Obesity as Adaptation Response Alan Christianson, NMD.
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Transcript of Obesity as Adaptation Response Alan Christianson, NMD.
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
10
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
17
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
18
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
23
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
26
HPAP Axis
• Hypothalamus• Pituitary• Adrenal• Peripheral tissues
• Visceral fat• Liver• Brain
27
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
32
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
35
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
38
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