-by Dr. Bob Berger, MS, MVSc, PhD
“The only thing to fear is fearlessness”
…John Michael Stipe (R.E.M.)
Cardiovascular Disease is not just an ailment! It is an epidemic…
I won’t get into the stats…most health journal articles have already done that…but whatever we are doing about this problem is just not working very well, is it?!!!!
We always consider diet, exercise, reducing stress, sleeping properly, and yet…a combination of all these will work… if people would actually do them…but most won’t! Why?
Because most folks come up with every reason why they can’t do them!!!!
“I haven’t got time to exercise for 20 minutes, 3 times/week“…yet I do have time to sit on my butt for 3 hrs/night and stuff as many empty-calories into a body that now could be designated as a sovereign state!
Most of these people, although they can’t justify their actions, still deserve to be treated properly…medically, that is!
I look at the people who roll around grocery stores in those golf carts, and think…the only way to help them, (and their cardiovascular issues), is to do something that will allow “lipophilic, bioactive-molecules to get to the fat burning cells in their bodies“…because there is NO WAY IN HELL that any diet, exercise, (which at this point they couldn’t do anyway), nor proper sleep alone, is going to solve their problems…not at the stage these folks are at!!!! Although, it is impolite to say anything to them after looking at what they are purchasing and will soon be inhaling is mass quantities, all I can ask is; “do you want to play through?“
If these were overweight, or just regular obese folks…proper diet, exercise, sleep, counseling , etc…would probably work…if they were compliant!
The people I’m referring to would have to work like an undrafted, free-agent at an NFL Training Camp just to become obese!!!! Imagine what their cardiovascular systems look like!!!!
But many of these “Beyond Morbidly Obese” people began their lives being non-compliant…and now their cardiovascular systems, “imprisoned” inside their bodies, are completely out of control!!!!
Yes…we want everyone to be able to eat properly, exercise, have relationships, etc…but for the doctors, nutritionists, psychologists, psychiatrists, etc..to truly believe that some of these people could lose this kind of mass, while simultaneously, doing the physical things that appear so healthy…some of these health professionals must be in total denial themselves…apparently more so than their patients!
There are some health professionals who indeed [many times] appear to be poorly trained in metabolic science. And there are always some who would rather sweep the problems under the rug and advise their patients with the standard; “Well you see, taking my information from the “Harvard Study”, you must eat properly, exercise and think positively.”
Although most of these people have no idea what this person is talking about…(myself included)…it’s Ok, because the professional did his/her job and advised them of the “Harvard Study”…oh, of course, that study! Wasn’t that the one they started when T-Rex roamed the earth?!!!!
So…let’s look at modern science and realize that things are just not working and it’s time to get “metabolically” serious…
It appears that there are far too many people out there that think cardiovascular disease could never happen to them…did you ever go to an “All-You-Can-Eat” restaurant and check out some of the loyal patrons? You know what I am talking about!
These folks I am referring to are FEARLESS…and this, in itself, is scary. They will NOT eat correctly, they will NOT exercise (unless you count the numerous times they “sprint” to the buffet table), and proper sleep?…as they would say in Philly; “forget about it!”
In the cases of these “cardiovascular catastrophes” waiting to happen, their “fearlessness” is exactly the thing that should be feared!!!!
Besides being a hazard to themselves…and are they ever…many of these people put others in danger…
Here are just 5 examples why:
1. They drive cars…yes? The chances of them having a stroke or a “cardiac event” while “behind the wheel” is many times greater than that of non-morbidly obese people or those without a CV problem. They lose consciousness, and even if the “event” itself may not be fatal, they will most probably either die in the pile up and/or they will injure or kill other drivers and their and passengers…many of these being children!!!!
2. A friend of mine is an ER physician at the Hospital of Pennsylvania. He hates when a car accident, a cardiac event, a stroke, a gunshot case, a Code Blue, etc…comes in and involves morbidly obese “patients”. He said that the odds are always against them surviving…mostly due to “complications”, (as he puts it)! Making things worse… if an “exploratory” is required, he has trouble seeing “anything” through all the fatty tissue!
3. For the morbidly obese and/or CV-compromised person, it is not just about the heart and lungs…it’s about every organ, (i.e., the kidneys, the liver, the GI-tract, the urogenital system, etc…). Because fat (adipose tissue) has such poor circulation through it: compromised cardiovascular=compromised whole body! The kidneys, the liver, etc…all take a beating!!!!
Medical science depends a lot on organ donors…the organs of the folks we’re talking about here usually can’t be used because their malfunctioned, CV-systems usually have caused collateral damage to other organs that could have been used to save lives!
4. These people put fireman, policemen, EMT’s, and other “emergency” personnel at increased risk…”911″ calls are usually higher in areas where there is a greater populous of morbidly obese and CV-compromised people.
5. These folks all have increased incidences of Type II Diabetes, estrogen-driven cancers, (i.e., breast cancer…as fat holds estrogens in the body), poor immunity and wound healing, and other metabolic and organic diseases…besides the already present cardiovascular compromises…need I say more!!!!
So yes…we all should fear this fearless complacency!!!!
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OK…so here is where the “catch-22″ of scientific policy and the concept of Nanomedicine comes in…
Before discussing the above…please note that there are still many who believe, that even though, given the dangerous scenario of some of the people who have serious CV-compromises/disease conditions, and especially the ones who are morbidly obese, they can lose fat by simply cutting calories…but by doing this, they also run the risk of seriously threatening their health in so many ways.
To think that mere diet and exercise will even come close to helping many of these people is metabolically unfeasible!!!! Most of these people are too covertly sick and overtly obese to make any drastic dietary change and/or even begin an exercise program that makes any sense.
Unless these folks consume the number of calories that their bodies require [at this stage of where they are]…for starters…they would most probably become hypoglycemic, and quite ill. Doing otherwise would be comparable to attempting to propel an Arleigh Burke Class Naval destroyer with the fuel of a PT boat!!!!
Regardless of what some of the TV-Marketing, “Nutrition Guru’s” might tell you…this just won’t work…at least not very well.
So… some background info…
SIRT1: Also known as Sirtuin-Silent Matching Type Information Regulation 2 Homolog 1 or Nicotinamide Adenine dinucleotide (NAD)-dependent deacetylase Sirtuin-1.
SIRT1 is an enzyme that catalyses the removal of various acetyl groups from specific proteins which control cellular regulatory processes. [For our purposes, this is important for all metabolic functions which aid in the reduction of fat stores and control of longevity.]
Because SIRT1 is an important enzyme for longevity and lifespan, it is also linked to mitochondrial function…which in turn, is linked to the health of muscle tissue, muscle mass, and lean body tissue.
It appears that up-regulating SIRT1, which increases insulin sensitivity of the cells, and down-regulating SIRT1, which increases insulin resistance, (as what would be observed in Type II (NIDDM) diabetes), is important as far as longevity, since people with insulin resistance/diabetes have a greater chance of dying earlier in life than those who don’t have these issues. This also applies to those with and without CV health issues.
We also have to look at another important metabolic connector to this system; this is the PCG-1 {alpha} or Peroxisome Proliferator Activated Receptor Gamma Coactivator1-alpha system.
PCG-1a is a genetic transcription co-activator that regulates specific genes involved in energy metabolism. When SIRT1 binds to and thus activates PCG-1a through the deacetylation mechanism, it is this cascade that increases mitochondrial size and function in order to aid in lipolysis…(i.e., fat burning).
On paper, the above mechanism appears all well and good, but the body is not made of paper…and this is now where we should begin to look for some better answers!
“Nanotechnology is a multidisciplinary scientific field now undergoing explosive development”…this quote from; Sajja, HK, and East, MP, et. al., (2009) Development of multifunctional nanoparticles for targeted drug delivery and noninvasive imaging of therapeutic effect. Curr. Drug Discov. Technol., 63, 43. [Department of Surgery/Winship Cancer Institute, Emory University, School of Medicine, Atlanta, Ga.].
Nano- science/technology and delivery uses the laws of quantum chemistry and biophysics to deliver extremely small bio-molecules directly to the body in pre-determined, physiological concentrations in order to achieve optimal absorption and utilization; an “optimally Intelligent delivery system“.
These bio-molecules must be in the size range between 100-400 nanometers (nm). Anything larger than 400 nm would no longer be considered “nano”. [1nm=1 billionth of a meter]
Nanotechnology used in medicine=Nanomedicine
Now, this being said, I believe that it is important to understand that in order for the SIRT1 and the PGC-1a systems to work properly, and in tandem, (i.e., synergistically), just like most physiological systems, the body does require a “catalyst” or a “proactive” mechanism which will initiate the lipotrophic, (fat/lipid-burning), cascade…especially when considering the severely CV-compromised, morbidly obese, or the combination of the two.
One of the many ways that we can utilize both nanotechnology and the nano-delivery of a catalyst, is to initiate the entrance of specific enzymes, which can now be delivered by a protective “nanosphere/nanoenvelope” into the system, which will in itself, initiate a catalyst reaction.
There is an enzyme, carnitine acetyltransferase (CAT) (E.C 2.3.1.7) which is the primary catalyst which allows the lipotropic substance, L-carnitine, to attach to long-chain fatty acids and shuttle these LCFAs into the mitochondria of the cells where they are oxidized (burned) and utilized for energy. Once these “fats” are secured for fatty-acid oxidation, (i.e., β-oxidation)…the primary system which burns fats for energy), carnitine is transferred back out of the mitochondria to hook on to another LCFA.
The entire reaction can only takes place if CAT is present and active.
The concept here is to deliver this enzyme to the source, which could not be done in any way other than through a nanotechnological variance, as this enzyme, (like all others), would be inactivated by attempting to deliver it in any other way. The fact that a protected sphere or envelope would not only protect the enzyme but would also deliver it to a specified site, is something of physiological as well as metabolic importance.
Just as the right diet, various metabolic drugs and or stimulating supplements, specific forms of exercise, shocking the body to initiate change, etc…stimulating internal/cellular fat oxidation will also initiate what is known as lipolysis.
Lipolysis, (the mechanism where fat cells are burned for energy and the stimulation of this mechanism), would most definitely be initiated if internal/cellular stimulation were present through positive-feedback mechanisms which our bodies are based on. In this particular case, the CAT enzyme could actually be initiating an internal metabolic reversal, which once in motion, exercise, diet, and then appropriate caloric reduction could then take place and most notably make a significant difference.
Now with the nonotechnology wheels in full motion, and a system that has now truly been metabolically regulated to burn fat, systems such as the SIRT1 and PCG-1a will be more adept to “doing what they do”.
Thus…these types of processes are the determinant factors to becoming a “fat-burning entity”.
These are the types of metabolic processes that need to be considered and they must be backed by NEW science, and not the stuff that has never worked…and will never work!!!!
A great published paper on the use of nanotechnology and CV health is; Plourde, NM and Kortagere, S. (2009) Structure-activity relations of nanolipoblockers with the artherogenic domain of human macrophage scavenger receptor A. Biomacromolecules, 10, 1381. [Rutgers University]…”A new tactic in the fight against cardiovascular disease is to employ very small molecules (“nanolipoblockers”) as guards against harmful cholesterol (LDL/VLDLs)”
And…there are many more…
Once again, if “Scientific Policy” is followed, we need to look to new and modern technologies and scientific avenues in order to defeat old enemies that have appeared to get the better of us and our overall health…much of this due to our own complacency. Being fearless is good in many cases, but not in the health field…I personally believe that if we do not accept the use of new technology and remain fearless about the future, we will be one day soon be in for a rude-awakening!!!!
-fin-