Moderation is key:

1. Eat less

2. Eat plants

3. Exercise

Now an important health concern in North America; food used to be analyzed based solely on taste, but now eating has become a "clinical experience" involving exactly what food is; vitamin content, fiber, cholesterol, etc.

Increased analytical capabilities which allow us to do so

Coronary heart disease is the leading cause of death in North America

From 2004 - 2005, high blood pressure rates went up by 77%, diabetes rose by 45% and obesity rose by 18%

1. Low Birth Weight

2. Sex

3. High Blood Pressure (hypertension)

4. Obesity or Overweightness

5. Smoking

6. Diabetes

7. Stress

8. Microbes

9. Homocysteine

10. High levels of triglycerides (fat) in blood

11. Cholestrol

Low Birth Weight

(Risk Factor for Heart Disease)

Sex

(Risk Factor for Heart Disease)

High Blood Pressure (Hypertension)

(Risk Factor for Heart Disease)

Tends to increase with age; can be reduced with a better diet, exercise, and reduced salt intake

Can cause heart failure with little warning; "silent killer"

Can only be known by measuring it

Obesity or Overweightness

(Risk Factor for Heart Disease)

Smoking

(Risk Factor for Heart Disease)

Bigger risk factor for heart disease than lung cancer

Increases carbon monoxide intake, which displaces oxygen from hemoglobin (in red blood cells), reducing their oxygen-carrying capacity and causing oxygen deficiency

Diabetes

(Risk Factor for Heart Disease)

Stress

(Risk Factor for Heart Disease)

Microbes

(Risk Factor for Heart Disease)

Bacterial infections (e.g. cytomegalovirus, chlamydia pneumonia, porphyromonas gingivalis) can cause inflammation in coronary arteries, which can lead to heart disease

Related to dental hygiene; flossing can reduce risk of bacteria entering the bloodstream

Homocysteine

(Risk Factor for Heart Disease)

Molecule forms Methionine (amino acid); can be broken down into various metabolites by B vitamins

Arguments for its role in heart disease are not science-based: Kilmer study and Harvard study

Men (~8-12 umol/L) and Women (~6-10 umol/L); risk begins at 11 micromol/L

Conclusion that homocystein may be a marker for heart disease, not the causative agent

Showed that people with higher homocysteine levels in their blood had higher risks of developing heart disease; those in the top 5% had heart attack risks three times greater than those with lower levels

However this was a correlation, which doesn't imply causation

Consumption of food with high B vitamin levels (fruits and veggies, especially spinach); some cereals have added B vitamins, and there are also supplements

Heart Outcomes Project Evaluation (HOPE) conducted a study; concluded that reducing homocysteine levels had no effect on reducing risk of heart disease

High Levels of Triglycerides in the Blood

(Risk Factor for Heart Disease)

Triglycerides = fat molecules in the blood, consisting of 3 fatty acids joined to a glycerol backbone; fats enter the blood from consumption of fatty foods

Serious risk factor in high amounts

Cholesterol

(Risk Factor for Heart Disease)

Found only in animal products (dairy, meat, eggs, etc.)

Steroid molecule; multi-ring compound (four fused carbon rings); not a protein nor a fat

Essential to life; body requires cholesterol to produce hormones and functional cell membranes

Not a vitamin, because we can make cholesterol in our bodies

High cholesterol levels in the blood is a risk factor for heart disease

Epidemiological study (disease patterns in large-scale population study) performed on a relatively homogenous population (low genetic variability)

Conclusion that higher cholesterol in the blood is associated with higher risks of heart disease; but correlation doesn't imply causation

Inherited genetic condition where cholesterol deposits on the surface of the skin due to over-synthesization in the liver

Causes early death from heart disease

Woman depicted in the Mona Lisa may have had it

Muscle, requiring a constant replenishing of oxygenated blood 

Located in the middle of the chest, not the left

Located on the surface of the heart

Feed the heart muscle with oxygenated blood

Stem out of the aorta

"Coronary" because they form a crown around the heart

Occurs when part of the heart muscle cells begin to die from lack of oxygen

Severity depends on where the blockage occurs in the coronary arteries; the closer to the aorta (upstream), the more damaging

Condition that causes blockage of arteries

Inner walls of arteries build up deposits of plaque and harden

An artery that is x% blocked means that x% of the cross section of the artery is closed off from plaque

Plaque can sometimes become oxidized, causing severe problems

Oxidation is a chemical conversion

Oxidized cholesterol is attacked by white blood cells (macrophages) because it is deemed "undesireable" or foreign by the immune system

Can induce inflammation (pain, swelling, redness and heat)

Can become trapped when invading plaque with oxidized cholesterol, causing even more infalmmation; plaques swell and then burst; blood clots can then cut off blood flow and potentially cause a heart attack

e.g. Vitamin C and E

May reduce the risk of heart attacks, since oxidized cholesterol is a factor; this is not scientifically proven though

Good measure of risk of plaques bursting in arterial walls

High sensitivity to inflammation is measured by measuring levels of C-Reactive Proteins in the blood; the higher the C-reactive proteins, the higher risk of inflammation

Less than 2 mg/L blood of CRP = no indication of inflammatory processes

Conclusion: 100% reduction in Cardiovascular "events" in people treated with a Statin drug (cholestrol lowering) based solely on the fact that they had high CRP levels

 ~9000 people given statins, ~9000 given placebo; 83/9000 in the statin group had a cardiovascular event within 2 years while 157/9000 in the placebo group had the same

The results were presented in a way to appear more appealling to the public

Drug that lowers cholesterol

In the JUPITER study, the Statin group also experienced a higher risk of developing diabetes

Statins are not exceptionally safe; plenty of side effects 

Researchers involved had vested interests in the success of the study

Grant money that funded the study came from big pharma AstraZeneca who created Crestor, the statin drug being tested

A scientist in the study also sold a chemical used to measure CRP in the blood

Lipoprotein that transports cholestrol from the liver to the rest of the body by unloading cholestrol into cholesterol / LDL receptors (proteins) on cell surfaces

"Bad cholesterol"

In excess, LDL-receptors can all become occupied and result in LDL despositing cholestrol in the bloodstream, along arterial walls

Total cholestrol is proportionate to the amount of LDL

1960's: two American physicians that first studied how cholesterol is implicated in heart disease; studied transportation dynamics of cholestrol in the body

Thus far, it hasn't been proven that lowering cholesterol is beneficial; all we know is that cholestrol levels are correlated with risk of heart disease

Cholesterol is not soluble in water, but needs to be transported around the bloodstream from the liver; it is transported via lipoproteins, which are soluble in water and blood

Consist of Apoprotein + Cholestrol; HDL and LDL have different properties and Apoproteins

Lipoprotein that scavenges excess cholesterol and contributes to its elimination; increasing HDL will decrease cholesterol levels

"Good cholesterol"

Picks up excess cholestrol in the bloodstream, which if left alone may harden and clog arteries

3800 men at high risk for heart disease; half given a cholesterol-lowering diet and half given a cholesterol-lowering diet and a drug that reduces cholesterol

Results: Group with drug saw cholesterol decrease 9%, heart attacks reduced 19% and cardiac deaths decreased 24%

It is worthwhile to decrease cholesterol levels; they are not only correlates but causative agents

Commercially available tests; a drop of blood is all that is needed to analyze cholesterol content

Canada + most of the world measure in mmol/L (milli-mol / L)

USA measures in milligrams per deci-litre

mmol/L = mg/DL x 0.026

Healthy levels are under 200 mg/dL or 5.2mmol/L

Borderline unhealthy is 200-240 mg/dL; Above 240 mg/dL is unhealthy. These refer to total cholestrol (HDL + LDL)

LDL preferably between 130 and 160 mg/dL

HDL preferably above 60 and not below 40

Canada + most of the world measure in mmol/L

USA measures in mg/dL

mmol/L = mg/dL x. 0.0113

Preferably below 200mg/dL, and not higher than 400

LDL usually parallels total cholesterol; those with high cholesterol have high LDL levels usually

However it is possible to have high cholesterol and still be healthy by having high HDL levels

LDL/HDL ratio below 3 is good

Total Cholesterol/HDL ratio below 4 is good

Raising HDL is more beneficial than lowering LDL; high HDL levels = low risk of heart disease

Genetics, exercise, alcohol consumption and diet are all factors in determining LDL/HDL ratio

Discovered in Limone Sul Garda Italy study

Gene codes for a lipoprotein which has antioxidant properties

Decreases free radical oxidation

1. Diet (animal products - particularly lobster, eggs, shrimp, etc.)

2. Ourselves (formed in our livers from precursor molecules - saturated and trans fats)

Most people's blood cholesterol doesn't respond to dietary consumption; it has little impact generally speaking

Flaxseed fed to chickens increases Omega-3 fats in eggs

Omega-3 is a marketing tool in many egg products to combat negative views of cholesterol in eggs

Contains Alpha-Linoleic Acid; which differs from Omega-3 in fish and is less beneficial

Can reduce risk of irregular heartbeat (cardiac arrhythmia)

20 or 22 carbons in fatty acid chains and 5 unsaturations (aka 5 double bonds)

Double bond in the 3rd carbon from end, hence the name Omega-3

Mackerel has the most "good" omega-3

~1000mg/day reccommended

However contents are not carefully regulated; a third of 20 fish oils tested had 18-67% less omega-3 than advertised

Monounsaturated fats with some polyunsaturated; neither significantly affect blood cholesterol levels

Contains Alpha-Linoleic Acid which is an omega-3

Contains Linoleic Acid (not to be confused with Alpha-Linoleic)

Problematic fat because it stimulates inflammation, especially in the case of insufficient antioxidants in diet

1. Saturated Fats - implicated in raising LDL levels

2. Trans fats

Coconut oil, butterfat, beef tallow, palm oil

Monitoring diet vs. heart disease incidence

Showed that decreasing overall fat consumption can have 0 effect on the risk of heart disease; complicates the relation between dietary saturated fat and heart disease

Also showed that lowering LDL levels (from reducing saturated fat intake) also had no effect on heart disease risk; may be likely that the cholesterol was not lowered significantly enough

Activist in "cholesterol movement" that had a heart attack

Discovered that eating saturated fats from processed foods contributed to cholesterol levels

Campaign to make people aware of diet and its importance

Margarine perceived to be a healthy alternative to butter; however it has transfat which is just as bad

Way of reducing cholesterol with margarine

Saturated fats are broken down into glycerol and fatty acids; unsaturated fats are broken down into the same

They are then combined to result in glycerol backbones with both saturated and unsaturated fats, an improvement from only saturated fats

Ingredient in margarine, extracted from bark of pine trees

Prevents the absorbance of cholesterol by the digestive tract

Interferes with bile acid recycling

3 grams of Sitostenol is needed everyday to cut cholesterol down significantly

Contain protein that can lower blood cholestrol

Not common, but edamame (steamed soybeans) are tasty!

25g of soy protein per day = reduce cholesterol, breast and prostate cancer in youth

Tofu is made from soy beans

Can be sprinkled on cereal or put in bread

Contains soluble fiber, which lowers cholesterol by increasing requirement of bile acids in digestive system, reducing its presence in blood

Contains Alpha-linoleic Acid

Used to be cheap, used only for animal feed but have since become popular

"O" in Cheerio's stands for Oat Bran!

3grams daily to lower cholesterol (1 cup of oat bran, 1.5 cups oatmeal, 3-5 oat bran muffins, 5 servings cheerios)

Showed that people that already have plaque deposits (atherosclerosis) can lower cholesterol and regress plaque size with extremely low-fat diets

However, dramatic reduction of fat intake automatically increases carbohydrate intake which can reduce HDL

Measure of how quickly a certain food releases glucose into the bloodstream; food with lower glycemic index releases it slowly

Complex carbohydrates, e.g. beans, have lower glycemic indexes

Believed to reduce risk of heart disease

French drink 30x more red wine than North Americans and have a lower incidence of heart disease

Red wine contains a compound called Resveratrol, a powerful antioxidant

Grape juice also contains this; red wine pills

French eat much more fat and smoke more but have a lower incidence of heart disease 

However they eat less and drink more wine and eat more fresh fruits and vegetables

Eat a lot of dairy foods because they are cattle breeders; bleed their animals and add blood to dairy food

Remarkably low incidence of heart disease

Consumption of tree bark, cooked into soup

Suggested to lower cholesterol, but minimal in effect

Other studies do show that there is no beneficial effect at all

Product shown to be able to lower cholesterol

Sold in health food stores

Under-regulated health products; uncertain how much of the active ingredient you are really getting

B-Vitamin known to reduce cholesterol

Vitamins regulated in terms of content in supplements and food

1000mg required to reduce cholesterol effectively; flushing skin as a side effect

Bead-like material added to juice to lower cholesterol; reduces blood cholesterol the same way as flax/oat

Bile acids, made from cholesterol, secreted into the intestine and out of the bloodstream because they are needed for digestion

Questran (Cholestyramine) binds bile acids and eliminates them from the body rather than allowing them to become reabsorbed

Competitor of statin drugs; food that reduces cholesterol

Yeast that grows on rice (same ingredient as Mevacor, a statin drug) incorporated into drug

FDA prevented Cholestin from claiming to replace statin drugs as it was not properly tested and studied

Company used Policosanol instead, which reduced cholesterol minimally

Randomized trial of cholesterol lowering with statins

Showed that statin treatment saved lives of patients with coronary heart disease; for each patient saved, 30 patients needed to get treatment for 5 years

Another statin drug; first that showed a reduction in cholesterol and reduction in incidence of heart disease

Works better combined with Niacin, but not with other antioxidants such as Vitamin C

More Statin drugs

Lipitor is the number 1 drug in the world in terms of sales

Never been shown to reduce heart disease, but only total cholesterol, LDL and triglycerides

2011 expiry date on Lipitor patent

Novel drug; combination of statin (Simvastatin) and Zetia (Ezetimibe), the later of which interferes with the absorption of cholesterol in digestive tract

Reduced LDL significantly but did not reduce plaque buildup

Good statins must be doing something else besides lowering cholesterol in reducing risk of heart disease

Combination of statin and zetia is no better than just the statin alone

LDL molecules bigger than HDL, but the sizes differ throughout

Small LDL particles are more likely to deposit cholesterol in arteries as they oxidize faster and are cleared from the blood at a slower rate

Large LDLs are relatively benign and small HDL are better than large according to NMR Lipoprofile Test

Believes that fat has been given a bad name; diets replacing saturated fats with unsaturated or carbs are not necessarily better

Refined carb consumption likely has a bigger contribution to heart disease

Source of minerals; boiling a cup of ocean water will leave a salt mixture

3.5% salt by weight

Unit of quanitity

6 x 10^23 molecules of water

Elements usually found in ionic form, which means that an electron has been removed from the outer shell of the atom

Balance required in charges of the molecule; "counter ion" (ion with opposite charge) must be paired with positive ion to form a neutral salt

Salt formed when cations are paired with anions in a charge neutralizing way

E.g. Ca++ paired with SO4 to form CaSO4

Calcuium sulfate

CaSO4

Ca(HCO3)2

Decomposes to Calcium Carbonate (CaCO3), or limestone spontaneously

NaCL

Sodium Chloride

Mixture of many salts, mainly NaCL

Do not necessarily come from the ocean itself

Crystallization

Belief that some minerals bring mystical energies, scamming people into buying them

E.g. Pyradyne Hydrogen Quantum Sound Generator

Mixed mineral formed from CaCO3 and MgCO3

Dolomite Mountains in Northern Italy; many statues are also made of dolomite

Common for minerals to co-crystallize to other minerals

Dolomite supplements can lead to complications from overconsumption due to various other elements included

Organized representation of all elements known to man

Elements in the same column have similiar characteristics (e.g. Fluorine, Chlorine, Bromine and Iodine are all negatively charged, -1 in ionic form)

Ion is always charged; elements are neutral

Weight difference between element and its ion is less than a microgram, equivalent to weight of an electron

Negatively-charged atoms existing outside of the nucleus

Equal number of protons and electrons to form a neutral element

Explodes upon contact with water

Na + 2H20 --> NaOH + H2

Elemental hydrogen will ignite and produce flames

11 electrons, 11 protons; atomic number is 11

10 electrons in inner shell and 1 in outer for ionic bonding

Ions involved will either lose or gain electrons, depending on the chemical behavior of the atoms involved

E.g. Br2 + 2K --> 2KBr + explosion

Ionic compound KBr (Potassium Bromide); Potassium loses electron and Bromine gains; crystalline solid with high melting point

Potassium and Bromide are at opposite sides of the Periodic Table

No loose hydrogens; all tied up with carbons

Store elemental potassium and sodium to prevent water from reacting with it

Diatomic in elemental state (Cl2)

17 protons, 17 electrons

Combined with Sodium forms Sodium Chloride

Outer electron shell of sodium atom originally has 1 - unstable; outer electron shell of chlorine has 7

Sodium donates its extra electron to form a complete and stable outer shell (Full Octet) and form NaCl,

1.2 grams/day

A few grains = 1mg

1 salt crystal = 60micrograms

Morton Iodized Salt: 75 cents / 26 oz

Fleur de Sel: $12 / 5.7 oz

Kosher Salt: $1.5-2 / lb

Hawaiian Sea Salt: expensive

Pink Himalaya Salts: expensive

Excessive salt intake is related to high blood pressure

Previously, bloodletting was a treatment

120 systolic / 80 diastolic is regular bp; smaller numbers are a bit better

Excessive salt intake; body takes in too much water and it becomes harder for the heart to pump

150/100 is high bp

Herbs recommended to add flavor as a salt alternative

Chemically similar to Sodium

KCl is a typical salt used to reduce NaCl intake, though they taste differently

Unclear whether or not potassium increases blood pressure or not however

Bananas and Potatoes are good sources of potassium

Body needs a stable potassium / sodium ratio

Potassium is much bigger than sodium and fits into ion channels differently

400-500g/day

Protein (100g)

Fat (150g)

Carbs (200g)

Calcium, Phosphorus, Vanadium, Molybdenum, Tin

1-2g/day

Often required by proteins for proper function

Mo6

2 mg/day - very little

Nuts, canned veggies, bread, cereal, etc.

Essential component of certain enzymes including Xanthine Enzymes

Fe needed in small quantities, 10-20mg/day

2-4g found in body, mostly in blood

Put into wine to better health

Present in meat and broccoli

Best absorbed with Vitamin C, which assists in iron absorption in gastrointestinal tract

Added into foods such as bread

Anemia: Iron deficiency

Hemochromatosis: Genetic disorder in which teh body absorbs too much iron and it gets stored in the heart, liver, joints and pancreas and causes various problems including arthritis

Large, complicated, organic molecule that has an iron atom in its center

"iron-carrying" molecule in the blood

Iron atom carries an oxygen molecule around the body, allowing for blood to transfer oxygen from our lungs to our extremeties

Iron supplement product

~3mg/mL, 50mg in a spoonful

"slow release" iron supplement

Provides 264% of the daily requirement; over twice the required amount

Inherited genetic condition; body produces too much porphyn which sequesters a large portion in ingested iron

Affects nervous system and/or skin; reddish skin and excessive hair

"Werewolf syndrome"; relatively common

Important micronutrient

Silvery in appearance as element, white as ionic

0 in elementary neutral form and 2+ charge in ionic form

Ionic zinc = 0.003% of body weight (2g), necessarily for function of insulin

Levels measured through hair samples; zinc-sequestering enzymes in proteins that comprise hair

Required for healing, smell, taste and circulation

20% of the world lacks sufficient zinc in diet

Discovered in 1869

Black fungus that causes respiratory problems

Organism requires zinc to grow

Condition in which an individual lacks a proper sense of smell / taste

Zinc is involved

Circulation disease

Involves zinc

Fingers and toes are purplish hue in sufferers

1. Anosmia

2. Ranaud's Disease

3. Schizophrenia

4. Prostate Gland problems

Peanuts and meat are high in zinc

50mg/day required

Most people with a rounded diet will get enough zinc

High fiber diet may interfere with zinc levels since fiber sequesters zinc

Individuals receive less zinc than expected from foods

Halogen; in elemental form, it is diatomic

Sublimes from crystal to purple vapour (skips liquid form)

Seaweed is a good source of iodine; thus oceanic communities don't have deficiences / develop goiters

70% of commercial salts have added iodine (KI, or potassium Iodide)

150 micograms required per day

Causes goiters; thyroid gland needs iodine for fat metabolism

Discovery by Theodore Kocher, who received a Nobel Prize in 1909

Goiter = growth of thyroid gland, which is "trying to find more iodine"

Reversible condition; treatment with Synthroid, which mimics a functioning thyroid gland

30% of the world's population (2 billion people) have an iodine deficiency

Now add KI to salt to prevent goiters, significantly reducing incidences in Kazakh people

Government heavily advertising the use of iodized salt

Selenite (SeO3^2) is the ionic form the body is exposed to

Similar properties as Sulfur

100 micograms supplemented in pills

Function as antoxidant that works best with Vitamin E

50 micrograms /day required for normal function

Natural sources: garlic, onion, seaweed, Brazil nuts and tuna

Contains Selenium

Protects cells against oxidative damage

Contains Sulfur and Selenium compounds both associated with good health, but unfortunately also with flatulence

China produces 75% of all the garlic in the world

12 million metric tons produced globally

Ionic Calcium is a 2+ ion

Most consumed member of the micronutrients

Composes 99% of bones and teeth; 1% of calcium ingested is used in nerve transmission and blood clotting

Approx. 1kg of calcium in bones (and phosphate)

Ages 0-10: 800mg/day

Ages 10-20: 1200 mg/day

Ages 20+: 800 mg/day

On average, women do not take enough calcium while men do

In middle-aged people, calcium deficiency accompanies osteoporosis and other bone-related diseases

Consumption of 250mg of calcium per day: 85 mg ends up in urine and 265 in stool; net loss of 100mg of calcium per day, which is bad

Increasing intake = more calcium left over for the body

Mid-life hypertension and heart disease

Postmenopausal osteoporosis in women 50-75yo

Senile osteoporisis in men 75+

Affects 10% of the population; 350 000 hip fractures/year in the US; 700 000 people in Quebec alone

Risk factors: short stature, underweight, early menopause and physical inactivity, alcoholism, smoking, caffeine, protein or fiber

Can result in excessive curving of the spine

Problems in Resorption

Factor of osteoporosis

40-50yo women: 1-5% of bone mass is lost per year

Men 10-20 years later experience the same

This means that half the bone mass is gone in 14 years

Equation: 70/5% = 14 years to get to half bone mass

Mostly caused by osteoporosis

10% loss in hip mass = 170% increase in fractures

Study with 165 000 fractures: 17% die within 3 months and 27% die within the year 

Osteoclasts = cells that remove calcium from the bone and body

Osteoblasts = cells that fix calcium onto bones

Specific inhibitor of osteoclast-mediated bone resorption (breakdown); inhibits the action of osteoclasts, reducing breakdown of bones

Can cause improvements in bone mass up to 4% per year

Claims that it causes GI tract abnormalities, nausea, cramping, gas, and severe constipation, jawbone problems

"reclast" product that prevents osteoporosis in postmenopausal women with convenient less frequent dosing

Unpleasant side effects

2 Ca²⁺ + 2PO₄^3- + OH ---> CA₃(PO₄)₂OH

Calcium + Phosphate + Hydroxide ---> Bones (calcium apatite)

Ca₃(PO₄)₂OH ---> 3 Ca₂+ + 2PO₄^3- + OH

Bone ---> calcium + phosphate + OH into blood

Bone material

Ca₃(PO₄)₂OH

Treatment of a molecule with fluorine, which takes place of the hydroxyl group (similar size and same charge) to form Fluro apatite, a stronger form

Used to treat osteoporosis

Stimulate osteoblast cell formation; helps to build bones

Sales of calcium supplements increased from 20 million to 300 million; by 2009, 1.2 billion

1. Caltrate (supplement of calcium carbonate, limestone)

2. Tums (little acid to allow for melting and bubbling of calcium for easier consumption)

Some calcium supplements have slow dissolution rates; takes longer for calcium to be released

2HCl + CaCO₃ ---> CaCl₂ + H₂O + CO₂

Equation used for testing rocks for Calcium Carbonate; also the same reaction in stomach

Meta analysis showing that calcium supplements may increase the risk of fracture by 60%

Calcium citrate or calcium carbonate interferes with phosphate absorption, which is also needed for bone building

Sardines, Yogurt, skim milk, whole milk, turnip greens, oysters and broccoli

Need 1000-1500 mg/day

Least invasive method of detecting bone mass

Sending photos into wrist area

Has been shown that non-depressed people have higher bone densities than depressed people by ~20%

Study had a small sample size

Can cause heart attacks in postmenopausal women

Elderly women (mean age of 74) taking calcium supplements had a 50% higher chance of having a heart attack / stroke compared to those taking a placebo

Bones have estrogen receptors; estrogen is associated with bone production

2 year double blind study with 2000mg Calcium supplements and placebo estrogen tablet: REsult was that estrogen + calcium saw an increase in bone mass

Premarin (Estrogen) was the most prescribed drug in the US, usually with Progestin

Raloxifine was an estrogen mimic with fewer side effects

Increased risk of uterine cancer and breast cancer 

Relative risk vs. absolute risk for women > 50yo

Topic of concern for many

Billboard advertising sparkling water made from no caffeine, sodium of scientists which is problemative because food production requires scientists to determine food safety

Bone formation

BORAX cleanser

Sodim Borate promotes bone formation; comes from Mojave Desert in California (aka Boron, California)

Added to preserve water inside

Wax is mostly of vegetable origin; same wax used in shoe polish

Chemical morpholine, an emulsifying agent

Potentially cancer causing in the presence of nitrites

However these are small doses; Aldous Huxley: "An unexciting truth is often eclipsed by a thrilling lie"

Waxes include beeswax, carnauba wax, candelilla wax and shellac

Leader of alarmists, based on the idea that everything is dangerous

Emphasis on the "good ol days"

Global warming advancing due to new chimneys

However in London 1952 there was an 8 day thick smog that calimed 8000 lives 

Cuyahoga River was so polluted that it caught fire in 1970

Montreal did not have sewer treatment before 1984

Advent of antibiotics in the 1950s

We now have the Canadian Food Inspection Agency

Romans used toxic lead acetate as wine sweetener

Copper salts added to veggies in the Middle Ages

Addition of Calcium sufate to flour to dilute it (Plaster of Paris)

Naturally occurring poisonous chemical in foods

Present in bitter almonds, lima beans, fruit seeds (e.g. apples), cassava roots, etc.

These foods must be prepared properly (e.g. Cassava in Africa is a major source of carbs)

Contained in Sassafras leaves, used as flavoring agent in root beer

Now illegal; shown to be an animal carcinogen

Previously used in tea

Precursor to ecstasy

Genuine popcorn

Pure vegetable oil

Natural Salt

Real artificial color (?!)

Salt listed as 2nd ingredient

Amount of salt added into prepared foods is a major problem

Many other additives in the soup like hydrolyzed plant proteins, monosodium glutamate (MSG), disodium guanylate and disodium inosinate

#1 in Canada and #2 in the US (behind sugar)

10 lbs of salt consumed per year per person, risk of hypertension

"Salary" comes from "salt" because Roman Legionnaires would be paid in salt rations

Sugar substitutes exist but it is difficult to reproduce the flavor of salt

Difficult to replicate the taste of salt

Potassium Chloride has a different + bitter taste

Addition of amin acid ornithyltaurine to combat bitterness of KCl

Another method is to increase saltiness of salt so people consume less; reducing NaCl crystal size so they fit more effectively

Of 160lbs of food additives consumer per year, 1 lb is of classical food additives

1 lb of 2000 allowed chemicals

140lbs is sugar

Present in seaweed and is a sodium salt of glutamic acid

Oriental cuisine uses seaweed to enhance flavor for ages

Glutamic acid present in many foods; subjecting it to a salty environment creates MSG

Molasses converted to glutamic acid via bacteria and then converted to MSG via treatment with Sodium Hydroxide

1. Sweet

2. Salty

3. Bitter

4. Sour

5. Umami

Discovered by Kikunae Ikeda, brought on by MSG

MSG increases salivation or sensitivity

Umami has no taste but increases flavor, esp. in high protein foods

aka Kwok's Syndrome

Discovered by Dr. Kwok, 1968

Adverse reaction to MSG; chest pain, sweating and pain down one's arm, similar symptoms of a heart attack

Can result in anaphylactic shock, which causes 200 deaths a year in North America by decreasing blood pressure

Peanuts are a prominent cause

Treatment is neurotransmitter epinephrine (adrenaline), delivered via ana-kits or epi-pens

Latex allergies are the worst; people can have reactions from food prepared with latex gloves

Survival of a reaction can be a warning sign that hte next will be much worse

No butter; coconut oil instead

Contains Sodium TripolyPhosphate (STP) which traps moisture

Contains salt which acts as a preserving agent (the same used to be done with fish off boats during long trips so that they would be splashed with seawater)

Present in many different foods such as Kraft Dinner

Present in cleaning agents; traps calcium found in water so cleaning product is more effective

Claims trisodium phosphate is dangerous because phosphorous is used in incendiary bombs

Author equated trisodium phosphate with phosphorous; neglected the fact that it is combined with sodium and oxygen

First to realize that microorganisms were responsible for degradation of food

Debunked the Theory of Spontaneous generation; people thought maggots appearing in rotten food were spontaneously generated

Realization that bacteria and other things in air degraded food

"L'experience du col de cygne"; longnecked glass container that prevented bacteria from reaching food

Heating/cooling/salting food to prevent degradation of food: rate of multiplication dependson temperature / salt content

Salt kills bacteria this way; e.g. brine solution

Osmosis: movement of solvent through a semi-permeable membrane from a region of low solute concentration to a region of high solute concentration

Salt pulls water from bacteria, causing them to dehydrate and die

Sugar is a good preservative and works the same way

Cucumbers in brine

Pickles are high in salt

Health food ketchup's sugar acts like preservative

Heinz ketchup contains the exact same thing

Smoke can dry fish and remove moisture, which bacteria needs to survive

Toxic chemicals also kill off vacteria

Smoked herring is common; turn red after process, which is where the expression "red herring" comes from

Schwartz' smoked meat sandwiches!

Canada: Estimated 2 million cases and 30 deaths a year

US: 20-80 million cases and 10 000 deaths a year

Listeria, E.coli and Salmonella are causative agents

Maple Leaf scare due to Listeria monocytogenes

Organic foods don't lower the risk; e.g. organic spinach found to be contaminated with E.coli O157H:7 and peanuts by salmonella

1. Better reporting

2. Increased meat consumption

3. Increased lifespan (increases chances for exposure and weakened immune systems)

4. Increased traveling

5. Industrial farming (contamination of a batch will affect a large region)

Bacteria that mainly affects young and old and immunocompromised (e.g. AIDS victims)

Pregnant women's immune systems are suppressed in order to not reject baby

By weight, 50% of all antibiotics in North America are used for animals in order to induce "less competition" in the gut so animals grow faster on less feed

Exposure to antibiotics for an extended amount of time creates bacterial resistance; bacteria gains ability to grow in the presence of the antibiotic

Contamination can then infect humans

FDA wanted to ban the use of antibiotics in animal feed, but this would increase cost by 5%

Used to blend fat-soluble (oil) and fat-insoluble (water) ingredients

Polysorbate 60, glycerides, etc.

Found in salad dressings where different layers may be found within container

e.g. Imitation Butter

Chemicals used to mimic taste of foods are not listed on the product - only "artificial flavors"

500 chemical compounds combined in the distinct flavor of an apple

Include acetone, ethanol, formaldehyde, sugar, and water

Found in artificial vanilla flavoring; most widely used chemical in flavors

"nature identicial" artificial flavor, meaning it is chemically identically to the natural substance

10 Synthetic Colors (2 are restricted) and 24 natural colors in food in Canada; Canadian dyes are referred to by their chemical name while US dyes are identified by their number

Most widely used food color is caramel, in cola drinks

Beta Carotene used for orange; butterball turkeys

T

Used to contain beta carotene or canthaxantin as the main ingredient

Compound absorbed into fatty section of skin and color it orange

Beta carotene is the precursor to Vitamin A; thus it crystallizes in the body when taken in excess

Depends on seasons

In the summer, cows eat grass (with beta carotene) so coloring is not required

In the winter, cows eat hay so coloring is added

Cows that eat carrots produce yellower butter

Coloring agent: cochineal red

Natural food dye, also used in ice cream

Found in salamis and Campari and red beverages

Compound comes from cochineal insect, which grows on cacti in the southern US; female insects used since the color is present in the eggs

Red pigment in paintings - carmin red

Produced in the lab and may have harmful effects on consumer

aka Coal Tar Dyes; extracted from coal tar in the past

Intense colors, very stable

"Certified" dyes have nothing to do with safety 

Preservative used in soda and juice

Can react with absorbic acid to produce a carcinogenic agent, benzene

Dr. Ben Feingold proposed that food colors could be implicated in causing disorders in children, e.g. hyperactivity

Small sample of children consuming a large amount of food dyes

Dr. Fenster: we should stay away from food dyes not because they are harmful but because they are most often found in foods of poor nutritional value

Shown to be potentially carcinogenic in animals

Banned in the US, allowed in Canada

Cancer-causing in test animals and people exposed to it exhibit higher cancer rates 

e.g. Tobacco smoke

However high dose animal studies may not reflect human exposure and risk; e.g. Red Dye #3 caused tumors in male rats but not female

There are more natural carcinogens than there are synthetic ones; 1 cup of coffee contains 10 mg of known carcinogens

Cancer rates were lower before because of the decrease in deaths due to infectious diseases

Old Age disease; aging population and other diseases being conquered, so people tend to die form cancer

In 1900, the life expectancy was 48.4, and it is now over 80

Incidence of cancer is increasing; however detailed analysis reveals that some forms are increasing while others are decreasing

Toxic substance, antimony trichloride, used to make plastic that holds water

However the part that leaks into the water is a very very small amount; to cause harm, a person would need to drink 800 litres

A woman's death caused by drinking 8L of water in a radio contest

Fatal disturbance in brain functions occurs when the normal balance of electrolytes in the body is disturbed by over-consumtption of water 

Osmosis causes cell tissue in brain to expand and get crushed against the skull

Polydipsia is a condition in which a person has urges to drink huge amounts of water

~20 billion hot dogs consumed per year in North America

Contain nitrites; concerning because they can convert with naturally occurring amines into nitrosamine, which is carcinogenic to animals

Sodium Ascorbate (Vitamin C derivative) is added to prevent this 

Carcinogen

Biologist in Nebraska who tried to poison his cheating girlfriend with DMNA, thinking he wouldn't be caught since she would get cancer; however the body degrades DMNA quickly, and she died from liver hemorrhage with traces of DMNA still in the body

Chemist in Germany tried the same thing but in smaller amounts; he was caught eventually anyway

Aka Sodium Nitrite

Can convert with natural amines into nitrosamine, carcinogen to animals

Known preservatives, prevent botulism (Botulinus is one of the most toxic substances known; 1 teaspoon can kill a million people)

Botulinus can be found in any preserved meat

Nitrites added to give tangy taste and pink color, as natural cut meat is blueish red due to presence of myoglobin (Iron in myoglobin oxidizes and discolors meat)

Browning of fruits and vegetables

Presence of metals can speed this up (cutting an apple with a metal knife will brown it faster than cutting it with a plastic knife)

Citric Acid is an anti-browning agent, or an antioxidant, because it is an chelating agent (sequesters metals)

Sodium Sulfate and Sodium Bisulphite are anti-browning agents as well as antimicrobial agents in wine and grapes

Oxidation of fat

Produces butyric acid, chemical responsible for the fragrance of sweaty feet

BHA and BHT are antioxidants that prevent rancidity by trapping free radicals

Antioxidant-rich diets are implicated in reducing signs of aging

Hypothesis on why we age concerned with accumulation of free-radical encounters and cell damage

Can produce hallucinations

LSD is derived from this plant

Ergot fungus found in rye bread

During Salem Witch trials, women exposed to ergot fungus experienced hallucinations and 19 were executed as witches; depicted in The Crucible by Arthur Miller during the 1950s (he was married ti Marilyn Monroe)

Bacteria used in production of swiss cheese

Placed incide cheese where it produces CO2 and holes in the cheese

Lactic acid used to produce CO2 and Propionic Acid

Swiss cheese requires no preservatives because propionic acid is a natural preservative, present at 10x concentration than what is added to bread as an anti-fungal agent

Do not have preservatives because they are usually consumed in a day

Propionic acid is found in human sweat; which is why in France people carry baguettes home under their armpits

Used in foods like ice cream to give a better mouth feel

Gums (guar gum, carob bean gum, gum arabic)

Crystals form on "old" ice cream; moisture trapped by gums is crystallized on top of the ice cream

Carboxymethylcellulose (sawdust) is added to absorb the moisture and prevent formation of ice crystals

Radishes: goitrogens (causes goiters)

Cheese: Tyramine (increases blood pressure)

Oranges: Tangeratin (embryo-toxic substance)

Celery: goitrogens

Carrots: myristicin (hallucinogen)

Banana: serotonin that lowers sex drive

Apples: phlorizin (causes ammonia to accumulate in urine)

US population is overweight to the extent that the population is suffering new diseases not seen in humans before, e.g. Type 2 Diabetes

Recently married via special bed attached to truck; special contraption used to conummate marriage; currently around 500lbs

For women in 1960 it was 140lbs and it is now 164 lbs

Hippocrates had to council his people about weight problems; solution was to eat only after work, be naked as much as possible and to sleep on a hard bed

Risk factor for heart disease, stroke, hypertension, cancer, and diabetes

North American society is full of obesity-promoting foods; caloric intake has been progressively increasing over time

Soft drinks contain tons of sugar; fructose in particular leads to weight gain quicker than glucose (HFCS)

Corn sweetener, containing 55% fructose and 45% glucose

Cheaper than real sucrose; appears sweeter to the consumer

Neuroendocrinology studies show that fructose makes people want to eat more in their next meal than glucose; fructose doesn't affect hormone Leptin (appetite) as much as glucose, so there is less satiety in consuming fructose

Man-made chemicals released in the environment; believed to contribute to increased levels of obesity in the population

Men with abdominal obesity, insulin resistence or both were more likely to have high concentrations of phthalate metabolites in urine (chemicals used to make flexible plastic)

However it is important to remember that correlation does not imply causation

Extra weight on the belly is a risk factor for stroke

Men tend to put weight on their bellies while women on their thighs

Fat at the front (abdominal) is more metabolically active and more readily released in the bloodstream as triglycerides

Way of measuring weight relative to height

Calculated by the following formula: BMI = Weight (kg) / Height (m)

BMI of 30 or above means you are obese

However bodybuilders have a high BMI without being obese

Another way of measuring body composition; more effective than BMI

Close association with health risks; high waist-to-hip ratio and high BMI means risks of heart disease and cancer are significantly increased

Unit of measure of energy

Amount of energy needed to raise the temperature of 1 gram of water by one degree Celsius

Calories in food are actually kilocalories (1 food calory = 1000 small calories)

Classification of both food and energy requiring exercise in calories

Gaining / losing weight depends on balance between energy expenditure and intake - thermodynamic concept

Used to determine how many calories are contained in a food

Contains circulating water, heated by combustion and measuring temperature to determine caloric content

Approximation as bodies do not function at the same efficiency as the calorimeter

Scientist that made many calorimetric measurements

Understood that urine contained food byproducts (e.g. urea) and also burned urine samples / feces to incorporate into caloric measurement of food

Amount of energy that can be made available from a particular food, as measured by calorimetry

Approximation

Real caloric content of a food, taking into account its breakdown by the body and whatever doesn't get absorbed and ends up in urine or feces

E.g. slice of lasagna may contain 400 calories of energy if burned by calorimeter, but will only provide 367 net calories if ingested

Cooked and raw food has a difference; cooked food has already begun the digestion process

Glass of orange juice: 108 calories

Square of fudge: 155 calories

1 gram of Dynamite: 155 calories (however the energy is released immediatrely upon lighting)

Amount of energy your body requires if you were at complete rest for 24 hours - just breathing, heart beating, organs functioning, etc.

Exercise requires more energy than BMR

Walking: 2.8 cal/min

Bicycling: 3.2 cal/min

Dancing: 5 cal/min

Running at 11mph: 21.7 cal/min

Swimming: 26.7 cal/min

1400-1700 calories per day

A sedentary lifestyle might require 2000 calories per day in men or 1500 calories per day in women

Consuming less than BMR means weight loss, as the energy needs to come from the stored fat/protein/carbs in the body 

Humans are biochemically individual; some have a more efficient metabolism and therefore require fewer calories, and gain weight more easily

Analogy: 2 cars with the exact same amount of gas with 2 drivers driving - a heavier car will require more gasoline, and it also depends on speed and tire conditions etc. - so the 2 cars will not run out of gas at hte same time

Overweight people tend to have overweight pets; this is obviously not genetic and is due to them feeding their pets similarly to how they themselves eat

Clear evidence that there is a genetic compenent involved; e.g. Pima Indians in Arizona; the whole tribe is overweight

Low BMR when young is a prediction factor

BMR increases with weightgain; once BMR reaches the level similar to an average non overweight person, weight is no longer gained

BMR is similar to obsese and normal weight people

Weight loss for the first few weeks, but then there is a plateau due to the body reducing its BMR

Exercise is the solution because it aids in increasing the BMR

Documented his weight loss journey

Began losing weight within 3 months

By a year he had lost a dramatic amount of weight and was running marathons

He regained some weight over the years

Lower than cure rate for cancer

Only 5% of people manage to keep the weight off

Exercising is crucial

Over 50 billion dollars/year on diet programs

They don't work; since the 1920's over 23 000 diets published; most work in the short term but not in the long run

Cut down or eliminate carbs; thus diets become high in fat and protein

Production of ketone bodies in urine from this diet; breakdown products of fatty acids

e.g. Robert Linn's Last Chance Diet caused some people trying it to die; all-protein diet with no carbs meant that people were missing essential amino acids

Atkins' diet; high protein diet with no carbs

Logic was that carbs break down to glucose which triggers insulin, which allows glucose to be absorbed into muscle cells to be used for energy

Excess of insulin causes receptors to become overwhelmed and resist; then glucose is absorbed into fat cells and converted into fat

Absence of glucose in the blood leads to the use of stored fat to produce energy and weight loss

Problem: diet is deficient in fruits and fiber, and the extra protein puts a burden on the kidneys

Monitors 6000 people who have lost at least 30 pounds and kept it off for a year

Benchmark for weight loss; average participant has lost 70 lbs and kept it off for 6 years

Combination of diet and exercise, mainly walking

Breakfast daily curbs appetite

Frequent weighing

Limited amounts of TV, marker of activity level

less than 8% were on Atkins

60 people on Atkins, 60 people on American Heart Association diet for 6 months

People at Atkins lost 31 pounds, AHA lost 20

Each liet was less than 1500 cal, i.e. less than BMR

LDL unchanged; HDL up on Atkins only

Triglycerides dropped on Atkins, increased on AHA

After 12 months however the weight loss was the same for Atkins as any other diet

Modified Atkins diet into South Beach Diet

Reduced "bad" carbs, i.e. baked potatoes and bananas, or foods with a high glycemic index

Did not cut calories

Diet doesn't work

Low glycemic index, propsed by French accountant

Drink wine and eat chocolate but still leads to a lower caloric intake

another low glycemic index diet

Questionable diet as she was seen exiting a lipsuction clinic

Laser therapies that lyse fat cells in the body

Promotes intake of complex carbohydrates; best chance of actually working

Intake of fruits, vegetables and whole grain, which makes you more full

Dr. Dean Ornish conducted experiments; people lost weight and cholesterol and actually stuck to the diet

Combining foods the right way will enable one to lose weight

No science behind it; but it does promote a low caloric intake

Chitosan intake - carb extracted from shellfish shells

Cannot be broken down by the body and prevents fat from being absorbed

Works, but causes digestive upset and incontinence as fat lubricates the stool

Based on 80's studies that showed people who had a high calcium intake had lower blood pressure and lower body weight

Low calcium diets caused their weight to initially go up; then a high calcium diet caused their weight to go down

Rationale that low calcium intake causes kidneys to release more Calcitriol but also allows fat to be absorbed

Mice on the diet led to a 69% loss in body fat

32 obese people put on the diet; greatest weight loss was with 1200-1300 mg of Calcium from low fat dairy

Nutrition professor demonstrated the importance of cutting calories by eating a diet of only twinkies to lose 27 lbs, because he was in a caloric deficit

Weight loss doesn't depend on the diet type but rather the caloric intake

Guarantees weight loss; works, but dieters must buy all their food from them and eat according to a premade schedule

Company calculates everything according to you, taking into account your BMI and activity level and assigning a caloric intake

Tastes good; 300 cal/meal

Small servings

1. Most successful dieters do not enroll in programs

2. Eating low glycemic index foods helps curb hunger

3. Minimize sugar and eat high fiber foods

4. Protein slows absorption of food; also results in eating more slowly, and ultimately eating less due to its satiety

5. Low energy density foods like soup and fruits enhance satiety

6. No need to cut fat below 30% calories; keep mono and polyunsaturated ones

7. Exercise - weight or power training reduces weight more than cardio alone

Sex burns 125-300 calories

Kissing burns only 6-12 calories

Study showed that people who lose just 10% of their weight report significant improvement in their sex lives

St. Catherine, ON is the city with the largest ratio of overweight people in Canada; PEI has the highest proportion of overweight people

In the US, Las Vegas as the highest proportion of overweight people

36% of Canadians and 34% of people in US are overweight

23% of Canadians and 35% of Americans are obese

Canada 1980: 75L of soft drinks per year per person

Canada today: 115 L per year

US 1980: 120L

UStoday: 200L

In 1923 it had 63 000 seats; rebuilt in 1975 with 54 000 seats because the North American bum had grown 20cm

Nicknamed "the house that Babe built" because Babe Ruth would overfill the stadium; she had 714 career home runs

Study of obesity as a medical condition

Treat obesity as a long-term disease, with medicine

Targets metabolic activity, nutrient absorption or appetite

Caffeine is a common ingredient because it is chemogenic, meaning it increases metabolic activity

Coffee would have to be drunk in huge amounts to make a difference, so this is impractical

1. Caffeine (impractical)

2. Ephedra (aka Ma Huang)

3. Synephrine and Octopamine

4. Nicotine

5. Insulin

6. 2,4-dinitrophenol

Natural substance extracted from Chinese herb

Active ingredient: Ephedrine

Benzene Ring with 3 bonds (1 double 1 single), N makes it an amine

Same family as Amphetamine, aka speed; stimulant

Sold as  supplement

Ephedrine combined with caffeine

1 billion $/year sales before it was banned in Jan 2004 due to causing 155 deaths from its simulant effects

Affected cardiovascular system, causing heart problems 

Steve Bechler, baseball player, was one such person to die from this

Not completely banned, but banned only if:

1. dose is greater than 8mg

2. caffeine is present

3. labeled for weight loss / appetite suppression

Allowed in traditional medicine; one person actually crashed their car while on an Ephedrine high, killing 2 people

Extracted from citrus fruits

Somewhat less dangerous and potent, similar to Ephedrine in structure

Synephrine used as nasal decongestant

Chemogenic substance

20% of canadians smoke; 25% in Quebec and 16% in British Columbia

High proportion of female smokers; this is due to advertising that appeals to people trying to lose weight from smoking

Stop smoking = BMR slows and weightgain

Cigarette ads never show overweight women smoking

Increases BMR

Von Bulow Affair: Aristocrat Claus Von Bulow married heiress Sunny; she was found in a coma and next to her was a syringe with insulin

Children launched court case accusing Von Bulow of trying to kill his wife

They couldn't prove that he injected her; defense was that Sunny injected herself with insulin to try to lose weight

Sunny died after 28 years in a coma

Movie: Reversal of Fortune, Book: Crime a L'Insuline

Women working in ammunitions factories were losing weight after WW1 due to this substance, found in gun powder, which was thermogenic and expended calories in the form of heat

First diet drug, but the side effects killed 20 people and it was banned

Cells absorb fats efficiently, and burn the energy from fat to create heat

Rodents have large proportions of brown fat

Babies also have brown fat since it is important to keep warm

BRL 26830 by LaRoche was developed to try and increase brown fat cells, but it was ineffective

In theory these would be great because you could eat whatever you wanted and not gain weight

e.g. Xenical

Affects the way fat is metabolized

Fat molecules, containing 3 long carbon chains, must be cleaved from glycerol backbone with lipase enzymes to be metabolized

Blocking lipases causes fat to not be metabolized

Drug aims to inhibit lipase and stop metabolism of fat; however only 20% less fat is metabolized

Side effects: gastrointestinal discomfort, loose stool (anal leakage) and malabsorbtion of fat-soluble vitamins

Appetite can be controlled by 2 neurotransmitters: noradrenaline (aka norepinephrine) and serotonin

Inhalers based on amphetamines, which affect noradrenaline, but they caused cardiovascular, anxiety, dependence and tolerance problems

Elvis Presley was addicted to amphetamines and he had a weight problem

1. Phentermine

2. Dietac

3. Fenfluramine

4. Prozac

5. Meridia

6. Mediator aka Benefluorex

etc.

Derivative of Amphetamine

Diet supressing Bariatric drug

Drug had less side effects, but also ineffective as a weight loss drug

Contains phenylpropanolamine, which suppresses the appetite and is also found in cold medicine Contac-C

High amounts cause hallucinations

Constricts blood vessels around the nose; people with hypertension need to be careful

Linked to strokes and eventually banned; women were especially at risk, 17x more likely to suffer strokes 

Carbs decrease appetite by increasing tryptophan (amino acid) levels in brain; Tryptophan increases serotonin levels which cuts appetite

Wife Judith Wurtman wrote The Carbohydrate Craver's Diet

High serotonin levels lower sex drive

Low carb diets don't work because people on them remain hungry

Baratric drug that suppresses the appetite

Sold as Ponderal by Servier

Phentermine and Fenfluramine mixed into Fen/Phen, hoping stimulating action of phentermine would counteract drowsiness of Fenfluramine

Drug still caused drowsiness as well as depression, pulmonary problems and increased sex drive

Scientists attempted to modify its structure to reduce side effects

e.g. Fenfluramine

Carbon with four different substituents

causes the structure to have a mirror symmetry called enantiomers

Right handed enantiomer of Fenfluramine

Suppresses the appetite while lefthanded enantiomer, Levfenfluramine, does not

Marketed by Richard Wurtman under the name Redux

Became rapidly popular; 100 000 prescriptions per week

Side effects: dry mouth, diarrhea, fatigue and primary pulmonary hypertension

Increases serotonin levels

Did not have side effects like other bariatric appetite suppressing drugs

Blocks reuptake of serotonin into neuron that released it, keeping levels of serotonin high in the synapse; aka reuptake inhibitor

Increases production of serotonin slightly

Neurotransmitter

Nerve cells are divided by gaps called synapses

One of 2 diet drugs allowed in North America

Reuptake inhibitor ofr both Norepinephrine and Serotonin

Can cause problems; 400 serious adverse reactions of cardivascular nature and 84 deaths

Now banned in Europe and North America

Produced by the same company as Redux

Only metabolic product of Mediator causes side effects

Caused cardiac valve failures, amounting to 500-2000 deaths in France between 1979 and 2010

When people smoke weed, they get munchies because of tetrahydrocarabinol 

Acomplia blocks receptors of this; CB1 Cannabinoid Receptor Antagonist

Side effects: depression, suicidal thoughts, etc.

Drug used for epileptic seizures; side effect that causes appetite suppression

Side effects: numbness, tingling, infections, diarrhea, nausea and anorexia

Qnexa is commercially available, a mix between Topiramate and Phentermine

Discovered during studies on rats; obese rats were genetically deficient in the hormone leptin

They lost weight upon injection

This did not work in humans however because obese humans are not deficient in leptin, but rather the leptin receptor