratio of arachidonic acid (AA) and eicosapentaenoic acid (EPA). This AA/EPA ratio provides the information to determine the balance of inflammation and resolution in your body. I would recommend starting at four capsules per day for 60 days, then taking the AA/EPA test (http://www.zonediet.com/shop/omega-3-fish-oil/cellular-inflammation/). Based on your results you can then adjust the dosage for your unique biochemistry and genetics. That is the essences of Evidence-based Wellness.

      Reply
  4. Barry Sears

    Leptin resistance falls under the general category of hormone resistance. This also include insulin resistance. Hormone resistances simply means in the transmission of the hormonal signal to the interior of the cell is being compromised. As a result the levels of the hormone in question rise in the blood in an effort by brute force to try to get the signal communicated to the target cell. The usual suspect in hormone resistance is inflammation. Once inflammation is reduced in the cell, the hormonal signaling becomes more efficient and you see the hormone levels in the blood dropping as a consequence of this new communication efficiency.

    Reply
  5. Mark Mcginn

    well written, nicely organized Dr Sears, one of the well known ‘experts ” you refer to, who has a book and PBS TV show, claims Leptin resistance as the cause of obesity, how does Leptin relate to insulin resistance ?

    Thanks Dr Sears for staying on the cutting edge and speaking the truth.

    Reply

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