I have been fortunate to work with American
Indians in the USA. Because of their uniqueness, I tried to learn as much of
their history and culture as possible. Jokingly my teacher once said: What a
pity, you are not smart enough to learn everything we can teach you.
A good lesson in HUMILITY, it was!
From the beginning I wondered: why is that
a population that was all LEAN, was now all overweight. In a book published in
1908, after doing anthropometric studies among various tribes, Ales Hrdlicka,
considered father of American Physical Anthropology, emphatically stated:
Pathological Obesity does not exist.
If a certain percentage of the population
becomes overweight or obese as has happened in rapidly developing economies of
late, BRIC countries are an example: Brasil, Indian, China and South Africa, we
could blame it on indiscretion on those affected. But when it comes to American
Indians, they are unique; perhaps another Native group such as Australian
Aboriginals face a similar problem, in that over 90 per cent of the Indians are
either overweight or obese.
I enjoyed talking to many of the older
people, during my early days with the Indians, and all of them said, that as
late as the 1950s, overweight and obesity was uncommon.
Another startling fact to learn was the
dramatic changes in the nutrition of the American Indians. I can think of no
other group, perhaps Australian Aboriginals could be included here, which had
undergone such a dramatic CHANGES in nutrition. During the Second World War in
Europe and during the Pol Pot/Khmer Rouge regime in Cambodia, there was
malnutrition but not a complete substitution of ones natural food for the
manufactured food of another culture, as happened to the American Indians
following the institution of Reservation System.
Wouldn't a dramatic change in the
nutrition/ingredients have some dent in the metabolism of these ancient people?
Who can claim to be older than the American Indians when it comes to continuous
inhabitation of the land they call Turtle Island.
During a visit to Melbourne, I had a chance
to discuss these matters with an Endocrinologist who had a keen interest and
eye for such matters. He was the one who told me that the hepatic glucose
output among the Australian aboriginals was not controlled by Insulin. Later on
when I became an anthropologist I was to understand the significance of his
statement.
A leading Nutritionist had published some
work suggesting that Native people eating their tradition foods were protected
against higher levels of postprandial glucose excursions and Insulin levels.
Long before I became interested in such
matters, long before I dreamt of being a doctor, I had noticed that certain
foods satisfied me more than the others. Even though I was living in Australia
at that time, I am of Asian origin and I remember enjoying Greek Food, which
suited me more than the Australian steak and potato diet or creamy pastas of
the Italian migrants. So it was easier
for me to accept the theory of Mediterranean diet, which became popular decades
later.
Could it be possible that the sudden and
dramatic changes in nutritional components presented to these ancient people,
elicited a reaction from their metabolism, which became detrimental to them,
leading them towards Obesity, Diabetes and other chronic diseases of the
Western Civilization?
In the last few years, there has been
tremendous interest in the micro biome of the gut, the paying passengers in our
intestinal tract.
I began to feel that the alteration of
these beneficial bacteria and other matters, resulted in many of the chronic
diseases that began to appear among the Indigenous peoples: Auto immune
diseases, endocrine related cancers such as Breast Cancer, and of course
Obesity.
And perhaps manipulation of the very same
would be the treatment of the future, as has been shown in Gastro Jejunal
Bypass surgery in which many of the Chronic Diseases are shown to disappear
even before there is any great difference in the weight of the person.
So it was with great pleasure and
excitement I read a paper published this week in the Journal of Clinical
Endocrinology and Metabolism, the flagship journal of our professional society,
The Endocrine Society.
Methane and Hydrogen Positivity on Breath Test
Is Associated With Greater Body Mass Index and Body Fat
Division of
Endocrinology, Diabetes, and Metabolism (R.M.), GI Motility Program (M.A.,
K.S.C., G.M.B., M.P.), and Biostatistics Core (J.M.), Research Institute,
Cedars-Sinai Medical Center, Los Angeles, California 90048
Abstract
Context: Colonization
of the gastrointestinal tract with methanogenic
archaea (methanogens) significantly affects host metabolism and weight gain
in animal models, and breath methane is associated with a greater body mass
index (BMI) among obese human subjects.
Objective: The
objective of the study was to characterize the relationship between methane and
hydrogen on breath test (as a surrogate for colonization with the hydrogen
requiring methanogen, Methanobrevibacter smithii), body weight, and
percent body fat in a general population cohort.
Design and Subjects: This was a prospective study (n = 792) of consecutive
subjects presenting for breath testing.
Setting: The
study was conducted at a tertiary care center.
Outcome Measurements: BMI and percent body fat were measured.
Conclusions: The presence of both methane and hydrogen on breath
testing is associated with increased BMI and percent body fat in humans. We
hypothesize that this is due to colonization with the hydrogen-requiring M smithii, which affects nutrient availability for the
host and may contribute to weight gain.
(Highlighting
done by me, and not the authors)
Methanogens
are a type of microorganism, to differentiate them from bacteria that produce
methane as a by-product of metabolism. We normally associate methane gas
production in swamps, bogs and wetland. Cows and humans also harbor methanogen
in their guts, they are classified as Archaea. Methanobrevibacter smithii is
the prominent methanogen in the human gut, where it helps digest
polysaccharides or complex sugars. They are strictly anaerobes, in that they do
not require oxygen, in some cases cannot even survive in its presence.
At this
stage, I though to myself, American Indians were very healthy when the
Europeans arrived in their continent. Their way of life and with it eating
patterns and ingredients, hunting and gathering, disappeared and were replaced
by artificial foods and ingredients.
This
certainly must have had a tremendous influence on the metabolism of the
bacteria and archiae inhabiting their guts. It is of greatest interest to note
that American Indians became overweight and obese long before their European
North American Counterparts caught up with them.
Was there a
chemical connection? What did they put in that artificial food which they gave
to the Indians in the Reservations in the early part of the last century that
now is commonly consumed by all the Americans?
Is there is
anything in our modern nutrition that can be shown to alter the behaviour of
the micro flora of our guts?
It did not
take me too long before I came across the following information.
Oleic acid, an 18 carbon acid with one double bond (C18 : 1) was
degraded anaerobically to palmitic (C16 : 0) and myristic
(C14 : 0) acid by-products at 21°C by a culture unacclimated to long-chain fatty acids. These by-products were
degraded to acetate and ultimately to methane. In comparison, no long-chain
fatty acid by-products were observed in unacclimated
anaerobic cultures receiving stearic (C18 : 0)
acid although slow removal of stearic acid occurred. Oleic acid concentrations above 30 mg l–1 inhibited acetate degradation but stearic
acid up to 100 mg l–1 did not
inhibit aceticlastic methanogenesis. Hydrogenotrophic methanogenesis was
slightly inhibited by oleic and stearic acids. A thermodynamic basis for
comparing anaerobic C18 acid degradation and predicting by-products is
presented.
Anaerobic degradation and
methanogenic inhibitory effects of oleic and stearic acids
·
1 Department of Biosystems and Agricultural Engineering, Oklahoma
State University, 218 Ag Hall, Stillwater, OK 74078-6021, USA
·
2 Department of Civil Engineering, University of Toronto, 35 St.
George Street, Toronto, ONT., Canada M5S 1A4
We have two pieces of scientific information here.
High Oleic and Low stearic Acid can be beneficial in the methanogenesis. And
secondly, methanogenesis seems to be correlated to Obesity in a current general
population.
It does not take much imagination to understand
that the complete conversion of food from a natural state to an artificial
state that has taken place since the industrialization of food production in
America, the most overweight of all nations.
Now we read about Oleic Acid and Stearic Acid,
there is a resonance between their presence and absence and the sound nutritional
advice given to our patients now. Just see what food is high in Oleic Acid that
we should use more of (such as Olive Oil) and the high stearic acid foods we
should avoid (Fatty meat, White Chocolate etc.) and adopt low stearic acid
foods (rice paddy gruel, lactic acid bacilli etc.).
Oleic
acid is a monounsaturated fatty acid found naturally in many plant sources and
animal products. It is an omega-9 fatty acid, and as
such is considered one of the healthier sources of fat in the diet. Health
experts often recommend using it in cooking, and a number of so-called health
foods and diet products will use this compound in place of animal fats.
Where It’s Found
One of the chief sources of
this acid in foods is olive oil. Whole olives also contain the compound, but
typically only in trace amounts. When pressed and drained together, however,
the olives' acid levels are combined, leading to high concentrations in most
cases. Canola and grapeseed oil also contain oleic acid.
Many nuts and seeds contain
the fat as well, and it can also also be found readily in most poultry,
particularly chicken and turkey. Isolating it from animal sources is often
somewhat challenging, however. While vegetables and nuts usually contain oleic
acid as the primary fat, most meats contain a combination of both saturated and
monounsaturated elements.
Oleic
acid has the molecular formula C18H34O2 and
is usually found trapped in triglycerides, which are lipids closely connected to
oil secretion and production. Blood triglycerides help the liver isolate fat
and glucose, and are often responsible
for the secretion of skin oils. In vegetables and plants, they occur as a means
of providing nutrition and sustenance. Scientists sometimes isolate oleic acid
from triglycerides in order to conduct health research, but most of the time,
the compound is sought after for its health benefits.
Health Benefits
oleic acid is one of the better fats for humans to consume.
It can lower total cholesterol levels by raising
blood concentrations of high-density lipoproteins while reducing low-density
lipoproteins, also known as the “bad” cholesterol. It has been shown to slow
the development of heart disease and also promotes the production of antioxidants, elements that can help
trap harmful free radicals in the body.
Nutrition and
pharmaceutical therapies are moving away from Calories, fats and carbohydrates
and proteins to quality of what we eat and how it secondarily impacts our metabolism,
thus we would have new means to decrease this damage to ourselves.
Medical
knowledge is advancing rapidly, but the practice always lags behind by about
ten years. One of the advantages of working with a group of indigenous people
is that we can culturally enforce our decisions to treat and prevent diseases
which cultural contacts with our civilizations gave it to them.
Stearic Acid.
Oleic Acid, Cooking Oils myths about Omega 6 all are in the right direction.
The future nutritional counseling would be done by anthropologically trained
nutritionists, they would know more about culture than macro ingredients, such
as why shouldn't a Hindu not begin consuming beef on his arrival in the USA.
This would also
answer many health related questions, which has a cultural basis to it:
Why do Khmer
people have such high rate of Diabetes? Why so many of them require Insulin but
it is not necessary for their survival?
Why do East
Indians die 15 years earlier when they migrate to the West?
Why do Diaspora
Africans have high rates of Blood Pressure compared to their countries of
origin?
In the future,
treatment of a chronic disease such as Diabetes, will be done not by Physicians
but people who have a global understanding of the patient, society, culture and
physiology. There would not be disappointed professors who express their dismay
that FDA has denied permission for newer insulins or continue to promote
medications that cause damage to the patient, such as Pancreatitis or Cancer! The
newer medications for treatment of Type 2 Diabetes, the so called Incretin
mimetics, work on the assumption that there is a hormone secreted by the Gastro
Intestinal Tract.. I am sure there is more to this story!
During my first
week with the Meskwakia, Dr B, the clinic nurse who was to become my teacher,
said to me: They poisoned us… the significance of it is slowly beginning to
seep in.
