Note: Please see the updates on healthism here. Flexibility, social connection, enjoyment of health, and not obsessing on perfection of diet is what makes health a means, not an end.
How toxic our world has become is getting harder to ignore. The recent release of the CDC‘s Fourth National Report on Human Exposure to Environmental Chemicals provided the most comprehensive assessment to date on the chemical exposure to the US population and its resultant health affects. The study estimated that an average of 212 chemicals can be found in an any individual’s blood or urine. Furthermore, out of these 212 chemicals, 75 are new and have never before been measured in the U.S. population until this study. (These new chemicals include acrylamide, arsenic, environmental phenols (including bisphenol A and triclosan), and perchlorateorate). What this translates to is a lot of extra burden placed on our body as the years go by, the main organ being affected is our detoxifying powerhouse- the liver.
The liver is responsible for not only detoxifying harmful substances, but it also cleanses the body of old red blood cells, converts ammonia to urea for exertion, and breaks down hormones. The liver is also involved with amino acid synthesis for proteins, the metabolism of carbohydrate, protein, and lipids, synthesizing of platelets, blood clotting factors, and angitotensinogen hormone, and the formation of bile. Furthermore, your liver stores glucose, vitamin A, vitamin D, vitamin B12, iron, and copper.
There are many ways to support our liver. One is by aiding detoxifying pathways through our diet. Dark leafy greens and healthy lean proteins provide good support for the two liver detoxification pathways. “Greening our home” using chemical-free products and natural personal care products also reduces toxic burden. A final way to help out our liver is to avoid things which harm it such as excess alcohol, drugs, and processed foods. The top processed food offender today is high fructose corn syrup.
Below are some highlights in journal articles between liver disease and processed foods.
Fructose, Sugar and Fatty Liver
The results of the Hepatology Journal article concluded that fructose consumption is associated with fibrosis, increased triglycerides, lowered HDL, and increased cholesterol levels in those with non-alcoholic fatty liver disease:
After controlling for age, sex, BMI, and total calorie intake, daily fructose consumption was associated with lower steatosis grade and higher fibrosis stage (P < 0.05 for each). In older adults (age 48 years), daily fructose consumption was associated with increased hepatic inflammation (P < 0.05) and hepatocyte ballooning (P = 0.05). Conclusion: In patients with NAFLD, daily fructose ingestion is associated with reduced hepatic steatosis but increased fibrosis. These results identify a readily modifiable environmental risk factor that may ameliorate disease progression in patients with NAFLD.
Furthermore, the combination of fructose with glucose can complicate matters. Another study in International Journal of Obesity Related Metabolic Disorders links liver steatosis (fatty infiltration of the liver) with obesity and higher serum glucose.
The severity of the steatosis was associated with BMI (P = 0.002) but not with the duration of obesity or the age of the patient. When compared with patients without fatty change, those with liver steatosis had significantly higher fasting plasma glucose (5.5 mmol/l vs 5.1 mmol/l, P = 0.007) and triglycerides (1.8 mmol/l vs 1.3 mmol/l, P = 0.002). Mean serum liver enzyme activities (alkaline phosphatase, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyl-transpeptidase (gammaGT) were significantly (P < 0.001) increased in patients with fatty change but remained within laboratory reference values.
(Here’s a link to an overview of how different sweeteners are processed with a surprise for most healthy food junkies-agave may be worse than HFCS!)
The good news is that we have healthy sweet alternatives! Appetiate Journal provided evidence on the benefits of stevia affecting insulin and blood glucose levels.
Stevia preloads significantly reduced postprandial glucose levels compared to sucrose preloads (p<.01), and postprandial insulin levels compared to both aspartame and sucrose preloads (p<.05). When consuming stevia and aspartame preloads, participants did not compensate by eating more at either their lunch or dinner meal and reported similar levels of satiety compared to when they consumed the higher calorie sucrose preload.
(Another helpful sweet option is xylitol, which has been shown to be anti-microbial and have negligible effects on blood glucose).
Although its easy to tell someone to stop doing a behavior, in reality the cycle of food addiction can be hard to break. Dr. Amen and Dr. Emmons have both published books that explain how different addictive patterns have different brain imbalances. These imbalances make following through with healthy eating patterns a lot harder to follow.
For example, those who crave carbohydrates and sugar could have overactivity in their prefrontal cortex and be deficient in serotonin. Those who are impulsive with eating, may have under-active basal ganglia and may be lacking the stimulant neurotransmitter dopamine.
As an integrated medical professional, I try to support lifestyle choices not just through facts, but by assessing biochemical imbalances. What’s one of my most quoted statements by my patients? “Biochemistry will trump willpower every time!” Blaming someone for not being able to stop an addiction ignores that brain biochemistry could be going haywire and creates a viscous cycle of self deprecation to the patient and frustration for the practitioner.
I have seen wonderful results for those with addictive behavioral patterns and weight loss resistance when their brain biochemistry is supported. Then they are better able to implement the lifestyle modificaitons. This seems to be the key player that is missing or ignored in integrated medicine, yet one of the most vital. Remember mind-body-brain connection is just a one way street! You can create a better body, through a better brain!
Other Resources not linked in article:
Induction of Phase II Detoxification Enzymes in Rats by Plant-Derived Isothiocyanates: Comparison of Allyl Isothiocyanate with Sulforaphane and Related Compounds J. Agric. Food Chem., 2004, 52 (7), pp 1867-1871. DOI: 10.1021/jf030549
Chemoprotective glucosinolates and isothiocyanates of broccoli sprouts: metabolism and excretion in humans. Shapiro TA, Fahey JW, Wade KL, Stephenson KK, Talalay P. Cancer Epidemiol Biomarkers Prev. 2001 May;10(5):501-8.PMID: 11352861
Physiological effects of broccoli consumption. Phytochemistry Reviews. Volume 8, Number 1 January, 2009. DOI:10.1007/s11101-008-9106-4
Broccoli contains many bioactives, including vitamins C and E, quercetin and kaempferol glycosides and, like other members of the Brassicaceae, several glucosinolates, including glucobrassicin (3-indolylmethyl glucosinolate) and glucoraphanin (4-methylsulphinylbutyl glucosinolate). A key bioactive component responsible for much of this activity may be sulforaphane (1-isothiocyanato-4-methylsulfinylbutane), a hydrolysis product of glucoraphanin. Sulforaphane not only upregulates a number of phase II detoxification enzymes involved in clearance of chemical carcinogens and reactive oxygen species, but has anti-tumorigenic properties, causing cell cycle arrest and apoptosis of cancer cells.
Changing your Body By Changing Your Brain. Dr. Daniel Amen, MD.
