Blame weight gain on the brain

Many people claim they are addicted to food. That may not be too far from the truth.

Over millions of years of evolution, our brains have adapted to provide us a reward for successfully ingesting food. The hormone dopamine appears to be the key link in this reward process. But to complete the circuit, dopamine has to interact with its receptor. It has been known for many years that the ability of dopamine to combine with one of its receptors (the D2 dopamine receptor) is compromised in obese individuals compared to normal-weight individuals (1). This led to the hypothesis that obese individuals overeat as a way to compensate for the reduction in the dopamine reward circuits just as individuals with addictive behaviors (drugs, alcohol, gambling, etc.) do when their dopamine levels are low. It is also known that food restriction up-regulates the number of D2 receptors (2). This likely completes the reward circuit.

This effect of increasing D2 receptors is confirmed in obese patients who have undergone gastric bypass surgery that results in calorie restriction (3). This may explain why gastric bypass surgery is currently the only proven long-term solution of obesity. More recent studies with functional magnetic resonance imaging (fMRI) have indicated that unlike women with a stable weight where the mere visual image of palatable food increases the reward activity in the brain, that response is highly reduced in women who have gained weight in the past six months (4). This suggests that the dopamine reward circuits are compromised in women with recent weight gain, thus prompting a further increased risk for overeating in those individuals to increase dopamine output.

So does this mean that the obese patient with a disrupted dopamine reward system has no hope of overcoming these powerful neurological deficits? Not necessarily. There are a number of dietary interventions to increase the levels of dopamine and its receptors. The first is calorie restriction, which is only possible if you aren’t hungry. The usual culprit that triggers constant hunger is a disruption of hormonal communication of hunger and satiety signals in the brain. It has been shown that following a strict Zone diet can quickly restore the desired balance that leads to greater satiety (5-7). The probable mechanism is the reduction of cellular inflammation by an anti-inflammatory diet (8-10).

Another dietary intervention is high-dose fish oil that has been demonstrated to both increase dopamine and dopamine receptors in animals (11,12). This would explain why high-dose fish oil has been found useful in the treatment of ADHD, a condition characterized by low dopamine levels (13). Finally, high-dose fish oil can reduce the synthesis of endocannabinoids in the brain that are powerful stimulators of hunger (14).

I often say that if you are fat, it may not be your fault. The blame can be placed on your genes and recent changes in the human food supply that are changing their expression, especially in the dopamine reward system. However, once you know what causes the problem, you have the potential to correct it. If you are apparently addicted to food, the answer may very well lie in an anti-inflammatory diet coupled with high-dose fish oil.

References

  1. Wang GJ, Volkow ND, Logan J, Pappas NR, Wong CT, Zhu W, Netusil N, and Fowler JS. “Brain dopamine and obesity.” Lancet 357: 354-357 (2001)
  2. Thanos PK, Michaelides M, Piyis YK, Wang GJ, and Volkow ND. “Food restriction markedly increases dopamine D2 receptor (D2R) in a rat model of obesity as assessed with in-vivo muPET imaging and in-vitro autoradiography.” Synapse 62: 50-61 (2008)
  3. Steele KE, Prokopowicz GP, Schweitzer MA, Magunsuon TH, Lidor AO, Kuwabawa H, Kumar A, Brasic J, and Wong DF. “Alterations of central dopamine receptors before and after gastric bypass surgery.” Obes Surg 20: 369-374 (2010)
  4. Stice E, Yokum S, Blum K, and Bohon C. “Weight gain is associated with reduced striatal response to palatable food.” J Neurosci 30 :13105-13109 (2010)
  5. Ludwig DS, Majzoub JA, Al-Zahrani A, Dallal GE, Blanco I, and Roberts SB. “High glycemic-index foods, overeating, and obesity.” Pediatrics 103: E26 (1999)
  6. Agus MS, Swain JF, Larson CL, Eckert EA, and Ludwig DS. “Dietary composition and physiologic adaptations to energy restriction.” Am J Clin Nutr 71: 901-7 (2000)
  7. Jonsson T, Granfeldt Y, Erlanson-Albertsson C, Ahren B, and Lindeberg S. “A paleolithic diet is more satiating per calorie than a mediterranean-like diet in individuals with ischemic heart disease.” Nutr Metab 7:85 (2010)
  8. Pereira MA, Swain J, Goldfine AB, Rifai N, and Ludwig DS. “Effects of a low glycemic-load diet on resting energy expenditure and heart disease risk factors during weight loss.” JAMA 292: 2482-2490 (2004)
  9. Pittas AG, Roberts SB, Das SK, Gilhooly CH, Saltzman E, Golden J, Stark PC, and Greenberg AS. “The effects of the dietary glycemic load on type 2 diabetes risk factors during weight loss.” Obesity 14: 2200-2209 (2006)
  10. Johnston CS, Tjonn SL, Swan PD, White A, Hutchins H, and Sears B. “Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets.” Am J Clin Nutr 83: 1055-1061 (2006)
  11. Chalon S, Delion-Vancassel S, Belzung C, Guilloteau D, Leguisquet AM, Besnard JC, and Durand G. “Dietary fish oil affects monoaminergic neurotransmission and behavior in rats.“ J Nutr 128: 2512-2519 (1998)
  12. Chalon S. “Omega-3 fatty acids and monoamine neurotransmission. Prostaglandins Leukot Essent Fatty Acids 75: 259-269 (2006)
  13. Sorgi PJ, Hallowell EM, Hutchins HL, and Sears B. “Effects of an open-label pilot study with high-dose EPA/DHA concentrates on plasma phospholipids and behavior in children with attention deficit hyperactivity disorder.” Nutr J 6: 16 (2007)
  14. Watanabe S, Doshi M, and Hamazaki T. “n-3 Polyunsaturated fatty acid (PUFA) deficiency elevates and n-3 PUFA enrichment reduces brain 2-arachidonylglycerol level in mice.” Prostaglandin Leukot Essent Fatty Acids 69:51–59 (2003)

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

Good thing I listened to Dr. Sears

By Mary Dinehart-Perry

Having recently delivered a baby, I was surprised to see the latest article published in the Journal of The American Medical Association that fish oil supplementation rich in DHA has no impact on postpartum depression or cognitive and language development in early childhood.

The study looked at approximately 2,400 Australian women who began supplementation at around 21 weeks gestation through to the birth of their children (1). Individuals were randomized into one of two groups, one getting a fish oil supplement exceptionally rich in DHA (800mg DHA and 100mg EPA) and the other vegetable oil. It has been know for years that fish oils containing both EPA and DHA have dramatic benefits for fetal outcome. However, since there is little EPA in the brain, it was assumed in the past that it was only DHA that contributed to all of these benefits. However, recent studies have demonstrated that EPA rapidly gets into the brain and is rapidly oxidized, but DHA is not (2).

Lack of awareness has led to the mistaken belief that DHA is the only omega-3 fatty acid attributed to optimal brain functioning. Needless to say, companies that market DHA-rich products work very hard to continue to foster this misconception. This explains why the clinical trials that have used only DHA to treat depression or other conditions such as ADHD have been found it to be wanting. This is because DHA is a structural omega-3 fatty acid, not an anti-inflammatory one like EPA.

As long as adequate EPA is constantly in the blood, there will be enough EPA in the brain to address any neurological problems for both the mother and the fetus. That’s why this published study with only 100 mg of EPA was providing essentially a placebo level of this critical omega-3 fatty acid (3).

Although I myself am only a data point of one, I took the same dosage of DHA described above (800mg) during my pregnancy, however, it was coupled with 1600mg EPA. I can’t help but think that it may have been the combination of EPA/DHA that helped me avoid postpartum depression.

Mary Dinehart-Perry is clinical trials director of Zone Labs.

  • Makrides M., Gibson RA, McPhee AJ, Yelland L, Quinlivan J, Ryan P and the DOMInO Investigative Team. Effect of DHA Supplementation During Pregnancy on Maternal Depression and Neurodevelopment of Young Children: A Randomized Controlled Trial. JAMA 2010; 304:1675-1683.
  • Chen CT, Liu Z, Ouellet M, Calon F, RichardP, and Bazinet RP. Rapid beta-oxidation of eicosapentaenoic acid in mouse brain. Prostaglandins, Leukotrienes and Essential Fatty Acids 2009; 80: 157–163
  • Wojcicki JM, Heyman MB. Maternal omega-3 fatty acid supplementation and risk for perinatal maternal depression. J Matern Fetal Neonatal Med. 2010 Oct 7. [Epub ahead of print]
  • Hill AM, Buckley JD, Murphy KJ, and Howe PRC. Combining fish-oil supplements with regular aerobic exercise improves body composition and cardiovascular disease risk factors. Am J Clin Nutr 2007;85:1267–1274.

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

Eat your breakfast

You’ve probably heard it a billion times. “Don’t skip breakfast!” But most Americans, adults and children, are not heeding this advice. There are a bunch of reasons why you should eat breakfast within one hour of waking. And it’s even better if the meal is Zone balanced – the correct amount of lean protein, low-glycemic carbohydrates and a dash of monounsaturated fat.

After sleeping a full night, your blood sugar level is low, and you are in a catabolic state. This means that body has been using up stored energy in the liver as well as beginning to cannibalize your muscle for energy. If you skip breakfast, your blood sugar stays low and cannibalization of your muscle will continue. This is a stress situation, and the body releases more cortisol as a response. This creates insulin resistance that increases insulin levels further, driving down blood sugar even more. No wonder by mid-morning you are incredibly hungry.

The whole basis of the anti inflammatory diet is to keep your insulin in a zone, not too high and not too low. This will stabilize blood sugar and prevent continuing muscle degradation for energy. Eating a Zone breakfast can help keep your insulin stabilized, provide the necessary protein to start rebuilding muscle mass and increase the levels of glycogen in the liver. This is called anabolism. It is this continued balance of catabolism and anabolism that we call metabolism. As long as the two phases of metabolism are balanced, so are your weight and your mood. This is why breakfast is so critically important for your alertness, productivity, increased cognition and memory, satiety, and weight control because it starts your day out on a high note as opposed to digging a deeper hormonal hole that you try to crawl out during the rest of the day. A balanced Zone breakfast is also the easiest way to keep your sugar cravings under control during the day. In other words, you will not need the constant trips to the vending machine or your secret stash of candy to artificially maintain blood sugar levels.

Still not convinced? Then give your kids breakfast. Research shows a link between regular breakfast consumption and improvement in academic performance and psychosocial functioning as well as cognition among children. Eating a breakfast every day will be the best way to protect any child against becoming overweight. Make that a Zone breakfast balanced in protein, low glycemic-load carbohyrates, and monounsaturated fat, and you have the ideal pediatric weight-loss program as obese children are less hungry at their next meal as demonstrated at Harvard Medical School more than a decade ago.2 This finding at Harvard was also confirmed by a research study in the Journal of the American Dietetic Association on breakfast consumption among children that found the prevalence of obesity to be higher in those who regularly skipped breakfast.3 Evidence also suggests that breakfast consumption may improve cognitive function related to memory, test grades, and school attendance.4 Want the smartest and leanness kid in the school? It’s easy — feed them a Zone breakfast every day. While you are at it, make each of their meals a Zone meal and give them plenty of EPA and DHA at the same time.

[1] Affenito S. “Breakfast: A Missed Opportunity.” Journal of the American Dietetic Association 107:565-69 (2007)

2 Ludwig DS et al, “High glycemic index foods, overeating, and obesity.” Pediatrics 103: e26 (1999)

3 Deshmukh-Taskar P et al. “The relationship of breakfast skipping and type of breakfast consumption with nutrient intake and weight status in children and adolescents: The National Health and Nutrition Examination Survey 1999-2006.” Journal of American Dietetic Association 110:869-78 (2010)

4 Rampersaud G et al. “Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents.” Journal of American Dietetic Association 105: 843-60 (2005)

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

More bad news on Toxic Fat with a glimmer of hope

Last month, I discussed disturbing new data on the impact of omega-6 fatty acids on genetic expression (Cardiovascular Psychiatry and Neurology (2009;2009:867041). At the recent International Fatty Acid Conference in the Netherlands I had the opportunity to talk with Joe Hibbeln, the lead author, of that study at length.

During the conference, his group presented more data on how excess omega-6 fatty acids double the production of endocannabinoids (the hormones that make you hungry). Furthermore, increasing the intake of omega-6 fatty acids from 1 percent of total calories (what it was in 1960 and apparently all the way back to 1900) to 8 percent of total calories (the current level in the American diet) causes massive genetic changes that result in greater obesity.

It should be noted that the American Heart Association recommends 5-10 percent of total calories should be omega-6 fats. Let’s put this into perspective. 1 percent of total calories represents about 20 calories or about 2 grams of omega-6 fatty acids. That’s the amount to fill about one-half teaspoon. Eight percent of the total calories (assuming a 2,000-calorie-per-day intake) represent 16 grams of omega-6 fatty acids. That’s the amount that would fill a tablespoon.

There it is. The difference between being lean and fat may be determined by a very small amount of the same fats being pushed by agribusiness and the American Heart Association. These fats are ubiquitous as they also represent the cheapest form of calories and are the foundation of American agribusiness.

The only good news from the conference is that if you take 2 grams of EPA and DHA per day, you can reverse the inflammatory damage done by the increase in omega-6 fatty acid consumption. So maybe our obesity epidemic started the day that mothers stopped giving their children a daily tablespoon of cod liver oil that would have contained 2.5 grams of EPA and DHA. Fortunately, you can get the same amount of EPA and DHA today with only four capsules or one teaspoon of OmegaRx and without the excessive toxins contained in today’s cod liver oil or other fish oil available in grocery or health-food stores.

But without the added EPA and DHA in the American diet, we are probably doomed to become fatter, sicker and dumber with each succeeding generation.

United States’ major export: Obesity

By Dr. Barry Sears

Back in 2005, in my book “The Anti-Inflammation Zone” I wrote that many trends start in the United States and then cover the globe. We’ve exported Big Macs, Coca-Cola and the USDA Food Pyramid.

Now, five years later a report from the research organization, Datamonitor, indicates we have also exported childhood obesity – now more than one-third of European children are obese.

The organization attributes this weight gain to increased affluence and blames the usual suspects. “This is caused by a combination of eating too many calories and not doing enough physical activity,” according to the report.

That’s the same mantra that is used over and over in the United States. But obesity will not be curbed by eating less and exercising more unless we find shelter from the perfect nutritional storm that began in the United States and now has been exported across the globe.

New research indicates the primary factor has been the increasing consumption of omega-6 fatty acids found in vegetable oils, made in the USA.

The United States is also the king as far as processed foods are concerned, and we’ve been happy to share our junk food with children around the world.

And in Europe, as well as here at home, the amount of omega-3s consumed has dramatically declined.

The solution is to follow an anti inflammatory diet, increase intake of omega-3 fatty acids and dramatically reduce the intake of omega-6 fatty acids. Unfortunately this is easier said than done because of the ubiquitous presence of omega-6 fatty acids in virtually every processed food. Fortunately, increased intake of EPA and DHA (about 2.5 grams of EPA and DHA per day) can dilute out the inflammatory impact of these excess omega-6 fatty acids on our genes.

The bottom line, no pun intended, is that if there is no dietary change, children will continue to get fatter no matter how much they exercise because the genes that make children fat and keep them fat are being constantly turned on by diet they consume.

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

Getting kids to eat more fruits and vegetables

It is well known that portions sizes in the United States have increased tremendously throughout the years, but what about increasing portion sizes as a way to promote increased fruit and vegetable intake among children? It may just a work.

A recent study published in the March edition of Obesity examined just that (1). The study took 43 boys and girls ages 5 and 6 and fed them dinner once a week for two weeks. Each dinner consisted of a pasta dish with tomato sauce, milk and varying portion sizes of carrots, broccoli, and unsweetened applesauce. At each meal the size of the pasta dish remained the same, but the portion size of the vegetables and fruit served were doubled between visits. At the meal in which the portion size of the fruit and vegetables was increased, the children consumed 43 percent more of the fruit dish and less of the main entrée. This may be one way to get your kids to eat more fruits and vegetables and decrease their intake of more energy-dense foods.

Kids tend to be picky eaters so when preparing vegetables you need to get creative. In addition, it’s important to continue to expose them to various fruits and vegetables numerous times. The best time to introduce new fruits and vegetables is during meals they enjoy rather than having all new foods that are foreign to them. Consider having colorful salads with a dash their favorite salad dressing or melt some low-fat cheese on top of their broccoli. Incorporate vegetables into the meal itself instead of serving them separately or in the morning give them a yogurt parfait with fresh strawberries.

Starting a garden or getting kids involved with the preparation of their favorite fruits and vegetables also works to boost consumption of these foods. This doesn’t mean you have to smother vegetables in high-fat sauces and dressings or put sugar on fruit, but the more creative and tasty you make it, the more they’ll eat.

1) Kral TV, Kabay AC, Roe LS, Rolls BJ. Effects of doubling the portion size of fruit and vegetable side dishes on children’s intake at a meal. Obesity (Silver Spring). 2010 Mar;18(3):521-7.

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

What’s the buzz about magnesium?

Magnesium is a mineral that is inching its way into the spotlight. About 50 percent of the magnesium in our bodies is located in our bone, and the other half is found inside our cells and tissues (1). So what’s the big deal? Well in addition to maintaining muscle and nerve function, regulating heart rhythm, bone health and supporting our immune system, it also helps control blood sugar levels, blood pressure, energy metabolism and protein synthesis (2). This means it may play a role in diseases like hypertension, diabetes and even cardiovascular disease, although more research is needed. It has even been shown to help individuals with asthma based on its anti-inflammatory and bronchodilating effects (3) and a recent animal study shows promise with regards to its memory boosting properties (4).

Despite all the benefits attributed to magnesium, the increase in processed and refined food intake in the United States has led to a decrease in magnesium consumption through the years. So how can you make sure you’re getting enough? The best sources of magnesium include leafy greens, nuts and unrefined grains, such as oatmeal. Meats, starches and milk include some magnesium but are not the best sources. For women over the age of 30 the recommended daily intake is 320mg/day and for men 420mg/day (1). Women, you can meet your requirements with 1 ounce of almonds (80mg), 1 cup frozen spinach (150mg), 1 cup oatmeal (55mg) and 1 cup of yogurt (45mg). Men add 3oz. of halibut (90mg) to this and you’ve met your daily requirements too!

1) Magnesium: Available at: http://www.nap.edu/openbook.php?record_id=5776&page=190. Accessed: February 22, 2010.
2) Magnesium. Available at: http://dietary-supplements.info.nih.gov/factsheets/magnesium.asp. Accessed: February 22, 2010.
3) Bichara MD, Goldman RD. Magnesium for treatment of asthma in children. Can Fam Physician. 2009 Sep;55(9):887-9.
4) Slutsky I, Abumaria N, Wu LJ, Huang C, Zhang L, Li B, Zhao X, Govindarajan A, Zhao MG, Zhuo M, Tonegawa S, Liu G. Enhancement of Learning and Memory by Elevating Brain Magnesium. Neuron. 2010 Jan 28;65(2):165-177.

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.