More On Sugar And Obesity

Here is yet another study linking sugar and sweetened beverages to obesity.  The importance of avoiding excess sugar consumption and of avoiding drinking empty calories is underscored here. These sorts of dietary changes can have a large impact on overall health.

Sedentary Lifestyle And Your RNA

Take a look at this paper from several years ago, abstract:

Pioneering epidemiological work has established strong association of sedentary lifestyle and obesity with the risk of colorectal cancer, while the detailed underlying mechanism remains unknown. Here we show that Hotair (HOX transcript antisense RNA) is a pro-adipogenic long non-coding RNA highly expressed in gluteal-femoral fat over other fat depots. Hotair knockout in adipose tissue results in gluteal-femoral fat defect. Squeeze of the gluteal-femoral fat induces intestinal proliferation in wildtype mice, while not in Hotair knockout mice. Mechanistically, squeeze of the gluteal-femoral fat induces exosomal Hotair secretion mainly by transcriptional upregulation of Hotair via NFκB. And increased exosomal Hotair in turn circulates in the blood and is partially endocytosed by the intestine, finally promoting the stemness and proliferation of intestinal stem/progenitor cells via Wnt activation. Clinically, obese subjects with sedentary lifestyle have much higher exosomal HOTAIR expression in the serum. These findings establish that sedentary lifestyle promotes exosomal Hotair release from the gluteal-femoral fat, which in turn facilitates intestinal stem and/or progenitor proliferation, raising a possible link between sedentary lifestyle with colorectal tumorigenesis.

So, there is a link between a sedentary lifestyle, and release of this HOTAIR RNA from fat, which in turn promotes the growth of intestinal stem cells and/or progenitors - cells that form the target population for mutation leading to colorectal cancer.  The importance of an active lifestyle and a lean physique is underscored by these findings, in my opinion.

Dietary Lapses

What is the frequency and predictors of dietary lapses?  A paper from several years ago looks into this, abstract:

BACKGROUND:

Adherence to dietary prescriptions is critical for successful weight loss and weight loss maintenance. However, research on specific instances of inadherence (lapses) is limited, and findings regarding the frequency, nature, and causes of lapses are mixed. Additionally, no studies have examined lapses over the course of a weight loss program.

PURPOSE:

In the context of a reduced calorie diet prescribed as part of a behavioral treatment, we aimed to characterize lapse occurrence, examine lapse frequency across treatment, examine predictors of lapses, and assess the relationship between lapses and weight loss.

METHODS:

Adults (n = 189) enrolled in a 12-month behavioral weight loss program completed ecological momentary assessment (EMA) at baseline, mid-treatment, and end of treatment. At each EMA survey, participants indicated whether a lapse had occurred, and responded to questions assessing situational, environmental, and affective states.

RESULTS:

Lapse frequency showed a curvilinear relationship over time, such that frequency first decreased and then increased. Lapse frequency at baseline was negatively associated with early and overall weight loss. Lapses most often occurred at home, in the evenings, on the weekends, and entailed eating a forbidden food. Greater overall levels of assessed affective and environmental triggers predicted lapses, and greater momentary hunger and deprivation, and the presence of palatable food, also prospectively predicted lapses.

CONCLUSIONS:

In addition to characterizing lapse frequency, the current study identified prospective predictors of lapses across treatment. These findings support the importance of lapses to weight control and provide insight for potential targets of intervention to prevent lapse occurrence.

One point I would raise in response to: "Lapses most often occurred at home, in the evenings, on the weekends, and entailed eating a forbidden food. Greater overall levels of assessed affective and environmental triggers predicted lapses, and greater momentary hunger and deprivation, and the presence of palatable food, also prospectively predicted lapses" is to suggest that a pre-planned cheat meal (for those more overweight) or cheat day (or those who cab be more flexible, who have less weight to lose) may alleviate some of these problems.  The key is discipline, not to "cheat" all week.  "Cheating" may help reset metabolism and leptin levels and avoid the slowing of metabolism that accompanies dieting (although this requires more evidence).  The psychological benefits are obvious.

Another Study On Obesity And Kidney Disease

It should come as no surprise that obesity contributes to chronic kidney disease as explained in this paper.  Abstract:

Obesity has become a worldwide epidemic, and its prevalence has been projected to grow by 40% in the next decade. This increasing prevalence has implications for the risk of diabetes, cardiovascular disease and also for Chronic Kidney Disease. A high body mass index is one of the strongest risk factors for new-onset Chronic Kidney Disease. In individuals affected by obesity, a compensatory hyperfiltration occurs to meet the heightened metabolic demands of the increased body weight. The increase in intraglomerular pressure can damage the kidneys and raise the risk of developing Chronic Kidney Disease in the long-term. The incidence of obesity-related glomerulopathy has increased ten-fold in recent years. Obesity has also been shown to be a risk factor for nephrolithiasis, and for a number of malignancies including kidney cancer. This year the World Kidney Day promotes education on the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that makes preventive behaviors an affordable option.

Nephrolithiasis is the formation of kidney stones, which are quite painful (I have had them). Chronic kidney disease and kidney cancer are obviously key effectors of morbidity and mortality and anything we can do – including maintaining a healthy body weight – to avoid such outcomes would be well worth it.

An Optimal Diet?

An article on whether there is an optimal diet for weight management and metabolic health can be found here.

The bottom line is that while different types of diets may stress optimizing different health outcomes (low fat diets helping with LDL; low carb diets helping more with triglycerides and HDL), the main point is to adhere to a healthy diet.  Both low fat and low carb can work; people have different preferences, but if you are overweight, sticking to a diet that results in weight loss will improve many metrics of health and fitness.

Fat Tissue miRNAs

Here is an article from several years ago that should raise some eyebrows, and we'll have to keep track of further developments in this field.  Abstract:

Adipose tissue is a major site of energy storage and has a role in the regulation of metabolism through the release of adipokines. Here we show that mice with an adipose-tissue-specific knockout of the microRNA (miRNA)-processing enzyme Dicer (ADicerKO), as well as humans with lipodystrophy, exhibit a substantial decrease in levels of circulating exosomal miRNAs. Transplantation of both white and brown adipose tissue-brown especially-into ADicerKO mice restores the level of numerous circulating miRNAs that are associated with an improvement in glucose tolerance and a reduction in hepatic Fgf21 mRNA and circulating FGF21. This gene regulation can be mimicked by the administration of normal, but not ADicerKO, serum exosomes. Expression of a human-specific miRNA in the brown adipose tissue of one mouse in vivo can also regulate its 3' UTR reporter in the liver of another mouse through serum exosomal transfer. Thus, adipose tissue constitutes an important source of circulating exosomal miRNAs, which can regulate gene expression in distant tissues and thereby serve as a previously undescribed form of adipokine.

So we have known for a long time that fat (adipose) tissue can release macromolecular factors (adipokines) that can affect metabolism of other tissues.  These adipokines may mediate some  of the negative health effects of obesity including an increased risk for cancer. MicroRNAs (miRNAs) are small RNA molecules that affect gene expression by binding to target mRNA and are this crucially important to both normal function and to disease.  Initially, it was thought that the miRNAs operated within the cell producing them, but later it was learned that miRNAs can be released by one cell to affect others (exosomal miRNAs).  This paper shows that fat tissue is an important source of such circulating miRNAs, demonstrating another mechanism by which fat tissue can affect metabolism of other parts of the body, contributing to human disease.

The harmful effects of overweight/obesity keep on growing.

Some Adventures In Body Composition

Does body composition affect food intake and, hence, obesity?  It seems so.  Abstract:

In his last review entitled "Some Adventures in Body Composition," Gilbert Forbes reminded us that "lean body mass and body fat are in a sense companions." To what extent the lean body mass (or fat-free mass) component in this companionship impacts on energy intake is rarely a topic for discussion, amid a dominant adipocentric view of appetite control. Yet an analysis of the few human studies that have investigated the relationships between objectively measured food intake and body composition reveals a potentially important role for both an increase and a decrease in fat-free mass in the drive to eat. These studies are highlighted here, together with the implications of their findings for research directed as much toward the elucidation of peripheral signals and energy-sensing mechanisms that drive hunger and appetite, as toward understanding the mechanisms by which dieting and sedentariness predispose to fatness.

A deficit in lean body mass may lead to overeating/obesity, dieting may, and a sedentary lifestyle.  It would seem that exercise that builds lean body mass, overall physical activity, and a healthy diet that avoids overly strict "fad dieting" may all be helpful in regard to this.

Short Chain Fatty Acids And Weight Loss

Can short chain fatty acids contribute to weight loss?  A paper looks at this, abstract:

Elucidating the mechanisms by which short chain fatty acids (SCFA) reduce body weight may assist in the development of an effective weight control strategy. Dietary supplementation of acetate, propionate, butyrate or their admixture was shown to significantly inhibit the body weight gain induced by high-fat diet feeding. Supplementation of SCFAs caused significant changes in the expressions of G-protein coupled receptor 43 (GPR43) and GPR41 characterized by increases in the adipose tissue and reductions in the colon. Additionally, they influenced the bacterial community structure in feces, with a reduction in the proportion of Firmicutes and an increase in the proportion of Bacteroidetes. The effects of dietary SCFAs on the GPR expression and gut microbiota composition may further result in body weight reduction by enhancing triglyceride hydrolysis and FFA oxidation in the adipose tissue, promoting beige adipogenesis and mitochondrial biogenesis, and inhibiting chronic inflammation.

Keep in mind that short chain fatty acids can be produced in the colon by the fermentation of dietary fiber by the gut microbiota, with beneficial effects for colonic health.  However, the effects described in this paper required direct supplementation of these agents into the diet of the test mice.  Nevertheless, the findings suggest a role for short chain fatty acids in weight control.

Carbon Dioxide Secretion And Weight Loss

Here is a hypothesis paper that suggests that carbon dioxide excretion maybe linked to problems with weight loss.  Abstract:

Weight regulation depends on the difference between weights of absorbed and metabolised carbon and excretion of the end products of metabolism, calories and carbon dioxide, which can be independently and variably excreted. Calories can be variably excreted as heat by vasoconstriction or vasodilation and carbon dioxide can be excreted variably as exhaled carbon dioxide (the major route of carbon excretion). Unless there are changes in ventilatory carbon excretion, 'metabolism,' 'genetic factors,' 'hormones' or 'exercise' do not provide complete explanatory mechanisms for weight changes, obesity and failure of diets. Low sensitivity of respiratory centres to carbon dioxide may cause overweight and dietary failures after initial weight loss.

Individuals less sensitive to carbon dioxide, and thus with impaired respiratory activity, may have more trouble with obesity and weight loss, opening up new avenues of prevention and treatment.

Bread and pizza every weekend

I love pizza and warm, crusty bread. But we have no bakery close by that caters to healthy food choices. Also, no bakery would customize my pizza toppings the way I want them.

Therefore, for the past two months I have been making my own bread and pizza every weekend. I went through several recipe variations from online sources and simplified until I settled on a short and cheap routine. I do not even have a Dutch oven, which seems to be a prerequisite for all recipes on Internet! I use two cookie sheets instead.

The recipe is for one thin pizza that may or may not feed three people and two small loaves of bread. If you would like to feed more people, scale accordingly or bake bread more frequently. 

I have time to cook only on weekends. Therefore, I prepare the dough on Friday evening, let it rise overnight and bake on Saturday. When I retire, I can bake twice a week. Why? Because the bread and pizza baked at home are superior to any products from the supermarket. They are also cheaper, especially if you buy the ingredients on sale.

As you can see on the picture above, even the "healthy" 100% whole wheat bread is prepared with sugar and honey, plus a ton of "preservatives". 

So, roll up the sleeves and open your own personal bakery. Happy baking!


Ingredients for the dough
6 cups of flour (I use any ratio of white to wheat flour, depending on what I have)*
3 cups warm water
1 packet yeast
1 tsp salt
2-3 Tbsp olive oil


*I recently switched to a different brand of flour and it seems that a ratio of 6.5-7 cups of flour to 3 cups of water is better for some flour brands.  You will establish if you need more flour if the dough cannot be handled at all due to its moisture. To resolve the problem, simply add another 0.5-1 cup of flour.


For the pizza topping
crushed tomatoes (a can of 28 oz)
any seasonings you like; I use lots of hot red pepper flakes, crushed garlic, salt 
any cheese(s) you like, in any quantity

Directions for the dough prep
In a huge bowl, mix the flours and salt. Make a well in the middle and in it, mix the yeast and water. After dissolving the yeast in the water, incorporate all ingredients with your hands. It takes only 2 to 3 minutes. The dough is messy and sticky, and this is normal! Pour some olive oil around the dough ball, roll the ball in the oil and smear the oil on the walls of the bowl. Cover with Saran wrap. I use two pieces of the wrap since the dough size triples overnight. On top, I add a kitchen towel.

The bowl goes on top of the refrigerator and stays there overnight. On the next day, two hours before the pizza is to be served, divide the dough into three equal size balls. Spray two cookie sheets with PAM (this is very important). On one of the cookie sheets, shape one of the balls into a thin layer and spread olive oil on top (the oil will help you press down the dough into a thin layer). The layer should occupy the entire cookie sheet.  On the second cookie sheet, shape the two remaining balls into two rolls to form two loaves of bread. Cover the loaves with Saran wrap again and leave on the kitchen counter for another 30 - 40 minutes. To bake, preheat the oven to 400°F.

Pizza sauce prep
Warm up the crushed tomatoes in a pot, add crushed garlic and spices to taste. Let it simmer for maximum of five minutes under a cover. I use a can of 28 oz tomatoes for two pizzas; one half of the amount is used one week, and the second half is frozen in a jar for the next week’s pizza. 

Baking directions
Before baking the pizza, spread the tomato sauce and arrange the cheese on top of the dough.   Cut diagonal slits on the loaves with a sharp knife (see picture below).

Bake the bread and pizza together. I have two shelves in the oven. On the top shelve, I bake the two loaves, on the middle shelf (under the bread) I bake the pizza. The pizza is done in 15-20 minutes. The loaves take longer (approximately 25-30 minutes). One can leave the loaves in the oven after turning off the heat for another 10 minutes (this allows for a better crust to form).

Lentils, potatoes and sausage

There is nothing better than a steaming, fragrant bowl of soup on a chilly winter day. The one hour of soup cooking warms up the house and sharpens the senses for the upcoming treat.  

The added benefit is that the soup is high in fiber and it will support your effort for normal body weight.

Be prepared to cook for a crowd with this recipe! The low price of the ingredients puts this soup recipe on my short list of dishes for the winter.

Best lentil soup ever 

Ingredients
1 lb green lentils
1 large sweet onion, chopped into cubes
celery, sliced thinly (optional and to the taste)
1 cup carrots, chopped into chunks (or a handful of baby carrots)
garlic, chopped (I usually peel one entire head)
2 large potatoes, cubed (any type)
sausage (any type you like, in any quantity)
spices: salt, winter savory, paprika, hot pepper flakes, mint (anything beyond salt is optional, to your taste)
1 Tbsp olive oil (optional)
to serve: your favorite vinegar or lemon juice
 

Directions
Start with baking the sausage and cutting it into cubes.
While the sausage is baking, take the largest soup pot you have and in it, combine all vegetables except the lentils with 2-3 cups of water and a spoonful of olive oil (optional). Bring to boil and cook until the potatoes are soft (add water, as needed). 

Once the potatoes are soft, stop the heat and mash everything in the pot with a hand masher. After some of the potatoes are mashed (to create the thicker texture of the soup), add the lentils and water to almost the final volume of the soup. I usually add hot water pre-warmed in the microwave or on an additional stove burner.

Once the soup is boiling again, add the cubed sausage and cook until the lentils are ready. Add salt and spices according to your taste. Some suggestions on seasonings are listed above; however, you could change the soup taste by using cardamom, turmeric, bay leaf, etc. I usually stick to winter savory, mint, and hot flakes.

The aroma during the cooking is irresistible. You might notice the rest of the family being attracted to the kitchen by the tantalizing smell. Be patient! Once you add a few drops of lemon or apple cider vinegar to your  bowl, enjoy the most fragrant and nourishing soup ever! 

Bon appetit!

As I indicated, I cook the soup amount for a battalion (well, maybe for 18 - 20 servings).  Therefore, I usually portion the soup into glass jars and freeze. If you do so, be careful not to fill the jars to the brim (otherwise, they may break)!