Saturday, February 28, 2009

El Problema con la Fructosa

La fructosa es diferente a la glucosa. El azúcar (la glucosa) va directamente al torrente sanguíneo para que los tejidos y órganos la puedan utilizar como energía, y de ella sólo un 30 a 40 porciento pasa por el hígado."

Mientras más fructosa contenga la dieta, más alto es el subsiguiente nivel de triglicéridos en la sangre" escribe Tauber. Mientras nuestras autoridades de la salud se han enfocado principalmente en los riesgos de los niveles altos de colesterol LDL (de baja densidad), Taubes demuestra que son nuestros niveles de trigliceridos - grasas - en términos del riesgo de ataque cardiaco.

Y específicamente problemático para la gente con diabetes es el hecho que las dietas altas en fructosa nos llevan a producir más insulina, lo que a su vez nos conduce a más resistencia a la misma (insulina). Esto es porque la fructosa parece bloquear tanto el metabolismo de la glucosa en el hígado, como la síntesis de la glucosa a glicógeno, que es la forma como el hígado almacena la glucosa.

Y es aún peor, dice Taubes. La fructosa es quizás 10 veces peor que la glucosa por la manera en que nuestros cuerpos forman las AGEs, o Advanced Glycation end Products. Mientras leía a Taubes, mi Educador Certificado sobre Diabetes preferido me señaló la existencia de una provocativa entrevista con el Dr Lustig. Esta entrevista publicada originalmente en el ABC Ratio National de Australia, confirma los delineamientos del concepto de Taubes contra la fructosa."

El único órgano de su cuerpo que puede utilizar la fructosa es el hígado," la primera cosa que causa la fructosa es aumentar los niveles de ácido úrico. La fructosa inhibe el óxido nítrico, el cual de otra forma reduciría nuestra presión sanguínea. De manera que la fructosa es ahora famosa por causar hipertensión."

Lo segundo es que la fructosa inicia lo que se conoce como 'de novo lipogénesis', exceso de producción de grasas... Y entonces lo último que hace la fructosa en el hígado es que inicia la producción de una enzima... Lo que pasa es que los receptores de insulina de su hígado cesan de trabajar... Eso significa que los niveles de insulina tienen que elevarse en todo el organismo."

Cuando le pregunté al Dr Lustig el nombre de la enzima que la fructosa inicia en el hígado, me contestó que ellos la llaman "c-jun N-terminal kinase-1"o sólo JNK-1 o Junk-1 (basura-1). "Ella fosforila en el suero una proteina llamada IRS-1 (Insulin Receptor Substrate-1), la cual desactiva la proteina. Tal cosa induce la resistencia hepática a la insulina."

El artículo del Dr Lustig puede encontrarse aquí.

Esta maldita cosa!!!. De hecho "nos estamos envenenando mortalmente", concluye el Dr Lustig.

Lo que disparó el problema reciente con la fructosa empezó en 1978, con el sirope de maíz de alto contenido de fructosa. La forma más común, el HFCS-55 es 55 porciento fructosa y 45 porciento glucosa.El HFCS es ahora el endulzante más común en los EE UU. Ha reemplazado la glucosa (azúcar de mesa) especialmente en las bebidas gaseosas, pero también se encuentra en muchos otros alimentos.

Para los que leen en Inglés:

Thursday, February 5, 2009

12 Tips for Better Heart Health

Diet, sleep, fitness, and more -- how to strengthen and protect your heart right now

By Denise Mann
WebMD the Magazine - Feature
Reviewed by Brunilda Nazario, MD
How do you get a healthier heart, right now? The answer sounds too good to be true: “By simply leading a healthier life,” according to Nieca -Goldberg, MD, medical director of New York University’s Women’s Heart Program and author of Dr. Nieca Goldberg’s Complete Guide to Women’s Health.
That’s because even small, steady changes in your life mean a stronger, more efficient heart. “More than half of heart disease is preventable, and studies have shown that 90% of heart attacks in women can be prevented,” she adds. Further, the latest study in Archives of Internal Medicine shows that women who eat loads of veggies, fruit, whole grains, fish, and legumes; drink moderate amounts of alcohol; exercise; maintain a healthy weight; and don’t smoke have a whopping 92% decreased risk of having a heart attack compared with women with less healthy diets and habits.
An added bonus? “So many things we do to help our heart, like quitting smoking, eating more fiber, and moving more, also help other parts of our body, including our bones, colon, lungs, and skin,” Goldberg says. And February is Heart Disease Awareness Month, making this the perfect time to start improving your ticker -- and the rest of you.

1. Know your heart health numbers.
Establish a baseline to help plan every preventive step for the rest of the year. “You need to know if you are at risk before you can take action to lower your risk,” says Lori Mosca, MD, PhD, director of preventive cardiology at New York-Presbyterian Hospital and author of Heart to Heart: A Personal Plan for Creating a Heart-Healthy Family. Know your HDL or “good” cholesterol, LDL or “bad” cholesterol, total cholesterol, triglycerides, blood pressure, weight, and body mass index (BMI) numbers. And make an appointment now for a check-in next February to see if your new healthy habits are making the grade.

2. Target your triglycerides.
Shoot for a level of 150 or lower, says Peter H. Jones, MD, an associate professor of medicine at Baylor College of Medicine in Houston.
“Doctors usually talk about good and bad cholesterol and most folks will have that down, but triglycerides are a better marker for high risk of diabetes and heart disease,” says Jones.
Triglycerides are also much more responsive to lifestyle changes than other types of blood fats. “Your triglycerides can drop 30% to 50% just by reducing saturated fats and reducing your weight,” Jones says.

3. Be a nut about heart health.
Your heart will love you if you eat six walnuts before lunch and dinner, according to Michael Roizen, MD, the chief wellness officer for Cleveland Clinic and chairman of the clinic’s Wellness Institute. Why? Because “walnuts are rich in omega-3 fatty acids, which help to decrease inflammation in the arteries surrounding your heart, so they keep your heart functioning longer and better,” promises Roizen, co-author of the best-selling You: Staying Young: The Owner’s Manual for Extending Your Warranty. “Walnuts will also make you feel fuller faster so you are less likely to overeat at meals.”
You may want to give pistachios a try as well. A recent study shows that a serving or two of pistachios each day may help reduce levels of LDL cholesterol, as long as you are mindful of calories. One cup of pistachio nuts has about 700 calories!

4. De-stress your heart.
Unplug yourself from the news cycle and your email. It’s good for you and your ticker. And that begins with your PDA. “Start turning it off for 15 minutes at a time and work up to an hour a day to reduce stress,” Goldberg says. “Stress raises blood pressure, heart rate, and levels of the stress hormone cortisol,” she says. “These days, people are less and less capable of leaving stress at the office because everyone is connected 24/7.”
Consider swapping your BlackBerry for another handheld gadget -- your iPod. “Put some relaxing music on your iPod, close your office door for 10 minutes, and listen and breathe.”

5. Get heart healthy social support.
You know exercise improves heart health by keeping weight down and raising levels of HDL cholesterol, but doing it with a friend adds benefits.
“Finding an exercise buddy is really important because social support lowers your risk of heart disease and helps you stay motivated,” Mosca says. Build up to 60 minutes of exercise a day, but even 20 minutes is better than nothing.
In fact, being married and having a strong social network may help protect against heart disease, according to a study of nearly 15,000 men and women. It turns out that people who have a spouse, go to church, join social clubs, and have a lot of friends and relatives have significantly lower blood pressure and other heart disease risk factors than loners.

6. Volunteer to fight heart disease.
People who volunteer tend to live longer than people who don’t. It’s that simple, Mosca says. “We think this is because volunteering reduces isolation and increases social connectivity.” Find a charity that means something to you and donate your time now.

7. Take a heart-felt approach to quitting smoking.
Smoking is a major risk factor for heart disease, but kicking this nasty habit can be much easier said than done. “If you smoke, talk to your doctor about some of the new therapies that are available,” Goldberg says.
Need an added incentive? Take this advice to heart: “You start to improve your heart health within minutes of quitting,” she says. And the heart health dividends keep growing. “After one year, your heart disease risk is cut in half -- and after 10 years of not smoking, your heart disease risk is the same as for someone who has never smoked.”
Secondhand smoke counts too. A recent study found that women who are exposed to other people’s smoke increased their risk of heart attacks by 69%, strokes by 56%, and peripheral artery disease (PAD) by 67%, when compared with women who did not hang out around smokers. Clogged arteries in the legs, abdomen, pelvis, arms, and neck are linked with PAD. “Tell your friends to quit, too, or make new friends,” Goldberg says.

8. Drink a little alcohol a day to keep heart disease away.
“For women, up to one glass of alcohol a day and, for men, up to two glasses a day can help reduce risk of heart disease,” says Goldberg. “Alcohol may help the heart by increasing levels of HDL cholesterol,” she explains. But keep in mind: More is not merrier. “Alcohol also has calories, and too much can cause high blood pressure, worsen heart failure, and cause heart rhythm abnormalities.”

9. Strengthen your heart with weight training.
“Strength training reduces your percentage of body fat, keeps your weight down, and increases your muscle mass and endurance for aerobic exercise,” says Goldberg. “Do some weight training with free weights twice a week, making sure to focus on both your upper and lower body,” she says. “As your aerobic capacity improves through strength training, your good HDL cholesterol levels will increase.”

10. Measure your waist size to gauge your heart health.
“Take a tape measure and measure your middle,” Goldberg says. “If your waist size is more than 35 inches in women or more than 40 inches in men, this tells you that you are at increased risk for heart disease and type 2 diabetes.”
The best way to make a dent in that spare tire? “Get serious about being more active and get rid of simple sugar and white-floured foods in your diet,” Goldberg says, adding that these foods tend to take up residence right around the middle.

11. Reduce your blood pressure by reducing your salt.
High blood pressure is a major risk factor for heart disease, and reducing salt intake can help lower blood pressure. Cook with herbs in place of salt, and make sure you read food labels to see just how much salt is in prepared foods. “Aim for less than 2.3 grams [about a teaspoon] of salt per day,” Goldberg says. And keep up the good work when you are dining out, she adds. “Ask for the sauce and salad dressings on the side because restaurant food tends to be heavily salted.”

12. Sleep to your heart’s content.
People who sleep fewer than seven hours a night have higher blood pressure and higher levels of the stress hormone cortisol, making the arteries more vulnerable to plaque buildup, says Goldberg. In fact, the latest research shows that people who do not get enough sleep are more than twice as likely as others to die of heart disease. Try to avoid caffeine after noon, and develop a stress-free wind-down ritual before bed. Hint? Take a bath, and don’t pay your bills right before bed.