Reverse aging by manipulating your own hormones for maximum growth hormone production.

Subject: 1) flaxseed oil versus Udo's Choice mixed oil supplement 2) medium chain triglyceride 3) an open letter from Rob to Dr. Udo Erasmus

ROB SAYS:

The "good fat" prescription is a very important aspect of the NHE Eating Plan (see Chapter 18), and I've received many letters from individuals asking for specific advice about dietary fat supplementation. I will now accommodate that request.

One of the reasons why fats are so important is that cholesterol (not technically a fat, but can be synthesized from fat and is present in the same foods as fat, i.e., animal) is used by the body to make steroid hormones. "Steroid" refers to chemical structure. Sex hormones are steroid hormones, and levels of these hormones are influenced by fat intake (see NHE, "Dietary Influences on Testosterone," p. 329-331). This explains why extreme dietary fat restriction is associated with arrested muscular development and low sex drive. Furthermore, essential fatty acids are used to make eicosanoids. Eicosanoids are paracrine and autocrine hormones, which unlike the endocrine hormones that NHE deals with, do not travel via the bloodstream to target tissues but rather work on a cell-to-cell basis. In addition to impacting upon sex hormones and eicosanoids, one type of fat, omega 3, affects insulin sensitivity (see NHE p. 178). Moreover, not only is dietary fat a precursor of hormones, but fascinating new research disclosed on p. 171 of NHE shows that fat can, itself, act as a hormone!

In NHE, I discussed flaxseed oil; and, taking issue with both Dr. Barry Sears and Dr.s Michael and Mary Dan Eades, I recommended it. (Eades and Eades, to their credit, have since reversed their anti-flax position.) However, I now believe that a mixed oil supplement called Udo's Choice is even better. ("Udo" is Dr. Udo Erasmus, the creator of the product. I commented on Dr. Erasmus and his book, Fats that Heal, Fats that Kill, in an earlier Ask Rob posting.) Udo's Choice and is produced organically, and contains a better balance of omega 3 to omega 6 fatty acids than does flaxseed oil.

Another advantage of Udo's Choice over flaxseed oil is that the former contains gamma linolenic acid (GLA). GLA is the "activated" form of omega 6 fatty acids. Unless omega 6 fatty acids are converted to GLA, they can't go through the production pipeline leading to eicosanoids and they are of little biological value. Similarly, unless omega 3 fatty acids are converted to stearidonic acid (SDA) they can't be converted to EPA, the precursor of the "good" series-3 prostaglandins (prostaglandins are a subset of eicosanoids). The enzyme responsible for catalyzing both of these conversions is delta 6 desaturase. As I point-out in NHE, delta 6 desaturase activity declines with advancing age. Other factors that can inhibit delta 6 desaturase activity are stress and trans fatty acids. Furthermore, delta 6 desaturase operates preferentially to convert omega 3 to SDA as opposed to omega 6 to GLA. Therefore, supplementation of GLA serves as insurance for those consuming a diet high in omega 3 fatty acids. GLA also serves as insurance for those who may not be consuming enough omega 3, because GLA can "pinch hit" for omega 3 fatty acids (i.e., fulfill some of its functions). Unfortunately, there's only one commonly eaten food that contains GLA (in trace amount): oatmeal. The other sources are evening primrose oil, black currant oil, borage seed oil, and human breast milk. Breast milk is the richest, but there are complexities to obtaining it from this source.

GLA is the "activated" form of essential fatty acids. Unless essential fatty acids are converted to GLA, they can't go through the production pipeline leading to eicosanoids and they are of little biological value.

Another nutritional component of Udo's Choice not found in flaxseed oil is medium chain triglyceride (MCT). This initially gave me pause (see below), because I had come across negative information about MCT. Ultimately, I resolved my concerns and, based on my research, I concluded that MCT is a worthy supplement.

Because I cherish the trust of my readers and feel a duty never to disappoint their high expectations of me, I will not issue an endorsement unless I have thoroughly investigated the subject. Reprinted below is a letter dated March 14, 2001 that I wrote to Udo Erasmus's organization. In addition to disclosing my findings concerning medium chain triglyceride, this letter shows the investigatory process through which I arrived at my decision to endorse Udo's Choice.

From: Rob Faigin

March 14, 2001

Dear Dr. Erasmus,

First, I wish to compliment you on your assistant, Usha. My associates and I have had occasion to correspond with her several times during the last few months. She has impressed me with her enthusiasm and efficiency.

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Dr. Udo Erasmus

I am the author of Natural Hormonal Enhancement, a book that addresses how to modulate beneficially the hormones that we unknowingly influence every day. NHE embodies a comprehensive approach to health and fitness, encompassing diet, exercise, and lifestyle. As an avid reader of yours, I know that you subscribe wholeheartedly to the central tenet of NHE that only a holistic and integrated, natural approach to human wellness can yield optimal results.

The purpose of this letter is to discuss two unrelated topics: 1) your reviewing my book, and 2) my endorsing Udo's Choice to my current and future readers.

Your Reviewing My Book

As one can readily detect from NHE, I harbor a generally cynical view of the health and fitness industry. At the same time, I am exceedingly conscientious about recognizing the exceptions and giving credit where due. One example of this is my remarks about you and your book on my website (see the "Ask Rob" section of www.extique.com).

Because I respect you, I value your opinion of my work. Accordingly, I ask that you read my book and evaluate it. In this connection, Usha has informed me that you are extremely busy. I would expect nothing less from someone who is in a position to influence positively the health of millions of people, and who passionately aspires to do so. If anyone can relate to the oppressiveness of your schedule, a first-time author can who works 14 hours a day to promote his book, answer reader questions, and research and develop new informational products. I imagine that I am in a position similar to your position in 1987 when Fats and Oils, the forerunner to your current book, was first printed. I can only hope that years from now hindsight affirms this analogy.

As one who has written a health book of encyclopedic breadth and seminal significance, you can relate to the awesome and spiritual experience that writing a book can represent. However insignificant in the scope of human events, Natural Hormonal Enhancement is my contribution to society. Only a fellow author can fully appreciate this sentiment. And only a health author can see a book as its author's non-biological progeny capable of affecting the biology of others.

However insignificant in the scope of human events, Natural Hormonal Enhancement is my contribution to society. Only a fellow author can fully appreciate this sentiment. And only a health author can see a book as its author's non-biological progeny capable of affecting the biology of others.

If your opinion of my book proves favorable, I will feel proud and inspired. If your opinion of my book proves unfavorable, I will endeavor to utilize your criticisms constructively. Please respond by indicating whether you intend to read Natural Hormonal Enhancement (or have already read it); and if so, whether you intend to write an evaluation/review; and if so, approximately when I can expect to receive such an evaluation/review.

My Endorsing Udo's Choice

Chapter 18 of Natural Hormonal Enhancement is titled, "Using Dietary Fat to Burn Bodyfat" - a catchy phrase that expresses the point, still disorienting to many despite your unstinting efforts to enlighten them, that consumption of certain kinds of fat can facilitate fat loss. This is a "sequel" to Chapter 8, "You Broil, Never Fry, But You've Been Living a Lie" - a phrase not intended to imply that frying is good, but rather to proclaim provocatively the prevalence of misinformation concerning fat. Collectively, these chapters seek to: 1) impress upon the reader that fat is not necessarily unhealthy or fattening, 2) explain that the physiological fate of ingested fat is influenced by the overall diet and the prevailing hormonal milieu, and 3) identify and define "good fats" and urge their consumption as a means to improve physique and health.

My exhortation in NHE to consume "good fat" in moderate quantity has prompted a predictable clamor of requests for a recommendation of a "good fat" dietary supplement. Intent on accommodating my readers, I asked my associate to procure information from your company about Udo's Choice. In response, Usha sent information and directed us to your website. After availing myself of both sources, I wrote to Usha on November 30, 2000. Following is an excerpt of that letter.

I have reviewed the material you sent, and explored your website. Based on the information, I am going to hold off on endorsing Udo's Choice until I have had an opportunity to confer with Dr. Erasmus concerning medium chain triglycerides. Specifically, there is information suggesting that the implications of medium chain triglycerides, in terms of fat burning, may be less favorable in the context of a reduced carbohydrate diet as opposed to a diet rich in carbohydrate (due, purportedly, to preferential utilization of medium chain triglyceride at the expense of long-chain-triglyceride oxidation). Your father is, in my view, the foremost authority on the subject of fats and oils. Therefore, I will accord great deference to his statement on this matter. Nonetheless, I take my duty to my readers very seriously. My readers act or refrain from acting based on my pronouncements. Thus, I am obligated to investigate thoroughly before issuing an endorsement.

"The information suggesting that . . . " to which my letter to Usha refers essentially consists of arguments to this effect advanced by Mauro Di Pasquale, M.D., in two of his books: The Anabolic Diet and Supplement Review. While I deeply respect Dr. Di Pasquale, I accept no man's statement as gospel. Furthermore, in the interest of practicing what I preach on p. v, "Note from the Author," of NHE, I shall never abdicate my responsibility to "sort through the ocean of often contradictory health information . . . " for this is "a duty from which we must never shrink." Moreover, through my years of research and discovery, I have learned that many an intellectually appealing theory founded on a plausible physiological mechanism cannot withstand scrutiny and testing. Accordingly, I undertook to ascertain whether Dr. Di Pasquale's contentions, ascribing to MCT an antagonistic effect on long-chain fatty acid oxidation that is more significantly manifested when carbohydrate consumption is restricted, were valid.

While I deeply respect Dr. Di Pasquale, I accept no man's statement as gospel.

. . . through my years of research and discovery, I have learned that many an intellectually appealing theory founded on a plausible physiological mechanism cannot withstand scrutiny and testing.

I have concluded that Dr. Di Pasquale's theory lacks merit. Contrary to Dr. Di Pasquale's assertions, my research leads me to infer that not only is it unlikely that provision of MCT in the diet will impede fat burning, it is likely to promote it. Stated more precisely, I conclude that isocaloric substitution of MCT for LCT transiently increases fat oxidation and metabolic rate and this outcome is not dependent upon the macronutrient composition of the diet.^1,2,3,4,5,6 (However, evidence suggests that with continued feeding of MCT this effect is blunted or nullified by compensatory mechanisms.^7,8) MCT may also indirectly foster fat loss by reducing appetite^9,10 (which I find interesting given evidence showing that, unlike LCT, MCT does not slow gastric emptying¹¹).

. . . my research leads me to infer that not only is it unlikely that provision of MCT in the diet will impede fat burning, it is likely to promote it.

I have long been aware that MCT is converted into energy more readily than triglyceride containing fatty acid chains of greater than 14 carbon atoms due to: 1) more efficient absorption in the intestines, 2) direct transport to the liver via the portal vein, 3) easier passage into the mitochondria due to non-dependence upon carnitine for transport across the mitochondrial membrane (but I recently learned that carnitine plays a role in MCT metabolism in infants^12,13). Notwithstanding my appreciation of these facts, I found Dr. Di Pasquale's countervailing proposition attractive because, to the extent that MCT is preferentially utilized, a disparate impact of MCT supplementation on fat burning in a carbohydrate-rich/lower-fat versus a carbohydrate-restricted/higher-fat diet can be reasonably postulated. The mechanism of action posited by Dr. Di Pasquale is that MCT hampers adaptation to a higher-fat diet by providing a competing substrate. Tantalizing though it may be, this line of conjecture finds not refuge but rather refutation in the scientific literature I have reviewed.

The mechanism of action posited by Dr. Di Pasquale is that MCT hampers adaptation to a higher-fat diet by providing a competing substrate. Tantalizing though it may be, this line of conjecture finds not refuge but rather refutation in the scientific literature I have reviewed.

The next step in my investigation is to solicit the opinion of the person whom I regard as the foremost authority on the subject of fats and oils. If you affirm my conclusion, then I will feel that I have responsibly discharged my duty to my readers. And I will, on the combined strength of my carefully drawn inferences and your sage judgment, confidently endorse Udo's Choice to my readers. My endorsement will include mention of this product on my website. If, however, rather than affirming you contradict my conclusion, I will refrain from endorsing Udo's Choice pending further research. Ultimately, I will decide whether or not to endorse Udo's Choice based all the relevant information, including your opinion to which I will accord great weight. Incidentally, I am aware of other physiological implications of MCT consumption, but because I deem them mainly favorable they would not deter me from endorsing Udo's Choice. (Specifically, MCT supplementation has been shown to improve nitrogen balance^14,15,16and may have useful applications in the treatment of cancer.^{17,18,19,20,21} In the other direction, cautionary evidence exists warranting further investigation of the impact of chronic MCT consumption on blood lipids levels.^22,23,24,25)

While you have made no such offer, I must peremptorily disavow any form of reciprocal consideration, monetary or otherwise, in order to preserve my objectivity and credibility. In particular, the content of your evaluation/review of NHE, or even your unwillingness to read my book, will not influence my decision whether to recommend Udo's Choice nor the vigor with which I advance such a recommendation. Rather, I am considering endorsing your product to facilitate NHE-reader compliance with NHE's vital "good fat" prescription. Therefore, though I would be sadly disappointed if you were to turn a deaf ear to my entreaties and brush aside my work, personal considerations are irrelevant where the welfare of my readers is concerned.

In closing, you are among a small handful of health writers who have positively inspired me. (Many have negatively inspired me, meaning that they galvanized my determination to combat health misinformation by their contribution to it.) Though I am merely one of thousands of your beneficiaries, I differ from the legions of others moved by your work in one critical respect. I have managed to produce a work that is, itself, a source of inspiration for many. Indeed, the inspiration and knowledge conveyed via the written word can be transmitted from one open mind to another, igniting the imagination and compelling worthy action, ad infinitum. As authors, it is well for us always to remain mindful of this fact.

Thank you for your time and attention. I wish you the best of health, success, and happiness.

Sincerely yours,

Rob Faigin

. . . you are among a small handful of health writers who have positively inspired me. (Many have negatively inspired me, meaning that they galvanized my determination to combat health misinformation by their contribution to it.)

. . . the inspiration and knowledge conveyed via the written word can be transmitted from one open mind to another, igniting the imagination and compelling worthy action, ad infinitum.

1. Papamandjaris AA, MacDougall DE, Jones PJ. Medium Chain Fatty Acid Metabolism and Energy Expenditure: Obesity Treatment Implications. Life Sci 1998;62:1203.

2. Bray GA, Lee M, Bray TL. Weight Gain of Rats Fed Medium-Chain Triglycerides is Less Than Rats Fed Long-Chain Triglycerides. Int J Obes 1980;4:27.

3. Geliebter A, et al. Overfeeding with Medium-Chain Triglyceride Diet Results in Diminished Deposition of Fat. Am J Clin Nutr 1983;37:1.

4. Papamandjaris AA, et al. Endogenous Fat Oxidation during Medium Chain Versus Long Chain Triglyceride Feeding in Healthy Women. Int J Obes Relat Metab Disord 2000;24:1158.

5. Matsuo T, et al. The Thermic Effect is Greater for Structured Medium- and Long-Chain Triacylglycerols Versus Long-Chain Triacylglycerols in Healthy Young Women. Metabolism 2001;50:125.

6. Lai H, Chen W. Effects of Medium-Chain and Long-Chain Triacylglycerols in Pediatric Surgical Patients. Nutrition 2000;16:401.

7. Papamandjaris AA, White MD, Jones PJ. Components of Total Energy Expenditure in Healthy Young Women are Not Affected after 14 Days of Feeding with Medium-Versus Long-Chain Triglycerides. Obes Res 1999;7:273.

8. White MD, Papamandjaris AA, Jones PJ. Enhanced Postprandial Energy Expenditure with Medium-Chain Fatty Acid Feeding is Attenuated after 14 D in Premenopausal Women. Int J Obes Relat Metab Disord 2000;24:1158.

9. Van Wymelbeke V, et al. Influence of Medium-Chain and Long-Chain Triacylglycerols on the Control of Food Intake in Men. Am J Clin Nutr 1998;68:226.

10. Stubbs RJ, Harbron CG. Covert Manipulation of the Ratio of Medium- to Long-Chain Triglycerides in Isoenergetically Dense Diets: Effect on Food Intake in Ad Libitum Feeding Men. Int J Obes Relat Metab Disord 1996;20:435.

11. Beckers EJ, et al. Gastric Emptying of Carbohydrate--Medium Chain Triglyceride Suspensions at Rest. Int J Sports Med 1992;13:581.

12. Labadaridis J, et al. Carnitine Supplementation and Ketogenesis by Small-For-Date Neonates on Medium-and Long-Chain Fatty Acid Formulae. Biol Neonate 2000;77:25.

13. Rebouche CJ, Panagides DD, Nelson SE. Role of Carnitine in Utilization of Dietary Medium-Chain Triglycerides by Term Infants. Am J Clin Nutr 1990;52:820.

14. Lindgren BF, et al. Nitrogen Sparing Effect of Structured Triglycerides Containing Both Medium-and Long-Chain Fatty Acids in Critically Ill Patients; A Double Blind Randomized Controlled Trial. Clin Nutr 2001;20:43.

15. See, supra, note 6.

16. Tisdale MJ, Brennan RA. A Comparison of Long-Chain Triglycerides and Medium-Chain Triglycerides on Weight Loss and Tumour Size in a Cachexia Model. Br J Cancer 1988;58:580.

17. Kimoto Y, et al. Antitumor Effect of Medium-Chain Triglyceride and its Influence on the Self-Defense System of the Body. Cancer Detect Prev 1998;22:219.

18. Nebeling LC, Lerner E. Implementing a Ketogenic Diet Based on Medium-Chain Triglyceride Oil in Pediatric Patients with Cancer. J Am Diet Assoc 1995;95:693.

19. Wolters U, et al. Influence of Various Fatty Acids on Tumour Growth in Total Parenteral Nutrition. Eur Surg Res 1994;26:288.

20. Cohen LA, Thompson DO. The Influence of Dietary Medium Chain Triglycerides on Rat Mammary Tumor Development. Lipids 1987;22:455.

21. See, supra, note 16.

22. Asakura L, et al. Dietary Medium-Chain Triacylglycerol Prevents the Postprandial Rise of Plasma Triacylglycerols but Induces Hypercholesterolemia in Primary Hypertriglyceridemic Subjects. Am J Clin Nutr 2000;71:701.

23. Kern M, et al. The Effect of Medium-Chain Triacylglycerols on the Blood Lipid Profile of Male Endurance Runners. J Nutr Biochem 2000;11:288.

24. Hill JO, et al. Changes in Blood Lipids during Six Days of Overfeeding with Medium or Long Chain Triglycerides. J Lipid Res 1990;31:407–16

25. Swift LL, et al. Plasma Lipids and Lipoproteins during 6 D of Maintenance Feeding with Long-Chain, Medium-Chain, and Mixed-Chain Triglycerides. Am J Clin Nutr 1992;56:881–6.

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