Category: Gastroenterology/Hepatology

High fructose consumption and fatty liver disease

Interviewed by Steven E. Greer, MD

In 1080iHD full screen for better viewing of data graphs

Manal F. Abdelmalek, MD, MPH, of the Duke Medical Center’s Division of Gastroenterology/Hepatology discusses a paper she co-authored investigating the effects on the liver of high levels of fructose typical of the American diet. The study compared the effects to glucose. The study suggests that fructose causes more fatty liver disease than other sugars.

This is a timely publication given the recent New York City ban on single serving sizes of sugary drinks that exceed 16-ounces, and builds on the body of literature supporting that regulation.


Cutting through the hype surrounding gluten

October 19, 2014- Interviewed by Steven E. Greer, MD

Did you know that one out of three Americans think that they are “gluten intolerant”. Of those 100 Million people, only 13 Million really have a medical problem caused by gluten.

Alessio Fasano, MD, director of the Center for Celiac Research and Treatment at MassGeneral Hospital for Children, is the man who started all of the gluten hype back in 2003 with a paper in the Archives of Internal Medicine. Hoping to reduce some of the current “gluten hysteria,” he has written a book explaining what gluten is, who can and can’t eat it, and why. We interviewed him.

The Gluten Crazies are out of control and affecting menus in restaurants

April 26, 2015- By Steven E. Greer, MD

I was eating at a French restaurant recently, and the waiter asked me if I had any allergies, such as “gluten”. This greatly upset me, because the waiter was forced to asked this. Read more »

Overview of rHGH therapy

January 14, 2015- Interviewed by Steven E. Greer, MD

We interviewed Dr. Shlomo Melmed, Director of the Clinical Research Institute and Dean of Faculty at Read more »

Current surgical weight loss therapies

January 24, 2014- Interviewed by Steven E. Greer, MD

Erik Dutson, MD, weight loss surgeon at UCLA, explains why his medical center does not implant the Lap-Band, and how the “sleeve” bypass is the main procedure of choice now for weight loss surgery.

New therapies for hepatitis C

Interviewed by Steven E. Greer, MD

In Part 1, Sammy Saab, MD, MPH, liver disease and GI doctor from UCLA, discusses the standard of care for hepatitis C, which is 48-weeks of interferon with ribavirin. He then discusses the new protease inhibitor drugs, Incivek and Victrelis, and why their bad side effect profile limited usage despite higher cure rates.

In Part 2, Dr. Saab discusses the data on the new all-oral therapies that do not require the toxic interferon injections, are only 12-weeks of therapy, and have much higher cure rates approaching 100% SVR. He mentions Gilead’s sofosbuvir, the Abbvie cocktail of drugs, and others.


Celiac disease is not reduced by breast feeding or delaying the introduction of gluten

October 19, 2014- Interviewed by Steven E. Greer, MD

Alessio Fasano, MD of Harvard discusses his 10-year-long study in children testing whether the delayed introduction of gluten into the diet reduced the eventual incidence of celiac disease. Dr. Fasano is most responsible for raising awareness of gluten intolerance after his 2003 NEJM and Archives of Internal Medicine papers were published.

Tip of the Week: Non-alcoholic fatty liver disease, and how to cure it

January 23, 2013 By Steven E. Greer, MD

Thanks to a few medical doctors, most notably Robert Lustig of UCSF, it is becoming known that humans can develop fatty liver disease even if they do not consume alcohol. Certain foods are processed exclusively by the liver and have no other pathway than to be converted into fat and stored in lover cells. Sugar and trans-fats are the big villains. Also, overeating of other food will cause NAFLD, but not as quickly as fructose, trans-fats, and alcohol.

One can be normal weight and still have excessive fat around the abdominal organs and a fatty liver. This can lead to lack of energy, diabetes, cancer, and other illnesses.

Dr. Lustig was recently featured on CBS’s “60 Minutes” about the harm of fructose and how it has contributed to the obesity epidemic. I asked him some questions too.

Dr. Greer: When one eats more non-fructose calories than they expend, and thus add fat to fat cells, does the liver become fatty from that too, or is fatty liver disease just caused by alcohol and fructose? In other words, if I add 5 pounds from eating pasta and rice, is my liver going to look the same as if I were binging on alcohol and candy?

Dr. Lustig: Steve, because only 20% of a glucose load enters the liver, it takes WAY MORE glucose to overwhelm the liver’s capacity. In contrast, 100% of a fructose (which is table sugar or corn syrup) load enters the liver. Also, glucose (in starches such as pasta or potatoes) can go on to form glycogen, so the liver has a pop-off valve. But if you force it, can you do it? Yes. But it takes a lot of glucose for a long time to do it.

The four foodstuffs that are exclusively metabolized in the liver and don’t go to glycogen are:

1. Trans-fats

2. Branched chain amino acids (leucine, isoleucine, valine)

3. Ethanol

4. Fructose

Tip of the Week: A good way to eat less sugar and trans-fats is to eat vegetables. This relates to my other tip about juicing. Buy a blender and make the veggies go down more easily. You also have to cut out the sugary cakes and desserts. You won’t miss them. You can still have a sugary snack once a week. In addition to juicing, I also recommend this dietary change.

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