Ok that was a bit dramatic, but still…it’s true.
If you’ve been following this blog for some time, you might think I’m a little obsessed with dietary fat. You’re right. I think – no, scratch that – I know that the past several decades of advice to eat a “low-fat diet” are inherently flawed. My last post was also about fat, and you can read that here. However, there is still more to say on the matter…hence today’s post!
I have been inspired to write about a few specific conditions today: non-alcoholic fatty liver disease (NAFLD), high triglycerides, prediabetes, gout, and heart disease. I’ve been inspired because if I hear one more medical professional recommend a “low-fat diet” as a therapeutic intervention for any of the conditions I just mentioned, I might actually lose my mind. We’ve all heard that advice at some point throughout the past 30 years, I’m certain of it. But it is wrong…so wrong.
First of all, the common denominator in NAFLD, high triglycerides, prediabetes, gout and heart disease is a dysfunctional metabolism. In fact, when several of these conditions are found congregating in one individual, the diagnosis is often called “metabolic syndrome.” These conditions all manifest in slightly different ways, but they all indicate that the individual’s system is not functioning as it should. It could be said that the biggest contributor to ALL of these conditions is insulin resistance. Guess what the biggest cause of insulin resistance is? You’re right! It’s poor eating habits! Let’s dive into why.
Insulin has multiple important jobs in our body, but the two we’re going to focus on today include blood glucose (sugar) management and fat metabolism and storage. Think of insulin like a key that unlocks all of your body’s cells so that glucose has a way in. Glucose needs to get into your cells, because it is fuel for your metabolism to function properly. One of insulin’s best friends is an enzyme called lipoprotein lipase (LpL). LpL is like the gatekeeper for your fat cells. When insulin in the bloodstream is elevated, that signals your fat cells to lock up tight, as your body does not need to burn any fat (it senses it has plenty of sugar to supply energy). LpL also helps to break down triglycerides for transport into your fat cells for storage. However, the fat cells have already been locked-up because they were told they don’t need to release any fat, and they aren’t taking in any new fat for storage.
So what now? Well, if we are insulin-resistant, and when we eat too many carbohydrates, we have some serious issues. We end up with a surge of blood glucose, a surge of insulin, and a bunch of triglycerides – all of whom don’t have anywhere to go but our bloodstream. Eventually our liver becomes a dumping ground for all these triglycerides that don’t have a home, hence the development of “fatty liver.” Those elevated blood sugars that are stuck in our bloodstream because insulin is not working properly lead us toward prediabetes (and eventually type 2 diabetes).
Excessive carbohydrate consumption doesn’t just affect our weight, blood glucose, or our liver; it affects our entire blood vessel system and is one of the main contributors to gout. I know, everyone with gout has been taught to “avoid purines, especially from beer and red meat.” This advice, although partially true, is going to fail you if you have gout. Gout is a painful arthritic condition that is caused by the accumulation of uric acid crystals in joints, most often one’s big toe, and most often in men (but also in women). Fructose, a type of sugar, is a major contributor to the production of uric acid. I’m not talking about fructose from whole fruit; I’m talking about fructose from added sugar – high-fructose corn syrup, plain ol’ table sugar, sugary beverages, and honey (yep, seriously). Too much sugar, too much beer, and/or not enough fiber-rich vegetables (inadequate antioxidant intake), and omega-3 fatty acids are the biggest pathways toward developing gout.
Heart disease is not caused by cholesterol. Ok, don’t have a heart attack from what I just said. Cholesterol is guilty by association when it comes to heart disease. Having cholesterol in our bloodstream is not independently why we get clogged arteries. Having damaged arteries and damaged cholesterol is why we get clogged arteries. I will attempt the best analogy I can think of to explain what I mean, next.
Imagine your arteries are like a big sewer drain, the kind you see all the rainwater and leaves and gook and stuff go into on the side of the street in the curb. Typically, the sewer drains are designed to expect a decent amount of water, leaves and gook; and when it rains a lot, everything just dumps in there and travels…well somewhere…(I don’t know exactly where it goes, but stay with me here!). Think of the sewer drain pipes as your arteries, the water as your blood, and the leaves and gook as your cholesterol. Even when there is a ton of leaves and gook, the sewer drain somehow seems to gather it all up and it flows nicely. But when a twig or something gets caught in a little crack or something in the sewer drain, now all the leaves and gook are collecting around that twig. Sometimes so much leaves and gook collect around that twig, or around many twigs, that the sewer pipe flow slows down and eventually can get backed up. That twig is like a little damaged area of your artery. Without the twig in the sewer pipe, the leaves and gook wouldn’t have gotten stuck; without damage to your artery, the cholesterol wouldn’t have gotten stuck.
So…it’s not the presence of cholesterol that causes heart disease; sure, too much cholesterol is like too much leaves and gook in the sewer: it increases the likelihood of clogging if damage occurs. But, if you’re tracking here, the real problem is the damage itself. What causes this damage in our arteries? Many things do, but in the context of today’s discussion, it’s inadequate omega-3 fatty acids, inadequate fiber and antioxidants, too much refined/processed carbohydrate, and inadequate exercise mostly. Antioxidants are pretty important in the case of preventing damage to our arteries, because antioxidants sort of neutralize the “bad stuff” that damages our cholesterol and our artery walls. When we have high cholesterol, we are given medications to reduce the cholesterol; but that doesn’t solve the real issue. Even people without high cholesterol have heart attacks.
Thanks for sticking it out this far, I’m impressed you’re not asleep! Despite all this wordswordswords today, I am doing my absolute best to oversimplify things for the sake of explanation. What should you do with all this info? Well here are the major take-aways:
- Insulin-resistance is the #1 contributor to many of our major chronic conditions, especially NAFLD, high triglycerides, prediabetes, gout, and heart disease.
- Reducing intake of carbohydrates, especially white [enriched] flour, white rice, white pasta, sugary foods, sugary beverages, and fruit juice is critical.
- You don’t have to completely give up carbs, just stop having them be the center of your universe.
- Some carbs that can and should be included in your mealtime delight in very small portions are:
- Eating vibrant, copious amounts of whole, non-starchy vegetables is critical to good health.
- The pigments that make those plants so vibrant and beautiful are antioxidants.
- We must have antioxidants to prevent damage to our bodies, especially our arteries.
- Examples include dark leafy greens, tomatoes, bell peppers, carrots, and beets.
- Just because a non-starchy vegetable may not be vibrant doesn’t mean it lacks antioxidants; the vibrancy is only one indicator.
- Examples of pale, but antioxidant-rich vegetables, include onions, cauliflower, jicama, and daikon radishes.
- We have to, have to, have to consume omega-3 fats.
- The BEST sources include wild-caught fatty fish, especially salmon (even canned), tuna, sardines, halibut, and mackerel.
- Some other good sources of omega-3 fats include flaxseed and walnuts.
- If you truly cannot handle eating fish or flax, you really should be taking an omega-3 fish oil supplement (but that is a last resort – real foods always prevail).
Low-fat is not the answer to improving health; in fact, eating a moderate amount whole-food-based fats, especially things like avocados, olives, nuts, seeds, and fatty fish, can help you to have a more stable appetite and subsequently help you to lose weight over time if done right. Saturated fats like butter, ghee, and coconut oil are resistant to damage from heating, and therefore less likely to contribute to damaging your arteries than oils (vegetable aka soybean oil, canola oil, corn oil, etc.). Extra-virgin olive oil and avocado oil are some helpful fats, but best when NOT heated.
Eat real foods. A healthy diet is one that is high in vegetables, moderate in fruits, moderate in fats, moderate in protein, and low in carbohydrates (the right kinds). Don’t overcomplicate things. See a registered dietitian nutritionist (especially those involved in integrative and functional nutrition) for an individualized plan of action.
xoxo – Casey