Obesity and the Fluid-in, Fluid-out Therapy for Edema

I recently attended a lecture by Dr. Arya M. Sharma here at the University of Washington. Dr. Sharma is a Canadian clinician who specializes in the treatment of obesity. He gave the UW Science in Medicine lecture, which is a prestigious invited lecture.

He spent a little bit of time pointing out the fallacy behind conventional obesity treatment. He used the analogy of edema, which is an abnormal accumulation of fluid in the body.

Since we know that the amount of fluid contained in the body depends on the amount of fluid entering the body and the amount of fluid leaving the body, the treatment for edema is obvious: drink less, pee more.

Of course, this makes no sense. It doesn't address the underlying cause of edema and it will not help the patient. Yet we apply that exact same logic to fat loss. Since the amount of energy contained in the body (in the form of fat) depends on the amount entering and the amount leaving, the solution is easy: eat less, move more. Well, yes, if you can stick to that program it will cause fat loss. But that's equivalent to telling someone with edema to drink less water. It will cause a loss of fluid, but it won't correct the underlying problem that caused excessive fluid retention in the first place.

For example, if you have edema because your heart isn't pumping effectively (cardiac insufficiency), the heart is the problem that must be addressed. Any other treatment is purely symptomatic and is not a cure.

The same applies to obesity. If you don't correct the alteration in the system that causes an obese person to 'defend' his elevated fat mass against changes*, anything you do is symptomatic treatment and is unlikely to be very effective in the long term. My goal is to develop a method that goes beyond symptomatic treatment and allows the body to naturally return to a lower fat mass. I've been doing a lot of reading and I have a simple new idea that I feel confident in. It also neatly explains the results of a variety of weight loss diets. I've dropped a few hints here and there, but I'll be formally unveiling it in the next couple of months. Stay tuned.


* The body fat homeostasis system. The core element appears to be a negative feedback loop between body fat (via leptin, and insulin to a lesser degree) and the brain (primarily the hypothalamus, but other regions are involved). There are many other elements in the system, but that one seems to set the 'gain' on all the others and guides long-term fat mass homeostasis. The brain is the gatekeeper of both energy intake and energy expenditure, and unconscious processes strongly suggest appropriate levels for both factors according to the brain's perceived homeostatic needs. Those suggestions can be overridden consciously, but it requires a perpetual high degree of discipline, whereas someone who has been lean all her life doesn't require discipline to remain lean because her brain is suggesting behaviors that naturally defend leanness. I know what I'm saying here may seem controversial to some people reading this, because it's contrary to what they've read on the internet or in the popular press, but it's not particularly controversial in my field. In fact, you'll find most of this stuff in general neuroscience textbooks dating back more than 10 years (e.g., Eric Kandel and colleagues, Principles of Neuroscience).

How to Treat Supot-supot or Skin Asthma or Hives?

When I was a child, I and my siblings often suffer from a skin disorder locally called Supot-Supot. This Supot-supot, I later found out is called by the doctors as Skin asthma or Hives.

Hives or skin asthma usually starts with small, almost a dot, red, itchy, raised rashes that may appear in any part of the body. As the rashes are scratched, it grows bigger and bigger until they join together.

Because we live in a barrio my mother thought the cause of the rashes is kulam or a witch’s inflicted disease. Treatment was then for us drinking a concoction of bitter herbal medicines. And for the relief of itch, she would apply Caladryl on our rashes. She would have us dress in black to make the rashes go away (it always puzzled me how). And she would give us a warm bath and make us stay in room with all the windows closed.

I never believed in my mother’s beliefs, because instead of relief, we suffered more with her remedies. So when my daughter suffered from hives, I didn’t do, not even one, of the remedies she treated us with. Instead I went to my pediatrician and I learned that the disease is an allergy, and I learned to properly deal with it.

Hives is very itchy. It’s painfully itchy. A child won’t be able to avoid scratching. And this is not good because the scratching causes the rashes to grow bigger (as it was mentioned earlier). It may as well cause abrasions or bruises which may lead to skin infections.

Causes:

• Hives is an allergic reaction. So it is caused by a wide array of substances. For example:
• Medicine
• Food like shellfish, citrus, fish, eggs, nuts even milk
• Pollen
• Insect bites
• Animal fur/hair like that of cats and dogs

Hives may also be caused by some conditions like:

• Sudden change of temperature
• Stress
• Extreme temperature (either hot or cold)
• Heavy sweating
• Infections
• Diseases

Treatment:

Hives doesn’t need to be treated. The rashes usually go away in a few days. But if it’s causing difficulty in breathing, nausea and dizziness, fever and weakness and if it has persisted for at least more than 4 weeks, it is best to see a doctor.

 Remedy to alleviate the itching:

• Cold compress – you can use water, milk, tea, or boiled guava leaves. When we say cold, it means cool enough, not freezing. Wet a cloth with any of the suggested and cover the rashes with it. Let stand until the coolness disappear.
• Take a cool bath – not necessarily icy cool, just the normal tap water temperature. My pediatrician advised me to add oatmeal. They have this powdered oatmeal in sachets specifically for baths. If you do not have oatmeal you can also use baking soda. ½ box for every bath.
• Aloe Vera Gelly – I have discovered this lotion years ago and it helps a lot. It’s a Forever Living Company product. It’s all natural so it is safe. It also helps cool the rashes.

IMPORTANT:

• Avoid scratching. But since children cannot avoid it, have your child use mittens or soft cloth gloves to help prevent him from bruising himself.
• Have your child wear long clothes to cover the rashes that he may not be able to scratch it with his finger nails.
• Never give your child a warm bath. It will only make the rashes itch more!
• Watch your child for signs of weakness or difficulty in breathing, should these conditions be present, don’t waste time. Bring him to the hospital at once.
• Discover the triggering conditions so as you know to avoid. 

Home Remedy when Kids have Sore Throat

Sore throat is a common health problem among children, but usually is left unattended so it progresses to more severe cases like cough, cold and even flu


Symptoms:


When your child complains of an itchy throat, that's the start
Hoarse voice,
Difficulty in speaking because the throat is sore,
Sometimes fever is present


Remedy:
Have your child drink lots of water, and freshly squeezed citrus juices, preferably with less sugar.
Gargle with lukewarm water mixed with vinegar

US Omega-6 and Omega-3 Fat Consumption over the Last Century

Omega-6 and omega-3 polyunsaturated fats (PUFA) are essential nutrients that play many important roles in the body. They are highly bioactive, and so any deviation from ancestral intake norms should probably be viewed with suspicion. I've expressed my opinion many times on this blog that omega-6 consumption is currently too high due to our high intake of refined seed oils (corn, soybean, sunflower, etc.) in industrial nations. Although it's clear that the quantity of omega-6 and omega-3 polyunsaturated fat have changed over the last century, no one had ever published a paper that attempted to systematically quantify it until last month (1).

Drs. Chris Ramsden and Joseph Hibbeln worked on this paper (the first author was Dr. Tanya Blasbalg and the senior author was Dr. Robert Rawlings)-- they were the first and second authors of a different review article I reviewed recently (2). Their new paper is a great reference that I'm sure I'll cite many times. I'm going to briefly review it and highlight a few key points.

1. The intake of omega-6 linoleic acid has increased quite a bit since 1909. It would have been roughly 2.3% of calories in 1909, while in 1999 it was 7.2%. That represents an increase of 213%. Linoleic acid is the form of omega-6 that predominates in seed oils.

2. The intake of omega-3 alpha-linolenic acid has also increased, for reasons that I'll explain below. It changed from 0.35% of calories to 0.72%, an increase of 109%.

3. The intake of long-chain omega-6 and omega-3 fats have decreased. These are the highly bioactive fats for which linoleic acid and alpha-linolenic acid are precursors. Arachidonic acid, DHA, DPA and EPA intakes have declined. This mostly has to do with changing husbandry practices and the replacement of animal fats with seed oils in the diet.

4. The ratio of omega-6 to omega-3 fats has increased. There is still quite a bit of debate over whether the ratios matter, or simply the absolute amount of each. I maintain that there is enough evidence from highly controlled animal studies and the basic biochemistry of PUFAs to tentatively conclude that the ratio is important. At a minimum, we know that excess linoleic acid inhibits omega-3 metabolism (3, 4, 5, 6). The omega-6:3 ratio increased from 5.4:1 to 9.6:1 between 1909 and 2009, a 78% increase.

5. The biggest factor in both linoleic acid and alpha-linolenic acid intake changes was the astonishing rise in soybean oil consumption. Soybean oil consumption increased from virtually nothing to 7.4% of total calories, eclipsing all sources of calories besides sugar, dairy and grains! That's because processed food is stuffed with it. It's essentially a byproduct of defatted soybean meal-- the second most important animal feed after corn. Check out this graph from the paper:

I think this paper is an important piece of the puzzle as we try to figure out what happened to nutrition and health in the US over the last century.

Welding And Parkinson's, Can Fumes Lead To The Disease?

Fumes produced by welding contain manganese. Manganese is a chemical element that, even at low levels, has been linked to neurologic problems, including Parkinson's disease-like symptoms. New research suggests that workers exposed to welding fumes may be at risk for developing brain damage in an area of the brain also affected inParkinson's disease.

Brad A. Racette, MD, with Washington University School of Medicine in St. Louis and a Fellow with the American Academy of Neurology stated:

"There are over one million workers who perform welding as part of their job functions in the United States. If a link between neurotoxic effects and these fumes were proven, it would have a substantial public health impact for the U.S. workforce and economy."

Almost everyone is exposed to small amounts of manganese, a naturally occurring substance in our air, soil, water and food, daily. If kept in check, the body is able to control manganese levels by expelling extra amounts, but if the intake becomes too great, it can become overwhelming and cause a variety of health problems, including permanent nervous system damage.

What makes manganese so dangerous is that the current safety levels may not be adequate, so people may be taking in dangerous levels of this compound that almost no one is aware of.

The study involved 20 welders with no symptoms of Parkinson's disease, 20 people with Parkinson's disease who were not welders and 20 people who were not welders and did not have Parkinson's.

The welders were recruited from two Midwest shipyards and one metal fabrication company. All participants were given brain PET and MRI scans, motor skills tests and examined by a neurologist who specializes in movement disorders. The welders had an average of 30,000 hours of lifetime welding exposure. Their average manganese levels were found to be two times the upper limits of normal.

Scientists found that welders had an average 11.7% reduction in a marker of dopamine in one area of the brain on PET scans as compared to people who did not weld. Dopamine is a chemical messenger that helps nerve cells communicate and is decreased in specific brain regions in people with Parkinson's disease. The welders' motor skills test scores also showed mild movement difficulties that were about half of that found in the early Parkinson's disease patients.

Racette continues:

"While these changes in the brain and dopamine dysfunction may be an early marker of neuron death related to welding exposure, the damage appeared to be different from those of people with full-fledged Parkinson's disease. MRI scans also revealed brain changes in welders that were consistent with manganese deposits in the brain."

Perhaps most concerning is that permanent damage to the nervous system may occur after exposure to manganese levels that the Environmental Protection Agency (EPA) has noted as safe.

W. R. Wayne Martin, MD from University of Alberta in Edmonton, Alberta, Canada and also a member of the American Academy of Neurology adds:

"Although this study shows that these workers had dopamine dysfunction in the brain, the study authors could not determine whether this was specifically related to manganese. Will these individuals develop full-fledged Parkinson's disease? We can't answer that question based on the study but more research should be done to explore this possibility."

What to do when your child has a flu.

Flu

Flu is not as simple as we thought. It is caused by a virus and it is transferred from one person to another through coughing, sneezing, sharing of eating utensils and having a direct contact with people sick from it. Recovery can be expected in 1-2 weeks time, but there are instances when the infection may develop to life-threatening complications.

Children are mostly at risk because their immune system is not yet as developed as to that of the adults although, it affects all ages.

Symptoms:

• Headache
• Dizziness
• Nausea
• Vomiting
• Weakness or feelings of fatigue
• Muscle aches
• Joint aches
• Sore throat
• Cough
• Cold
• Irritated, watery eyes
• Fever and chills 

What to do when your child is down with fl?

• Give paracetamol to relieve the fever and pain.
• Rest and plenty of water are necessary.
• Monitor the temperature.
• If fever persists and your child is shivering or is having chills, better consult a doctor. 

Caution: 

• Don’t give aspirin to your children.
• Flu is caused by a virus so don’t give your child antibiotics unless your pedia instructs you to. (antibiotics are for bacteria caused diseases)

Prevention:

• Prevention is better than cure. Have your child vaccinated against flu.
• Teach your child to practice good personal hygiene, like proper hand washing. Hand sanitizers are also a great help when hand washing can’t be possible.
• Teach your child to avoid touching his eyes, nose mouth and to cover her mouth and nose when someone sneezes or coughs near or in front of him.

Fat-ten-u

I recently bought the book Food in the United States, 1820s-1890. I came across an ad for an interesting product that was sold in the late 1800s called Fat-ten-u. Check your calendars, it's not April fools day anymore; this is for real. Fat-ten-u was a dietary supplement guaranteed to "make the thin plump and rosy with honest fleshiness of form." I found several more ads for it online, and they feature drawings of despondent, lean women and drawings of happy overweight women accompanied by enthusiastic testimonials such as this:

"FAT-TEN-U FOODS increased my weight 39 pounds, gave me new womanly vigor and developed me finely. My two sisters also use FAT-TEN-U and because of our newly found vigor we have taken up Grecian dancing and have roles in all local productions."

I'm dying to know what was in this stuff, but I can't find the ingredients anywhere.

I find this rather extraordinary, for two reasons:

• Social norms have clearly changed since the late 1800s. Today, leanness is typically considered more attractive than plumpness.
• Women had to make an effort to become overweight in the late 1800s. In 2011, roughly two-thirds of US women are considered overweight or obese, despite the fact that most of them would rather be lean.

A rhetorical question: did everyone count calories in the 1800s, or did their diet and lifestyle naturally promote leanness? The existence of Fat-ten-u is consistent with the idea that our bodies naturally "defended" a lean body composition more effectively in the late 1800s, when our diets were less industrialized. This is supported by the only reliable data on obesity prevalence in the 1890s I'm aware of: body height and weight measurements from over 35,000 Union civil war veterans aged 40-69 years old (1). In that group of Caucasian men, obesity was about 10% of what it is today in the same age group. Whether or not you believe that this sample was representative of the population at large, I can't imagine any demographic in the modern US with an obesity prevalence of 3 percent (certainly not 60 year old war veterans).

Here are two more ads for Fat-ten-u and "Corpula foods" for your viewing pleasure: