The Big Fat Missing Chapter

Condtradictions of the lipid hypothesis in The 4-Hour Body

Great read for more info on this topic

Great read for more info on this topic

In the book that states “Everything Popular is Wrong” you would think there would some strong points against the conventional thoughts on fat (specifically saturated fat) and the lipid hypothesis.  What the heck is the lipid hypothesis?  Here is a good summary from wikipedia:

The lipid hypothesis was one of two hypotheses (the other being the chronic endothelial injury hypothesis) developed in the 1850s to explain the pathogenesis of atherosclerosis. It proposes a connection between plasma cholesterol level and the development of coronary heart disease.

Note: The connection between dietary cholesterol and serum (blood) cholesterol is also strongly related to this hypothesis, but is a separate and distinct hypothesis.

The science that was used to ‘prove’ the lipid hypothesis has been proven to be faulty[1][2][3].  Rabbits were fed cholesterol from animal products, which, is not part of a normal diet for rabbits.  The results were not the same using dogs and rats.  There also is many studys that show low cholesterol is actually associated to a higher overall morbidity rate [4].  And that most people admitted to hospital for heart attacks don’t have high cholesterol [5].  The immediate assumption from doctors is then, ‘…  the current guidelines may not be low enough …’ which to me is illogical and short sighted. Not only is cholesterol show to be not a good marker but calculating the so called bad (LDL) cholesterol is a estimated calculation not a measured test [6].  It is also important to understand what cholesterol is, what it is used for, and why it is a ‘good’ thing to have in the right context.

It is an essential structural component of mammalian cell membranes and is required to establish proper membrane permeability and fluidity. In addition, cholesterol is an important component for the manufacture of bile acids, steroid hormones, and vitamin D.

Why is the lipid hypothesis still thought to be true in North America?  Well 1) Politicians with no scientific background wrote dietary guidelines based off Ancel Keys bad science in 1977[7] 2)Pharmaceutical companies make a lot of money selling cholesterol lowering drugs (statins) that work in the sense they lower your cholesterol, but don’t work because lowering cholesterol does not solve the actual cause of poor health.

The hypothesis that has more logic and science being the chronic endothelial injury hypothesis.  The idea is that inflammation is the primary cause of CHD and cholesterol (LDL) oxidation occurs after there is inflammation, as a defence mechanism.  The research points to this as a more correct answer to the cause and effect of CHD.  A good talk on this topic was given by Chris Masterjohn at the Ancestral Health Symposium

Tim addresses the lipid hypothesis in his book, but this is hidden at the end of the chapter “Sex machine I: Adventures in Tripling Testosterone”

But isn’t cholesterol bad for you?

This belief is based on the Lipid Hypothesis of cardiac health (cholesterol = bad), which I disagree with based on the sum of total available evidence.  Between 2006 and 2009, I had obsessed over lower my total cholesterol.  The outcome?  Lower testosterone and fatigue.

I’ll take my egg yolks, thank you very much.[8]

It is great that Tim addresses cholesterol and the Lipid Hypothesis, but I think he could have done a better job.  I think this should have been addressed in the Subtracting Fat chapter with a complete page.  Cholesterol is big deal these day with all the marketing companies put into the “Heart Healthy” scam and the money they pay to the American Heart Association.  And also the whole ‘low fat’ myth that is highly associated to the Lipid Hypothesis.  Tim provides a page of science for other issues but this one is simplified to “… I disagree with… ”  That and the fact he seems to contradict himself a big.  Early in the book the chapter  “Rules That Change The Rules” he states:

I had gained 34 pounds of muscle, lost 4 pound of fat, and decreased my total cholesterol from 222 to 147, all in 28 days, without the use of any anabolics or statins like Lipitor.[9]

Then later in “Slow Carb Diet Part I” chapter.

Egg whites with 1-2 whole eggs for flavour (or, if organic 4-5 whole eggs, including yolks)[11]

And then again in that chapter

Scrambled Eggology® pourable egg whites with one whole egg[10]

Also in this chapter Tim measures his cholesterol with the “fructose experiment” at the end of the chapter.  In it he states that after 7 days of 14 oz of pulp free orange juice upon waking and before bed his total cholesterol went from 203 to 243 and his LDL went from 127 to 165[11] (which we now know is just a calculation using total cholesterol).

These have me confused and seem like contradictions to me.  My first guess is that they were written at different time periods and the stats about lower cholesterol were during 2006 to 2009 when he was “obsessed with lowering his cholesterol”.  It would have been nice if he mentioned that some where though.

In regards to differentiating between organic egg yolks and commercially farmed eggs.  I must agree that the yolk of commercial egg vs an organic (or omega 3) egg is completely different in look and nutrition.  The organic version most likely being much more nutritionally dense.  I was unable to find any numbers or nutritional comparison of the two.  In my opinion there is nothing that bad in the yolk of a commercially produced egg and no reason to avoid it.  As Tim also says, “pay the six pack tax” and get better quality eggs.

The lipid hypothesis also seems to be closely related to many of the vegetarian arguments and reasons for people to think animal fat is bad.  Stay tuned for next weeks post, which will most likely be on veganism and vegetarianism, and check out this talk from the Ancestral Health Symposium by Denis Minger “How to Win an Argument With a Vegetarian”

References

1. Anitschkow NN, Chatalov S (1913). “Über experimentelle Cholesterinsteatose und ihre Bedeutung für die Entstehung einiger pathologischer Prozesse”. Zentralbl Allg Pathol 24: 1–9.
2. Anitschkow NN (1913). “Über die Veränderungen der Kaninchenaorta bei experimenteller Cholesterinsteatose”. Beitr Pathol Anat 56: 379–404.
3. Duff GL, McMillian GC (1951). “Pathology of atherosclerosis”. Am J Med 11 (1): 92–108.doi:10.1016/0002-9343(51)90011-3. PMID 14837929.
4. Jacobs, D (1992). Report of the Conference on Low Blood Cholesterol: Mortality Associations American Heart Association
5. Champeau, Rachel (2009). “Most heart attack patients’ cholesterol levels did not indicate cardiac risk” UCLA Newsroom
6. Guyenet, Stephan (2009). “When Friedewald Attacks”
7. Enright, Louisa (2010).  “Mainely Tipping Points 13: The Failure of the Low-Fat, High-Carbohydrate American Diet”
8. Ferriss, Tim (2010).  “The 4-Hour Body” pg 264
9. Ferriss, Tim (2010).  “The 4-Hour Body” pg 35
10. Ferriss, Tim (2010).  “The 4-Hour Body” pg 90
11. Ferriss, Tim (2010).  “The 4-Hour Body” pg 89

Does Obesity Have a Single Cause?

Could multiple hypothesis all be right?

I recently starting listening to another podcast hosted by Sean Croxton which you can find here http://undergroundwellness.com/.  His podcast is usually guest interviews and on this episode he was interviewing Russell Farris, author of The Pot Belly Syndrome.  Russell has an interesting hypothesis on obesity that stress (and the hormonal response from it) is the cause of obesity.  That got me to thinking, Gary Taubes and the Low Carb community blame carbs and insulin, Stephan Guyenet and few others blame reward and leptin.  Who is wrong and who is right?  What if none of them are wrong and all three of the are right?

I will admit that my knowledge of endocrinology is very limited, but it does not take much to realize that our hormones feedback loops have many entry points which could be a cause.  Determine what is cause and what is affect in our endocrine system seems to be very difficult.

Studies have been done which show the effect sleep has on leptin “Leptin Levels Are Dependent on Sleep Duration: Relationships with Sympathovagal Balance, Carbohydrate Regulation, Cortisol, and Thyrotropin” A couple interesting points from this study:

• Mean levels, maximal levels, and rhythm amplitude of leptin were decreased (−19%, −26%, and −20%, respectively) during sleep restriction compared with sleep extension.
• In conclusion, sleep modulates a major component of the neuroendocrine control of appetite.

Another study titled “Evidence for a novel peripheral action of leptin as a metabolic signal to the adrenal gland: leptin inhibits cortisol release directly.”  This test was done on mice which were injected with leptin.  Their conclusion was:

These data clearly demonstrate that leptin inhibits cortisol production in adrenocortical cells and therefore appears to be a metabolic signal that directly acts on the adrenal gland.

So cortisol affects leptin, but leptin also affects cortisol?

My hypothesis, they are all right.  This is why I think some people can go on a low carb/insulin controlling diet and not have success, while others can.  You can just isolate controlling and fixing one hormone when they are all so closely related.  You need to address all of them.

Although these people disagree on some thing there are a few things they all seem to agree on.  First that altering body composition by controlling energy input and output (calorie counting) is not required or as effective as controlling the endocrine system.  Also that eating industrial processed foods is not a good thing.

From reading and listening to Stephan Guyenet I have learned a lot about leptin.  From reading and listening to Gary Tabues I have learned a lot about insulin.  From reading and listening the TS Wiley and Russell Farris I have learned a lot about cortisol.  Putting all these together I have the following recommendations.

1. Cortisol:
   Get good quality and quantity of sleep.
   Especially in the winter months.
   Try to get to bed at least 2 hours after dark.
   Keep lights dim and below eye level after dark if possible.
   Avoid flashing lights like TVs and computers after dark.
   Sleep in a pitch black room.
2. Insulin:
   If you have a lot of fat to lose keep carbs and exercise low.  If you are exercising keep carbs in line with your performance needs.
   Use high quality carbs like veggies and fruit.
   Eat lots of fat and get your body adjusted to using fat for fuel, and will keep you satiated.
3. Leptin:
   Keep food bland.
   Avoid all industrially processed/engineered food that is highly rewarding
   Avoid processed sweeteners, both natural and artificial.
   Avoid liquid calories.
   Try to eat food as a single ingredient and cook food gently

References

A great post from The Whole9 http://whole9life.com/2011/10/theres-more-to-the-story-a-leptin-primer/

Stephan Guyenet’s Blog http://wholehealthsource.blogspot.com/2011/06/food-reward-dominant-factor-in-obesity_28.html

Stephan Guyenet Interview: http://chriskresser.com/the-healthy-skeptic-podcast-episode-10

Gary Tuabes’ Article: http://www.nytimes.com/2002/07/07/magazine/what-if-it-s-all-been-a-big-fat-lie.html?pagewanted=all&src=pm

Gary Taubes’ Books: http://amzn.com/1400033462?tag=myfohobodi-20 http://amzn.com/0307272702?tag=myfohobodi-20

Gary Taubes’ Interviews: http://www.blogtalkradio.com/undergroundwellness/2010/03/18/good-calories-bad-calories-with-gary-taubes http://www.thelivinlowcarbshow.com/shownotes/2403/the-return-of-gary-taubes-episode-401/ http://robbwolf.com/2011/05/03/the-paleo-solution-episode-78/

TS Wiley’s Book: http://amzn.com/0671038680?tag=myfohobodi-20

TS Wiley’s Interview: http://undergroundwellness.com/tag/ts-wiley/

Russell Farris’ Site: http://www.potbellysyndrome.com/

Russell Farris’ Book: http://amzn.com/159120058X?tag=myfohobodi-20

Russell Farris’ Interview: http://www.blogtalkradio.com/undergroundwellness/2011/07/29/the-potbelly-syndrome-with-russell-farris