Reasons Why Health and Nutrition Supplementations Are Harmful for Health

A lot of health-conscious individuals are in the mistaken belief that taking nutrition and health supplements is health-protective, prevents disease and increases longevity.

As a former senior medical researcher and a nutritionist-clinician, let us have a quick look at this belief that has reaped untold profits for health and pharmaceutical companies world-wide.

But first, take this personally coined adage from me:

“Man Eat Food, Not Nutrients”  

Taking high doses of nutritional supplements instead of obtaining nutrients from a balanced diet can have several adverse effects on health.

 While supplements can be beneficial in certain situations, such as to counteract acute nutritional deficiency diseases, examples beriberi from thiamine (vitamin B1) deficiency, or ariboflavinosis causing stomatitis of the mouth and tongue, cheilosis (chapped and fissured lips) and a scaly rash on the genitalia due to riboflavin (vitamin B2) deficiency.

Vitamin B2 deficiency can also been associated with visual disturbances including night blindness (similar to retinol or vitamin A deficiency), migraine headaches, mild anaemia, and psychological effects including depression, while  pellagra is caused by niacin or vitamin B6 and tryptophan deficiency, scurvy from vitamin C deficiency, rickets due to vitamin D deficiency, and macrocytic anaemia from vitamin B12 deficiencies and so on without us needing to write an entire heavy textbook on nutrition deficiency diseases as nutritionists would during their postgraduate training as a specialist in this area of medicine.

However, vitamin supplementations may be used only for short-term therapeutic purposes, but they should not be used as a substitute for a well-rounded and diverse diet. Here are several reasons why excessive reliance on nutritional supplements can be dangerous and inadvisable. Let us look at least 10 reasons why we can think of here:

1.       Nutrient Imbalance:

1. Overloading on specific nutrients can disrupt the delicate balance of vitamins and minerals in the body, leading to imbalances that may be harmful. For example, excessive intake of one nutrient may interfere with the absorption or utilization of another.

2.       Toxicity Risk:

1. Some vitamins and minerals can be toxic in high doses. Fat-soluble vitamins like A, D, E, and K are stored in the body, and excessive amounts can lead to toxicity. Even water-soluble vitamins like vitamin C can cause adverse effects in high doses.

3.     Incomplete Nutrient Spectrum:

1. Whole foods contain a wide array of nutrients, phytochemicals, and fibre that work synergistically for optimal health. Relying solely on supplements may result in missing out on these beneficial compounds.4

4.       Digestive System Interaction:

1. The process of digestion involves a complex interplay of various nutrients and enzymes. Obtaining nutrients from whole foods allows the body to process them in a way that supplements cannot replicate.
2. Bioavailability:
3. Nutrients in whole foods often have higher bioavailability than those in supplements. The body may not absorb and utilize synthetic nutrients as effectively as those from natural sources.

5.       Lack of Other Essential Compounds:

1. Whole foods provide not only essential vitamins and minerals but also other important compounds like antioxidants, fibre, and phytochemicals that are not present in most supplements. These compounds contribute to overall health and disease prevention.

6.       Interaction with Medications:

1. High doses of certain supplements can interact with medications, either reducing their effectiveness or causing harmful side effects. It's crucial to consult with a healthcare professional before combining supplements with prescribed medications.

7.        Cost and Accessibility:

1. Relying on supplements can be more expensive than obtaining nutrients from a balanced diet. Additionally, not everyone has equal access to nutritional supplements, potentially exacerbating health disparities.

8.        Psychological Dependency:

1. Depending solely on supplements may lead to a mindset where individuals believe they can compensate for an unhealthy diet with pills. This can discourage the adoption of positive dietary habits and lifestyle changes.

9.       Unregulated Supplements:

The supplement industry is not as tightly regulated as the pharmaceutical industry. This lack of oversight can result in variations in the quality and effectiveness of different supplements 

10. Unbalanced Protective Phytochemicals:

There is evidence for instance of certain populations such as smokers and asbestos-exposed workers who took beta-carotene supplements for prevention of lung cancer, but instead landed at even higher risk of lung cancer. One noteworthy study that raised concerns about beta-carotene supplementation and lung cancer risk is the Alpha-Tocopherol Beta-Carotene Cancer Prevention (ATBC) trial.  In that study, conducted among male smokers in Finland, it was found an increased incidence of lung cancer among those who took beta-carotene supplements compared to those who did not.

 It's important to note that these findings were specific to high-risk populations, and the relationship between beta-carotene supplements and lung cancer risk may not apply to the general population or non-smokers.

 

In contrast, dietary intake of foods rich in beta-carotene, such as fruits and vegetables, has not been consistently associated with an increased risk of lung cancer. In fact, a diet rich in fruits and vegetables are generally considered beneficial for overall health, including cancer prevention.

 

Foods rich in beta carotenes are carrots, a type of carotenoid, beta-carotene that gives carrots their orange colour and is a precursor to vitamin A. But carrots also contain alpha carotene, as well as lutein and zeaxanthin that are also carotenoids that contribute to eye health, and also falcarinol, a natural pesticide found in carrots, which may have some anti-cancer properties.

 

Besides carrots, tomatoes are also rich not only in beta-carotene, but also lycopene, a powerful antioxidant and carotenoid responsible for the red colour of tomatoes. Lycopene has been associated with various health benefits, including reducing the risk of certain cancers. Furthermore, tomatoes are also rich in quercetin that is found in other fruits and vegetables. Kaempferol is another flavonoid also found in tomatoes, contributing to their overall antioxidant content.

Other beta-carotene-rich foods, along with other carotenoids-rich foods are sweet potatoes, pumpkin, butternut squash, cantaloupe, spinach and kale.  

We can see these natural foods contain a wide variety of carotenoids, and not just beta-carotene alone. All these act synergically as a family to protect against cancer, and not skewed-up with just beta-carotene alone as with beta-carotene supplementation that would then act just like drugs or agents that may cause cancer as with beta-carotene supplements that increased the risk of lung cancer.

If we use only beta-carotene alone as a food supplement, then it is not surprising we increase the risk of lung and other cancers instead of lowering their risk if we consume foods that have a wide variety of phytochemicals including beta-carotenes and other carotenoids.  

It's imperative to consume a variety of colourful fruits and vegetables to ensure a diverse intake of phytochemicals and other nutrients. Different phytochemicals offer various health benefits, and they often work synergistically in the body. Remember that cooking methods can also affect the availability of these compounds, with some being enhanced by cooking (like lycopene in tomatoes) and others being better preserved in raw forms.

Phytochemicals, also known as phytonutrients, are bioactive compounds found in plants. These compounds are not essential for the growth and development of plants, but they have been found to have various health benefits when consumed by humans. Phytochemicals are responsible for the colour, flavour, and disease resistance of plants, and they also play a role in protecting the human body from certain diseases. There are thousands of different phytochemicals, and they can be classified into several main classes:

1.       Flavonoids: This is one of the largest and most studied classes of phytochemicals. Flavonoids have antioxidant properties and are found in a variety of fruits, vegetables, tea, and red wine. Subclasses of flavonoids include flavanols, flavones, flavanones, flavan-3-ols, anthocyanins, and isoflavones.

2. Carotenoids: Carotenoids are pigments that give fruits and vegetables their red, orange, and yellow colours. They have antioxidant properties and are converted to vitamin A in the body. Common carotenoids include beta-carotene, lutein, and zeaxanthin, found in foods like carrots, sweet potatoes, and leafy greens.
3. Glucosinolates: Found in cruciferous vegetables such as broccoli, Brussels sprouts, and kale, glucosinolates are known for their potential anti-cancer properties. They are broken down into bioactive compounds when the vegetables are chewed or chopped.
4. Alkaloids: This diverse class includes compounds such as caffeine, nicotine, and morphine. Alkaloids have various physiological effects and can be found in plants like coffee, tobacco, and poppies.
5. Saponins: Found in beans, lentils, and other legumes, as well as some fruits and vegetables, saponins have anti-inflammatory and immune-boosting properties. They also have a soap-like quality, which can affect the absorption of cholesterol.
6. Phenolic acids: These are a group of compounds with antioxidant properties. Examples include ellagic acid, found in berries and nuts, and caffeic acid, found in coffee.
7. Terpenes: These are compounds derived from the basic building blocks of isoprene. Terpenes include essential oils found in many plants, such as citrus fruits, and have various health-promoting properties.
8. Phytosterols: These plant-derived compounds have a structure similar to cholesterol and can help lower blood cholesterol levels. They are found in nuts, seeds, and vegetable oils.

It's crucial to note that these classifications are broad, and individual phytochemicals within each class may have unique properties and health benefits. A diet rich in a variety of fruits, vegetables, whole grains, nuts, and seeds can provide a diverse array of phytochemicals.

Before making any decisions about using nutrition supplements to augment the goodness of natural foods like fruits, vegetables, legumes, pulses, nuts and cereal grains, especially in the context of specific health conditions, it's advisable to consult with a healthcare professional especially a well-qualified nutritionist who would be able to provide personalized advice based on our individual health status and needs. Additionally, research in the field of nutrition and health is ongoing, so staying informed about the latest scientific developments is always a good practice.

Just remember, all water-soluble vitamins like B1, B2, C and B12 will lose into the urine when taken in excess than the body can retain, and all fat-soluble vitamins like vitamins A, D, E, and K that cannot be excreted in the urine when taken in excess than what the body requires may damage the liver.

One example is the polar bear liver. The livers of polar bears and other arctic animals that are known to be toxic.  Eskimos often eat polar bear meat, but strictly avoid consuming the bear's liver. Polar bear liver toxicity was first reported by Europeans in 1597 when the Dutch explorer Gerrit de Veer wrote in his diary that while taking refuge during the winter in Nova Zemlya (an archipelago in the Arctic Sea in northern Russia) that he and his men became seriously ill after eating polar bear liver.

Since that early report, other similar reports of arctic explorers becoming ill and even dying after consuming polar bear liver have appeared. So why is polar bear liver so toxic? For decades the finger has been pointed at vitamin A. A single polar bear liver (about 500 g) has an astonishing 9 million IU of vitamin A, and acute human toxicity occurs at about 300,000 IU! Long-term (chronic) toxicity can be achieved by ingesting 4000 IU/kg every day for 6–15 months. Therefore, a 90-kg (about 200-lb) man would have to ingest 360,000 IU every day to achieve toxicity. 

 

“Let food in moderation be thy medicine, not nutritional supplements”.

 

“Man eat food, and NOT nutrients” (JB Lim) 

 

 

The Reason Why White Table Sugar and also Fructose in Fruits are Bad for Cardiovascular and Metabolic Health?

 

In this blog post here I posted yesterday on cholesterol and heart disease there was a comment by Dr Mary Lee that reads (in pink)

https://scientificlogic.blogspot.com/2023/

Thank you, Dr Lim for your splendid article and explanation on why cholesterol is not the main cause of heart disease as all along we all thought, even among doctors, that cholesterol is the cause of heart disease, resulting in untold profits from statin drugs being prescribed unnecessary as you correctly said. I don’t encourage the use of statins myself as a doctor.  

Frankly I find your biochemical equations on the synthesis of cholesterol in the body difficult to follow. I wonder if other readers understand.

 You also mentioned Professor Dr John Yudkin who was your mentor at London University that sugar was the primary cause of coronary heart disease rather than saturated fats or cholesterol. I have heard and read about Professor John Yudkin who was very famous.  His findings on why sugar is deadly rocked the world and medical and scientific professions are now reviving very strongly among the medical communities.

But how does that work since fruits also contain a lot of sugar?  As a doctor, as with everyone else, I would have thought fruits are good for health and may also be heart protective as they are rich in antioxidants. How would you explain that?

Dr Mary Lee

Here’s my reply to her (in blue):

Thank you for your kind words, your opinion and your question Dr Lee

Let me try to explain why cane white sugar (sucrose) is more harmful than glucose or even the sugars in fruits.

 Kindly allow me to explain this in technical biochemical language. Please bear with me.  Later I shall then explain why I like to use simple layman’s language.

The metabolic pathways of glucose and fructose take different pathways upon entry into the cell. Glucose undergoes phosphorylation via hexokinase to form glucose-6-phosphate, initiating glycolysis.

 This pathway generates pyruvate, subsequently entering into the Kreb tricarboxylic acid (TCA) cycle for ATP production.

Conversely, fructose is also being phosphorylated by fructokinase, forming fructose-1-phosphate, which enters glycolysis downstream.

The unique metabolism of fructose contributes to distinct intermediates, such as dihydroxyacetone phosphate and glyceraldehyde-3-phosphate quite different from glucose. Furthermore, fructose metabolism culminates in the production of acetyl-CoA, influencing lipogenesis. This is the key entry into cholesterol synthesis.  This divergence underscores the nuanced impact of glucose and fructose on cellular energy homeostasis and metabolic outcomes.

I hope this divergence in metabolic pathways of glucose and fructose, although both are simple sugars as glucose and fructose found in sucrose (ordinary sugar) and also in fruits explains why sugars on hydrolysis and in digestion is harmful, not just in the aetiology of cardiovascular disease as explained by Professor Dr John Yudkin my very highly respected mentor.

Fructose in fruits and also in sucrose or ordinary table sugar is the root cause of all these metabolic syndromes such as hyperglycaemia and Type 1 diabetes, atherosclerosis, dyslipidemia, hypertension, cardiovascular diseases, fatty liver and liver diseases... etc for which there is no cure unless we are willing to change the ways we chose our foods for better protective nutrition by reducing sugar intake.  

Fruits though are health-protective as you said, but excessive intake are also very heath-damaging because of the presence of fructose (fruit sugar) that takes different metabolic pathways.

The pancreas where insulin is secreted by the alpha and beta cells is then unable to handle even glucose as it usually does, let alone fructose that is then diverted to the liver. This may damage even the liver into fatty liver, perhaps into liver cirrhosis.  

 Fructose or fruit sugar overloads the pancreas into degeneration till even blood glucose becomes out of control and diabetes mellitus sets in.

A good example was Steve Jobs who died of pancreatic cancer because he only ate fruits and nothing else in his skewed-up belief that fruits was good for health and longevity. I hope my explanation here is clear.

On your complaint that I used technical language and biochemical equations to explain the synthesis of cholesterol in the body which you found it difficult to follow, and that you wonder if other readers understand, I am sorry about this.

 I had no choice, and here again to explain the difference between glucose and fructose (though both are simple sugars as monosaccharides that cannot be broken down further by hydrolysis or by digestion). There is no way I could explain the synthesis of cholesterol in the body or how statin drugs work without bringing in the complex pathways of biochemistry or pharmacodynamics.

Neither would I be able to explain why sucrose containing fructose in equal parts with glucose is more harmless than glucose without using the language of biochemistry again to explain. 

Sometimes it is very difficult for a scientist to explain to another scientist in another field of expertise, and I have this difficulty myself, let alone explain to lay people.

Whatever it is, scientists normally would prove their point with emperical evidence and data. Often scientists in order to carry an infornmation across to the lay public they really have to go down to their level of understanding without quoting studies published in scientific journals. 

Scientists initially search through past literature and published papers. They may then propose a new theory using previous studies as a springboard towards their new discoveries. They do this by carrying out their own studies with data to back up their hypothesis. Sometimes other scientists will try to prove the other scientists was right or wrong by carrying out their own studies. This is very daunting and challenging especially during paper presentations in scientific conferences. 

For instance,  scientists I know today have shown that both Einstein Special and General Theory of Relativity were correct by carrying out their own observations and studies such as using Michelson-Morley experiment, time dilation and length contraction for Einstein Special Relativity, or using Eddington's solar eclipse experiment, gravitational redshift and gravitational lensing effect to detect another extrasolar planet outside our own during a stellar eclipse, or they may use lunar laser ranging experiment for Einstein’s Theory on General Relativity.

More recently, scientists started using GPS satellites systems to detect very teeny tiny differences in time to prove Einstein was correct for both his Special and General Theory of Relativities

These experimental validations, along with subsequent advancements in technology and observational capabilities, have consistently supported the predictions of Einstein's theories of relativity.

Sometimes it may not be possible to get experimental data, but their methodologies must be reproducible by other scientists such as the way they are able to trace highly complex metabolic pathways.   

For instance, biochemical scientists use a variety of techniques to elucidate and understand biomolecules and to trace metabolic pathways such as by using radioactive isotope labelling to look at emitted radiation that can be detected and traced, by using mass spectrometry, nuclear magnetic resonance spectroscopy about the structure and abundance of metabolites. Alternatively, they may use enzyme assays, gene expression analysis, fluorescent probes and microscopy, metabolic flux analysis, chemical inhibitors among others. 

By combining these techniques, scientists can gain a comprehensive understanding of metabolic pathways, their regulation, and their significance in various biological processes. These are reproducibly without needing to show data 

We cannot challenge the academic and intellectual ingenuity of these scientists using their probes and their experimental studies.   

 I knew what I wrote was beyond even medical doctors who have just a basic bachelor’s degree in general medicine. 

They have just  simple broad understanding on anatomy, biochemistry (if any), physiology, pharmacology, microbiology which they do in their first two pre-clinical years, studying just a bit of each in 2 or 3 lectures before spending the remaining 3 years in various wards, each ward for only 3 or 4 months before moving on to other aspects of general medicine, mainly in appled medicine such as in  diagnosis, and treatment of diseases, all spread out over their remaining three clinical years. 

So, I don’t expect medical doctors who are basically clinicians to understand much biochemistry unless they also hold a PhD degree in biochemistry or a PhD in nutrition, in which case they would know more than my simple self.

In most of my blog articles you read here, you would notice I use very simple layman’s language to carry my message across. I hardly use any technical language with references and citations as I used to do when I was in medical research for publications of papers in scientific journals.

Since retirement I wanted to write simple articles only for lay general readers to get more readership. But if I were to use technical language then I would lose readership. I get between just 20 – 50 readers every day for my blog if I don’t write anything for days. But if I were to write a new article in simple English language, then my readership would jump to between 130 to over 800 per day.

But in certain cases, like now and in my last article on cholesterol and heart disease I can’t avoid it, else there was no way I could explain why cholesterol per sec is harmless by using simple language or explanation.

 Then they will ask me to explain in what way is it harmless when everybody including medical doctors believes it is harmful for the heart. Then how else could I explain without the language of biochemistry, pharmacology or even medicine.

I hope you understand Dr Mary Lee. Thank you for understanding why I want to avoid using scientific language except in very few cases.   

Lim jb 

 

Does Cholesterol cause Coronary Heart Disease?

 

A medical doctor friend two days ago asked me if high cholesterol has anything to do with heart disease and how it really works in blocking the arteries?  I have already answered this issue many times in the past.

 I knew that neither cholesterol nor saturated fats was the cause of heart disease in 1964 when I was a postgraduate student of Professor John Yudkin MA, MD, PhD, FRCP, FRIC, FIBiol who was the Chair of Nutrition at Queen Elizabeth College, University of London.  See John Yudkin’s biography here:

https://en.wikipedia.org/wiki/John_Yudkin#Career

At that time the prevailing theory was saturated animal fats that caused elevated blood cholesterol that in turn caused coronary heart disease. John Yudkin’s greatest rival was Ancel Keys (1904 – 2004) who advocated saturated animal fats as the cause of coronary heart disease. Yudkin’s theory of sugar as pure, white and deadly was the root cause of death from heart disease that rocked the entire world and the medical community.

Below are two links that I wrote to two of my other medical specialist colleagues who asked the same, seeking my opinion about cholesterol and heart disease.  

https://scientificlogic.blogspot.com/search?q=cholesterol

The Truth about Cholesterol, HDL and LDL and Heart Disease here: 

https://scientificlogic.blogspot.com/search?q=The+Truth+about+Cholesterol%2C+HDL+and+LDL+and+Heart+Disease

 Cholesterol per sec is completely harmless. It is a pale-yellow substance, though waxy, it does not stick on to anything, let alone onto the coronary arteries of the heart. It is not soluble in water except in organic nonpolar solvents such as petroleum ether (pet ether), chloroform, ether, benzene, ethanol and methanol (alcohols). I have seen and touched very pure analytical grade cholesterol many times before when we were working in an analytical medical diagnostic laboratory.

Cholesterol is intentionally produced by the body for numerous biochemical and physiological functions such as for the brain and nervous system. It is needed to produce hormones, especially the corticosteroid hormones produced by the adrenal glands.

 It is the diet that partially determines the HDL and LDL cholesterols ratios and total amounts in the blood. It is the liver that synthesizes cholesterol from acetyl-CoA. We shall go into this later.

Most dietary cholesterol are neither HDL or LDL cholesterol except certain foods like eggs, dairy products, and certain types of meat that contain both HDL and LDL cholesterol. Most dietary cholesterol is just neutral cholesterol. It is the types and amounts of fat in the diet that help determine the quantity of triglycerides, the HDL, and LDL cholesterol ratios in the bloodstream.

Cholesterol-rich foods generally as already mentioned contain the normal cholesterol with the molecular formula C27H46O. It is neither called high- or low-density cholesterol.  But they can contribute to the production of both high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol levels in the body.

Cholesterol is synthesized by the liver through a complex series of enzymatic reactions, and its production involves multiple metabolic pathways. The primary pathway for cholesterol synthesis is known as the mevalonate pathway or the HMG-CoA reductase pathway. The key steps in cholesterol biosynthesis comes from acetyl-CoA formation.

This process begins with the conversion of acetyl-CoA, a molecule derived from the breakdown of carbohydrates, fats, and proteins, into a compound called acetoacetyl-CoA.

Then we have the HMG-CoA Formation in which two molecules of acetoacetyl-CoA combine to form 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) through the action of the enzyme thiolase.

Next comes the mevalonate formation where HMG-CoA is then converted into mevalonate by the enzyme HMG-CoA reductase. This step is often considered the rate-limiting step in cholesterol synthesis, and HMG-CoA reductase is the target of statin drugs, which are commonly prescribed to lower cholesterol levels.

Statin drugs are a class of medications commonly prescribed to lower LDL (low-density lipoprotein) cholesterol levels in the blood. LDL cholesterol is often referred to as "bad" cholesterol because elevated levels can contribute to the buildup of plaque in arteries, leading to atherosclerosis and an increased risk of cardiovascular disease.

Statins work by inhibiting an enzyme called HMG-CoA reductase, which plays a key role in the synthesis of cholesterol in the liver. By reducing the production of cholesterol, particularly LDL cholesterol, statins help lower overall cholesterol levels in the bloodstream.

In addition to lowering LDL cholesterol, statins may also have other beneficial effects, such as increasing high-density lipoprotein (HDL) cholesterol often referred to as "good" cholesterol and reducing inflammation.  We shall go into “good” and “bad” cholesterol a little bit more later.

It's important to note that the use of statins is typically recommended based on an individual's overall cardiovascular risk profile, and the judgement to prescribe statins is made by healthcare professionals. While statins are effective in lowering cholesterol and reducing the risk of cardiovascular events, they may also have side effects such as damage to the liver, and their use should be monitored and managed. Unfortunately, statins have been abused by health care providers through over prescribing.  For instance, statin prescriptions average a total annual cost of $24.5 billion in the US alone.

Back to the synthesis of body cholesterol, after the mevalonate formation where HMG-CoA is  converted into mevalonate by the enzyme HMG-CoA reductase, the next step in the synthesis of cholesterol in the body results in conversion to Isoprenoids where mevalonate undergoes a series of enzymatic reactions to form isoprenoids, such as farnesyl pyrophosphate and geranylgeranyl pyrophosphate and the formation of squalene in which Isoprenoids are then converted into squalene through a series of reactions. The squalene undergoes cyclization and modification reactions to form lanosterol, which is then further converted into cholesterol.

These are the biochemical steps how the body naturally produces its own cholesterol, and it could do this far more efficiently than the cholesterol we can eat through food.

The liver is a major site of endogenous cholesterol production. The amount of cholesterol produced by the liver varies among individuals. It is influenced by factors such as genetics, dietary habits, and overall health. On average, the liver synthesizes a substantial amount of cholesterol each day to meet the body's needs for cell membrane structure, hormone synthesis, and other essential functions. There are feedback mechanisms on the amount of dietary cholesterol intake and the endogenous turnover by the liver to keep the level of cholesterol in the blood under check and balance.

The impact of dietary cholesterol intake on blood cholesterol levels can vary from person to person. Even though dietary cholesterol does contribute to total cholesterol levels, the body's response to dietary cholesterol is complex. Some individuals are more sensitive to dietary cholesterol, while others are less affected.

Since cholesterol is not water soluble as already mentioned, for cholesterol to be transported through the bloodstream, which is water-based, cholesterol needs to be combined with proteins in the blood to form lipoproteins. These cholesterol-protein complexes vary in density, and there are two main types. Let’s talk about them in a bit more detail.

Low-Density Lipoprotein (LDL): LDL cholesterol is often referred to as "bad" cholesterol. LDL particles are denser and smaller. They transport cholesterol from the liver to the cells. However, if there is an excess of LDL cholesterol or if the LDL particles are damaged by oxidation such as from free radicals to become gummy and sticky, and this can contribute to the buildup of plaques on the intima or inner walls of arteries, leading to atherosclerosis. Foods high in saturated and trans fats, which are often found in animal products and processed foods, can raise LDL cholesterol levels to cause this problem, whereas fruits, vegetables and plant-based foods rich in antioxidants can short-circuit free radicals into harmless neutral molecules, thus preventing atherosclerotic plagues formation.

High-Density Lipoprotein (HDL) cholesterol is often referred to as "good" cholesterol. HDL particles are larger and less dense. They help remove excess cholesterol from the bloodstream by transporting it to the liver, where it can be broken down and excreted from the body. HDL is considered beneficial because it helps prevent the buildup of cholesterol in the arteries. It is also less prone to become sticky through oxidation. Foods that are rich in healthy fats, such as certain oils, fatty fish, nuts, and seeds, can contribute to increased levels of HDL cholesterol.

The terms "low density" and "high density" refer to the comparative proportion of lipids (fats) to proteins in these lipoprotein complexes. LDL has a higher ratio of cholesterol to protein, making it denser, while HDL has a higher ratio of protein to cholesterol, making it less dense.

It is important to note that the relationship between dietary cholesterol and blood cholesterol levels is complex. For many people, dietary cholesterol has less of an impact on blood cholesterol than the types of fats consumed.

In recent years, research has indicated that the link between dietary cholesterol and heart disease is not as straightforward as once thought, and factors such as overall diet, genetics, and lifestyle play central roles. What is important is to limit the intake of sugar, saturated and trans fats and focus on consuming healthy fats to support heart health.

In short, and simply put in simple language, LDL cholesterol often referred to as "bad" cholesterol and high-density lipoprotein cholesterol or HDL cholesterol often referred to as "good" cholesterol may not be technically correct so to speak. LDL cholesterol may not be “bad” after all if a diet has a high content of antioxidants to deal with oxidative stress of the cells and on the intima of coronary and other blood vessels by damaging free radicals.

HDL merely picks up excess cholesterol in the blood and returns them to the liver where it's broken down and removed from the body. It is also less prone to oxidation and oxidative stress. That’s why they term HDL cholesterol as “good cholesterol”. It is the diet that partially determines the HDL and LDL cholesterols ratios and total amounts in the blood. It is the liver that synthesizes cholesterol from acetyl-CoA as already described in some details.

In summary, I have found no relationship between blood cholesterol and heart disease when our medical technicians analysed tens of thousands of blood samples at the Institute for Medical Research where I once worked as a Senior Medical Research Officer, and what clinicians wrote there in their requests for cholesterol analysis. The blood samples were taken from hundreds of government hospitals in East and West Malaysia. I have gone through these analytical data and have signed tens of thousands of these analytical and diagnostic reports for doctors in hospitals.

But I found no relationship between serum cholesterol and heart disease and heart attacks. Their requests were sent to us for support and confirmatory diagnosis.

But I could not do anything to tell them because the prevailing theory at that time was saturated animal fats and cholesterol that caused  coronary heart disease. So, I signed all their doctors' and government hospitals' requests and sent them back to the hospitals and let them do what they like that pleased them. 

 There was nothing I could do to change the mindset of doctors who insisted that high cholesterol was the culprit, and should be treated with statins when sugars, smoking, stress, free radicals were the wrongdoers.

 I was the only lone voice in the wilderness in Malaysia at that time, but numerous scientists and eminent physicians in the UK who were my mentors would have supported me.

It is only now that multiple voices from the scientific and medical communities are revealing the myth about cholesterol and coronary heart disease.

Here are just a few publications since 1998 with their scientific voices in support of my silent thoughts in the mid 1960’s    

Do I need to say more?

How this myth about cholesterol and heart diseases first started is here:

Cover Story | The Heart Study Heard Around the World: Origins of Framingham and its Continued Legacy

https://www.acc.org/latest-in-cardiology/articles/2014/08/19/09/23/the-heart-study-heard-around-the-world-origins-of-framingham-and-its-continued-legacy

The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159698/

Dietary Cholesterol and the Lack of Evidence in Cardiovascular Disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024687/

7 Myths About Cholesterol, Debunked

https://time.com/6287926/cholesterol-myths-debunked/

Cholesterol does not cause coronary heart disease in contrast to stress here:

https://www.tandfonline.com/doi/full/10.1080/14017430801993701

“The real truth about diet and cholesterol came out in a 1992 Archives of Internal Medicine article stating that, “in Framingham, Mass, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person's serum cholesterol”. The author who said this was William Castelli who was the Director of the Framingham study at that time.

Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review here:

https://bmjopen.bmj.com/content/6/6/e010401

From Framingham to Hunt 2: 60 Years Blaming the Wrong Culprit?

https://medcraveonline.com/JCCR/from-framingham-to-hunt-2-60-years-blaming-the-wrong-culprit.html

The US Government finally officially removed Cholesterol from Naughty List here:

https://www.linkedin.com/pulse/cholesterol-finally-officially-removed-from-naughty-list-barot#:~:text=The%20US%20government%20has%20finally,heart%20disease%20and%20clogged%20arteries.

Think this over and thank you for reading.

Lim ju boo 

A Letter from A Former Medical Colleague on Her Health Problems

 

I received this letter from a former medical-scientific colleague of mine (her name I withheld for professional ethical reasons), but she gave me the permission to publish her letter to me  in pink below.

Dear Dr Lim,

I am so sorry for not being in touch for a long time.

I sincerely hope the problem with your leg has been resolved.

I fractured my right wrist and a deep cut on my right eyelid which required 9 stitches recently.

I had surgery to put in a titanium plate. I am recovering well; range of motion is getting better, but I still need to do exercises to regain strength on my right hand.

Dr Lim, may I consult you on my results of cholesterol and glucose levels.

I saw an Endocrinologist on 27/11/23 and my results are as in the Table below.

The Endocrinologist prescribed Rosuvastatin Sandoz 10mg, once a day. 

Till date I have not started this medication.  Do I need to start this statin?

For the last one week, I have had a stomach-ache when I wake up, loose stool and a bit dizzy. 

I have had a right frontal dull headache since mid-morning (I have this type of headache on and off). Fingers on my right hand are numb now. I am not sure the numbness is due to my injured right wrist. I still have stiffness and slight numbness on my right-hand fingers in the morning. 

Dr Lim, I really appreciate your kind advice.

Thank you very much,

(Signed by my former medical colleague)

 

Here’s my reply and advice to her in blue:

My dear Colleague,

I am sorry to hear about your fall, the surgery you underwent, the numbness of your right hand and right fingers, and your occasional headache.

Your numbness is almost certainly due to the pressure by the titanium plate exerting on the median nerve on the flexor muscles of the forearm and hand. There may be some inflammation there that may increase the pressure over the nerve for which you may need some antiinflammatory medication.

It may go away after some time with physiotherapy and hand exercises, else go back to your surgeon if it does not improve over time.  

Meantime take Dyna Vitbion Forte tablets ( Vit B1, Vit B6 and Vit B12) tds (3 times a day) for your numbness.  

As for your headache, your symptomatic presentation sounds to be typical migraine. Take the herbal medicine called “feverfew” one – two tablets in the morning. Try the local pharmacy to get feverfew, else buy them online.

Also try to avoid harsh drugs for migraine and chronic headaches like acetaminophen, ibuprofen, triptans or erenumab, fremanezumab and galcanezumab.

Try also to avoid foods like aged cheeses, alcohol especially red wine, chocolate, cured and processed meats containing nitrates, nitrites, and MSG. Also avoid artificial sweeteners, smoked fish and food containing yeast extract, and also contraceptive pills which may not apply in your case.

As for your total cholesterol, a trend during these 4 years showed your total cholesterol was hovering around 9.3 mmol / L when preferably it should be less than 5.2 mmol / L.

But total cholesterol level per sec does not mean anything desirable or undesirable since your HDL averages at 3.2 mmol/ L when the optimal HDL cholesterol level for females should be between 1.2 - 1.3 mmol/L. Yours was very good.

What is important to know is that HDL cholesterol levels are just one part of the overall cholesterol profile.  The lipid profile should include levels of LDL cholesterol, total cholesterol, and triglycerides, in addition to HDL cholesterol.

But your more harmful LDL was 5.75 mmol (which was given there as null for normal level). The optimal LDL cholesterol level should be less  than 2.6 mmol/L which means it may be harmful if you let this LDL to be oxidized by free radicals into gummy plagues that may  block your coronary arteries of your heart that may result in  cardiovascular events such as angina pectoris (chest pains) or AMI -  heart attack, or a stroke in the cerebral vessels in your brain. The risk is there if accentuated by high blood pressure.

However, your total /HDL ratio was 2.9 when it should ideally be less than 5.0. Overall, your blood cholesterol level is not very desirable if cholesterol was truly the cause of coronary heart disease? See my comment and opinion on this here:

https://scientificlogic.blogspot.com/search?q=cholesterol

See also my letter to Consultant ENT Surgeon Professor Andrew about: 

The Truth about Cholesterol, HDL and LDL and Heart Disease here:

 

https://scientificlogic.blogspot.com/search?q=The+Truth+about+Cholesterol%2C+HDL+and+LDL+and+Heart+Disease

Your FBS (fasting blood sugar) was 6.65 when the normal fasting blood sugar range is approximately 3.89 to 5.49 mmol/L. but given there as less than 5.6 mmol / L. A fasting blood sugar level of 6.65 mmol/L may suggest impaired glucose tolerance or mild diabetes or pre-diabetic status. However, a single elevated reading may not be sufficient for a diagnosis. Other tests such HbA1C as a long-term duration of existing diabetes showed that your HbA1C from 25/7/2019 till 14/11/2023 hovered around an average of 5.65 % which is not too bad when the normal HbA1C is 5.7 %. I think you are just at the border line (pre-diabetes status). Pre-diabetes and Type 1 diabetes can be addressed through dietary means including using botanical medicine such as consumption of bitter gourd, fenugreek (Trigonella foenum-graecum): Fenugreek seeds have been studied for their potential to lower blood sugar levels. They may also help improve insulin sensitivity, cinnamon (Cinnamomum verum): Cinnamon is a spice that has been studied for its potential to improve insulin sensitivity and lower blood sugar levels, ginseng (Panax ginseng): Some studies suggest that ginseng may have anti-diabetic properties and could help improve insulin sensitivity, aloe vera (Aloe barbadensis miller): Aloe vera has been studied for its potential antidiabetic effects, particularly in type 2 diabetes, berberine: Although not a plant per se, berberine is an alkaloid found in several plants, including goldenseal and barberry. It has shown promise in improving insulin sensitivity and glucose metabolism, turmeric (Curcuma longa): Curcumin, the active compound in turmeric, has anti-inflammatory and antioxidant properties and may have potential benefits in managing diabetes.

Some nutritional products like a combination of chromium and niacin called ‘glucose tolerance factor (GTF) help dramatically. 

I have a lot of clinical experiences using chromium and niacin to manage diabetes among staff and colleagues working with me at the Institute for Medical Research in the 1970’s to 1980’s. The clinical efficacy with GFT is very high and impressive.

But I don’t think you need to take anti-diabetic drugs such as sulfonylureas (glipizide, glyburide, gliclazide, glimepiride), meglitinides (repaglinide and Nate glinide, and the more popular biguanides (metformin) normally prescribed in Malaysia or even using thiazolidinediones.

Try to avoid using all these antidiabetic drugs. They don’t “cure” diabetes, as they need to be taken every day just to control it.  I don’t suggest you use all these drugs either as yours is just pre-diabetes that can easily be controlled by nutritional and dietary approach.

As for your blood cholesterol I don’t think Rosuvastatin, Atorvastatin (Lipitor), Simvastatin (Zocor), Pravastatin (Pravachol) or any of these statins are necessary as they can damage your liver.  Use dietary approaches such as oats and barley.

 These whole grains contain beta-glucans, a type of soluble fibre that can help reduce LDL (low-density lipoprotein) cholesterol. Consume fatty fish rich in omega-3 fatty acids found in fatty fish like salmon, mackerel, and trout may help lower triglycerides and increase HDL (high-density lipoprotein) cholesterol. Then nuts like almonds, walnuts, and other nuts are rich in monounsaturated and polyunsaturated fats, which may help lower LDL cholesterol. Cook food in olive oil especially extra virgin olive oil, a source of monounsaturated fats that may contribute to heart health. Plant sterols and stanols, compounds found in small amounts in various plant foods They can help lower LDL cholesterol. Avoid margarine, white refined sugar especially. Use raw garlic as some studies suggest that garlic may have a modest cholesterol-lowering effect. I suggest turmeric that has curcumin, the active compound in turmeric with antioxidant and anti-inflammatory properties that may have cardiovascular benefits. All raw vegetables are very rich in antioxidants that will prevent the oxidation of harmful LDL cholesterol into gummy products that may stick on to the coronary blood vessels as plagues. Drink green tea as green tea contains antioxidants called catechins, which may contribute to heart health.  Apples or any tropical fruits that contain soluble fibre, which can help lower cholesterol levels. Lastly, I suggest consuming legumes such as beans, lentils, and chickpeas are rich in soluble fibre and can help lower cholesterol levels. Fruits like avocado that are high in monounsaturated fats and may help improve cholesterol levels. Some studies suggest that cinnamon may have modest cholesterol-lowering effects. So do psyllium husk and oats.

!00 mg of aspirin (standard dose of aspirin is 300 mg) a day after meals to thin the blood is useful against heart attack and also against colon cancer. Salicylates (in aspirin) are also found in abundance in curry powder. The Indians who eat curries everyday have the lowest rate of colorectal cancer, but the Chinese who don’t eat curry or very seldom, have the highest statistics in colon cancer incidence.  

Do this instead of all dosing yourself with all those statin drugs as they may harm the liver with long-term usage.

Kind regards and get-well dear.

Lim ju boo 

 

 

 

The Management of Post-Covid Anosmia

 

Here’s a piece of information sent to me by a friend of mine, Professor Dr Charles Andrew Gomez, a Senior Consultant ENT Surgeon on:

 Overcoming Post-COVID-19 Long-Lasting Olfactory Issues written by Dr  Antonio Segovia


Exploring the Impact of COVID-19 on Smell and Taste, Its Repercussions on Daily Life, and Advances in Innovative Treatments


The COVID-19 pandemic has messed up millions of lives in all sorts of ways.

Even my wife wasn’t spared and had to deal with weird stuff like losing her sense of smell, everything smelling foul, and taste changes when she got infected.

Fortunately, in her case, these symptoms were temporary, lasting about 15 days.

However, in my line of work as a medical doctor, I have seen many patients still struggling with these changes that mess up their quality of life and mood, particularly those who find joy and healing through cooking.

 The Extent of Post-COVID-19 Anosmia in the US

Post-COVID-19 anosmia  statistics in the United States reveal a worrying picture.

According to the World Health Organization (WHO), as of November 2023, 103,436,829 cases of COVID-19 have been reported in the US, with 1,138,309 deaths.

World meter updated these figures to 109,378,312 cases with 1,182,614 deaths as of November 2023.

Olfactory disorder is common among COVID-19 patients, with approximately  70% experiencing loss of smell during the illness  and 65% having olfactory dysfunction 18 months later.

This 2022 paper on MDPI found that:

24.2% of mildly symptomatic patients still experienced chemosensory (responsive to chemical stimuli) dysfunction one year after infection, with 45.1% presenting with dysfunction after 12 months and 35.9% suffering from parosmia (abnormality in the sense of smell.)

Recent studies suggest that up to 20% of all COVID-19 patients experience long-term olfactory disorders.

 Mechanism of Loss of Smell and Taste in COVID-19

Anosmia (temporary loss of smell) is one of the primary neurological symptoms and one of the most common and earliest indicators of COVID-19.


Interestingly, the sensory neurons that detect and transmit smell to the brain are not among the cell types most vulnerable to SARS-CoV-2 infection.

Studies led by neuroscientists at Harvard Medical School have identified that
 the virus primarily affects cells that supply metabolic and structural support to olfactory sensory neurons and  specific populations of stem cells and blood vessel cells.

Cells contain the receptor, which SARS-CoV-2 uses to enter human cells.

It implies  that in most cases, SARS-CoV-2 infection is unlikely to damage olfactory neural circuits permanently and lead to persistent anosmia.

Accompanying symptoms and causes

Patients with post-COVID-19 anosmia
 not only lose their sense of smell, but may also suffer from parosmia and other related symptoms.

Parosmia is a condition where our sense of smell is distorted, causing us to perceive smells differently from how they are.

People with parosmia *may experience odours that are unpleasant or different from their true nature. All these sequelae cause:

Mood disturbances,

 Weight loss,  and a decreased quality of life  caused by damage to sensory neurons or brain areas responsible for the smell.

 Work-Life and Mental Health After the Pandemic

The COVID-19 pandemic has destroyed part of the work and private lives of many people, as well as employees' mental well-being and self-rated health.

About 30% of employees reported that their work and personal lives had worsened, while about 10% reported improvements at work and 13% in private life.

The negative perception of the impact of the crisis is enormously strengthened by lower mental well-being and self-rated health.

 Conventional Treatments and New Options

Although there are pharmacological and topical treatments for anosmia, their effectiveness is limited, especially in cases of parosmia.

It is where hope arises with A CT-guided stellate ganglion block (SGB) to treat post-COVID parosmia.


With this technique, an aesthetic and a depot steroid are injected into the stellate ganglion under the guidance of computed tomography.

A recent study indicated that most patients treated with this technique experienced a significant improvement in their symptoms.

This technique helped a bunch of patients who hadn’t gotten relief before. But patients got even more relief when they had the treatment on both sides. The good old CT-guided stellate ganglion block (SGB)is a promising new way to help those dealing with long-term smell issues after COVID-19.

The advancements are exciting, as this technique offers hope to those facing persistent smell disorders post-COVID. However, microsurgery is a minimally invasive new option that gives hope to those with long-lasting loss of smell after COVID.

 Conclusions

From my own experience and medical practice, I’ve noticed that not only does losing your sense of smell after COVID-19 mess with daily life and enjoyment, but it can also really hit mental health and job performance hard.

The roll-out of treatments such as the CT-guided stellate ganglion block is like a light at the end of the tunnel for folks grappling with these lingering disorders.

As you can see, the news is excellent for the many people still facing long-term COVID-19 symptoms.

Overcoming anosmia and parosmia after COVID-19 is not just about regaining smell; it’s about reclaiming mental well-being in daily life.

To truly get into the weeds on this topic, there’s a detailed research piece you should look at in the Radiological Society of North America (RSNA).

You might find the “Analysis of Prevalence and Predictive Factors of Long-Lasting Olfactory and Gustatory Dysfunction in COVID-19 Patients” in PubMed.

Here is some additional information on “Impact of the COVID-19 crisis on work and private life, mental well-being” on BMC Public Health

Here’s my reply to my friend, Professor Charles Andrew Gomez, who sent me the above article someone else wrote about anosmia (loss of smell) from post-Covid effect:

…………………………………………………..

Thank you, Professor Andrew, for this post Covid olfactory dysfunction information.

I am not surprised because this virus affects the nose first as Covid is a respiratory infection

I am unsure the mechanisms in which this virus paralyzes the olfactory sensation to the brain, but my feeling is, the effect may be temporary even without all those elaborate, expensive, harmful radiation CT guided stellate ganglion block treatment,  whatever it is

The virus is not going to stay unchallenged by the immune system forever

Once the virus is overwhelmed, I believe as in most cases of repair systems by the body, the olfactory cells and  nerves will automatically regenerate, and the patient will and must recover from loss of smell.

One very cheap and natural way to deal with this anosmia is to stimulate the olfactory cells by steam inhalation  with antivirus eucalyptus oil alone or in combination with tea tree oil. The strong stimulating smell from the hot vapour of this anti-viral oil will excite the olfactory cells and nerves.

See details here:

https://taionn.blogspot.com/2021/05/recommendations-of-steam-inhalation.html

This is physiologically logical and is my take. There is no need for all those high end, highly expensive and time-consuming CT guided therapy which would be inaccessible to a large population of people with post-Covid symptoms. Imagine if we have 5 billion people world-wide, especially in poor countries like India, Indonesia, Yemen or in rural areas of African countries with Long Covid symptoms. How are they going to get CT-guided stellate ganglion block therapy? Doctors who devise and recommend such expensive out-of-reach methods of treatment that benefit only a few elite and rich patients will not get a Nobel Prize in medicine or in physiology. Clinicians and scientists need to find the cheapest and highly effective method that would benefit tens of hundreds of millions of people world-wide who shall be eligible for the prestigious Nobel Prize in medicine or in physiology

In the practice of medicine do it the easiest, cheapest, most effective and most convenient and natural way for the patient

That is good and ethical medicine

Thank you

Jb 

On Human Nutrition: Frequency of Meals, and How Much to Eat?

I read with interest an article on nutrition written by Datuk Dr Nor Ashikin Mokhtar, a consultant obstetrician and gynecologist, and a functional medicine practitioner. She wrote in The Star today (10 December 2023) on “How many meals to eat.”

Nutrition probably is the most interesting, the most popular and widely read subject among all health and medical subjects. It is widely read by most people, including doctors, nutritionists, food scientists and just ordinary laymen alike.

 It is probably the only subject that appeals to most people because food and nutrition is the only ingredient that gives us health and life, and yet nutrition is the most complex subject to understand. Several US $ billion are being spent yearly on research on nutrition, resulting in thousands of research papers being churned out every year, and yet we understand just a bit how food affects our body, and overall health.

Nutrition is so complex to fully understand that resulted in many research findings contradicting each other.  Our understanding on nutrition today is far more than just our knowledge about the proximate principles, namely, carbohydrates, protein, and fat how they are metabolized through the Hans Krebs Cycle and other metabolic pathways to yield energy and body needs, besides the wide spectrum varied roles of various vitamins, and minerals and trace elements. Besides these nutrients, nutritional and food scientists have over the years discovered untold tens of thousands of other functional compounds especially the phytochemicals in plant-based foods besides the traditional carbohydrates, proteins, fats, vitamins and minerals.

Nutrition and food scientists are now trying to unravel the medicinal properties of these functional foods containing tens of thousands if not tens of millions of these phytochemicals and their roles in health, in the prevention of disease and their curative values when consumed in small amounts over long periods of time.

 Truly, Hippocrates, Father of Medicine once said: “Let Food be Thy Medicine” He never said “let medicine be thy food” which the pharmaceutical companies and doctors today put words into his mouth long, long after his death for obvious monetary reasons.

On the very interesting and challenging question “how many meals to take” Datuk Dr Nor Ashikin Mokhtar was trying to discuss, I don’t think anyone really knows. She has discussed several interesting issues to determine the frequency between meals, among them are enhanced satiety, metabolic kickback, steadier energy levels, blood sugar control, meal frequency and chronic disease, meal frequency and weight loss, metabolic boost from frequent meals, meal frequency and athletic performance, diet quality, and which to choose.

 She also mentioned some might find it more beneficial to eat small, but frequent meals, while others prefer the usual three -meals-a-day structure. She has discussed these issues very interestingly that I enjoyed reading.

From my angle of perspective, we do not know how much nutrients – energy from carbohydrates, proteins and fats are recommended as our Recommended Daily Allowances (RDA) as these recommendations are not fixed as they keep changing every 5 years by expert committees on nutrition.  Each country has its own “Recommended Daily Allowances” depending on the Chairman sitting in these committees, and their recommendations keep changing for review every few years. I have studied the RDA and found they are a bit inflated over our actual basic needs especially in energy (caloric) from carbohydrate, and fats.

Nutritionists have yet to determine what constitutes “optimal nutrition” for an individual as this would vary from person-to-person due to individual biological variations based on our needs, occupation, age, gender, physical activities, body build, possibly climate and environment too. We have yet to define optimal health which would depend on the nutritive quality of the food, optimal time and frequency of eating to provide optimal nutrition for different individuals. Without understanding these criteria for optimal health, we would not be able to determine how much to eat, what to eat and how often we need to eat?

 It only shows how little we understand nutrition despite the avalanche of research papers churned out yearly with the highest research budgets and research fundings given out for nutrition, with research on cancer coming only next.  

My feeling on how many meals to take and their frequency a day would depend on our individual body needs and how our body signals to us through hunger. We can’t dictate what and when the body should have them. The body has an inborn and innate feedback mechanism to signal us and to decide for us when we should eat. If we decide and dictate to our body, for instance the traditional way of having 3 meals – breakfast, lunch, dinner, and even supper for some individuals, I think we would be overeating.

Nutritionists consider overeating as bad nutrition or malnutrition as much as under eating is also malnutrition since the Latin word “mal” means “bad”. Hence “malnutrition” applies to both overnutrition as well as undernutrition which may surprise many of my readers.

We know that overeating results in obesity, type 1 diabetes, cardiovascular disease, renal disorders, stroke, metabolic syndrome, gout, and other nutritional lifestyle diseases, and probably cancers too. Bear in mind there are many poor communities throughout the world, especially in countries where families do not have one meal a day, and yet they live relatively healthily though optimal health is extremely difficult to define.

My feeling on this issue is to allow the body to signal us when blood sugars are low, but not too low causing hypoglycaemic attacks. Hunger and the desire for food sets in automatically, and we eat only in moderate amounts to bring up blood sugar levels to slightly above pre-prandial levels.

Bear in mind the body cannot utilize excessive sugars than it needs when large meals are taken. It will be stored as glycogen, and if not used up, turned into fats. Neither can the body store excess proteins when too much meat is consumed in one meal. It too will turn into fat and not into muscles.

In other words, the long-term effects of overeating and overnutrition causes some of the calories to build up as fat causing overweight. Overweight leads to obesity, and if this is not controlled it slips into pathological obesity. This increases risk for cardiovascular diseases, type 1 diabetes, metabolic syndrome, possible cancer and other chronic health problems.

Excessive eating may also overload the digestive system.  The limited secretion of digestive enzymes is also being overstretched, resulting in indigestion.

It may also influence the sleep rhythm. The circadian clock, which controls the wake-sleep-wake cycles, causes the sleep and hunger hormone levels to rise and fall throughout the day. Overeating may impact this rhythm resulting in difficulty in sleeping.

 

My opinion is, take only two moderate meals a day, spaced out over an 8-to-10-hour interval. This will also give bowel rest as well as metabolic rest to the liver that need to store, break down the nutrients or detoxify products of metabolism such as protein into ammonia into urea and creatinine as well as to prevent the continuous production of free radicals produced by the continuous metabolic breakdown of food, let alone the kidneys that need to excrete urea, creatinine and other metabolic wastes. In short, I think we need to ensure that our body is allowed bowel, liver, kidneys and all metabolic rest between meals.

Furthermore, excessive protein intake a day can also result in elevated blood lipids and cardiovascular events because many high-protein foods also contain saturated fat, although sugar (sucrose) would be the main culprit leading to coronary heart disease as shown by Professor John Yudkin, a very eminent physician, physiologist, chemist who was also the Chair of Nutrition at the University of London in the mid 1960’s. Yudkin showed that pure white sugar is more deadly  than saturated fats in causing coronary heart disease. Yudkin’s findings caused a stir at that time over the saturated fat theory but currently his sugar findings are revived and accepted by many nutritionists and scientists world-wide.  It is just our advances in our understanding in nutrition and medicine with new findings.

  Excessive protein intake too causes an overload to the kidneys, adding to the risk to those predisposed to kidney disease.

I should think taking just two moderate meals a day allows bowel, liver, metabolic and kidney rest in between the 24 hours.  That would scientifically, and logically be the best approach rather than the traditional regimen of having three-square meals a day whether the body requires them, only to be stored as body fats leaning to obesity and nutritional lifestyles pathological events.

I should advise not just two moderate balanced meals a day with high fruits and vegetable contents that have the benefits of medicinal phytochemicals and antioxidants in them, but more importantly caloric restriction that can prolong longevity, not just longer life span, but also disease-free longevity.

As far back as in 1935, Clive McCay and his colleagues at Cornell University clearly demonstrated when rats were given severely restricted diets, they lived up to 33% longer than their normal lifespan. Over the last few decades, similar experiments carried out on countless species, from worms to rodents and even primates have shown the same results, probably due to reduced toxic metabolic wastes. The excessive calories that need to be metabolized resulting in excessive free radicals generated besides toxic metabolic wastes produced.

I think this subject on how frequent and how much to eat is a very complex question which all clinicians, biological and medical scientists and even qualified nutritionists need to understand as there is no one answer that fits all individuals.