Notes on "The Park Avenue Diet Show: Inflammation: an Introduction"; November 21, 2010

The inflammatory response is the body's way of protecting us when infections or injuries threaten our health. The biochemistry is extremely complex, involving many different chemical mediators (prostaglandins, leukotrienes, thromboxanes) secreted by many different types of cells (granulocytes, macrophages, leukocytes).

In medical school we were taught the classic signs of inflammation along with their Latin names (which are redness/rubor, swelling/tumor, heat/calor, and pain/dolor). Of course, these are the signs of inflammation that you can see; a good example would be a skin infection like an infected cuticle.

But inflammation has a dark side. It may also be a destructive process on a microscopic level and might be so small that someone might feel entirely well yet may be perilously ill.

Remember our program called "Oil and Water" a few months ago? If not, you might want to listen again on my website http://www.parkavenuediet.com/. Here's a quick recap, but try to listen again to the entire program.

Cholesterol floats through your bloodstream isolated from water-soluble molecules. Being fat-soluble, cholesterol cannot dissolve and therefore is in somewhat of a state of suspension, like grease stains on a shirt or the fatty component of lamb stew, chicken soup, or spaghetti with meat sauce. Ever leave beef stew leftovers in a plastic container overnight in your refrigerator? In the morning you'll find an orange-yellowish wax that has floated to the top. Oil and water don't mix.

So when you're overeating and your triglyceride levels and LDL start overflowing, some of those fat droplets wind up in the walls of the larger arteries. And you know that oil and water don't mix. These fat droplets are very irritating to the surrounding tissues, and your body decides to try to get rid of them, or at least wall them off and neutralize their effect. This happens by the process of inflammation; those chemical mediators we mentioned are called into action and white blood cells swarm into the area.

But this process is totally counterproductive. The arterial wall, a most delicate organ, is now a battleground between oil and water.

The extent to which damage occurs depends on many factors: which arteries are affected (brain/heart/kidneys); if the individual decides to avoid further damage by making lifestyle changes (such as you will read in The Park Avenue Diet); and if the individual is wise enough to use the benevolent force of good nutrition to help save the day.

We've been discussing inflammation, which as you know is part of the human body's normal response to injury or infection. But when it occurs in an inappropriate way, such as when the arterial wall becomes a battleground between cholesterol droplets and white blood cells, the result is tissue destruction, circulatory impairment, and other self-inflicted wounds.

The abnormal inflammation in the walls of the heart's arteries is thus a form of "friendly fire." Instead of bullets, white blood cells release powerful chemical mediators that are forms of arachionic acid and its precursor, linoleic acid.

An enzyme called cyclo-oxygenase turns the arachionic acid into one of several possible potentially dangerous chemicals. These are named; prostaglandins, thromboxane, and leukotriene. Thromboxane A2 is a good - or rather a bad-example . This chemical mediator causes platelets, those sticky little cells that are part of the clotting system, to become even more sticky and start to clump together while circulation throughout the body.

You can see them at work, and even feel them, if you are a male medical student at Maimonides Medical Center shaving in the morning too quickly. Those teeny red "shaving-nicks" are in part made up of platelets. But Thromboxane A2, one of the prostaglandins made from arachidonic acid, turns this usually appropriate function into something altogether different.

In people with high levels of Thromboxane A2 (and by the way, this is a chemical that becomes excreted due to stress), platelets start to stick to those irritating cholesterol droplets inside the arterial wall. The more platelets that stick to the cholesterol droplet, the narrower the artery becomes. Then , the entire irritated area literally explodes-just like a pimple on the surface of your skin. Except this pimple is inside a coronary artery. And after it explodes, more platelets become stuck to the lesion.

I'm sure you have heard the medical term for this horrible cascade of biochemical events. It's called a coronary thrombosis. And you've heard about the illness that is the immediate and sometimes fatal result. It's called a heart attack. The end result of a heart attack might have severe pathological, psychological, and social repercussions. But it all began due to abnormal biochemistry...biochemistry that activated the body's inflammatory response in an inappropriate, painful, and sometimes tragic way.

And now for some really good news: there's a way to manipulate these chemical mediators in an extremely beneficial way. Nature has provided beneficial molecules called Eicosanoids that have the ability to offset the dangerous accumulation of thromboxanes, leukotrienes, and malevolent prostaglandins.

Eicosanoids are made from omega-3 or omega-6 essential fatty acids. And the more omega-3 oils one has circulationg through the body, the more healthy the overall picture. Omega-3 oils reduce the inflammatory effects of arachionic acid and its products.

Let's review this: Arachionic acid promotes inflammation. Omega 3 and 6 oils are much less inflammatory, or inactive, or even anti-inflammatory.

Tune in next week when we will continue with our discussion on inflammation.

Note on "The Park Avenue Diet Show: What Should I Have for a Snack?"; November 14, 2010

Snack foods have been around since the Paleolithic Era, when cave-dwellers first discovered berries, nuts, and certain vegetables right on their doorsteps--although they lacked doors and steps. These foods provided energy, nutrition, and enjoyment. Ten of thousands of years later, snacking has evolved, or rather devolved, thanks to prepackaged, unhealthy "foods" developed during the Industrial Revolution.

But enough of an anthropology lesson and pseudo-political commentary! Snacks foods, and there are literally thousands of them, need not be unhealthy, fattening, or carcinogenic, especially the ones you choose to sustain yourself between meals. Armed with a full understanding of insulin resistance, you now know that unstable blood sugar levels usually force people to choose unwisely--potato chips, salted peanuts, candy, pastries. Your choice of snack may be related to whatever you had for breakfast--the more sugar in your breakfast, the more likely you will be to pick a sweet snack.

The ideal snack food for people on a weight-loss diet is precisely the one Dr. Atkins taught me: a slice of turkey wrapped around a carrot stick or celery stalk...extremely low-calorie, extremely low-fat, and obviously very nutritious. The relative macronutrient balance (namely more protein, less carbs) keeps insulin stabilized, thus preventing another swing of blood sugar several hours later.

Think about this when you reach for "nutrition" bars at the grocery: these glorified candy bars, containing negligable amounts of vitamins, were primarliy designed for weight-lifters and exercise enthusiasts. Just because a candy bar has 30 grams of protein doesn't mean that you'll be more muscular tomorrow. Ya gotta exercise beforehand, otherwise the protein is metabolized as fuel, just like glucose is---a total waste of time, nutritionally speaking.

Read labels carefully, and avoid artificial sweeteners--these might also over-stimulate insulin even though no calories are involved or somehow attempt to trick one's brain into thinking that a huge amount of sugar has just been ingested--which the body overcorrects later on by doing just that!

Your grandmother told you (and mine told me) that breakfast is one of the most important meals of the day. She probably also knew that balancing your insulin levels was important so that you wouldn't overdo it at snack time and thereby jeopardize your weight and your health. People who pick the right snacks remove a tremendous obstacle to weight loss. They gain Enlightenment...and Lightenment !

Notes on "The Park Avenue Diet Show: Diabetes Mellitus"; November 7, 2010

Diabetes Mellitus has been recognized throughout virtually all of recorded history. Scholars and physicians from ancient Greece, Rome, India, Japan, and China had their own names for the disease, explanations of its causes, and ineffective remedies.

Diabetes has had a tumultuous history even within the past forty years. I was taught about Adult Onset Diabetes Mellitus in medical school. This term no longer exists since the exact same problem occurs now in teenagers and young adults.

Even the more scientific-sounding term "non-insulin dependent diabetes" which replaced AODM is somewhat misleading. It is now thought that virtually 100% of diabetics will eventually need injections of this pancreatic hormone. Strictly speaking, NIDDM means that a given patient will not develop ketoacidosis within 48 hours if he or she does not take insulin.

"Juvenile diabetes", another antiquated term is an auto-immune disease that results in total and permanent absence of insulin. People with NIDDM may be taking insulin every day, but they will not die suddenly without it.

Most people who have diabetes in 2010 have the more "benign" form. And 95 or more percent of these individuals have overweight or obesity provoking or complicating this disease. As modern medical research shows, diabetes actually exists in a hidden form in these individuals for up to ten years before a blood sugar rise is noted by the patient or a physician.

I'm sure you would not like to have the flu for ten years in a hidden form before you start coughing and sneezing and realizing you are sick. Diabetes is hundreds of times worse than that and potentially debilitating or fatal.

While it is true that modern pharmaceuticals can immediately correct blood sugar abnormalities, they have little effect on pancreatic exhaustion and death of the beta cells of the Islets of Langerhans where insulin is produced. Simply put if you are a diabetic who has not corrected their diet or achieved a normal weight, your diabetes will worsen with the years, requiring even more medicine, repeated doctor visits, and protection against numerous emergencies.

The next time you go to the supermarket, take a peek at some of those diabetic cookbooks or magazines. They feature lascivious pictures of chocolate cake, creme brulee, brownies, cupcakes, cheesecake, etc. If you were a recovering alcoholic, would you want the newsletter for Alcoholics Anonymous to be strewn with ads for vodka, beer, or wine? If you are a member of PETA and idealistically are committed to protecting all living creatures, what would you think if the PETA journals featured pictures of shotguns, bows and arrows, or animal traps? This is how I view those horrid magazines that tempt diabetics with seemingly forbidden pleasures.

Diabetes is not an incurable illness like pancreatic cancer. Its prevalence reflects the prevalence of obesity, which is most certainly a self-inflicted wound. While obesity does not strike many as inherently unhealthy, diabetes has frightened scholars and physicians for over 2000 years. In an era where we are reminded often to treat "root causes", please consider diabetes a "clear and present danger", and do your best to erase it from your life.

Notes on "The Park Avenue Diet Show: Trick or Treat?"; October 31, 2010

"Trick or Treat?" is not usually a question applied to health topics. But there's a first time for everything. Last night was the world premiere of a one-time-only quiz show with that name as part of "The Park Avenue Diet Show".

Using the format of "You Bet Your Life", a legendary television program starring Groucho Marks, the choice was expanded to the areas of nutrition, obesity, personal myths, food additives, and even Hollywood monsters. Noah Fleischman, my fantastic broadcast associate, channeled the spirit of George Fenneman, a legendary 1950's announcer.

"Trick or Treat" could be rephrased very simply "is it good for you or bad for you?" Here are some examples of things that are bad for you: margarine, Olestra, sugar-free creme brulee, a bmi of 40, taenia solium (pork tapeworm, definitely not a recommended treatment for obesity), GM (genetically modified) foods and ayahuasca tea (a psychadelic).

Some of the "treats" included: branched-chain amino acids (leucine, isoleucine, valine), dandelion tea, a blood pressure of 90/60, and positive personal myths.

Here are a few questions that were not used in the quiz. What's your answer? Trick or Treat? Quinoa; Turducken; Christmas pudding; Scotch Egg; Bulgaricum; Alfalfa; Borjomi water; Ectoplasm; Fugu; "Muffin Top"; leptin.

Our final caller amazingly knew two out of the three medical questions in the category of Hollywood movie monsters. Boris Karloff modeled the Frankenstein monster's walk from knowledge of tabes dorsalis, a sign of neurosyphilis. This would have been especially frightening in a pre-antibiotic era. Victims walk with extremely stiff legs, their arms outstretched to achieve balance. Imagine my surprise when Dr. David Grob demonstrated this walk during a lecture on neurology while I was a medical student at Maimonides Medical Center.

Our caller from Freehold, New Jersey also knew that Dracula has type AB-+ blood and is thus protected against "transfusion reactions". Did you ever think that you can learn so much medical information on Halloween? Of course "The Park Avenue Diet Show" is entertaining and informative every week of the year!