Is a Calorie really Just a Calorie?

A recently published medical article discusses research done at the Functional Medicine Research Institute  in Gig Harbor, Washington. One of the principle authors of the article is my long time friend, teacher and colleague, Dr. Jeffrey Bland (see my picture with him below). Dr. Bland reviews this article in  his May 2006 monthly audio newsletter. Many of his comments are so well said that I have copied them into this article. Whenever I am quoting from his newsletter below you will see quotation marks around his words.

          For decades our society has assumed that calories are the name of the game; specifically, as long as you adjust the calories with the right ratio of protein, fat and carbohydrate percentages, there will be a favorable outcome.

          Now there comes an exciting study that shows the role of Nutrigenomics on our biochemistry and subsequently on our health in general.
          Nutrigenomics is the science that studies how our nutritional intake affects the expression of our genes. We learn in medical school, and many people still believe, that if you have a “certain gene” you are predestined to develop a certain health condition. The new science of genetics however shows us this is quite erroneous. Specific environmental factors -  which include the very nature of the food we eat and other nutrients we intake, as well as toxins in our environment — can turn on or off the genes that we have received from our parents. This is all to say, “there are many you’s within you."

The food we eat delivers information to our genes and thus affects how those genes express themselves. As the genes express themselves, so is our biochemistry.
 

The most recent public example of this information is Morgan Sperlock in his movie, “Super Size Me.” In this movie, Mr. Sperlock had more than just super-sizing of calories. “He also had super-sizing of bad information from toxic food that was inducing different gene expression patterns.” It was not just the calories in and of themselves that created the multiple effects he saw in his body, but the information in the particular calories that he consumed.

          Now in this exciting study from the Journal of Nutrition, we get an answer to the question, “What happens if you hold the percent of calories as protein, carbohydrate and fat comparable, but you change the information coming from the food between the two groups?” If you do this “Would there be a difference in outcome in the two groups?”

          The bottom-line results of this study showed such an overwhelming difference between the two groups, that no one can help but recognize the power of Nutrigenomics in our health.

          Specifically in this this study by Lukaszer, Bland, et al,  they took two groups of post-menopausal women at risk for coronary artery disease. (Cardiovascular disease, as everyone knows, is the leading cause of death in both women and men.)

          Half of the women in this study followed the American Heart Association’s proven diet program for weight loss. The other half of the group was put on a “low glycemic index” (LGID) diet which included protein powder containing soy isoflavones and phytosterols. All patients in the study were followed for 12 weeks.

          The study results showed that both groups lost about the same amount of weight, as would be expected from the American Heart Association Diet Guidelines. (AHAD)

          The results also showed that the American Heart Association diet group had an improvement in their total cholesterol and their triglycerides and their body composition. But, “these changes paled in comparison to the members of the LGID group, who had the same calorie intake and the same exercise, but had a different level of phytochemical intake and different diet persuasion. These individuals had a 46% reduction in their triglyceride to HDL cholesterol ratio and a significant reduction in total and LDL cholesterol.  They also had a significant reduction in their highly sensitive C-reactive protein (hsCRP), a significant reduction in fasting insulin” as well as another measurement that indicates tendencies toward diabetes or pre-diabetes.

          The degree of difference in improvement between the AHAD group and the LGID group was statistically significant at levels rarely seen in the medical literature. For example, on the LGID diet, there was a significant decrease of the total cholesterol/HDL cholesterol ratio at a p value less than 0.0001 level, as well as the triglyceride/HDL cholesterol ratio, also at the level of  p less than 0.0001.

          Of note, the total cholesterol to HDL cholesterol ratio did not significantly change at all for the AHAD group. The triglyceride/HDL cholesterol ratio approached, but did not reach, significance in this group, either.

          What this study tells us is the extreme power of Nutrigenomic tailoring that leads to our getting the right information sent to our genes to produce the improved outcome.

          Jeffry Bland, in his review of this article, went to the medical literature to ask what drugs the LGID group of patients would have needed to be on to produce the same effects. Dr. Bland concluded the results were equivalent to putting patients on three drugs: Statins (for cholesterol) , Metformin ( for blood sugar), and ACE Inhibitors( for blood pressure and other heart risk factors).

          As Dr. Bland comments, these results “represent the best medicine, not alternative medicine, not complementary medicine, not integrative medicine, but the best medicine.” This is very exciting information, indeed, and something I want all of my patients to be aware of!

          I would like to make a comment about the fact that some people talk about the “toxic effects of soy.”  This is surprising in light of the fact that “there are hundreds of clinical trials that are published in the medical literature that demonstrate the beneficial effects of moderate amounts of soy in the diet.” This study showed that with “appropriate intake of approximately 30 milligrams of soy isoflavones (part of the soy protein isolate that is found in the LGID beverage and in the context of an overall well balanced low glycemic-index diet which is rich in plant foods, there are no toxic effects” from soy.

          Quite the opposite, as the article shows: “there is a highly desirable effect on every lipid, glucose, insulin, inflammation connection that was studied.”

          This is the future of medicine. We are watching a transformation facilitated by our increasing knowledge about the roles of our environment and our diet in relation to our gene expression and the resultant outcome in our daily health.

          This study clearly shows that often the very best medicine is found in the particular nutrients that we put into our bodies on a daily basis, along with the information that they carry to our genes.

          I invite all of my patients to have a lively conversation with me about this most exciting development in medicine.

Reference

Lukaczer, D., J. L. Deann, et al. (2006). "Effect of a low glycemic index diet with soy protein and phytosterols on CVD risk factors in postmenopausal women." Nutrition 22(2): 104-13.