Obesity as Adaptation Response

Alan Christianson, NMD

The following potential conflict of interest relationships are germane to my presentation.

Employment: NoneSpeakers Bureau: Random House

Stock Shareholder: None Grant/Research Support: None

Consultant: None Commercial Publications: Healing Hashimotos’,

The Complete Idiots’ Guide to Thyroid Disease, Adrenal Reset Diet (2015)

Status of FDA devices used for the material being presented

NA/Non-Clinical

Status of off-label use of devices, drugs or other materials that constitute the subject of this presentation

NA/Non-Clinical

Learning Objectives

•Understand obesity as a multi factorial

manifestation of the adaptation response.

•Learn preliminary results from a study that used

diet alone to reverse the adaptation response.

Pre Event Quiz

Obesity is occurring in:A. Only AmericansB. Globally, but mostly adultsC. People of all ages globallyD. Humans and many other species globally

Pre Event Quiz

Obesity can be explained by:A. Excess calories and less activityB. Genetic SusceptibilityC. Lower self controlD. A circadian disturbance

Pre Event Quiz

Obesity can be consistently cured by:A. Carbohydrate restrictionB. Intermittent fastingC. Behavioral interventionsD. None of the above

Why Obesity Matters to Me

• 0-4 Epilepsy• 7-12 Obesity• 12–Present – Student of Health• Clinical Experiences

– Thyroid related obesity– Non-Thyroid related obesity

Introduction - Obesity is:

• Rapidly increasing

• Unprecedented

• Unexplained

• Misunderstood

• Among our largest global survival and economic threats

8

Outline• Obesity - Disease not Behavior

• Shortcomings of Current Model

• Emerging Causes of Obesity

• Adrenal Regulation of Metabolism

• Study Results9

Obesity - Disease not Behavior

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Imagine if:

• You were struggling with your health.

• People tell you that the problem is your habits,

personality and diet.

• When your efforts fail, you are told you are not

trying hard enough.

Imagine if:

• You are told you can recover if you:– Spend more time outdoors

– Engage in more physical activity

– Consume less sugar

– Eat more alkaline foods

Imagine if:

• You are told you can recover if you:– Spend more time outdoors

– Engage in more physical activity

– Consume less sugar

– Eat more alkaline foods

This is about Tuberculosis in the 1870’s

1990 - Mississippi first above 14%

• Adult obesity 15%

• First state to break this level

• Source: http://fasinfat.org/adult-obesity/

2010 – Colorado last below 20%

• 19.8% rate of adult obesity

• Lowest in United States

• Lousiana #1 at 34.7%

• Source: http://fasinfat.org/adult-obesity/

Obesity in Aminals

• 20,000 total animals over 30 years

• Macaques, chimpanzees, vervets, marmosets, lab rats and mice, feral rats, and domestic dogs and cats.

• In last 3 decades, obesity had increased in 100 percent of the species studied.

• In controlled settings, chimpanzees weight has gone up by 33.2 and 37.2 percent

per decade respectively

• the claim that obesity is a disease of willpower is completely unsupportable.

• Source Klimentidis YC, Beasley TM, Lin HY, Murati G, Glass GE, Guyton M, Newton W, Jorgensen M, Heymsfield SB, Kemnitz J, Fairbanks L, and Allison DB. “Canaries in the coal mine: a cross-species analysis of the plurality of obesity epidemics.” Proc Biol Sci 278(1712):1626-32. doi: 10.1098/rspb.2010.1890.

Shortcomings of Current Model

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Genes do not Explain Obesity

• Obesity increasing last 3 decades

• Minimal genetic change in 50,000 years

• Genes explain why some are more apt to get obese but do not explain global trend

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Calories – Description vs Explanation

• Inner city economics can be described as:– Poverty rate of 1.5 times greater than surrounding region– Median household income ½ or less than surrounding region– Unemployment rate 1.5 times greater than surrounding region

• Does this explain or describe?

(source Initiative for a Competitive Inner City http://www.icic.org/research-and-analysis/research-definitions)

“A lack of energy balance most often causes overweight and obesity. Energy balance means that your energy IN equals your energy OUT”

– Obese people consume 25% more calories– Obese people underestimate their food intake– Obese people average more time in sedentary activities

• Does this explain or describe?

Sources: National Institute of Health: http://www.nhlbi.nih.gov/health/health-topics/topics/obe/causes.htmlHebert JR, Patterson RE, Gorfine M, et al. Differences between estimated calorie requirements and self-reported calorie intake in the women’s health initiative. Ann Epidemiol. Oct 13(9):629-37.

Food Restriction Does not Work 31 long-term studies on calorie based weight-loss programs

83% of participants were heavier than before they started.

More than half gained 11 pounds or more over the weight they lost.

Source: Mann T, Tomiyama J, Westling E, Lew AM, Samuels B, and Chatman J. 2007. “Medicare’s search for effective obesity treatments: Diets are not the answer.” Am Psychol 62(3):220-33.

Assuming the calorie model is accurate:

• Why do some people eat more?• Why do some people move less• Why has this changed in the last few decades?

• If calories only Describe obesity, what Explains obesity?

Emerging Causes of Obesity

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Proposed causes from recent research

• Increased fructose intake• Obesogens (environmental toxins)• Thermal stability• Spectral exposure• Hyposomnia• Medication usage• Psychosocial stress• Dysbiosis• Noise pollution

Single cause vs single mechanism

Examples

• Germ Theory

• General Adaptation Response

• HPAP axis

Adrenal Regulation of Metabolism

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HPAP Axis

• Hypothalamus• Pituitary• Adrenal• Peripheral tissues

• Visceral fat• Liver• Brain

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HPAP Disruption

• Cortisol main biomarker• Adrenal glands main source• Total Adrenal production• Circadian Adrenal production• Total peripheral conversion

– Visceral fat– Liver– Brain

• Circadian peripheral conversion

Evaluating HPAP Disruption

• Radio isotope vascular studies

• In vitro evaluation (adipose / hepatic)

• Hair cortisol

• Symptom quiz

• 24 hour urine cortisol

• Salivary circadian cortisol

• Serum cortisol

Adrenal Regulation of Fuel - Thriving

• Cortisol slope present• Minimal peripheral cortisone to cortisol

conversion• Insulin sensitivity greatest in late evening• Insulin leads glucose to glycogen production in

skeletal muscle

Adrenal Regulation of Fuel - Surviving

• Cortisol slope absent• Increased peripheral cortisone to cortisol

conversion• Insulin sensitivity diminished• Insulin leads glucose to triglyceride production

in visceral fat

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Adrenal Regulation – The Fat Clock

• Visceral fat has independent circadian rhythm• Rhythm times cortisol to cortisone conversion• Biopsied visceral fat can have it’s rhythm measured• Increased Sagittal diameter equals greater variance

between central circadian rhythm and visceral fat

Source . Hernandez-Morante JJ, Gomez-Santos C, Milagro F, Campión J, Martínez JA, Zamora S, and Garaulet M. 2009. “Expression of cortisol metabolism-related genes shows circadian rhythmic patterns in human adipose tissue.” Int J Obes (Lond) 33(4):473-80. doi: 10.1038/ijo.2009.4.

Cycle of weight gainStress

Adrenal Dysfunction

Fat Storage

Appetite changes

Fatigue

Depression

Study Results

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Study Description

• 42 participants

• Average age 45.4 years

• 30 days

• 88.1% female

• Median number of failed diets in last 3 years: 5

Study Results

Pre-Publication Study Methods and Materials

• Text Request:

JOINMETo: 38470

• Non-Disclosure Required

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Adjunctive Therapies for HPAP Reset

• Circadian hygiene

• Reduce xenobiotic burden

• Mind body techniques

• Herbal adaptogens

• Exercise per adrenal capacity

Presentation Summary

• Obesity as a disease

• Obesity as adaptation response

• Multi factorial triggers

• Adrenal disruption as mechanism40

Post Event Quiz

Obesity is occurring in:A. Only AmericansB. Globally, but mostly adultsC. People of all ages globallyD. Humans and many other species globally

Post Event Quiz

Obesity can be explained by:A. Excess caloriesB. Less activityC. Lower self controlD. A circadian disturbance

Post Event Quiz

Obesity can be cured by:A. Carbohydrate restrictionB. Intermittent fastingC. Behavioral interventionsD. None of the above

Pre-Publication Study Methods and Materials

• Text Request:

JOINMETo: 38470

• Non-Disclosure Required

44