Sunday, March 4, 2012

The "Insulin Resistance Saga" - Part III: Where Has All the Sweetness Gone? Plus: Bullied to Eat Twinkies

Figure 1: Obese highschool students have a 111% (boys) and 76% (girls) increased risk of relational bullying. (Kukaswadia. 2011)
[Note: This is a direct sequel to the last installment] Delicious! "Milk and vanilla and not a single bacteria in it! How much better can it get?" You are sitting at your desk in the elementary school and dream yourself back to the Kindergarten, when Mrs. Youesdeay's attacks against your Snickers bars still was the only thing you had to fear. Mrs. Undarstant is nice. She likes you. You always do your homework, never complain or talk to others during the lessons. Unfortunately, the latter is in parts a consequence of the fact that the other kids don't like you. "Fatso!", "No, I don't want to hold his hand, Mrs. Undarstant. His hands are sweaty and gooey from the candy he is constantly scoffing down.", ... and these are only the friendlier abuses and rejections you are facing on a daily basis.

"Are they secretly removing all the sugar from my foods?"

You take a look a the ingredient milk of your vanilla milk. "E407? Hmm... as long as its fat-free, it won't hurt, but I wonder if they have changed the formula. I mean, this stuff used to be sweet like crazy and now? It tastes like water." You have gotten used to these kind of inner-monologues over the years. Since Jeany had moved away, when you were in first grade, you have become more and more isolated. School, homework, Playstation, TV, ... that's what your day usually looks like. You take another look at the now empty bottle of vanilla milk. "They must have changed something..."
Image 1: If you "supplement" normal weight "lightly active" subjects with a daily dose of Lucozade Sport for one month you will increase their sweet preference by +130% (Gondivkar. 2009)
Did you know that acquired hypogeusia and ageusia, i.e. the reduced ability and the inability to taste, in this case, sweets, is a common feature in type II diabetics? In a 2009 study by Gondivkar et al. 62.5% of the type II diabetics had an impaired sweet taste reception (vs. 12.5% in the control subjects) and 15% of the untreated type II diabetics had a complete loss of sweet taste perception (Gondivkar. 2009)! A more recent study shows that the reduction in the ability to taste sweet goes hand in hand with obesity and is not something that arises all of a sudden (just as type II diabetes isn't). Sartor et al. did not only find that obese subjects had a -23% reduced sweet taste perception (compared to normal weight controls), but also that normal weight, "lightly active" adults developed a similar reduction in sweet taste perception and a 2.3-fold increase in sweet preference after only one month of soft drink (~760 ml/day) "supplementation" (Sartor. 2011).
What you obviously don't know is that the thing "they" changed is not the product formula, let alone its sugar or sweetener content, but rather your perception of the formerly obtrousively sweet combination of saccharine, aspartame and the high fructose corn-syrup they use in your lactose free vanilla milk as a replacement for the milk sugar. Aside from the habituation effect, the years of chocolate coated healthy whole-grain cereals, Snickers bars, Vanilla milk and peanut butter sandwiches for breakfasts, have taken their toll on your baseline insulin sensitivity. What used to be a pleasant inrush of glucose into your cells, has already become more of a trickle. Your triglyceride levels are on a constant rise and if it were not for the constant delivery of glucose from the high carb, low fat foods, of which your mother hopes that they will help you lose at least some of the superfluous pounds, your brain would long have switched you over into fat burning mode.
Figure 1: With the constant influx of glucose and the overproduction of triglycerides your body can neither use glucose nor fat as a fuel effectively; the one thing both signals, i.e. glucose => insulin signaling, as well as the cortisol (stress) + high triglyceride signaling have in common - and this does in fact still work - is that they will induce the storage of energy in your ever-expanding adipose tissue.
With the divergent signals your body is receiving (cf. figure 1), neither your glucose, nor your fat metabolism is working properly. It is like you were telling your metablism to go to the left, while pushing him further to the right with every of the four peanut butter sandwiches that were waiting for you in your bag, before...well, before John decided that "You are already fat enough fatso, let me eat those sandwiches!".

John is always right and the fatso should not eat peanut butter sandwiches

Image 2: Dr. Haub did not do fat kids like yourself a favor, when he lost 27 pounds in two months on what was purportedly a diet consisting of nothing but chocolate bars, chips, biscuits, pizza, doughnuts and sugary cereals (in fact, he used protein shakes and multi-vitamins to make sure he does not do permanent damage).
John is the nightmare of your sleepless dreams and your stressful days. He is the "cool kid" everyone looks up to and when John says that "...the fatso should not eat those, right?" This is only a rhetorical questions. After all, John is always right. You have learned that the hard way - several times of the last years. Although John had never hurt you physically, all the fat you had accumulated of the years could hardly disguise all the wounds each of his countless comments and jokes had left in your soul.

The bell rang! "Will I make it to the candy vending machine and back during the 5-minute break?" Your thoughts were revolving around a pack of Twinkies. "They worked for this professor on TV, right? If I don't eat the sandwich and just the pack of Twinkies as a breakfast. I mean, they have less calories than those sandwiches." You were looking over to John, who was gobbling his peanut butter sandwiches. When he realized that you were staring at him he said: "What's up fatso, you could be a little more appreciative of what I am doing for you!" It was grotesque, John had been eating your sandwiches probably 4 out of 5 days in the last months and still looked leaner than ever. "How can that be?" The bell rang another time. The break was over and you decided that it would probably be best not to eat anything today....

[to be continued...]