Tuesday, April 13, 2010

"Tell your doctor his chemistry is wrong, cholesterol and fat are not made from sugar..."

Really? You mean I have it all wrong?

This was a statement said to me by a patient who told his sister to check out my videos (or book, he wasn't sure which one she saw or read); and that was her comment back to him. I would have no problem if this statement was uttered by a layperson, but it turns out she happens to be a pediatrician. This frightened me because as a pediatrician she obviously sees children and if she does not understand the basics of biochemistry she cannot tell the parents the correct way their children should be eating.

Does this scare anyone? It scares the crap out of me and is the reason I so titled my book the way I did.

We have a childhood obesity pandemic, we are seeing diseases we only saw in adults now in children under 10; and this will never change until we start teaching our medical students the correct biochemical approach to eating. We doctors are not the solution, we are the problem and are making it worse.

As I am writing this my Nurse Practitioner saw what I was writing and stated "Well, that makes for an interesting debate?" But I propose that there is no debate. I am dealing with the facts of nutritional biochemistry. It's like debating that 1+1 is not 2, it could be 3 or even 4. Any doctor, nutritionist, or dietitian who thinks that cholesterol and fat production does not start with simple sugars (glucose, fructose) has forgotten their basic foundational biochemistry, period.

You see, it starts with a process called glycolysis which yields a molecule called Acetyl Co A. Turns out, Acetyl CoA is a pivotal biomolecule and can be the starting point for both cholestrol and fat production. Anybody reading this can type in 'glycolysis' in any search box and see the pathway yourself.Then type in Acetyl CoA and see what hits you get. Then review the pathway for cholesterol synthesis and notice what molecule starts the whole process. That's right, Acetyl CoA.

A few weeks ago a good friend of mine Greg e-mailed me because he got into a discussion with a biochemist who told him that cholesterol and fat production does not start with simple sugars. The biochemist, being skeptical not cynical, told Greg he would do a little research and get back to him with his results. After he did his research he notified Greg and stated that he, the biochemist, was wrong and that Greg was indeed correct. The glaringly obvious point is that here's a biochemist who wasn't trained the correct way, even though he studied all the pathways, it just wasn't tied together for him; he had to do that for himself after his 'official' training.

Make no mistake about it, cholesterol and fat production starts with simple sugars. If you do not understand or want to debate me, you are part of the problem, not the solution and you should not be educating people on the correct way to eat!

dr jim 'the shock doc'


  1. Bravo! I agree that we need to get people out of zombie mode and entice them to look into the facts for themselves, instead of arguing about it when they have no clue. Looking for answers myself is what started me on my low-carb journey 9 years ago.

  2. I don't pay too much attention to my carbs, but I try to use real food,shop along the outside edge of the store without going into the prepackaged sodium laden meals, cook all my meals at home, use more veggies than meat. So far my kids aren't fat.

  3. You say, "Make no mistake about it, cholesterol and fat production starts with simple sugars."

    While that's true, it's also true that beta oxidation of fatty acids produces acetyl coA. Are you saying that simple sugars are the only precursors that can be used to form cholesterol and fat?

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  5. Hi stargazey!

    No, I am not saying that 'only' simple sugars can create cholesterol and fat. Precursors can also be glucogenic amino acids and the glycerol backbone of triglycerides. My point is that we need to remember that simple sugars can indeed be the starting point for cholesterol and fat biosynthesis, and these simple sugars will come from our complex carbohydrate consumption.

    You're correct, beta-oxidation creates Acetyl Co A, which can be the starting point for cholesterol and fat production. But do not forget that if the cell is in beta-oxidation mode, there will be a relative increase in glucagon over insulin so the cellular signals will be in favor of shuttling the Acetyl Co A into the Kreb's cycle, then oxidative phosphorylation with the end result the creation of ATP :-)

  6. Are you sure you have this right? HMG-CoA reductase is the rate-limiting step in the synthesis of cholesterol. HMG-CoA reductase is phosphorylated and inactivated on its Serine 872 by an AMP-activated protein kinase. If the cell is in oxidative phosphorylation mode, AMP will be in short supply. That means that HMG-CoA reductase will not be phosphorylated and the synthesis of cholesterol from acetyl-CoA will NOT be inhibited.

  7. Be more concerned about whether your kids get too many grains in their diets than about whether they get more veggies than meat. I'm suspicious that the whole notion of veggies being some miraculous health food is little more than myth. Barry Groves in the UK pointed out that the serving recommendations for plant foods differ between the U.S. and the UK; if these recommendations were based in science, both nations should be recommending the same serving sizes and the same number of servings a day.

    The American diet used to be very meat-heavy, yet we had a lot less obesity then than we do now. Way less diabetes too. Not sure about heart disease, that one was less likely to be diagnosed until the early 20th when heart disease became something of a medical fad.

  8. @stargazey Why would AMP be low? I'm not an expert in biochemistry and I'd love to understand this better. I found a study that says AMP is created inside the mitochondria of the cell, not derived from cytoplasmic sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684673/