Today we will delve into, through a historical excursus, the metabolic origin of chronic diseases to underline that health is largely in our hands and in our daily choices especially regarding nutrition. We will refer to two giants of medicine: Gerald Reaven (1928-2018) and Otto Warburg (1883-1970), Nobel Prize in 1934, who linked metabolism with the immune system.
The awareness of the relationship between nutrition and health is ancient, but has been lost over time. Consider, in fact, that a hieroglyph found in an Egyptian tomb reads: "A quarter of the food you eat serves to keep you alive, the other three quarters serve to keep your doctor alive."
Keep in mind that I am a doctor, not an esoteric, therefore, I am aware that this point of view, although thousands of years old, is very innovative.
Today, nutrition revolves around the “Bliss point”, or the point of ecstasy that is discussed in the book “Grassi Dolci Salati” by Michael Moss, an independent journalist who denounces the role of the food industry in creating an amplified taste that creates a sort of addiction to certain flavors and stimulates the consumption of more and more foods of this type. Summarizing the history of human nutrition in half an hour is impossible, but for those interested I recommend the book by Beppe Rocca and Giulia Garaffo “Pop nutrition & Pop medicine from Imhotep to Ancel Keys”.
The real original sin lies in the agricultural revolution, which occurred about 12.000 years ago, which put cereals, or carbohydrates, at the center of food consumption. In the Paleolithic, Man came down from the trees to get food and from that moment began to hunt and move continuously, but then even this method became difficult due to the exhaustion of large animals caused by the warming of the Earth and so, towards the end of the Paleolithic, the human species began to become increasingly sedentary and abandon nomadism. The great river civilizations of the Tigris and Euphrates in Mesopotamia, the Indus and Yellow Rivers in China, the Ganges in India, but above all the civilization of the Nile in Ancient Egypt were formed. The discovery of agriculture tied men to cultivated land and profoundly changed their lifestyle habits.
The Egyptians were nicknamed “bread eaters” and they used to drink Beer. It was a drink basically made of “liquid bread” with the addition of a little alcohol, therefore subject to deterioration, so abundant honey was added to obtain an antiseptic action and to improve its flavor.
With the increasing use of cereals in nutrition, the metabolic conditions for chronic inflammation that leads to chronic non-communicable diseases were created. In that same period, animal breeding was born and the first zoonoses and epidemics were observed that were due to the passage of pathogens from animals to humans. Not that the first major epidemic of tuberculosis occurred in ancient Egypt. Another turning point in the history of nutrition occurred with the Industrial Revolution of the 800th century in Great Britain when, with the well-being of the middle class, the epidemic of overweight, obesity and cardiovascular diseases, such as strokes and heart attacks, began, which still grips our society today.
Charles Dickens's work "The Pickwick Papers" illustrates in a very elegant way a series of overweight characters in which there were many cases of diabetes and obesity. In that period John Rollo (1755-1809) was the first to popularize the Low-Carb diet (1797) stating that the only way to defeat diabetes and obesity was to completely abolish carbohydrates and sugars. Obviously, as happens to all enlightened people who are ahead of their time, J. Rollo was not very successful. On the other hand, the booklet "Letter on Corpulence" by Willian Banting was very successful. Banting was not a doctor, but an undertaker of the English King, who was also obese (he weighed 160 kg), diabetic and was the symbol of the characters in the aforementioned Dickens book. Since Banting was not satisfied with the food restriction treatments that were proposed to him by the doctors of the time, and was also accused by them of lacking dignity and willpower, he wrote a booklet that was demonized by the doctors of the time but was an enormous success with the public.
It was also around that period that the doctor William Heberden (1710-1801) first spoke of "heart pain", from which he himself suffered and it is therefore clear that cardio-metabolic disease began exactly during the Industrial Revolution when the middle-class, with the improvement of economic conditions, began to consume a large quantity of food, especially carbohydrates.
From 1800 onwards, the intake of sugar in the diet also increased because sugar beet was imported from the Americas, allowing for indigenous European production of sugar cane.
During the same period, potato cultivation also spread in Europe, particularly in the Netherlands, Ireland and Great Britain, well described by Van Gogh in his paintings.
In 1977, the American state, concerned about the epidemic of obesity, diabetes, and cardiovascular disease, entrusted Angel Chis with the task of studying the origin of cardio-metabolic diseases and drafting American dietary guidelines.
It was he who explored the hypothesis of the lipid origin of cardiovascular diseases, so much so that the magazine TIME nicknamed him “Mister Cholesterol”. The prevention of these diseases, therefore, focuses from that moment on on a diet with light fats and an increase in carbohydrates, that is, a diet that favors sugars and decreases fats and, among these, vegetable fats such as seed oil were indicated.
Seed oils, notoriously Omega-6, are pro-inflammatory oils at the expense of Omega-3 which are anti-inflammatory. At the same time, the production of other forms of sugars from corn is increased, which has a devastating effect on human health. Three cereals typical of three areas of the world are spreading: corn in the Americas, wheat in Europe, rice in Asia. At the same time, the consumption of potato starches and manipulated proteins from soy and legumes is spreading, which, being low-quality proteins, create, again, a pro-inflammatory situation.
Legumes, moreover, not only contain carbohydrates but also a series of substances called "lectins" that have a pro-inflammatory action, in particular with regard to the intestinal mucosa and the balance of the microbiota. Regarding corn, it should be emphasized that in the 70s a way was found to extract fructose from corn and all cereals thanks to enzymes. This produced a high-fructose syrup that has pro-inflammatory effects. The two books "Sweet, Salty Fats" by Michael Moss and "Against Sugar. Trial of the Worst Enemy of Health" by Gary Taubes denounce the massive use of sugars by the food industry that exploits the properties of these molecules to encourage the consumption of food itself.
Scientific evidence shows that sugar activates the Nucleus Accumbens, a structure present on both sides of the telencephalon, is responsible for most of the actions and movements that have an emotional meaning. As a whole the Nucleus Accumbens plays an important role in the cognitive processes of aversion, motivation, reward and multiple mechanisms of reinforcement of the action.
This is the exact same area that reacts to the stimulation of cocaine. Sugar, therefore, gives a dependence similar to that induced by cocaine and stimulates the repetition of its consumption and above all a consumption in ever greater quantities.
The Nucleus Accumbens is very important in the modulation of taste that develops according to the psychological reactions induced by food. Since sugar has an anxiolytic effect, it is understandable that an increasing need to consume it develops.
To make food choices worse, since the end of the last century there has also been globalization, which tends to spread low-quality and low-cost goods aimed at the masses of the planet. As Slavoj Zizek described in his book “Like a thief in broad daylight”, we are in the era of “Post Human Capitalism” in which globalization involves two aspects, one positive and one negative, as if there were a Mister Hyde and a Doctor Jekyll. To sell low-quality goods to so many different masses of the Earth, it is necessary to create a dependency and this has been possible thanks to the formulation of intense and specific flavors that create the “bliss-point”, or the so-called “point of ecstasy”, which is able to selectively stimulate the Nucleus Accumbens of the brain.
The perception of taste includes the 5 gustatory tastes: sweet, salty, sour, bitter and the one discovered by the Japanese researcher Kikunae Ikeda in 1908 called “umami” which is the typical pleasant flavour of broths, roasts, parmesan, ripe tomatoes, dried porcini mushrooms, dried garlic and monosodium glutamate.
The right mix of these flavors tends to stimulate the Nucleus Accumbens and gives an anxiolytic action in which emotions control our behavior pushing us to consume more and more food containing taste amplifiers. Usually the bliss-point is reached with a mix of umami flavor to which sweet and salty are added.
The World Health Organization has established March 4 as the day dedicated to obesity, as an epidemic problem caused by two factors: one metabolic and one inflammatory. While until 2021 life expectancy was increasing, since 2021 there has been a decrease, but in addition to the shortening of life, there is also a lowering of the quality of life due to chronic diseases, especially cardiovascular, metabolic and degenerative diseases. This shows that there is a correlation between metabolism and the immune system, as Gerald Reaven and Otto Warburg already mentioned had intuited. Humans are the animals that have the greatest capacity to use fats compared to any other animal species. This ability is greater in children (encephalization), I remind you that when children have acetone it is necessary to maintain it because acetone is a ketone body that serves to protect children from convulsions, due to the use of fats and not sugars while in adults the reduced ability to use fats is due to the current diet that inhibits the use of fats and hence the metabolic origin of chronic diseases as explained by Gerald Reaven.
Reaven was a special person (1928-2018), he was a researcher and an endocrinologist at Stanford University who received the chair of cardiology. In his practice he observed that heart patients had a whole series of symptoms that he grouped together in the so-called "metabolic syndrome". His patients had an increase in abdominal circumference (88 cm women, 102 men), an increase in triglycerides (>=150 mg/dl), a reduction in HDL cholesterol (the so-called good cholesterol: <40 mg/dl men, <50 mg/dl women), an increase in blood pressure (Systolic >=130 and/or Diastolic >=85) and an increase in fasting blood sugar (>=100 mg/dl). Subsequently, these symptoms are accompanied by an increase in uric acid, glycosylated hemoglobin, inflammatory markers and homocysteine, an alteration of the triglyceride/HDL ratio < 3,6. Later, polycystic ovary syndrome appears in women, snoring and sleep apnea, prostatic adenoma, etc. in men. Reaven highlighted that these pathologies were caused by insulin resistance and an inflammatory state, in a spiral that led to a series of chronic diseases that affect not only the cardiovascular system and the immune system, but also affect the neurological system with dementia, Parkinson's and Alzheimer's disease, and bone and muscle disorders.
In a typical scenario, if you want to socialize, you usually go out for a pizza and a beer, which are two foods par excellence most responsible for metabolic syndrome. We are faced with an excessive consumption of sugars, vegetable proteins and seed oils (not olive oil) which are pro-inflammatory, trans fatty acids (margarine), not to mention the excessive consumption of fructose contained in sugary drinks and fruit juices.
In any supermarket you will notice huge pallets of sugary drinks that cost less than mineral water. This happens because we are in the presence of an industrial manipulation of food aimed at stimulating the point of ecstasy so much that the consumer no longer feels the natural taste of the food. In addition to these aspects related to the stimulation of taste, we must evaluate the impact that the quality of food has on our microbiome, or intestinal bacteria. Consider, for example, the use of antibiotics in intensive farming, as well as the chlorination of drinking water and the use of herbicides and pesticides in the intensive cultivation of fruit and vegetables.
We essentially live in an enemy environment, which is recognized by the immune system, in particular by our antibodies. Each enemy is recognized as if it had its own bar code that I call “Epitope”. Enemies can be living substances, such as pathogenic microorganisms, or they can be molecules contained in food, water, air. Our immune system reacts to the information (bar code) of each of these epitopes, but the confused information creates a delirious state, as Otto Warburg (Nobel Prize for Medicine in 1931) has widely demonstrated. In any acute inflammatory situation, the best thing is to put the body to rest, through fasting, and then using an energy source other than carbohydrates and other than sugars, that is, healthy fats.
You need to acquire metabolic flexibility by using foods that provide correct information to your system, avoiding industrially produced foods and making the right food choices. Depending on your individual biography and heredity, you need to reduce insulin sensitivity and intestinal permeability. All this is achieved by changing the fuel, using fats and zero sugars. All this rebalances the neuroendocrine system which deactivates the vagus through the deactivation of sugars, insulin and activating the sympathetic with the new fuel. You need to take a nutritional supplement of fatty acids because, no matter how much you choose healthy fats, you can never reach the amount needed to activate fat metabolism. It is then necessary to reduce the frequency of meals, avoiding snacks, and gradually moving, during the phases of life, from three to two meals a day, until reaching one meal favoring the moment in which insulin in its physiological rhythms is practically produced in the greatest quantity and which corresponds to a timing between 17 and 19 pm. I realize that all this within a traditional situation becomes difficult anyway but it can be achieved by taking the necessary time.
In conclusion, the overall therapeutic strategy includes:
- fat supplementation;
- intervene on intestinal permeability;
- defusing chronic inflammation due to Herpes Viruses.
All this to reset our metabolic control unit.
I end my speech with an invitation to reread “Ecce homo” where Friedrich Nietzsche says “in the war of life what doesn't kill us makes us stronger”. This is to not demonize stress but to lead us to consider it as a challenge of life, where each one in relation to the inheritance he has had must face his moments of difficulty. For example, you can choose to change the fuel by starting to act on our metabolism, with the result of having more energy and no longer making our system go crazy which, according to biology, in a situation of imbalance, can encounter autoimmune or allergic diseases or degenerative diseases that are part of chronic diseases that do not resolve.
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