More Liver

It's time to celebrate your liver. It's a hard-working organ and it deserves some credit.

One of the liver's most important overall functions is maintaining nutrient homeostasis. It controls the blood level of a number of macro- and micronutrients, and attempts to keep them all at optimal levels.

Here's a list of some of the liver's functions I'm aware of:

• Buffers blood glucose by taking it up or releasing it when needed
• A major storage site for glycogen (a glucose polymer)
  
• Clears insulin from the blood
• Synthesizes triglycerides
• Secretes and absorbs lipoprotein particles ("cholesterol")
• Stores important vitamins: B12, folate, A, D, E, K (that's why it's so nutritious to eat!)
• Stores minerals: copper and iron
  
• Detoxifies the blood
• Produces ketone bodies when glucose is running low
• Secretes blood proteins
• Secretes bile
• Converts thyroid hormones
• Converts vitamin D (D3 --> 25(OH)D3)
  

The liver is an all-purpose metabolic powerhouse and storage depot. In the next post, I'll give you a recipe for it...

The Liver: Your Metabolic Gatekeeper

As I've been learning more about the different blood markers of metabolic dysfunction, something suddenly occurred to me. Most of them reflect liver function! Elevated fasting glucose, low HDL cholesterol, high LDL cholesterol, high triglycerides and high fasting insulin all reflect (at least in part) liver function. The liver is the "Grand Central Station" of cholesterol and fatty acid metabolism, to quote Philip A. Wood from How Fat Works. It's also critical for insulin and glucose control, as I'll explain shortly. When we look at our blood lipid profile, fasting glucose, or insulin, what we're seeing is largely a snapshot of our liver function. Does no one talk about this or am I just late to the party here?!

I read a paper today from the lab of C. Ronald Kahn that really drove home the point. They created a liver-specific insulin receptor knockout (LIRKO) mouse, which is a model of severe insulin resistance in the liver. The mouse ends up developing severe whole-body insulin resistance, dramatically elevated post-meal insulin levels (20-fold!), impaired glucose tolerance, and elevated post-meal and fasting glucose. Keep in mind that this all resulted from nothing more than an insulin resistant liver.

LIRKO mice had elevated post-meal blood glucose due to the liver's unresponsiveness to insulin's command to take up sugar. Apparently the liver can dispose of one third of the glucose from a meal, turning it into glycogen and triglycerides. The elevated fasting glucose was caused by insulin not suppressing gluconeogenesis (glucose synthesis) by the liver. In other words, the liver has no way to know that there's already enough glucose in the blood so it keeps on pumping it out. This is highly relevant to diabetics because fasting hyperglycemia comes mostly from increased glucose output by the liver. This can be due to liver insulin resistance or insufficient insulin production by the pancreas.

One of the interesting things about LIRKO mice is their dramatically elevated insulin level. Their pancreases are enlarged and swollen with insulin. It's as if the pancreas is screaming at the body to pick up the slack and take up the post-meal glucose the liver isn't disposing of. The elevated insulin isn't just due to increased output by the pancreas, however. It's also due to decreased disposal by the liver. According to the paper, the liver is responsible for 75% of insulin clearance from the blood in mice. The hyperinsulinemia they observed was both due to increased secretion and decreased clearance. Interestingly, they noted no decline in beta cell (the cells that secrete insulin) function even under such a high load.

Something that's interesting to note about these mice is they have very low blood triglyceride. It makes sense since insulin is what tells the liver to produce it. Could this have something to do with their lack of beta cell dysfunction?

The really strange thing about LIRKO mice is that their blood glucose becomes more normal with age. Strange until you see the reason: their livers are degenerating so they can't keep up glucose production!

LIRKO mice reproduce many of the characteristics of type II diabetes, without degenerating completely into beta cell death. So insulin resistance in the liver appears to reproduce some elements of diabetes and the metabolic syndrome, but the full-blown disorders require other tissues as well. As a side note, this group also has a skeletal muscle-specific insulin receptor knockout which is basically normal. Interesting considering muscle tissue seems to be one of the first tissues to become insulin resistant during diabetes onset.

So if you want to end up like your good pal LIRKO, remember to drink high-fructose corn syrup with every meal! You'll have fatty liver and insulin resistance in no time!

I have a lot more to say about the liver, but I'll continue it in another post.

Book Review: Blood Sugar 101

I just finished reading "Blood Sugar 101" by Jenny Ruhl. It's a quick read, and very informative. Ruhl is a diabetic who has taken treatment into her own hands, using the scientific literature and her blood glucose monitor to understand blood sugar control and its relationship to health. The book challenges some commonly held ideas about diabetes, such as the notion that diabetics always deteriorate.

She begins by explaining in detail how blood glucose is controlled by the body. The pancreas releases basal amounts of insulin to make glucose available to tissues between meals. It also releases insulin in response to carbohydrate intake (primarily) in two bursts, phase I and phase II. Phase I is a rapid response that causes tissues to absorb most of the glucose from a meal, and is released in proportion to the amount of carbohydrate in preceding meals. Phase II cleans up what's left.

In a person with a healthy pancreas, insulin secretion will keep blood glucose under about 130 mg/dL even under a heavy carbohydrate load. The implications of this are really interesting. Namely, that blood glucose levels will not be very different between a person who eats little carbohydrate, and one who eats a lot, as long as the latter has a burly pancreas and insulin-sensitive tissues.

Most Americans don't have such good control however, hence the usefulness of low-carbohydrate diets. This begs the question of why we lose blood sugar control. Insulin resistance seems like a good candidate, maybe preceded by leptin resistance. As you may have noticed, I'm starting to think the carbohydrate per se is not the primary insult. It's probably something else about the diet or lifestyle that causes carbohydrate insensitivity. Grain lectins are a good candidate in my opinion, as well as inactivity.

Diabetics can have blood glucose up to 500 mg/dL, that remains elevated long after it would have returned to baseline in a healthy person. Ruhl asserts that elevated blood sugar is toxic, and causes not only diabetic complications but perhaps also cancer and heart disease.

Heart attack incidence is strongly associated with A1C level, which is a rough measure of average blood sugar over the past couple of months. It makes sense, although most of the data she cites is correlative. They might have seen the same relationship if they had compared heart attack risk to fasting insulin level or insulin resistance. It's difficult to nail down blood sugar as the causative agent. More information from animal studies would have been helpful.

Probably the most important thing I took from the book is that the first thing to deteriorate is glucose tolerance, or the ability to pack post-meal glucose into the tissues. It's often a result of insulin resistance, although autoimmune processes seem to be a factor for some people. Doctors often use fasting glucose to diagnose diabetes and pre-diabetes, but typically you are far gone by the time your fasting glucose is elevated!

I like that she advocates a low-carbohydrate diet for diabetics, and lambasts the ADA for its continued support of high-carbohydrate diets.

Overall, a good book. I recommend it!

Insomnia : Causes, Prevention and Treatments

Insomnia is the inability to fall asleep and not being able to get enough sleep.This can make you permanently tired. It can last for days or weeks but if it lasts for months ,it is considered chronic.

Causes

1.Stress or anxiety

2.Physical illness such as asthma or pain

3.Drugs or medication

4.Lifestyles habits or changes

5.Environment factors such as noise,hot and cold.


Treatments

1.Take prescribed medicines

2.Avoid too much caffeine such as coffee,soda

3.Stop smoking

4.Exercise daily but not immediately before sleep

5.Do not take heavy meals before bed

6.Make sure your bed is comfortable

7.Do not take naps during the day

8.Take a warm bath before bed

9.Drink warm milk before going to bed

10.Listen to soothing music which can help to fall asleep.

Scientist Discovers that Only Pills can Control Hypertension

I went to a presentation today by a prominent hypertension researcher. His talk began with a slide that had two pictures side-by-side: one of the late fitness advocate Jim Fixx, and the other of Winston Churchill. Fixx was a marathon runner, while Churchill was inactive, overweight and had a famous appetite. Fixx died of a sudden heart attack at 52, while Churchill lived to 90. The presenter went on to state that this is an example of how genes control CVD risk, implying that despite Fixx's exercise, his genes had condemned him to an early death.

I wanted to jump up and yell "I think you're leaving out the alternate hypothesis: running marathons and eating junk food isn't healthy!" But instead I suffered quietly through what ended up being an inane yet informative presentation.

His lab looks for gene variations that affect blood pressure (BP). There's a huge amount of money and research going into this. His lab and others have come up with two classes of mutations:

• Common allele variants that have an insignificant but measurable effect on blood pressure.
• Rare genetic mutations that have a significant effect on BP. The most common affects 1 in 2,000 people in the US.

Despite truckloads of funding and research, they have yet to uncover any gene or combination of genes that accounts for even a fraction of hypertension in Americans. So what's the next step? Keep looking for genes.

There is certainly a genetic component to hypertension, but it is only expressed in an unhealthy environment.  Hypertension is tightly linked to lifestyle. It's a quintessential aspect of the "disease of civilization". It's highly responsive to carbohydrate restriction, as a number of clinical trials have shown. Remember the Kuna? They don't get hypertension when they live a non-industrial lifestyle (despite eating more salt than the average American), but as soon as they move to the city their hearts explode. It's been demonstrated in a number of other similar cases as well. Genetics are clearly not responsible.

Don't get me wrong, I do think genetics can modify a person's response to a poor lifestyle. But when the lifestyle is healthy, the vast majority of these differences fade away. I have a more thorough discussion of this point here.

If you give just the right dose of poison to a group of animals, 50% will die and 50% will survive (called the EC50 dose). You might then conclude that genetics had determined who lived and died. You wouldn't be wrong, but you'd be missing the point that what killed them was the poison.

The thing that really bothers me about this thinking is it's disempowering. The presenter suggested that the reason for the difference between Fixx and Churchill was their genes. If genes have us in such a tight grip, why bother trying to live well? The only logical solution is to pop hypertension pills and eat cake all day.

My guess is that if they had lived a more natural lifestyle, Fixx would have made it to 90 and Churchill would have been fit and lean.

Bad Breath : Causes,Prevention and Home Remedies

How do you know if your breath is less than pleasant? Without actually being told, you can't be certain. The common methods used are to blow into your cupped hands and smell quickly, floss your teeth and smell the floss afterwards or lick the top of your hand and take a whiff.

Causes Of Bad Breath

1.Plaque is a film of odor-producing bacteria that forms on your gums, teeth and tongue. Poor dental hygiene can result in tooth decay and gum disease.

2.Foods with strong odors such as garlic, onions and spices are absorbed into your body and exhaled out of your lungs. Acidic foods and beverages can promote sour breath.

3.Coffee and fruit juice can also cause an undesirable smell. Tobacco and excessive alcohol are not only detrimental to your health, they will wreak havoc on your breath and leave a bad taste in your mouth.

4.There may be an underlying health problem such as a stomach, intestinal or bowel infection that may cause less-than-favorable breath.

5.Sinus and throat infections are common and often cause a bad odor.


Home Remedies

1.Practice good oral hygiene and keep everything in your mouth as clean as possible. Brush and floss your teeth twice a day to get rid of plaque and food between your teeth.

2.Use baking soda toothpaste or household baking soda to freshen up. Brush white film on your tongue to reduce the bacteria residing there. Try to reach as far back as possible without gagging. A tongue-scraper is handy. Follow up with an antiseptic mouthwash to kill germs and give your breath a boost.

3.Drink some water, particularly after you've finished eating and keep some on your nightstand at home for a quick drink. In the day hours, chew on some sugarless gum or candy to keep the saliva flowing and enhance your breath.

4.Eliminate spicy and acidic foods. If you have stomach cramping, gas, bloating or diarrhea, reduce or cut out dairy products to see if you are lactose intolerant.

Home Remedies for Whiter Teeth : How To Get Whiter Teeh

Home Remedies For Whiter Teeth

1. Baking soda

Baking soda has many purposes including teeth whitening. It is safe to use and works fairly quickly.

You can use it alone on a damp toothbrush or mix it with toothpaste to help neutralize the salty taste.

2. Hydrogen Peroxide
Peroxide is cheap and most people have it. You will feel some burning in your gums but your teeth will be clean and whiter.
Deep a cotton swap in the solution and gently rubbing it into your teeth. Another way is by brushing your teeth as you normally do and swish for a minute Then spit it out and rinse with water.

3. Strawberries
Strawberries contain natural teeth whitening agents. The seeds work great for cleaning. You can either rub the strawberry against your teeth or mash it up and use it like toothpaste.

4. Wood ash
Hard wood ash can help whiten your teeth. Avoid using it for long periods of time because scrubbing too hard can wear down your tooth enamel.
Put the ash directly on your toothbrush or you can mix it with a small amount of toothpaste.

5. Homemade toothpaste
Mix a dab of toothpaste with baking soda,hydrogen peroxide and table salt. Mix them together and brush away stains.