Sunday, January 31, 2010

The Body Fat Setpoint, Part IV: Changing the Setpoint

Prevention is Easier than Cure

Experiments in animals have confirmed what common sense suggests: it's easier to prevent health problems than to reverse them. Still, many health conditions can be improved, and in some cases reversed, through lifestyle interventions. It's important to have realistic expectations and to be kind to oneself. Cultivating a drill sergeant mentality will not improve quality of life, and isn't likely to be sustainable.

Fat Loss: a New Approach

If there's one thing that's consistent in the medical literature, it's that telling people to eat fewer calories isn't a very effective fat loss strategy, despite the fact that it works if strictly adhered to. Many people who use this strategy see transient fat loss, followed by fat regain and a feeling of defeat. There's a simple reason for it: the body doesn't want to lose weight. It can be difficult to fight the fat mass setpoint, and the body will use every tool it has to maintain its preferred level of fat: hunger, increased interest in food, reduced body temperature, higher muscle efficiency (i.e., less energy is expended for the same movement), lethargy, lowered immune function, et cetera.

Therefore, what we need for sustainable fat loss is not starvation; we need a treatment that lowers the fat mass setpoint. There are several criteria that this treatment will have to meet to qualify:
  1. It must cause fat loss
  2. It must not involve deliberate calorie restriction
  3. It must maintain fat loss over a long period of time
  4. It must not be harmful to overall health
I also prefer strategies that make sense from the perspective of human evolution.

: Diet Pattern

One treatment that fits my criteria is low-carbohydrate dieting. Overweight people eating low-carbohydrate diets generally lose some fat and spontaneously reduce their calorie intake. In fact, in several diet studies, investigators compared an all-you-can-eat low-carbohydrate diet with a calorie-restricted low-fat diet. The low-carbohydrate dieters generally reduced their calorie intake and body fat to a similar or greater degree than the low-fat dieters, despite the fact that they ate all the calories they wanted (1). This may suggest that their fat mass setpoint had changed. At this point, I think moderate carbohydrate restriction may be preferable to strict carbohydrate restriction for some people, due to the increasing number of reports I've read of people doing poorly in the long run on extremely low-carbohydrate diets.  Furthermore, controlled trials of low-carb diets show that the long-term weight loss, despite being greater than low-fat diets, is not that impressive for the "average person".  Some people find it highly effective, while most people find it moderately effective or even ineffective.

Another strategy that appears preferable is the "paleolithic" diet. In Dr. Staffan Lindeberg's 2007 diet study, overweight volunteers with heart disease lost fat and reduced their calorie intake to a remarkable degree while eating a diet consistent with our hunter-gatherer heritage (3). This result is consistent with another diet trial of the paleolithic diet in diabetics (4). In post hoc analysis, Dr. Lindeberg's group showed that the reduction in weight was apparently independent of changes in carbohydrate intake*. This suggests that the paleolithic diet has health benefits that are independent of carbohydrate intake.

Strategies: Gastrointestinal Health

Since the gastrointestinal (GI) tract is so intimately involved in body fat metabolism and overall health (see the former post), the next strategy is to improve GI health. There are a number of ways to do this, but they all center around four things:
  1. Don't eat food that encourages the growth of harmful bacteria
  2. Eat food that encourages the growth of good bacteria
  3. Don't eat food that impairs gut barrier function
  4. Eat food that promotes gut barrier health
The first one is pretty easy in theory: avoid fermentable substances of which you're intolerant.  This can include lactose (milk) and certain polysaccharides, and a number of other FODMAPs.  For the second and fourth points, make sure to eat fermentable fiber. In one trial, oligofructose supplements led to sustained fat loss, without any other changes in diet (5). This is consistent with experiments in rodents showing improvements in gut bacteria profile, gut barrier health, glucose tolerance and body fat mass with oligofructose supplementation (6, 7, 8).  However, oligofructose is a FODMAP and therefore will be poorly tolerated by a subset of people.

The colon is packed with symbiotic bacteria, and is the site of most intestinal fermentation. The small intestine contains fewer bacteria, but gut barrier function there is critical as well. The small intestine is where the GI doctor will take a biopsy to look for celiac disease. Celiac disease is a degeneration of the small intestinal lining due to an autoimmune reaction caused by gluten (in wheat, barley and rye). This brings us to one of the most important elements of maintaining gut barrier health: avoiding food sensitivities. Gluten and casein (in dairy protein) are the two most common offenders. Gluten sensitivity is more common than most people realize; just under 1% of young adults and the prevalence increases with age.

Eating raw fermented foods such as sauerkraut, kimchi, yogurt and half-sour pickles also helps maintain the integrity of the upper GI tract. I doubt these have any effect on the colon, given the huge number of bacteria already present.

Strategies: Miscellaneous

Anecdotally, many people have had success using intermittent fasting (IF) for fat loss. There's some evidence in the scientific literature that IF and related approaches may be helpful (14). There are different approaches to IF, but a common and effective method is to do two complete 24-hour fasts per week. It's important to note that IF isn't about restricting calories, it's about resetting the fat mass setpoint. After a fast, allow yourself to eat quality food until you're no longer hungry.

Insufficient sleep has been strongly and repeatedly linked to obesity. Whether it's a cause or consequence of obesity I can't say for sure, but in any case it's important for health to sleep until you feel rested. If your sleep quality is poor due to psychological stress, meditating before bedtime may help. I find that meditation has a remarkable effect on my sleep quality. Due to the poor development of oral and nasal structures in industrial nations, many people do not breathe effectively and may suffer from conditions such as sleep apnea that reduce sleep quality. Overweight also contributes to these problems.

* Since reducing carbohydrate intake wasn't part of the intervention, this result is observational.

Friday, January 29, 2010

Oh What a Night & Some Exciting News!

We had such a great time last night at the Elle Decor- Bloomingdales - Apartment Therapy Big Window Challenge event!  Dave & I woke at 5 something AM, loaded the kids in the car, and headed up to New York to celebrate Eddie's big WIN at Bloomingdales!  (We dropped the kids off with our family in New Jersey before heading into the city.)  I'm still pretty bleary-eyed from that lack of sleep so I'll tell  you all about it & post pics on Monday.  We did have a beautiful dinner with Eddie & Jaithan, Mrs.Blandings, Deborah Buck, and {from Elle Decor}:  Matthew Talomie and Margaret Russell.  We met lots of amazing new people who are so incredibly passionate about what they do and I just loved being around them. 

Everyone was super-sweet and inclusive.  I was totally nervous/ freaking out about meeting Margaret Russell (Mom & Grandmother- she's the Editor-in-Chief of Elle Decor Magazine ;) and she couldn't have been nicer!!  (And yes, she's just as graceful & gorgeous in person as she is on TV & in pictures, if not more so.)  But more details on Monday.  Congratulations To Eddie & Jaithan on a HUGE win for Elle Decor!!

On another note, I'm insanely excited to tell you that Better Homes & Gardens is coming to shoot our house!! 

It's a Christmas story so it'll be in the 2010 holiday issue.  They're doing the outside, the entry, living room, dining room, kitchen and us.  (I'm a little worried about the "us" part, as I have an extra 30 lbs on me right now from the pregnancy and when I see pictures of myself right now it looks like a "me" inside of a "me."   So I'll need to either get over it or wear a sign that says "JUST HAD BABY."  Think they'll mind?? ;)   

Anyway, since we're travelling & have so much to recap on Monday, there won't be a formal Pure Organization Project for next week, but personally we're working on time management & figuring out our schedule like we talked about in Time (Or Lack Therof.)    I'll post the readers' projects I've received later in the week.  Have an awesome weekend!!!

Thursday, January 28, 2010

Recap and new resolutions for 2010

Last year finished too abruptly for me and it is already end of January 2010! It looks that time is not going to slow down at all… So, without further ado, back to daily chores. But firstly a quick recap of where the things are at.

2009 was a year of trials and errors. My overall goals were modest but I found so many exciting things to explore that I have gone off the main track a few times too many.

My primary goal “…to complete and deploy core functionality modules, including point-of-interest/ local search and driving directions” for is still in progress. Implementing fluid DIV elements to fit dynamic content is proving a challenge for a page which already has a complex structure. Development time on all my pet projects has totally blown out of proportions and several major functionality and content improvements are still only in partly finished state, not ready for deployment. A few blog articles I promised are still at early draft stage as I could not find enough time to finish them. My experiments with Twitter and online player for YouTube videos have gone stale although there is still a great potential there, only if I can put some effort into implementing improvements. Too many ideas, too little time…

However, on the positive side, free weather widget is proving very popular (just reached 70K loads a month and traffic is growing fast). This blog, although attracting only a modest audience of 1.5-2k visitors a month, already has Google PR 5 rank (which demonstrates clearly the power of quality links!). Cooperation with Keir Clarke from Google Maps Mania helped to rise the blog’s profile significantly and contributed some traffic to featured articles. Search engine traffic is growing steadily and many pages are in top 5 spot for several attractive keywords. Overall traffic to my mapping site has grown at a double digits pace in the last year and general pickup in online advertising spent is clearly evident on my monthly Adsense statements.

The theme for this year will be “FOCUS”! I have one great new idea that brings together many of my experiments, into a single, powerful and unique application concept (with online and desktop potential, as a freebie and software-as –a-service option). I would like to bring onboard a team of developers to help me reach 2010 milestones at acceptable pace so my concept “number 1,367” can be launched as soon as possible. Stay tuned!

Wednesday, January 27, 2010

Guest Blogger Before and After: Jennifer from The Newlywed Diaries

Hi everyone, it's Jennifer from The Newlywed Diaries here to show one of my favorite spaces in my house. First off, I just want to say that I am by no means a professional designer. I'm just a young newlywed with a desire to create a beautiful home on a real budget.

We're coming up on two years in our house, and the dining room is just now feeling "done" -- it started out as blank as it could get. It is between the kitchen and the living room, so we spend a lot of time there and wanted it to be multi-use space that was pretty and functional.

My mom found this barley-twist table at auction for a steal and gave it to us has a housewarming gift. Having a table in the room was definitely a step up from the months when our old sofa was against the wall (luckily no pictures of that exist).

Also in the room is a pair of chairs that my great-grandmother bought in the 1960s. They are in a great condition as they sat for years in a living room that was seldom used and then in an out-of-the-way corner in my family's lake cabin. I rescued them from being sent to the Goodwill when the house was redone and I love their French-inspired lines and don't care that they were mass-produced. Before: The pea-green chenille upholstery left a little to be desired.

After: I had the chairs were recovered in a simple linen with blue paisley embroidery and I cannot even express how much I love them now. (Photo by Becky-Luigart Stayner).

The other big piece in the room is a simple dresser (which also came from the lake house -- I'm not one to turn down free furniture!) that we use as a sideboard. Before: It was pretty dingy and the square drawer pulls were strange.

After: I cleaned it up and added a few coats of paint (Benjamin Moore's Stratton Blue -- leftover from my mom's living room). Oh and new hardware, though to be honest, I think I'm ready to replace those already (whoops!).

Having extra storage here has been essential. Our house is without a defined entry, so the table becomes the dumping spot for mail and whatever else. Those drawers hide a multitude of sins, and Lauren, I'm waiting on you to do a drawer clean-out so I can join!

So this is how we lived for a while. Totally fine, just nothing special. The walls are painted the same color as the living room (Benjamin Moore's Grant Beige), and my handy husband even added crown molding (painted BM Bennington Gray). Oh, and there's our dog, Maddie, can't leave her out!

Things really started to come together when we found an old lantern at a local antique shop -- exactly the kind we'd been looking for! The brass had been painted with a steel blue-gray color that went perfectly with the adjoining living room.

We had it rewired and wow! It really made a difference in the room. It was definitely the biggest single expense in the room, but was around what you might pay for a new lantern that size (believe me, I've looked at them all!). For us, its an investment that will definitely be coming with us to the next house (sorry, future home owners). The mirror was a Christmas gift from my mom last year (Brayden Arch by Uttermost, if you're interested).

Here is the room today. I hate to say "finished" because I'm like Lauren -- always moving things around -- but all of the big things are in place and we're quite pleased with how it's come together. The white upholstered chairs are our first Ikea purchase. They are super-comfortable and you really can't beat the price. It was a little scary to eat on white at first (though I actually served a red sauce the first time we used them!) but the slipcovers are machine-washable and can be purchased separately if one gets ruined.

The chairs sit under my "ironstone" platters which came from HomeGoods (my favorite!). The seagrass rug is another great HomeGoods find that really helped the room come together.

The top of the blue chest gets changed with the seasons (and according to my mood) and right now it is holding some meaningful things: the ceramic candle holder was Wes' grandmother's, the books are on my favorite subjects (decorating, collecting, cooking, old houses), the pewter pitcher has some grocery-store tulips, we picked up the old books at yard sales and flea markets, and the ruffled bowl holds Werther's candies -- Wes' favorite! I bought the marble lamp on a shopping trip with Eddie Ross in Atlanta, and the shade is from Martha Stewart's collection at K-Mart, which I dearly miss!

Whew! I think that was the longest post I've ever written -- hope you're still with me! Lauren, thank you so much for including me. I hope to meet lots of new blog friends!

-------------------------------------------------------------------------------- goodness.  Jennifer thank you so much for for sharing your gorgeous dining room with us. I think I can safely say that we're all crazy over that chair fabric!!  Your style is so beautiful & I love seeing how your space came together with things you already had & were able to completely renew.  Thank you for sharing!!


ps-  Don't forget to vote for Eddie's Bloomingdale's Window!  ( link at the top of the right sidebar) Dave & I are headed to NYC to celebrate (fingers crossed!) Eddie & Elle Decor's win and I'll be sure to take lots of pictures!

Tuesday, January 26, 2010

Time (Or Lack Thereof)

After reading everyone's desired super powers in the comments of this post, I was struck by how many of us said we wished we could snap our fingers & have chores finished (most mentioned was laundry), have more time to get everything done, be cloned because there's too much to do, and even grow extra arms to help with all of the work around the house!    I do think that some people came up with the perfect solution of BEING MARY POPPINS.  She can do shores in a snap and fly. 

But really, is this where we've come to?  Are we SO slammed with chores & work & short for time that we will pass up magical, incredible, unreal possibilities (C'mon!  Starting fire with a glance- controlling the weather- super strength- moving objects with our minds- flying- breathing underwater- talking to people through their dreams- etc ) for help with our house work??

I loved reading everyone's "super powers" but in a way I was a little bummed by the truth of how insanely busy we all are.  I didn't pick a chore-related power as my super power, but truth-be-told, I sort of wanted to...  I mean, the laundry situation in our house is insane.  And we only have two kids.

I'm not complaining about the chores,  (Ok, maybe a little) because it is just life, but it did get me thinking of what I could to to make it a little easier.  And I'm not sure I came up with any real solutions, but I do believe that even attempting to come up with solutions at least gets you thinking & makes you more aware of how precious your time is. 

We're all pressed for time.  There's never enough of it.  We have so much to do and so many people rely on us to get things done.  Laundry is endless (yes, I hate laundry) and it seems that just when you finish vacuuming one room, another one's dirty.  Can you even count the number of times you clean crumbs off of the counter a day?  Or do dishes or dust a surface (ok, I never really dust! ;) or pick & put away something that's not yours?   (And honestly, I'm so messy myself!) 

Look how happy she is:

 I'm not her.  I hate to clean.   But I do it because if I didn't, I'd eventually become a cat lady and my house would try to eat me & my neighbors would call the authories on me because of the smell and the trash pileup.  (Ok, and I love a pretty house & all the designing/ decorating would be wasted.)  ...  So all of these chores just have to happen. But is there any way to do these things more efficiently? 

Enlisting our kind friends from the forest?? 

How do we want to spend our time?  Most of us seem to want to spend it with the people we love.  To spend time working on what we love to do...  our passions....  Reading, writing, creating, designing, being good sisters, daighters, friends, girlfriends, wives, moms, granparents...  Doing fun things, making memories...  So how can we spend more time doing the things we want to do and less time with chores & house work? 

--On a sidenote, I believe time is money & money is time.  My idea of success is not based upon money, but rather on happiness.  A happy person is a successful one to me.  (Now a happy, rich person?  Well hot damn! ;)    ---

Anyway, the first thing that comes to mind is that anyone who can afford a cleaning service & doesn't already have one, should hire one asap.   That time that you would have spent cleaning, you can now spend in better ways.  So maybe you don't have as much money in the bank at the end of the month, but you do have more time at the end of the month.  And if you spent that time wisely, you have more memories, more bonding with the people you love, and a less harried life. 

Now what about those of us who can't afford a cleaning service?  (above)  Or those of us who already have one and are still pressed to the max??  (Laundry NEVER stops!!!)  Well, there HAS to be something we can do.  Something to make it more efficient.  A system perhaps?  Can we really possibly doing it the best possible way already?  I don't really know the answer. 

There are probably things all of us can cut out a little.  TV?  Chatting on the phone for too long? And dare I say it, blogging?   (oh that hurt to type.)  We could probably move faster too.  Some of us wanted lightning speed to get chores done quickly...  so maybe we should try going as fast as we physically can?  I know some people like to set the timer for a short period of time (my Grandmother!) and get as much as they can accomplish finished before the buzzer goes off.   I also love getting my toddler involved in chores and trying to have fun so it's less painful... 

And when I get REALLY pressed for time, the first thing I do is create a schedule.  I plan out my entire day. 

When I had my first baby, I was unprepared for life with a newborn.  I knew I'd be exhausted & slammed, but I didn't know what it would really be like.  After going through a few weeks or months (it's a haze) barely sleeping, eating, hanging out, never really relaxing and completely fawning over our new sweetie pie, my husband & I realized that we needed a solution.  We needed "us" time and it seemed like there was always something- laundry, cleaning, working, etc.- that kept us from enjoying each other & doing the things we really wanted to do and feel like good parents.  (Him- work out, me- work on a new business.)  SO, we created a weekly schedule.  On the back we both wrote what we wanted to do weekly and daily.  We had a date night on there (that could be as simple as making a great dinner at home & watching a movie), We had work-outs on there, a daily walk as a family, I had a couple of hours a day of business I needed to get done, and I even wrote "shower before 3:00" on there because as that point I was having trouble putting the baby down because the poor little guy would wail his head off if I did.  Anyway, once we wrote down the things that needed to happen, we put them into time slots on the schedule.  We didn't put chores on there.  Just the good things.  We did the chores in the unscheduled time. 

We basically reversed out priorities.   (In effect, the chores were still on there, but not written down, so the good things became the bigger priority.)  We weren't perfect at sticking to it, but it was something to strive for.  And it made a huge difference.  We still had piles of laundry and were behind on chores (like we'd always been) but we were happier, more satisfied.  We realized that a walk with each other around the lake was going to do us a lot more good than cleaning the house.

And the good thing was, that I knew when I was hanging out, bonding with Christian, that I didn't have to feel any guilt over not working, because it was scheduled in for later in the day and I would get it done.  (Working from home/ running your own business is often hard to balance:  when you're working you often feel guilty about not spending enough time with your family, and when you're with your family, it's easy to think about how much work is waiting for you in the other room.)  Anyway, I know it's not rocket science, but at the time it felt like it.  Life had completely changed for us & we needed a new way to handle it.

Well, life has changed for us yet again.  Add in another baby (Justin Alexander, above) and a business that's now full-time AND BLOGGING...  and, well, let's just say the laundry room floor is waist-high in clothes.  (And I haven't even gone "back to work yet!")  So it's time to break out a new schedule. 

And my new plan is to race through the chores...  To move like lightning!!  I think music & a timer will help... I'll let you know how it goes.  Could you share your ideas?  Life is short, so let's live it. 


ps-  Don't forget to vote for Eddie's Bloomingdales window today!!  (at the top right of the sidebar)  THANK YOU!!!!

We've also got a giveaway winner!!  (see previous post)

Giveaway Winner

The Lisa Leonard Giveaway Winner is Terri Wright!  Terri, please email me your address at and Lisa will contact you about selecting your custom jewelry piece!!

Sunday, January 24, 2010

Pure Organization Project #4: Update an "Ugly" (Bathroom Sink)

Well, you all said you were interested in even seeing the not-so-pretty projects, so this one definitely fits the bill!  Our kids' bathroom is AWFUL.  Really bad.  (And it's also the bathroom nearest the main living area so everyone uses it.)  Our house was built in the 70s and so was graced with beautiful green bathroom fuxtures!!  yum yum pretty...

When we replaced the old linoleum floors with hardwoord, we (Dave) installed a new white toilet. Since then, I've been dying for a new sink.  The green shower can be hidden by a shower cutrain but that sink is just out there.  We bought a new sink and then returned it, realizing that this bathroom isn't a space we want to put any money into right now.   So as a temporary fix, I decided to try out a porcelain refinishing paint kit from here for around $50.   It was a simple 2-step process of spraying on primer (2 coats) and then multiple coats of the spray-on Epoxy/ Porcelain Hard Finish. So here it is before:

And here it is now (san- new caulk-  that's happening soon):

It's SO MUCH better now.  My mom gave me these cute little blue gungham animal towel sets for the boys (from PB Kids)  and so I'm using these as the starting point for the design. 

I'm planning on sewing a sink skirt that removes with velco (thanks Eddie!) to hide a couple baskets of toiletries/ diapers/ etc.  I've also got a blue & white sheet to tun into the shower curtain & some art work for the walls.  Dave's adding in some woodwork for towel hooks.  We may or may not paint from there.  So, how did the spray on stuff work?  It looks much MUCH better but there is still a bit of a greenish hue about the sink when comparing it to the white toilet which is next to it.  If you look right at it alone it looks like a pure white as seen in this pic:

Since we haven't used it yet (we're letting it cure) I can't tell you about its performance.  I'll let you know how it's working in a month or so.  But for now, I'm very happy with it as an intermediate fix until we're able to do more in here.   When we're finished with this little bathroom redo, I'll of coures take pics & show you!

And now for Project #4:  Update an "Ugly"

Maybe you're lucky enough that you've already updated your uglies (Oh how I wish I were!!) and if so, you get the week off!! :)  But if you're like me and live in an old house or even a house that was done by someone else, or like to collect flea market pieces in need of a little TLC, you probably have some things that need a little updating or freshening up.  Door or cabinet hardware?  Any furniture you've been planning on repainting or refinishing?  Light fixtures?  Faucets?  Outlet covers?  Mailbox?  Door knocker?  Anyway, doing this little thing makes our whole bathroom feel 100 times less fugly.  Is there anything you can do to update a little something in your house?

UPDATE**  I LOVE getting all your photos & seeing them, but I'm getting so many that I've decided to use Mr.Linky's widgets so that you can link up to your photos straight from the post.  As soon as I figure out how to set it up, I will add it on to the end of this post so check back!! :)

Goodl luck!!    THANK YOU!!!

ps - Don't forget to vote again for Eddie's window!  (The top right pic on my sidebar is a link to the voting and you can also text "1" to 89800)

And tonight is that last night for the LISA LEONARD DESIGNS GIVEAWAY (previous post) so be sure to enter!! :)

Saturday, January 23, 2010

The Body Fat Setpoint, Part III: Dietary Causes of Obesity

[2013 update: I've edited this post to remove elements that I feel were poorly supported.  I now think that changes in the setpoint are at least partially secondary to passive overconsumption of calories, particularly low quality calories]

What Caused the Setpoint to Change?

We have two criteria to narrow our search for the cause of modern fat gain:
  1. It has to be new to the human environment
  2. At some point, it has to cause leptin resistance or otherwise disturb the setpoint
Although I believe that exercise is part of a healthy lifestyle, and can help prevent fat gain and to some degree treat overweight, it probably can't explain the recent increase in fat mass in modern nations. This is because exercise doesn't appear to have declined. There are various other possible explanations, such as industrial pollutants, a lack of sleep and psychological stress, which may play a role. But I feel that diet is likely to be the primary cause. When you're drinking 20 oz Cokes, bisphenol-A contamination is the least of your worries.

In the last post, I described two mechanisms that may contribute to elevating the body fat set point by causing leptin resistance: inflammation in the hypothalamus, and impaired leptin transport into the brain due to elevated triglycerides. After more reading and discussing it with my mentor, I've decided that the triglyceride hypothesis is on shaky ground*. Nevertheless, it is consistent with certain observations:
  • Fibrate drugs that lower triglycerides can lower fat mass in rodents and humans
  • Low-carbohydrate diets are somewhat effective for fat loss and lower triglycerides
  • Fructose can cause leptin resistance in rodents and it elevates triglycerides (1)
  • Fish oil reduces triglycerides. Some but not all studies have shown that fish oil aids fat loss (2)
Inflammation in the hypothalamus, with accompanying resistance to leptin signaling, has been reported in a number of animal studies of diet-induced obesity. I feel it's likely to occur in humans as well, although the dietary causes are probably different for humans. The hypothalamus is the primary site where leptin acts to regulate fat mass (3). Importantly, preventing inflammation in the brain prevents leptin resistance and obesity in diet-induced obese mice (3.1). The hypothalamus is likely to be the most important site of action. Research is underway on this.

The Role of Digestive Health

What causes inflammation in the hypothalamus? One of the most interesting hypotheses is that increased intestinal permeability allows inflammatory substances to cross into the circulation from the gut, irritating a number of tissues including the hypothalamus.

Dr. Remy Burcelin and his group have spearheaded this research. They've shown that high-fat diets cause obesity in mice, and that they also increase the level of an inflammatory substance called lipopolysaccharide (LPS) in the blood. LPS is produced by gram-negative bacteria in the gut and is one of the main factors that activates the immune system during an infection. Antibiotics that kill gram-negative bacteria in the gut prevent the negative consequences of high-fat feeding in mice.

Burcelin's group showed that infusing LPS into mice on a low-fat chow diet causes them to become obese and insulin resistant just like high-fat fed mice (4). Furthermore, adding 10% of the soluble fiber oligofructose to the high-fat diet prevented the increase in intestinal permeability and also largely prevented the body fat gain and insulin resistance from high-fat feeding (5). Oligofructose is food for friendly gut bacteria and ends up being converted to butyrate and other short-chain fatty acids in the colon. This results in lower intestinal permeability to toxins such as LPS. This is particularly interesting because oligofructose supplements cause fat loss in humans (6).

A recent study showed that blood LPS levels are correlated with body fat, elevated cholesterol and triglycerides, and insulin resistance in humans (7). However, a separate study didn't come to the same conclusion (8). The discrepancy may be due to the fact that LPS isn't the only inflammatory substance to cross the gut lining-- other substances may also be involved. Anything in the blood that shouldn't be there is potentially inflammatory.

Overall, I think gut dysfunction could play a role in obesity and other modern metabolic problems.
Exiting the Niche

I believe that we have strayed too far from our species' ecological niche, and our health is suffering. One manifestation of that is body fat gain. Many factors probably contribute, but I believe that diet is the most important. A diet heavy in nutrient-poor refined carbohydrates and industrial omega-6 oils, high in gut irritating substances such as gluten and sugar, and a lack of direct sunlight, have caused us to lose the robust digestion and good micronutrient status that characterized our distant ancestors. I believe that one consequence has been the dysregulation of the system that maintains the fat mass "setpoint". This has resulted in an increase in body fat in 20th century affluent nations, and other cultures eating our industrial food products.

In the next post, I'll discuss my thoughts on how to reset the body fat setpoint.

The ratio of leptin in the serum to leptin in the brain is diminished in obesity, but given that serum leptin is very high in the obese, the absolute level of leptin in the brain is typically not lower than a lean person. Leptin is transported into the brain by a transport mechanism that saturates when serum leptin is not that much higher than the normal level for a lean person. Therefore, the fact that the ratio of serum to brain leptin is higher in the obese does not necessarily reflect a defect in transport, but rather the fact that the mechanism that transports leptin is already at full capacity.

Thursday, January 21, 2010

Lisa Leonard Designs

I'm so excited to tell you about this GIVEAWAY from Lisa Leonard Designs!!   Her jewelry is so unique and just looks like it was made with love. 

 I'm always inspired by stories of people who take risks and follow their hearts to create sucessful businesses.  I think Lisa's story is best told by her: 

I have been making jewelry since high school but I decided to get serious after my first son, David, was born. I wanted to start a small business that would enable me to quit my job and stay home with my boys. At the time, I had never taken any formal classes or received special training in jewelry making. I just went for it! I am kind of the 'jump in and learn as you go' type. Creating jewelry not only allowed me to work from home, but has connected me with so many amazing women along the way.

My desire is to create simple, lovely pieces that can be worn with jeans or your little black dress. I want each piece to meaningful. Our custom jewelry is hand-stamped with your kids’ names or a special phrase or verse. I love to touch my necklace throughout the day and reflect on my husband and my sweet boys.

Each piece we create is a work of art—hand cut, hammered, polished, drilled and assembled with care. I am inspired by other artists--painters, scrapbookers, clothing designers and poets. I also love to soak up nature-the sky, the sea, the green hills. I let all these ideas and images swirl around in my mind and then I create. When an idea hits me I sketch it out and play until the perfect design comes together.  Lisa Leonard Designs exists because moms, grandmas and friends have shared our designs with each other while waiting in line at the grocery store or sipping coffee with a friend.

sloan photography:

Lisa has generously offered to give away one of her beautiful pieces to a reader. 

How cute is the spoon above?!  What a perfect gift for a new baby!   And the chandy necklace below?!!  Can you see how unique they are?  See how the names are stamped into the sterling silver?

And yes, I got something wonderful too out of this giveaway!!!  Lisa was sweet enough to send me the Family Crest necklace  (below) and I absolutely LOVE LOVE LOVE it!!!  It's just incredible and is the perfect thing to wear everyday.  Seeing the photos of her jewelry is one thing, but they're just amazing in real life.  I haven't been crazier over a piece of jewelry in a VERY long time. 

All you have to do to enter the giveaway is leave a comment answering this question:  If you could have any superpower, what would it be?  (And being able to heal people doesn't count because I think most of us would probably choose that, except my husband, who claims he wants a tail, which even isn't a superpower and is so gross.  He won't tell me his real coveted superpower.)     

I'll pick a name at Random, check back on Tuesday to see who won.  If you win, you'll  get to choose your favorite piece from the website & Lisa will send it to you.  Lisa also has a beautiful blog here with lots of pretty inspiration.

...  And I WOULD FLY!!! 
(Flying dreams are the best!!!)


ps-  Don't forget to vote again for Eddie's Elle Decor Window for Bloomindales!  (On the top of the right sidebar is a photo link to the voting.  :)

*All images from Lisa Leonard Designs

Wednesday, January 20, 2010

Krauss's New Article on Saturated Fat Intervention Trials

Dr. Ronald Krauss's group just published another article in the American Journal of Clinical Nutrition, this time on the intervention trials examining the effectiveness of reducing saturated fat and/or replacing it with other nutrients, particularly carbohydrate or polyunsaturated seed oils. I don't agree with everything in this article. For example, they cite the Finnish Mental Hospital trial. They openly acknowledge some contradictory data, although they left out the Sydney diet-heart study and the Rose et al. corn oil study, both of which suggested increased mortality from replacing animal fats with polyunsaturated seed oils. Nevertheless, here is the conclusion:
Particularly given the differential effects of dietary saturated fats and carbohydrates on concentrations of larger and smaller LDL particles, respectively, dietary efforts to improve the increasing burden of CVD risk associated with atherogenic dyslipidemia should primarily emphasize the limitation of refined carbohydrate intakes and a reduction in excess adiposity.

Saturday, January 16, 2010

The Body Fat Setpoint, Part II: Mechanisms of Fat Gain

The Timeline of Fat Gain

Modern humans are unusual mammals in that fat mass varies greatly between individuals. Some animals carry a large amount of fat for a specific purpose, such as hibernation or migration. But all individuals of the same sex and social position will carry approximately the same amount of fat at any given time of year. Likewise, in hunter-gatherer societies worldwide, there isn't much variation in body weight-- nearly everyone is lean. Not necessarily lean like Usain Bolt, but not overweight.

Although overweight and obesity occurred forty years ago in the U.S. and U.K., they were much less common than today, particularly in children. Here are data from the U.S. Centers for Disease Control NHANES surveys (from this post):

Together, this shows that a) leanness is the most natural condition for the human body, and b) something about our changing environment, not our genes, has caused our body fat to grow.

Fat Mass is Regulated by a Feedback Circuit Between Fat Tissue and the Brain

In the last post, I described how the body regulates fat mass, attempting to keep it within a narrow window or "setpoint". Body fat produces a hormone called leptin, which signals to the brain and other organs to decrease appetite, increase the metabolic rate and increase physical activity. More fat means more leptin, which then causes the extra fat to be burned. The little glitch is that some people become resistant to leptin, so that their brain doesn't hear the fat tissue screaming that it's already full. Leptin resistance nearly always accompanies obesity, because it's a precondition of significant fat gain. If a person weren't leptin resistant, he wouldn't have the ability to gain more than a few pounds of fat without heroic overeating (which is very very unpleasant when your brain is telling you to stop). Animal models of leptin resistance develop something that resembles human metabolic syndrome (abdominal obesity, blood lipid abnormalities, insulin resistance, high blood pressure).

The Role of the Hypothalamus

The hypothalamus is on the underside of the brain connected to the pituitary gland. It's the main site of leptin action in the brain, and it controls the majority of leptin's effects on appetite, energy expenditure and insulin sensitivity. Most of the known gene variations that are associated with overweight in humans influence the function of the hypothalamus in some way (1). Not surprisingly, leptin resistance in the hypothalamus has been proposed as a cause of obesity. It's been shown in rats and mice that hypothalamic leptin resistance occurs in diet-induced obesity, and it's almost certainly the case in humans as well. What's causing leptin resistance in the hypothalamus?

There are three leading explanations at this point that are not mutually exclusive. One is cellular stress in the endoplasmic reticulum, a structure inside the cell that's used for protein synthesis and folding. I've read the most recent paper on this in detail, and I found it unconvincing (2). I'm open to the idea, but it needs more rigorous support.

A second explanation is inflammation in the hypothalamus. Inflammation inhibits leptin and insulin signaling in a variety of cell types. At least two studies have shown that diet-induced obesity in rodents leads to inflammation in the hypothalamus (3, 4)*. [2013 update: several studies have shown that preventing hypothalamic inflammation attenuates fat gain in obesity models].  If leptin is getting to the hypothalamus, but the hypothalamus is insensitive to it, it will require more leptin to get the same signal, and fat mass will creep up until it reaches a higher setpoint.

The other possibility is that leptin simply isn't reaching the hypothalamus. The brain is a unique organ. It's enclosed by the blood-brain barrier (BBB), which greatly restricts what can enter and leave it. Both insulin and leptin are actively transported across the BBB. It's been known for a decade that obesity in rodents is associated with a lower rate of leptin transport across the BBB (5, 6).

What causes a decrease in leptin transport across the BBB? Triglycerides are a major factor. These are circulating fats going from the liver and the digestive tract to other tissues. They're one of the blood lipid measurements the doctor makes when he draws your blood. Several studies in rodents have shown that high triglycerides cause a reduction in leptin transport across the BBB, and reducing triglycerides allows greater leptin transport and fat loss (7, 8). In support of this theory, the triglyceride-reducing drug gemfibrozil also causes weight loss in humans (9)**. Low-carbohydrate diets, and avoiding sugar and refined carbohydrates in particular, reduce triglycerides and produce weight loss, although that doesn't necessarily mean one causes the other.

In the next post, I'll get more specific about what factors could be causing hypothalamic inflammation and/or reduced leptin transport across the BBB. I'll also discuss some ideas on how to reduce leptin resistance sustainably through diet and exercise.

* This is accomplished by feeding them sad little pellets that look like raw cookie dough. They're made up mostly of lard, soybean oil, casein, maltodextrin or cornstarch, sugar, vitamins and minerals (this is a link to the the most commonly used diet for inducing obesity in rodents). Food doesn't get any more refined than this stuff, and adding just about anything to it, from fiber to fruit extracts, makes it less damaging.

** Fibrates are PPAR agonists, so the weight loss could also be due to something besides the reduction in triglycerides.

Thursday, January 14, 2010

New Saturated Fat Review Article by Dr. Ronald Krauss

Dr. Ronald Krauss's group has published a review article titled "Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease". As anyone who's familiar with the literature could have predicted (including myself), they found no association whatsoever between saturated fat intake and heart disease or stroke:
A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD.

Sunday, January 10, 2010

Paleo is Going Mainstream

There was an article on the modern "Paleolithic" lifestyle in the New York Times today. I thought it was a pretty fair treatment of the subject, although it did paint it as more macho and carnivorous than it needs to be. It features three attractive NY cave people. It appeared in the styles section here. Paleo is going mainstream. I expect media health authorities to start getting defensive about it any minute now.

[2013 update.  Did I call it or what??]