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    Flexocrats: The Donut Is Not The Problem, It's Us
    By Greg Critser | March 1st 2013 01:07 PM | 11 comments | Print | E-mail | Track Comments
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    Greg Critser is a longtime science and medical journalist whose work appears in the LA Times, the Times of London and the New York Times. He is...

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    And the obesity wars drone on: it’s the sugar, it’s the fat, it’s the paucity of playgrounds, it’s the prevalence of too-thin models and TV and gaming and chips and texting. It’s the lack of parental discipline and self-restraint.

    But wait: what if we accepted that “the environment”--the catch-all phrase for the above--just can’t be changed, or at least not fast enough to make a difference? And what if we just accepted that people will, by and large, continue to do as their genetic backgrounds direct them: eat as much as they can, and move as little as they must?

    Slowly that heretical notion is taking root in the field of nutritional sciences. There, researchers are slowly and painstakingly shifting their inquiry to a more basic issue: homeostasis--the body’s innate capacities to recover from any kind of disturbance--and how we can strengthen those balancing mechanisms.

    Call these whitecoats the flexocrats.

    Theirs is not a difficult premise to understand. Consider: The human phenotype--the body our genes and environment dictate--has been shaped by evolution to adapt, to bend and flex and return to balance when confronted with a challenge, be it a Big Gulp or bad air. You eat a huge hit of sugar, your body pumps out insulin to make it possible for your cells to use it and return to balance. It’s an intricate, elegant system that worked just fine until we engineered an environment that made sugar virtually free and almost everywhere present. Then the system crashed, and we got our intertwined epidemics of obesity and diabetes.

    Traditional public health folks have responded to these public health problems in two ways: change the environment - ban Big Gulps! - or change the behavior - stop eating and start moving! Reduce your risks!

    Flexocrats say: rather than spending all our time making people do what is not in their nature, why not find ways to make our native metabolisms respond to the assault better? It’s a way to even the playing field and give us a fighting chance as we enter the unnatural arena of eating less and moving more.

    Consider the current (and, no doubt, very temporary) consensus talking point: that sugar consumption, not obesity, causes type two diabetes. ( Actually, they both do, but given the current “obesity does not equal diabetes” media phase we’re now in, we’re not able to handle such a staggering concept.) The current public health model would hence look to any number of “solutions,” a reasonable but politically impossible one being the regulation of sugar.


    The donuts are not the problem. It is you. Just kidding, you look pretty good. But that is not from the donuts either. Credit: Shutterstock

    A pheno-flexo-crat (that sounds even cooler!) would say something completely different: What, in our innate bodily system of self-regulation, can we tweak or reprogram - using everything from breast-feeding routines to fortification of the food supply - to let us simply take that sugar assault in metabolic stride? No, that wouldn’t mean you could eat like a pig all the time, but it would give your body a buffer when you did. (And, face it, you’re going to!)

    Predictably, some of the most robust flexocratic findings come from the world of laboratory rodents, our principal, if flawed, medical stand-ins. At Spain’s sunny University of the Balearic Islands (UIB), a huge program is studying the mechanisms of glucose control. In one experiment, lactating rat mommies were put into one of two regimens, one in which they ate normally, and one in which they ate 20 percent less than normal.

    The results: the offspring in the calorically-restricted group were dramatically less likely to develop insulin resistance and diabetes than their traditionally fed counterparts, regardless of how they ate later in life. “It was shocking,” said Jadwiga Konieczad, a doctoral student who oversaw the study. “It’s obviously not something for humans to try yet, but the result was so strong, so dramatic, that it may lead to us rethinking our current dogmas about how to feed infants. Maybe we can make them tougher to the realities of modern life.”

    In the realm of food supply supplementation, (not “healthy eating”), Swedish researchers have focused on the flexibility-inducing components of non-traditional grains--barley and rye and the like. At frigid Lund University, the preeminent diabetes scholar Inger Bjorck is tinkering with tiny, concentrated concoctions of rye. In one experiment Bjorck added the compound to the evening meals of one group of human type 2 diabetics; a control group ate an un-supplemented meal. The next day, both groups ate a normal (not a “heart-healthy”) breakfast - ham, eggs, toast and the like.

    Two hours later, Bjorck recorded the blood sugar and insulin levels in both groups. Finding: The patients who’d eaten the little rye supplement the night before registered the healthy  levels of a non-diabetic; the control group’s response remained impaired and diseased. “We don’t know why it works,” Bjorck says. “But we have some idea. We think it involves some kind of gastric memory, maybe driven by fermentation in the gut, that we, as humans, once possessed, but which we lost when we began consuming our modern wheat mono-culture.”

    What about reprogramming fat itself? After all, fat is not “bad.” Fat cells act like tiny endocrine organs. They are an essential part of our homeostatic toolkit, the way our body stores energy, fuels the immune system, and signals all kinds of beneficial processes. The problem is that modern life has accentuated, or perturbed, fat's bad qualities--its inflammatory, disease-causing signals. Yet new research, this also at UIB, has isolated a number of  potential additives that would "push" perturbed "bad" white fat cells into becoming more like brown fat cells, a form of fat that seems better equipped to handle the chronic over-consumption of sugar. This is not a try-this-at-home thing yet. Too much brown fat would likely make you so hot ( it partly works by increasing thermogenesis) you’d likely drink a Big Gulp.

    Ben Van Ommen, a Dutch researcher who has led much of the EU's multi-million dollar investment in pheno-flex, explains that the new approach simply made sense. "About ten or fifteen years ago, all of us studying metabolism and fat saw the same thing: Sure, getting people to change and making the environment more healthful would be the best way to go, but it was simply not working. The dice were loaded against people. One day somebody said, 'look, the problem is not the donut, the problem is us--our body.'"

    So far, few in the today’s world of public health have taken up the flexocrat cause. Think about it: it has no natural intellectual constituency. The vast “healthy lifestyle” industry - both private and public - would be threatened by it. The professional fatties would simply see another form of stigmatization and pseudo-eugenics. And such “unnatural” tinkering would also bring out the anti-nannies, the anti-pharmas, the truthers, the birthers, all three remaining anti-Trilateralists and, of course, those lonely, lonely Tea Party guys.
    It would just be too "radical."

    Yet Van Ommen points out that the flexocrat approach perfectly fits a nearly universally held definition of health. As articulated by one of its earliest 20th century proponents, the brilliant Johns Hopkins' pioneer Henry Sigerest, health “is not just the absence of disease. It is something positive, a joyful attitude to life, and a cheerful acceptance of the responsibilities that life puts upon the individual... A healthy individual is a man who is well balanced bodily and mentally, and well adjusted to his physical and social environment."

    Greg Critser is the author of Fat Land: How Americans Became the Fattest People in the World. And you can read more of his articles here.

    Comments

    Gerhard Adam
    Oh great!  Now you tell me after Twinkies have gone out of business!  :)
    MikeCrow
    I wonder if your favorite traveling buddies are also tuned starting at birth based on diet?

    Krispy Kreme's are the best!

    I would think this would select the lite eaters, and that you'd want the big eaters, but I've been surprised before.
    Never is a long time.
    Hank
    Are you making fun of woo social claims that are hoping get found by epigenetics? 'cause that is pretty funny if you are.
    Want more no-nonsense, independent science? Buy Science Left Behind
    MikeCrow
    I hadn't intended on it being funny, but I'll take funny over stupid, so, yes :)
    Never is a long time.
    rholley
    Twinkies?  Are they some transatlantic confection / concoction?

    I recently read on Telegraph Blogs the following:
    How dispiriting to learn that scientists in Belgium trying to work out the best formula for baking a cake have declared their experiment a failure. “The transformation of ingredients into cake comprises a series of complex procedures which are not fully understood,” said the food biochemists based in Leuven.

    That, at least, was the official verdict. Behind the scenes, however, I gather the scientists were fuming at “British interference”.

    Says a source: “Every time we were close to perfecting a Victoria sponge, a mysterious caller from Downing Street hinted that Her Majesty’s Government would veto our EU grant unless we folded in more cream. The results were too rich even for Belgian stomachs. This did not happen in Mr Blair’s day…”
    I think that the Eurocrats should be sent to Guantánamo and deprived of their favourite Belgian chocolates.  Instead, they should only be allowed Hershey’s Kisses.

    Even one of our students, who might well have been descended from the Pre-Columbian empress Chocaholic, could not work up any enthusiasm for them.
    Robert H. Olley Quondam Physics Department University of Reading England
    MikeCrow
    Twinkies are the ever lasting treat.

    Never is a long time.
    What's the standing on high-fructose corn syrup at this point? I get annoyed with the people claiming that it is the same as sucrose (beet/cane sugar), when it quite obviously isn't - sucrose is a disaccharide, while fructose is a monosaccharide. That should quite *obviously* have an effect. It's not really true to say that 50% fructose corn syrup has the same amount of fructose as the same amount of sucrose - as in one, the fructose is not chemically bonded, and in the other, it is. Sure, the body breaks it down fairly quickly - but it's what happens between ingestion and digestion, as well as the balance of ionization when glucose is there, vs. when it's not, that really matters. We can't simply treat all sugars as being identical for nutritional purposes! And yet, that's what we seem to do. (We do likewise, for the most part, for more general carbohydrates and fats, as well. Dumb, dumb, DUMB!)

    Murfomurf
    As someone interested in public health I find it rather interesting that seemingly everyone is "taken in" by the abundance of high- sugar/fat/calorie foods and feels they can't stop consuming them. I assume I was brought up very strangely (a long time ago), but I have neither a "sweet tooth" nor a chocolate craving. I DO really enjoy hot potato chips, but have decided I should only have them no more than once a month as a treat- I'm not craving them. Currently my weight's the upper end of normal due to eating a bit too much with my uniformly overweight dinner companions and not exercising as much as I could due to a massive dislike for hot weather, but I keep saying "No" quite happily to sugar or choccy treats. I've never been attracted to sweet foods with sugar substitutes like saccharine or aspartame either- they tasted weird and I wondered what would happen to my metabolic pathways when they encountered these substances that stimulated the taste buds, which in turn readied the stomach&liver etc for a sugary, calorie-filled bolus! Regularly I have a glass of tonic water (alone) or Coke, so I don't avoid sugar altogether. My dentist recently put the hard word on me to chew sugarless gum after meals, but I can't do it- my stomach gets all knotty and I start to feel shaky and sweaty, expecting calories along with the sweet flavour! I'm definitely NOT a restrained eater, have never been on anything that could be described as "a diet" and I'm not all that fussed about my body shape/size - so, am I an awful exception? Couldn't a different upbringing train kids to feel the same as I do? Of course it would require parents to practise what they preach, so I guess adults just can't "resist" the calorie-laden lifestyle or they would have changed by now. My family background is apparently riddled with diabetes also. When I was 18, my 19 year old cousin died from diabetes (1970) as she wouldn't stop eating high-calorie food while on insulin. All of my fathers siblings except one died due to diabetes aged 25 to 40, but neither my father nor mother had it, even in their 80s/90s. From my point of view it would be worth doing some big community interventions to try to cultivate a more active, less calorie-focused lifestyle centred on single streets and neighbourhoods, neither focused on age groups, organised sports nor true "dieting". Scientifically-speaking I can see no merits in trying to "outdo" our extremely complex metabolism after millions or more years of evolution, by tweaking a gene or diverting a pathway. Sounds like more of the same, ie. aspartame, food bulkers, Orlistat, Xenical etc. Not my glass of tea!
    rholley
    Very much in agreement with this, although for years I was a person who could not put on enough weight.

    This desire to modify the human organism sounds a bit like what Bertolt Brecht* said:
    Wäre es da nicht doch einfacher, die Regierung löste das Volk auf und wählte ein anderes?
    “Would it not be easier in that case for the government to dissolve the people and elect another?”

    A few weeks ago on the BBC there was an episode of The Big Questions, one of which was “Should we tax to fight the flab?”  The main thrust of the debate was supposed to the connection between sugar, obesity and diabetes, and public health finance.  One contributor, though, was a body image campaigner who almost derailed the discussion by harping on about the public perception of fat people.

    *(Brecht is something of a bête noire of mine.  His play Life of Galileo treated the great man as a political football: however, it is our Institute of Physics to which I award the Order of the Wet Lettuce for continuing to endorse the play more than half a century later.)
    Robert H. Olley Quondam Physics Department University of Reading England
    are you from steubenville ohio?

    critser@earthlink.net

    Yes--and I remember you well! My email is at gpcritser1@gmail.com
    Write me there when you have a moment and we can catch up!
    Greg

    Greg Critser