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Why Nature Wants Us to be Fat by Richard Johnson

The two popular theories that purport to explain the obesity pandemic are the carbohydrate insulin model and the standard model of energy balance.  In Why Nature Wants Us to be Fat, nephrologist Richard Johnson bravely proposes another theory:  the survival switch. In his formulation, nature has evolved a survival mechanism allowing organisms to rapidly gain weight…

Muscle, Protein and Aging

Muscle is a metabolically active tissue that plays a central role in health and longevity.  Beyond helping one get up from a chair and avoiding falls and hip fractures as we age, muscle accounts for 75% of glucose disposal and makes the greatest contribution to resting energy expenditure of any tissue in the body.  For…

Metabolic Syndrome

The diagram below details how overfeeding will lead to the so-called metabolic syndrome, a cluster of conditions that are linked and can lead to vascular disease, stroke and heart attacks.  The components of  metabolic syndrome are hypertriglyceridemia, truncal obesity, hypertension, diabetes and low HDL.  This diagram elaborates an insulin-centric model, and it’s important to recognize…

Metabolic Flexibility

Humans evolved in the setting of periodic food scarcity during which we developed the ability to rapidly switch between different fuel sources.  We are designed by evolution to burn fat in our fasting state and to burn primarily carbohydrates in our fed state in order to generate energy in the form of ATP.  All of…

Autophagy

Autophagy (literally “self-eating”) is the body’s way of cleansing cells by recycling old or damaged components and is a process that appears to have a strong relationship to preventing disease and aging.  More technically, it is a highly regulated lysosome-dependent catabolic program used by the body to clear dysfunctional proteins, organelles and other structures that…

Epigenetic clocks and Reprogramming  

How do we measure aging?  Certainly, there is the passage of time and how many birthdays someone has had, but we know that aging proceeds more quickly for some people than it does for others.  The speed of aging depends on your genes but also various factors such as, for instance, whether you smoke, your…

Weight Set Point Theory

The real challenge with weight loss is keeping it off.  When you lose a significant amount of weight (greater than 10% is a number that’s typically used, though certainly there is individual variability), the body does what it can to return to its original weight.  The body seems to have a functional weight set point…

Drugs For Obesity

Sometimes no matter how hard we exercise or how conscientiously we diet, the weight does not come off.   A short fast can jump start the process of fat oxidation, but we are also fortunate to have FDA-approved drugs to help us along if we cannot get started. Or if we plateau.   We offer medications…

One way of looking at anti-aging interventions

The hallmarks of aging as elaborated in the now famous paper are the key biological changes that occur in living organisms as they grow older. These changes are thought to be the underlying cause of many of the health problems associated with aging, such as loss of muscle mass, declining cognitive function, and increased susceptibility…