The Methuselah Foundation Blog

April 18, 2011

Sugar - The Sweetness That Stings

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Photo Illustration by Kenji Aoki for The New York Times; Prop Stylist: Nell Tivnan. Source: U.S.D.A. 2009 Estimates

With the average American consuming 2 to 3 pounds of sugar weekly, it's not a shocker that 62% of adults and 34% of children in the U.S. today are overweight or obese. Sugar consumption has drastically escalated from 26 pounds per person per year to a massive 135 pounds just in the past twenty years. Now the obesity epidemic has reached the far corners of the earth. Japan, China, Korea, Australia, and throughout Europe--countries where some of the oldest, healthiest people of the world reside--are now experiencing their own overwhelming surges of obese and overweight populations.

Robert Lustig, a specialist in pediatric hormone disorders and a leading expert in childhood obesity at the University of California, San Francisco, School of Medicine (one of the best med schools in the country) gave a lecture called "Sugar: The Bitter Truth" that went viral on YouTube July of 2009. It has since been viewed well over 800,000 times, gaining new viewers at a rate of about 50,000 per month. Not bad for a 90-minute discussion about the biochemistry of fructose and human physiology, no?


If his stance on the matter of sugar is right, then our excessive consumption of it is the primary reason that the numbers of obese and diabetic Americans have skyrocketed in the past 30 years. But more than that, if Lustig is right, then sugar is the likely culprit of other chronic ailments widely considered to be diseases of Western lifestyles: heart disease, hypertension, and many common cancers.

So baking a cake for a party, sharing a hot chocolate with marshmallows by the fire, getting that venti extra-whip caramel macchiato from Starbucks, or that pint of ice-cream after a break-up are not just unhealthy indulgences but actually toxic and harmful, no matter how much love goes into the experience? It's safe to affirm that Robert Lustig would vote "YES". Armed with genuine expertise and a carefully accumulated and synthesized mass of evidence, Lustig feels that his findings are compelling enough to convict sugar. According to him, it is the enemy.

His argument is not about the consumption of empty calories but that sugar has unique properties (specifically the manner that the human body metabolizes the fructose in it) that may make it singularly harmful if consumed in sufficient quantities. In describing this concept, Lustig uses the phrase "isocaloric but not isometabolic" which means that we can eat 100 calories of glucose, say from a potato or bread and 100 calories of sugar (half glucose and half fructose) and they will be metabolized differently, impacting our bodies differently. The calories are the same, but the metabolic consequences quite differ. Glucose (from sugar and starches) is metabolized by every cell in your body, whereas your liver primarily metabolizes the fructose component of sugar and high fructose corn syrup.

Lustig makes the compelling case that sugar is a "toxin" or a "poison", even "evil"
and that high fructose corn syrup is "the most demonized additive known to man".

"It's not about the calories," he says.
"It has nothing to do with calories. It's a poison by itself."

Here's the thing: The condition called insulin resistance, now understood as the fundamental issue of Type 2 diabetes and is common to obese and overweight individuals, is induced by the liver converting sufficient quantities of fructose into fat. This may also be the underlying defect in many cancers. But not everyone resistant to insulin becomes diabetic. Some continue to secrete sufficient insulin to overcome their cells' resistance to the hormone. However, chronically elevated insulin levels lead to harmful consequences on its very own-- heart disease, higher triglyceride levels and blood pressure, lower levels of HDL ("good") cholesterol, and further worsening insulin resistance, a.k.a. metabolic resistance.

Now physicians and medical authorities have come to accept the idea that metabolic syndrome is a major, if not the major risk factor for diabetes and heart disease. According to The Centers for Disease Control and Prevention, an estimated 75 million Americans suffer from metabolic syndrome. And for those who have heart attacks, metabolic syndrome will be the likely cause.

The National Institutes of Health are at the moment supporting disappointingly few clinical trials related to sugar and high-fructose corn syrup in the U.S. All of these studies are small and will last no more than a few months, one of which will be conducted by Lustig and his colleagues in UCSF, looking into what happens when obese teenagers consume no sugar other than that found naturally occurring in their daily fruits and vegetables. Another study will do the same with pregnant women to determine if their babies are born healthier and leaner.

Is sugar really as evil as Lustig claims it to be? It very well could be. Because of the particular way we metabolize fructose and at the levels that we consume it now, fat can accumulate in our livers, insulin resistance and metabolic syndrome can follow, thus initiating the process that leads to the heart disease, obesity, and diabetes that has been slowly killing the people of this country and now, the world. Sugar and high-fructose corn syrup may be toxic, but they take some time to do big damage. It doesn't happen overnight. But one thing is clear: Until long-term studies are done, we won't know for sure. With the way things are going, there will have to be definitive answers very soon. And some pretty big changes must be made.

Find out more here.

Reference:

Taubes, Gary. "Is Sugar Toxic?" The New York Times. The New York Times Company, 13 Apr. 2011. Web. 18 Apr. 2011. http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html?pagewanted=1&_r=1&smid=fb-nytimeshealth.

April 5, 2011

Together We Helped Save Lives in a Record-Breaking Multi-Kidney Operation



In what is the largest single-hospital kidney swap in the history of California, five patients received five kidneys from healthy donors in a marathon series of operations on Friday, April 1st 2011 at California Pacific Medical Center in San Francisco. "Paired donation" is the procedure that makes it possible, a relatively new phenomenon in transplantation surgery that allows for a live kidney going to someone who has a friend or relative willing to donate an organ not compatible for them but a match for someone else. The donor matches one who needs a kidney and that patient's incompatible donor matches someone else and so on, like a chain.

As of late 2010, a total of approximately 93,000 patients were registered on the kidney transplant waiting list at the United Network for Organ Sharing (UNOS) in the United States. In 2009, the number of live kidney donors declined to a shocking 6,387, leaving at least 87,000 individuals with families in the lurch in the U.S. alone. Lives are at stake worldwide. We have the collective responsibility to support the visions that will improve the health and quality of life for our fellow man, our families, and ourselves. Methuselah Foundation's vision is rapidly being realized not just in laboratories and medical research departments, but in the sterile environment of the operating room-- where it truly counts.

We are collectively the proud parents of this wonderful event!

Methuselah Foundation's angel financing arm funded the development of the bleeding-edge improvement to the Silverstone MatchGrid technology that helped make this rare multi-kidney transplant happen, sticking to our promise of making investments in life-extending technologies that extend lives RIGHT NOW. Matchgrid quickly computes the myriad of possible matches in a pool of prospective donors and recipients, minimizing time, effort, and resources that the transplant center would otherwise require to reach the same goal. Imagine that-- in one fell swoop, several lives were extended, even saved!

Our long term vision for this Matchgrid technology? We hope that its massive and super performance data management system will eventually play a role in the an envisioned "Postscript" language that can send printing instructions for creating new tissues and eventually organs to be used by tissue printers such as Organovo's sci-fi worthy 3D tissue printer, another founding angel investment by you, the donors of Methuselah Foundation.

David Jacobs of San Francisco began developing the system for California Pacific as he recovered from his own kidney transplant surgery in December of 2004. At 54 years old, after losing a brother to kidney disease, he says that he is grateful that he can help others "by providing doctors and clinicians the ability to rapidly and accurately build sophisticated cross-matching tables for paired donations from a varying set of recipient and donor clinical records... [t]hese cross-matching tables enable transplant professionals to rapidly find and analyze potential organ donations by mixing and matching a varying pool of potential donors with recipients in order to provide the best possible placement of compatible organs with recipients that are in need."




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The surgery involved six women and four men, five donors and five recipients. Not one of the patients needing kidneys were compatible with his or her willing donor, be it a friend, spouse or adult child, but another donor was found through the Matchgrid.

An example: 62 year old Alan Langstraat was not a match for his wife of 38 years, April, who inherited a painful condition that caused multiple cysts to form on the kidneys, enlarging her organs. Alan was rejected as a donor until he learned he could be part of the donation chain that made it possible for him to donate to another recipient, making it possible for his wife to receive a kidney from a stranger who agreed to the swap.

"It's a rare opportunity," Langstraat said before a surgeon removed one of his kidneys. "This is exactly what we should be doing," said his wife April, noting the irony of the surgery being performed both on her namesake month and on April Fool's. She feels blessed that she has options, and remembers with sadness that her uncle, who died of kidney disease, never had such an opportunity.



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Kidney recipient April and husband/donor Alan Langstraat share a kiss before his surgery.
(Photo cred: Lea Suzuki / The San Francisco Chronicle)


69 year old Leslie Warner is among the five who received a new kidney. "Certainly it's nice if this works out for, hopefully, five people who are getting kidneys from five other people who want to help. That's very gratifying and exciting," she said. She was moved to tears that all her four sons wanted to be tested to see if any of them would be a match. 44 year old David Sidle was the only son to match his mother's blood type, but a difference in antigens would have caused her to build up antibodies against his kidney. So when Sidle was informed of the possibility to participate in paired donor surgery, he described it as a no-brainer.

"The best outcome for my mom is to get a living donor," he said. "If I donate a kidney to someone else, that's what makes that possible. It's the same outcome for her, even though it's not my kidney."

Another recipient, 70 year old Susan Nelson, developed kidney disease from strep throat as a child. After hearing the news about receiving a new organ, she was so excited she practically jumped off her gurney in her hospital gown to go to surgery Friday morning. (Imagine that-- a 70 year old woman!)

"This is really going to happen, Suzi," said her husband of 48 years, Dick.

"Hot dog!" she said before kissing him and shuffling off into surgery.

A 50 year old friend of Susan's offered to donate a kidney but was rejected as incompatible with Susan. However, she was a match for another patient in the 10-person circle and someone else became a match for Susan Nelson. When the Nelsons arrived at the hospital at 6 am Friday morning, they looked at people all around them and wondered if Susan's donor was among them. "You don't know who it is and it really doesn't make a difference," Dick Nelson said. "It's a gift."



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Dr. Assad Hassoun cleans Alan Lanstraat's kidney after removing it
(Photo cred: Lea Suzuki / The San Francisco Chronicle)


5 transplant surgeons, 4 anesthesiologists, 10 operating room nurses, a team of more than 40 support staff, and 4 operating rooms were involved in the process. The first surgery began at 7:30 am. The last patient rolled out of surgery 10 hours later. Hospital officials said that all patients were doing well Friday evening and are expected to be released early next week.

It has only been 57 years since the very first successful kidney transplant in 1954. The idea that in the beginning of the 21st century alone would bring such medical strides such as organ matchmaking, tissue regeneration, chain organ transplantation, and organ printing was the stuff of heady science fiction. Now we are happy to see it as a reality that only grows in scope and magnitude. This gift saves lives more efficiently than ever before. Opportunities like this multiple kidney swap in California - resulting in five lives saved and five families deeply and gratefully affected with many more to come - are what make Methuselah Foundation's mission worth believing in and striving for.







Reference:

Colliver, Victoria. "Hospital's 5-transplant Kidney Swap a State Record." San Francisco Chronicle. Hearst Newspapers, 02 Apr. 2011. Web. 04 Apr. 2011. http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2011/04/02/MNEP1IOMAE.DTL.


The Methuselah Foundation is a charitable 501(c)(3) organization; its IRS tax identification number is 54-2040344.