Comments on: Go Get Yourself A Monkey Kidney http://www.bfdblog.com/2008/01/03/go-get-yourself-a-monkey-kidney/ We're bringing chubby back. Fri, 30 Jul 2010 07:37:28 +0000 http://wordpress.org/?v=2.9.1 hourly 1 By: None Given http://www.bfdblog.com/2008/01/03/go-get-yourself-a-monkey-kidney/comment-page-1/#comment-7355 None Given Mon, 07 Jan 2008 02:45:52 +0000 http://www.bfdblog.com/?p=304#comment-7355 Not at odds if you believe the huge increase in sugars, other highly refined carbs and vegetable oils in the standard American diet may have a deleterious effect on the expression of our genes. The quality of our food has deteriorated. We may be fat but many of us are also malnourished. It isn't how much we eat it's what we aren't getting from what we eat. We're also exposed to pollution, plastics and other hydrocarbons, hormone-mimics, other chemicals, etc. Obesity isn't the biggest change in our environment, it's actually one of the smallest differences, but all we hear where ever we turn is 'teh fat' 'teh fat!' The amount of crap we are exposed to from the time we are conceived is vastly different from previous generations, we're practically on a different planet. Just the amount of (nutritionally bankrupt) sugar we ingest is orders of magnitude higher than the amount our grandparents had. You don't need a dramatic change in the gene pool to explain an epidemic, if it indeed exists. I suspect that insulin resistance, the resulting obesity and probably the pancreatic defects causing most cases of type 2 diabetes will turn out to be at least partly epigenetic. Someday, almost everything in our environment may be found to have an effect on gene expression. Just the amount of sugar we consume may be enough, by itself, to explain any increase in insulin resistance and obesity. Also, not at odds if you believe the type 2 diabetes epidemic is as overstated as the obesity epidemic. The average person has only gained a few pounds. The criteria for a diabetes diagnosis seems to have changed as much or more than the BMI chart did a while back. After all, years ago there were no drugs, besides insulin, to treat diabetes, the home blood glucose monitor wasn't available. The pharmaceutical reps weren't in the doctors' offices constantly trying to get them to diagnose it so they could sell more drugs for it. Some doctors once tried to avoid making the diagnosis to spare their patients the social or economic disadvantages. My DH was recently diagnosed as type 2 with the same, supposedly normal, fasting blood glucose that I had at my annual physical for at least 15 years, that I know of, before I was diagnosed. That 15 years began before I gained 80% of my fat. In fact, I may not have been technically overweight then, according to the BMI charts of the time, if they existed. I never said that decades of weight gain is caused by undiagnosed diabetes, it is caused by insulin resistance. When you get diabetes depends on when (or if) your pancreas finally craps out on you. Many fat people will never get it because they keep making new ß-cells so insulin production increases to keep up with and also exacerbate the insulin resistance, while they keep getting fatter and more resistant. After all, insulin's job is to stuff glucose into cells. When the liver and peripheral tissues are more resistant than the fat cells, guess where it goes? When a fat person stops gaining weight (gets to their 'set point') it usually just means their fat cells have finally become as insulin resistant as their muscle cells. Insulin resistance causes at least some, probably most, obesity. Insulin resistance and a dysfunctional pancreas causes type 2 diabetes. Correlation is not causation. Don't stress your pancreas with a lot of carb if you know diabetes is in your family and you may be able to delay developing it. The knowledge is out there but you probably won't hear it from a doctor and it's a lead pipe cinch you won't hear it on the news. Sorry mo pie, I'll quit here. (btw I barely have access to a public library.) Not at odds if you believe the huge increase in sugars, other highly refined carbs and vegetable oils in the standard American diet may have a deleterious effect on the expression of our genes. The quality of our food has deteriorated. We may be fat but many of us are also malnourished. It isn’t how much we eat it’s what we aren’t getting from what we eat. We’re also exposed to pollution, plastics and other hydrocarbons, hormone-mimics, other chemicals, etc. Obesity isn’t the biggest change in our environment, it’s actually one of the smallest differences, but all we hear where ever we turn is ‘teh fat’ ‘teh fat!’ The amount of crap we are exposed to from the time we are conceived is vastly different from previous generations, we’re practically on a different planet. Just the amount of (nutritionally bankrupt) sugar we ingest is orders of magnitude higher than the amount our grandparents had. You don’t need a dramatic change in the gene pool to explain an epidemic, if it indeed exists. I suspect that insulin resistance, the resulting obesity and probably the pancreatic defects causing most cases of type 2 diabetes will turn out to be at least partly epigenetic. Someday, almost everything in our environment may be found to have an effect on gene expression. Just the amount of sugar we consume may be enough, by itself, to explain any increase in insulin resistance and obesity.

Also, not at odds if you believe the type 2 diabetes epidemic is as overstated as the obesity epidemic. The average person has only gained a few pounds. The criteria for a diabetes diagnosis seems to have changed as much or more than the BMI chart did a while back. After all, years ago there were no drugs, besides insulin, to treat diabetes, the home blood glucose monitor wasn’t available. The pharmaceutical reps weren’t in the doctors’ offices constantly trying to get them to diagnose it so they could sell more drugs for it. Some doctors once tried to avoid making the diagnosis to spare their patients the social or economic disadvantages. My DH was recently diagnosed as type 2 with the same, supposedly normal, fasting blood glucose that I had at my annual physical for at least 15 years, that I know of, before I was diagnosed. That 15 years began before I gained 80% of my fat. In fact, I may not have been technically overweight then, according to the BMI charts of the time, if they existed.

I never said that decades of weight gain is caused by undiagnosed diabetes, it is caused by insulin resistance. When you get diabetes depends on when (or if) your pancreas finally craps out on you. Many fat people will never get it because they keep making new ß-cells so insulin production increases to keep up with and also exacerbate the insulin resistance, while they keep getting fatter and more resistant. After all, insulin’s job is to stuff glucose into cells. When the liver and peripheral tissues are more resistant than the fat cells, guess where it goes? When a fat person stops gaining weight (gets to their ’set point’) it usually just means their fat cells have finally become as insulin resistant as their muscle cells.

Insulin resistance causes at least some, probably most, obesity. Insulin resistance and a dysfunctional pancreas causes type 2 diabetes. Correlation is not causation. Don’t stress your pancreas with a lot of carb if you know diabetes is in your family and you may be able to delay developing it. The knowledge is out there but you probably won’t hear it from a doctor and it’s a lead pipe cinch you won’t hear it on the news.

Sorry mo pie, I’ll quit here.

(btw I barely have access to a public library.)

]]> By: La Wade http://www.bfdblog.com/2008/01/03/go-get-yourself-a-monkey-kidney/comment-page-1/#comment-7354 La Wade Sat, 05 Jan 2008 00:51:48 +0000 http://www.bfdblog.com/?p=304#comment-7354 The articles you linked claim that diabetes is primarily genetic in origin, which is at odds with the fact that U.S. rates of diabetes have doubled in the last ten years despite a lack of dramatic change in the gene pool. Diabetes certainly has a genetic component, but environmental factors, including obesity, contribute to diabetes, as well. And there are thousands of studies contributing to the body of knowledge that obesity causes diabetes. If you have access to a medical library, a good review article is Kahn et al., Nature 444, 840-846 (14 December 2006). Furthermore, many patients are obese for 20 or 30 years or more before being diagnosed with type II diabetes. Do you really think it seems plausible that a patient group at high risk for this common disease could <i>routinely</i> go undetected for such a long period of time? Anyway, I do agree with you about one thing: type II diabetics should not be blamed for their condition. Obviously, nobody deserves to get a disease, and the prevalence of obesity and overweight in our society is a testament to the extreme difficulty most people have in avoiding it. The articles you linked claim that diabetes is primarily genetic in origin, which is at odds with the fact that U.S. rates of diabetes have doubled in the last ten years despite a lack of dramatic change in the gene pool. Diabetes certainly has a genetic component, but environmental factors, including obesity, contribute to diabetes, as well. And there are thousands of studies contributing to the body of knowledge that obesity causes diabetes. If you have access to a medical library, a good review article is Kahn et al., Nature 444, 840-846 (14 December 2006).

Furthermore, many patients are obese for 20 or 30 years or more before being diagnosed with type II diabetes. Do you really think it seems plausible that a patient group at high risk for this common disease could routinely go undetected for such a long period of time?

Anyway, I do agree with you about one thing: type II diabetics should not be blamed for their condition. Obviously, nobody deserves to get a disease, and the prevalence of obesity and overweight in our society is a testament to the extreme difficulty most people have in avoiding it.

]]> By: None Given http://www.bfdblog.com/2008/01/03/go-get-yourself-a-monkey-kidney/comment-page-1/#comment-7353 None Given Fri, 04 Jan 2008 23:59:15 +0000 http://www.bfdblog.com/?p=304#comment-7353 Before diabetes develops, insulin resistance causes weight gain, sometimes over decades. That is why most types 2s are overweight or obese. Young, thin people without diabetes who are related to diabetics have been shown to already have signs of insulin resistance, ie hyperinsulinemia even without any deterioration in blood sugar control. Read the articles. Obesity does not cause diabetes, it is ASSOCIATED with diabetes and there is no study anywhere that shows obesity causing diabetes. It is a myth, a dangerous myth that does a disservice to all diabetics, fat diabetics because they are led to believe they caused their disease and the only way to control it is something they have had no long term success at and thin diabetics because they are often misdiagnosed for years because doctors don't test thin people, even with classic symptoms but slow onset. Before diabetes develops, insulin resistance causes weight gain, sometimes over decades. That is why most types 2s are overweight or obese. Young, thin people without diabetes who are related to diabetics have been shown to already have signs of insulin resistance, ie hyperinsulinemia even without any deterioration in blood sugar control. Read the articles.
Obesity does not cause diabetes, it is ASSOCIATED with diabetes and there is no study anywhere that shows obesity causing diabetes. It is a myth, a dangerous myth that does a disservice to all diabetics, fat diabetics because they are led to believe they caused their disease and the only way to control it is something they have had no long term success at and thin diabetics because they are often misdiagnosed for years because doctors don’t test thin people, even with classic symptoms but slow onset.

]]> By: La Wade http://www.bfdblog.com/2008/01/03/go-get-yourself-a-monkey-kidney/comment-page-1/#comment-7352 La Wade Fri, 04 Jan 2008 18:45:06 +0000 http://www.bfdblog.com/?p=304#comment-7352 I agree that in the early stages of diabetes, some people experience weight gain as a consequence of increased appetite and promotion of fat storage. But as diabetes progresses, the catabolic side takes over. At any rate, it is exceedingly rare for a lean person to develop type II diabetes and then become obese as a result, which is what Jaed suggested. A majority of type II diabetes patients are obese prior to becoming diabetic, and weight loss has been shown to decrease risk of type II diabetes and weight gain to increase that risk. In addition, many mechanistic studies have been carried out in the last 10 years demonstrating how secreted factors from adipose tissue influence glucose homeostasis. I agree that in the early stages of diabetes, some people experience weight gain as a consequence of increased appetite and promotion of fat storage. But as diabetes progresses, the catabolic side takes over. At any rate, it is exceedingly rare for a lean person to develop type II diabetes and then become obese as a result, which is what Jaed suggested. A majority of type II diabetes patients are obese prior to becoming diabetic, and weight loss has been shown to decrease risk of type II diabetes and weight gain to increase that risk. In addition, many mechanistic studies have been carried out in the last 10 years demonstrating how secreted factors from adipose tissue influence glucose homeostasis.

]]> By: None Given http://www.bfdblog.com/2008/01/03/go-get-yourself-a-monkey-kidney/comment-page-1/#comment-7351 None Given Fri, 04 Jan 2008 18:22:57 +0000 http://www.bfdblog.com/?p=304#comment-7351 <i>Insulin resistance does cause a mild deficit in utilization of fat as an energy source, but a more prevalent effect of insulin resistance is that you’re not able to utilize the glucose you consume, so there is a net loss of weight.</i> Insulin resistance does not cause weight loss it causes fat storage. You aren't able to utilize the glucose in muscle cells because they are more resistant than fat cells. Most of the carb you consume in the presence of insulin resistance (and because of hyperinsulinemia, also the protein and fat,) goes to storage in the fat cells. This is the reason people are more sedentary when they are insulin resistant, muscle recovery of glycogen after exercise is inhibited. There is little energy available for exercise or anything else. Hyperinsulinemia causes insulin resistance to increase in a vicious cycle, it leads to wide fluctuations in blood glucose levels that can cause extreme hunger, and it inhibits the use of energy stored in the fat cells. The amount of added resistance due to weight gain is trivial compared to the amount of resistance added by increasing levels of insulin in the blood. It's a miracle when insulin resistance doesn't lead to weight gain. Diabetes will only result when a defect of insulin production in the pancreas means it is unable to continue increasing production of enough insulin to overcome the resistance. There are more fat people who will not get diabetes than will because they do not have this pancreatic defect. All along, during this process insulin resistance in the liver complicates the whole scenario by again, increasing glucose levels in the blood which also goes to more fat storage. Even on a WLD, muscle and organ tissue may be broken down by the liver to make more glucose which may still go to fat storage unless insulin levels and resistance can be controlled. Weight loss from any type of diabetes (muscle wasting mostly) only occurs after blood glucose has risen to a level that causes it to spill into the urine, increasing thirst and again, hunger. This wasting is more dramatic in Type 1 because the people usually start out without resistance, therefore thin, and lose their capacity for insulin production rapidly. A skinny person losing 20 pounds in a couple of weeks is a lot more noticeable than a fat person getting slowly fatter over the course of years and then losing a very small percentage of their weight. A really fat person's weight can fluctuate that much in a couple of days just from water retention. Read: "You Did NOT Eat Your Way to Diabetes! Don't fall for the toxic myth that you caused your diabetes by reckless overeating" at http://www.phlaunt.com/diabetes/14046739.php Read more about: "What They Don't Tell You About Diabetes" at: http://www.phlaunt.com/diabetes/ Many articles, well documented. Insulin resistance does cause a mild deficit in utilization of fat as an energy source, but a more prevalent effect of insulin resistance is that you’re not able to utilize the glucose you consume, so there is a net loss of weight.

Insulin resistance does not cause weight loss it causes fat storage. You aren’t able to utilize the glucose in muscle cells because they are more resistant than fat cells. Most of the carb you consume in the presence of insulin resistance (and because of hyperinsulinemia, also the protein and fat,) goes to storage in the fat cells. This is the reason people are more sedentary when they are insulin resistant, muscle recovery of glycogen after exercise is inhibited. There is little energy available for exercise or anything else. Hyperinsulinemia causes insulin resistance to increase in a vicious cycle, it leads to wide fluctuations in blood glucose levels that can cause extreme hunger, and it inhibits the use of energy stored in the fat cells. The amount of added resistance due to weight gain is trivial compared to the amount of resistance added by increasing levels of insulin in the blood. It’s a miracle when insulin resistance doesn’t lead to weight gain. Diabetes will only result when a defect of insulin production in the pancreas means it is unable to continue increasing production of enough insulin to overcome the resistance. There are more fat people who will not get diabetes than will because they do not have this pancreatic defect. All along, during this process insulin resistance in the liver complicates the whole scenario by again, increasing glucose levels in the blood which also goes to more fat storage. Even on a WLD, muscle and organ tissue may be broken down by the liver to make more glucose which may still go to fat storage unless insulin levels and resistance can be controlled.

Weight loss from any type of diabetes (muscle wasting mostly) only occurs after blood glucose has risen to a level that causes it to spill into the urine, increasing thirst and again, hunger. This wasting is more dramatic in Type 1 because the people usually start out without resistance, therefore thin, and lose their capacity for insulin production rapidly. A skinny person losing 20 pounds in a couple of weeks is a lot more noticeable than a fat person getting slowly fatter over the course of years and then losing a very small percentage of their weight. A really fat person’s weight can fluctuate that much in a couple of days just from water retention.
Read:
“You Did NOT Eat Your Way to Diabetes!
Don’t fall for the toxic myth that you caused your diabetes by reckless overeating” at
http://www.phlaunt.com/diabetes/14046739.php
Read more about:
“What They Don’t Tell You About Diabetes” at:
http://www.phlaunt.com/diabetes/
Many articles, well documented.

]]> By: La Wade http://www.bfdblog.com/2008/01/03/go-get-yourself-a-monkey-kidney/comment-page-1/#comment-7350 La Wade Fri, 04 Jan 2008 15:26:59 +0000 http://www.bfdblog.com/?p=304#comment-7350 Insulin resistance does cause a mild deficit in utilization of fat as an energy source, but a more prevalent effect of insulin resistance is that you're not able to utilize the glucose you consume, so there is a net loss of weight. Type I diabetes also causes weight loss because the absence of insulin has the same effect as insulin resistance. Luckily, most people get treatment for their type II diabetes before it becomes severe, but in animal models I work with in the lab, untreated diabetes results in significant wasting. Insulin resistance does cause a mild deficit in utilization of fat as an energy source, but a more prevalent effect of insulin resistance is that you’re not able to utilize the glucose you consume, so there is a net loss of weight. Type I diabetes also causes weight loss because the absence of insulin has the same effect as insulin resistance.

Luckily, most people get treatment for their type II diabetes before it becomes severe, but in animal models I work with in the lab, untreated diabetes results in significant wasting.

]]> By: jaed http://www.bfdblog.com/2008/01/03/go-get-yourself-a-monkey-kidney/comment-page-1/#comment-7349 jaed Fri, 04 Jan 2008 15:12:06 +0000 http://www.bfdblog.com/?p=304#comment-7349 <i>Diabetes does not cause obesity…in fact, untreated diabetes results in weight loss.</i> Eh? Certainly insulin resistance causes obesity. It's one of the most visible symptoms if not the most visible. Insulin resistance promotes glucose uptake and conversion by fat cells (since the insulin resistance keeps serum glucose elevated for extended periods of time), and the chronic hyperinsulinemia that goes along with it inhibits fat tissue loss (because fat cannot be metabolized in the presence of insulin). The mechanisms are well understood and have been for decades. When you say "untreated diabetes results in weight loss", I think you're thinking of Type 1 diabetes. Type 1 has a completely different etiology and yes, unexplained weight loss is often a symptom (because the lack of insulin in Type 1, as opposed to the overabundance in Type 2, causes wasting). Although such wasting may occur in patients with "double diabetes" (Type 1 occurring along with usually longterm untreated Type 2), it is not a symptom of Type 2 diabetes per se. Diabetes does not cause obesity…in fact, untreated diabetes results in weight loss.

Eh? Certainly insulin resistance causes obesity. It’s one of the most visible symptoms if not the most visible. Insulin resistance promotes glucose uptake and conversion by fat cells (since the insulin resistance keeps serum glucose elevated for extended periods of time), and the chronic hyperinsulinemia that goes along with it inhibits fat tissue loss (because fat cannot be metabolized in the presence of insulin). The mechanisms are well understood and have been for decades.

When you say “untreated diabetes results in weight loss”, I think you’re thinking of Type 1 diabetes. Type 1 has a completely different etiology and yes, unexplained weight loss is often a symptom (because the lack of insulin in Type 1, as opposed to the overabundance in Type 2, causes wasting). Although such wasting may occur in patients with “double diabetes” (Type 1 occurring along with usually longterm untreated Type 2), it is not a symptom of Type 2 diabetes per se.

]]> By: None Given http://www.bfdblog.com/2008/01/03/go-get-yourself-a-monkey-kidney/comment-page-1/#comment-7348 None Given Fri, 04 Jan 2008 05:52:37 +0000 http://www.bfdblog.com/?p=304#comment-7348 <i>Since weight loss can often help to moderate diabetic symptoms, it seems plausible to me that high BMI patients may have been less likely to receive transplants because they were more likely to be in poor health from uncontrolled diabetes. Of course it is also</i> Weight loss might, in some cases help insulin resistance to some extent, but carbohydrate restriction has a larger effect on blood glucose levels and blood pressure, even in the absence of weight loss. Since weight loss can often help to moderate diabetic symptoms, it seems plausible to me that high BMI patients may have been less likely to receive transplants because they were more likely to be in poor health from uncontrolled diabetes. Of course it is also

Weight loss might, in some cases help insulin resistance to some extent, but carbohydrate restriction has a larger effect on blood glucose levels and blood pressure, even in the absence of weight loss.

]]> By: thinfighter http://www.bfdblog.com/2008/01/03/go-get-yourself-a-monkey-kidney/comment-page-1/#comment-7347 thinfighter Fri, 04 Jan 2008 02:35:56 +0000 http://www.bfdblog.com/?p=304#comment-7347 jaed, you forget the #1 rule! Fat = bad and unhealthy! All the scientific studies point that way! jaed, you forget the #1 rule!

Fat = bad and unhealthy! All the scientific studies point that way!

]]> By: thinfighter http://www.bfdblog.com/2008/01/03/go-get-yourself-a-monkey-kidney/comment-page-1/#comment-7326 thinfighter Fri, 04 Jan 2008 02:35:00 +0000 http://www.bfdblog.com/?p=304#comment-7326 It's nice how humanity can be rounded up into scientific studies, isn't it? It’s nice how humanity can be rounded up into scientific studies, isn’t it?

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