Live Life to the Youngest with RealAge
Don’t panic.  I don’t have a paid ad for the RealAge Test stretching across the top of my blog post today.  This one is for illustration purposes only.  If you are like me, however, you’ve run across this banner countless times in your online surfing.  It seems to pop up everywhere.  Or at least it used to.  It hasn’t too much lately since the big New York Times exposé, more about which later.
But first let’s take a look at something else brought to the public by the team of Roizen and Oz.  I came across this page on their RealAge website while I was googling something else.
According to these two (or their team of ‘world-renowned scientists and doctors’) we should all avoid fructose and load up on glucose, the ‘sugar that staves off hunger.’

Sugar is sugar, right? Maybe not. Turns out that there is one type of sweetener that helps fill you up, while another leaves you craving more.
The two sugars in question: glucose and fructose. Glucose appears to quell hunger, and fructose seems to ramp it up.
The sugars may affect your appetite differently because of the unique ways in which they affect malonyl-CoA, an important appetite-suppressing molecule in the brain. Glucose causes malonyl-CoA to rise, resulting in less food intake. Fructose, on the other hand, lowers malonyl-CoA, resulting in more food intake.

The implication of their message is that if you eat glucose you won’t be hungry, but if you eat fructose you will.  They go on to discuss how important it is to cut fructose from the diet since fructose makes you eat more.  And, by implication, to add glucose.
I agree that we should all cut most of the fructose from our diets, but not for the reasons these guys (and their team of purported experts) give.
I would assume that both of these docs went to medical school and had many years of post-medical school training.  I would also assume the same about their ‘world renown’ staff of experts.  What I don’t understand, then, is how they can make such stupid statements that have no grounding in actual biochemistry.
The ‘important appetite-suppressing molecule’ under discussion is malonyl-coenzyme A (malonyl-CoA), which is one of the major signaling molecules in the body.  Malonyl CoA sits at the crossroad of fat storage and fat burning and drives the reaction one way or another.
If we’ve eaten a lot, especially a lot of carbohydrate, malonyl-CoA levels increase.  Increased levels of this substance then shift the flow of fat away from burning and toward storing.  Among its activities, Malonyl-CoA stimulates fatty-acid synthase (FAS), the enzyme that converts carbohydrate to fat.  And it inhibits the enzyme (CPT-1) that carries fat into the mitochondria where it is burned for energy.
If we haven’t eaten, or if we have been eating a low-carb diet, the opposite happens.  Malonyl-CoA levels are low, which removes the inhibition of CPT-1.  Fat is shunted away from storage in the fat cells and instead is transported into the mitochondria where it is burned.
Since malonyl-CoA is one of the main substances in the body that determine what happens to fat, it would make sense that this molecule would somehow be involved in the regulation of hunger.  Elevated malonyl-CoA levels indicate that we’ve got plenty of fuel aboard and that the body is in the process of getting it stored away, so it would stand to reason that these elevated levels may affect the hunger centers in the brain, sending the message not to eat any more.
Researchers have looked into this notion, and it indeed appears – in rodents, at least – that elevated levels of malonyl-CoA do suppress the hunger centers in the hypothalamus.
If you do a quick thumb through any decent medical biochemistry textbook looking for what makes malonyl-CoA go up, you’ll find that it is driven up by insulin and glucose, the surrogates for being well fed.  But here is where Roizen/Oz and the team of experts go off the rails.  The glucose in question isn’t dietary glucose – it’s blood glucose.  As I’ve written about before, the entire amount of glucose we have circulating through us if we have a normal blood sugar level is around 4 grams, a little less than one teaspoon.  If we eat a medium-sized baked potato, we ingest about 50 grams of glucose (potato starch is made of pure glucose), which is more than ten times the amount regularly circulating in our blood.  Our bodies quickly deal with this excess by increasing insulin and driving the glucose into the cells.  As a practical matter, dietary glucose never really impacts malonyl-CoA.  What does impact it is the level of blood sugar.  So if blood sugar is higher than normal, then more malonyl-CoA is made, and more fat is stored.  Which is one of the reasons type II diabetics are usually obese to some extent.  These people have the double whammy of too much sugar and, since they’re almost always insulin resistant, too much insulin.
Any readers who have type II diabetes will have increased levels of malonyl-CoA.  I will ask those of you who have this condition: are you less hungry?  I didn’t think so.  Despite the fact that in rodents (and probably in people who are normal weight) malonyl-CoA may suppress hunger, it doesn’t seem to do so in those who are overweight and insulin resistant.  It may a little, but there are other forces driving hunger more than the malonyl-CoA suppresses it.  And in any case, it doesn’t have anything to do with dietary glucose – a fact our illustrious crew of ‘world renowned’ experts should have known.  Their implying that adding glucose to one’s diet will decrease hunger is just plain stupid.
But let’s look at something a little more sinister than just plain ol’ stupid.
These same guys are behind the RealAge test that (until fairly recently) was popping up every time you turned on your computer.  I saw the ads for this test over and over and over again, and I wondered what they were selling to justify the huge expense such unremitting advertising requires.  Then I read a New York Times article that explained it all.
As it turns out, the RealAge test is a means for Roizen/Oz et al to gather health information from those who take the test.  I’ve taken the test, which requires many pages of questions, and discovered that I am about 8 years younger than my chronological age.  I also discovered that I would be younger yet if I didn’t eat so much red meat.  You can guess how to perform well on the test: tell them you eat no red meat and a lot of soy.  (My choices on the red meat were: no red meat; red meat once per week; or red meat more than once per week.)
During the course of the test, after a long list of medical problems that are to be checked if the test-taker suffers from them, this question pops up:
RealAge Test blog
If the answer is yes, you may be bombarded with information from various pharmaceutical companies that make drugs to treat the checked diseases. Or if, according to the Times, you decide to become a RealAge member.
Yep, that’s right.  These guys who seem so compassionate and are giving away their RealAge test (after capturing your email address) and providing all kinds of lifestyle change recommendations are really capturing your info and peddling it to Big Pharma.  Which, of course, is how they can afford the many ads for their ‘free’ RealAge test.
Says the NY Times:

But while RealAge promotes better living through nonmedical solutions, the site makes its money by selling better living through drugs.
Pharmaceutical companies pay RealAge to compile test results of RealAge members and send them marketing messages by e-mail. The drug companies can even use RealAge answers to find people who show symptoms of a disease — and begin sending them messages about it even before the people have received a diagnosis from their doctors.
While few people would fill out a detailed questionnaire about their health and hand it over to a drug company looking for suggestions for new medications, that is essentially what RealAge is doing.

Pretty sleazy, if you ask me.
They still provide their RealAge test, but as far as I can tell, only if you go to their website.  They are probably waiting for the fallout to be over from the Times piece.  Until then, they are dragging people to their website with idiotic pieces such as the one I discuss above.  If you are googling a health problem, nutrient, diet, etc., you may come upon their website and be presented with the RealAge test.
But, if the article I read is any indication of the value of their advice, I would be real leery.  The advice may be stupid, but the strategy behind the RealAge test is definitely sleazy.


  1. that oz doc once said on opra, “to reduce your saturated fat at breakfast you should put skim milk on your cereal”. i’ve never watched him since
    A good move on your part.

  2. When I first saw an ad for Real Age I was curious and went to the website, but I was put off by the intrusive (to me, anyway) questions and closed my browser. A similar sort of manipulation seems to be occurring with the “health advisers” some employers and insurance companies use. Their newsletters are all about pharmaceutical compliance, and they leave messages on our answering machine telling us we should call their “nurses” for consultation. (We don’t.) After my husband’s most recent blood tests, we received a letter from them saying he should talk to his doctor about a cholesterol-lowering drug. (I don’t remember the exact LDL number, but it was below 130.) We had, by then, already met with his doctor. It’s a good reminder that nothing is private.

  3. It is ironic but I was watching Dr Oz interview with Dianne Sawyer about antiaging as you were about to publish your new post. As soon as I finished watching I went on your blog and saw his name mention again. De ze vu? What do you think of a new enzyme called resveratol that so many news and people bragging about. Is it indeed a new panacea for a long youthful life or another hype that is about to pass by? I dont know but Dianne sawyer looks very appealing at the afe of 64! I would have no reservation dating her at all, I think she is totally thought provoking!–MNwjlm4&eurl=http%3A%2F%2Fresveratrol%2Dstudy%2Enet%2F%3Fkw%3Dresveratrol&feature=player_embedded

  4. I have most of the “You:” series of books that these doctors co-authored, but I have become increasingly cautious of their advice as I have learned more about insulin and carbohydrates in the body. At this point, I am going to just throw the books out; I can’t trust these fellows, and I wouldn’t feel right donating them to a library, where someone else will just pick it up and become misinformed as well.

  5. I’ve never had any use for Oz….not since I saw him on a show and he mentioned he keeps a handful of nuts in his pockets to eat when he gets too sleepy! This is a cardiac surgeon? The nuts I agree with, but the idea of having to worry about the sleepies didn’t seem to faze him!!
    He’s also WAY too hung up on the bowels! According to him, if you don’t pass gas something like 12-15 times a day you’re not healthy!! Of course, all those carbs contribute to the gas!!

  6. ME: “I also discovered that I would be younger yet if I didn’t eat so much red meat.”
    You would probably be younger if you never took the tedious RealAge test.
    It’s interesting how a pattern develops with these celebrity darlings, at least Oprah’s anyway. They start out as presumably skilled dedicated professionals deserving of some kind of notoriety. They are showered with praise and media attention, are over-exploited, make a ton of money, become obsessed with greed and end up rich but seemingly void of substance — kind of like guru today… gone tomorrow.
    I have learned not to trust the media a long time ago, but the realization that very personal information of mine is gathered continuously through activity on the internet without my knowledge or consent, is a tough one to accept.
    I heard on the news tonight that Oz and Oprah are suing 50 companies over claims of false endorsements… coincidence?
    I guess they won’t be suing me for false endorsement. At least not Oz. 🙂

  7. Just one example of the kind of sleazy marketing ploys used by Big Pharma. Melody Petersen tells of many, many more in her book ‘Our Daily Meds.’

  8. I think Dr. Oz is going down the step by step path to truly irrational behavior, a la “Mistakes were Made, But Not By Me”.. I’m on chapter 5 and it is really a fascinating read. Thanks for sharing it.
    Glad you’re enjoying it; it’s a great book.

  9. Very interesting post! I remember taking that Real Age questionnaire a few years ago. It does plumb the depths of sleaziness. It exploits our human nature (we want to feel special and healthy) and it has an agenda.
    I’m a free market guy, but the pharmaceutical industry takes deception to a new low. Thanks to your books and blog, I haven’t taken a prescription med in over 5 years. I’ve even greatly reduced ibuprofen in favor of fish oil and curcumin as you suggested.
    I would also be a little paranoid about answering a questionnaire like that for fear of privacy issues. It’s OK if you have an anonymous email but even that can’t be guaranteed.
    I was surprised a few years back when I applied for private medical insurance. The woman on the phone clicked a few keys and had access to all prescriptions I had taken in the last 10 years!
    Our loss of privacy is scary. Really Scary.

  10. Nice. Good job!!
    Check out on youtube: Sugar: The Bitter Truth, it’s an hour and a half long but it’s worth every second, it’s mostly about sugar: glucose and fructose..
    Thanks for the YouTube tip.

  11. I think Dr. Oz is going down the step by step path to truly irrational behavior, a la “Mistakes were Made, But Not By Me”.. I’m on chapter 5 and it is really a fascinating read. Thanks for sharing it.
    Glad you’re enjoying it; it’s a great book.
    Sorry, forgot to add great post! Can’t wait to see your next post!

  12. Doesn’t Dr. Oz now have a TV show, kind of like Dr. Phil? They get started on Oprah, and then go on to fame and fortune on TV. That woman has too much power. But it’s not her fault, it’s the fault of all the mindless people who hang on her every word.
    I did the Real Age test a couple years ago, and like you, came out younger than my actual age, and yet was slapped on the hand for eating red meat and for not eating 5 servings of fruits and veggies every day.
    My health insurance company at work has this wonderful program where you respond to a survey and then they give you an assessment. For doing that, they give you a $50 gift certificate to Then, if you agree to talk with a nurse WEEKLY about whatever failings you might have, you can get up to $200 in gift certificates.
    Fifty bucks for taking a survey? Sure! I was a good little girl and said I ate only lean fish and poultry, shunned red meat, and ate tons of fresh fruit and veggies. In other words, I lied. (Oops! I just re-read what I just typed, and I had typed “… and said I hate only lean fish and poultry.” Talk about Freudian slips!
    Several years ago, my husband went in for his physical and his BP was a little high. He went back a couple days later for a re-check and was told it was fine. That didn’t stop the insurance company. They started calling almost every night wanting to talk to him. I couldn’t understand, because the policy was in my name, not his, and they wouldn’t tell me why they wanted to talk to him (he travels 2 to 3 weeks a month, so was never around for these calls). Finally I badgered the woman enough that she told me he had been “diagnosed with high blood pressure” and she wanted to talk with him about what he should be doing and to answer any questions he may have. I explained that he was NOT diagnosed with it, and that at his re-check it was fine. And even if he DID have any health questions, he certainly wouldn’t be talking to a insurance company about it!
    I talked with my HR person at work and had her call the insurance company and tell them to never EVER call me again at home to offer unsolicited advice. They haven’t. Sheesh.

  13. Dr. Eades,
    I agree with the obtrusiveness of online questionaires. Something else has been troubling me lately about fructose however. In your books you promote eating berries and fruit, but their sugar is fructose. Are levels in fruit so low as to not make much of a difference? I’ve recently been avoiding fruit and sticking with green vegetables and meat. Could you please clarify this for me.
    Thank you very much.
    We promote eating low-carb berries and low-carb fruit. Fruit does contain small amounts of fructose, but the evidence seems to indicate that small amounts of fructose – that amount found in low-carb fruits and berries – actually helps the body deal with glucose. We get in trouble, however, with the huge amounts now consumed as part of the typical American diet.

  14. Dr. Eades,
    Many thanks for another very interesting and useful post and for the work you do. I have personally benefited in so many ways and am grateful. I have an off-topic question for you. I have two young children and am worried about the upcoming flu season largely because of the question of vaccines. Specifically I’m worried about flu vaccines including thimerisol and oil-based adjuvants (like Squalene). I don’t know very much about medical science but have heard the squalene is has been statistically linked (though the link was not publicized) to the auto-immune problems many of our soldiers have suffered upon returning from service overseas. I am confused as to how best to protect my family. It seems the risks are as high or higher in vaccinating as in not vaccinating. I trust your science and your opinions more than most and would love to hear your thoughts. Thanks. Sally
    The subject of vaccines is a controversial one, and one I haven’t spent a lot of time studying. I, myself, haven’t taken a flu shot in years…and haven’t had the flu, either. I ‘vaccinate’ myself against the flu by taking plenty of vitamin D, which I think probably does as much good as a flu shot – if not more – to prevent the disease. All our dutiful DILs give vitamin D to our grandkids, none of whom have had the flu. I like to look at risk/reward ratios when I consider vaccines. is it worth a tiny bit of increased risk to keep from getting tetanus or diptheria or polio? In my mind it is. But the flu in children I’m not so sure about. If I were elderly (more elderly 🙂 ) and frail, I might consider a flu shot but I would also take a lot of vitamin D.

  15. Oz and Roizen are examples of what a good marketing machine is all about. Sadly, it is one of the downsides we have to put up with in a free market economy
    The U tube Sugar: The Bitter Truth is eye opening and all should listen although if your not a bio chem type(i am not) it can get technical. Long and short of it is how damaging fructose is and consumption even in fruit should be limited (just like lo carb recommendations).

  16. Very interesting! I took one of those real age tests a couple of years ago, but had no idea that my information was being passed on. Now I know where all that “health” crap in my spam box is coming from! Very sleazy indeed.

  17. Dr Eades, I am surprised that you would take this “test”. I am extremely skeptical of clicking on these banners, I always assume they are gathering info for marketing purposes, unless it’s government, then god only knows what they will do with information.
    Whenever I do take these tests or fill out any kind of online forms that I know nothing about, I use a junk email account that I set up for the purpose.

  18. Sigh… Oz makes me wretch. He is obviously selling something as he has that Billy Mays look in his eye (not speaking ill of the dead, I loved his enthusiasm, we all knew Billy was selling something!). With a generous helping of Billy Graham. He comes across as ‘oh so reasonable’ with his look little ladies (as he pats the fat-so’s on the head), just listen to us, and we’ll ‘heal ya’. Don’t you go following none of them thar ‘fad’ diets.
    Here is a story that will make you wretch (I have edited to get th salient points across).
    Mumma is 93 years old.
    I just moved her to an Extended Residential Care facility (small 6 residents) She needs around the clock ‘presence’, but not a nursing home.
    I worked with the staff (long on heart, short on.. education). to try to get them to understand what a carbohydrate is. Obvious questions were “Potatoes are OK, right? Crackers are good, right?” So I made out a list of forbidden foods. Anyway, I thought I had gotten my point across, but one of the staff was not present at my ‘lecture’.
    Short story:
    I walked in during supper that was prepared by the missing staff member. This was just as Mumma was finishing a MASSIVE brownie heaped with iced cream. She had had a big portion of Shepherd’s pie before that (potatoes, corn, beef, heavy on the potatoes). You probably know where this is going by now…
    I looked at the woman and said “Oh no, she is going to be very, very sick!!”. Get the Maalox.
    Too late. Within 5 minutes (I am not exaggerating) Big attack, way out of the range of Maalox. (I was not believed, it had to be a heart attack!) Ambulance.
    Diagnosis (by a very good ER room doc who does NOT do private practice unfortunately): Hiatus hernia. Big. Very, very big. (I already knew this of course.)
    In fact, in a private conversation he revealed he is ‘one of us’, and completely believes that old people need: Fat. Protein. Supplements.
    I now have the staff convinced that she can’t have those sorts of meals. If in doubt? Give her scrambled eggs and a piece of sausage. She likes HOT sausage. Lots of pepper ;-> Won’t cause the problem!!!
    Now I have to work with her arrogant ‘know it all’ doc, that hasn’t read a research paper in 20 years, but gives special treatment to the pharma reps (they are ushered right in to the doc’s private office while the rest of us pound sand in the sparse waiting room). Rural Vermont doesn’t have much to choose from. I have to work with what I get. But I am getting mighty tired of the ignorant arrogance.
    Hope your mother gets some decent care. Her story is all too typical. Hey, wasn’t Howard Dean a doctor from Vermont?

  19. Thanks for that. Thanks also for your views on vitamin D and vaccines. Our kids have been taking the Carlson’s D drops (2000 IU per drop) and haven’t been sick for ages. I realize that’s anecdotal at best, but the lack of illness in our household is striking.
    There is a video game called Brain Age, where you play mental games similar to the ones that are in Dr. Mc Cleary’s book, and your supposed Brain Age is revealed to you. Those games are fun, but I don’t appreciate being told that I’m 83 years old when I’m only 43.
    One thing I found rather invasive and suspicious is that my daughter’s doc “diagnosed” her with anxiety. I’m extremely mad about it because my daughter is definitely not anxious when she’s not at the doc. I’d be a tad anxious too at age 12 if I were made to sit naked in a paper robe and doctors were poking me and prodding me and giving me vaccines! I think it’s a set-up.

  20. I’ve never seen the Real Age ad before. In fact, I haven’t seen any online ads for years. I use Firefox with the Adblock Plus add-on, and online ads are a thing of the past. You can block ads selectively yourself, or subscribe to a ready-made filter list. I highly recommend it.

  21. Mehmet Oz was once a pretty good cardiac surgeon at Columbia Presbyterian. (He in fact repaired my wife’s prolapsed mitral valve, back in 2000. But he was the ultimate rock-star-prima donna surgeon. Never talked to us, except through his physician’s assistant.)
    His colleagues in the department considered him a hot-dogging grandstander, always being quoted in the press and aggrandizing himself. They were apparently glad to see him go.
    His wife had been a producer for USA Network, and concocted a series starring him, which quickly tanked. Oprah fell in love with him, put him on her show, wearing scrubs. Which is silly, since he no longer operates. And certainly wouldn’t have walked out of the OR to sit on Oprah’s couch still in his scrubs.
    He was a competent cardiac surgeon who has anointed himself a media-star expert in everything.
    I’m not buying.
    Yeah, the whole wearing-scrubs-on-TV deal is a put off. No one but a real prima donna would do that.

  22. “Hey, wasn’t Howard Dean a doctor from Vermont?” LOL! You just can’t help yourself, can you?
    Interesting anecdote about the hernia and carbs. I was diagnosed with a small hiatal hernia (caused by years of high carb before my fructose malabsorption problem was identified), and the diagnosing MD told me to “stop smoking” (I’ve never smoked a day in my life), “take Pepcid, avoid fats, and raise the head of the bed.” Nary a word about carbs or meal size.
    As you have probably discovered, reducing carbohydrate intake is the easiest way to get rid of GERD and relieve the symptoms of a hiatal hernia.

  23. I love your blog!! Such a rich source of information. Thank you!!
    I read in your archives this week all your posts about intermittent fasting (IF). I have also been reading about leptin diets, which are targeted to improve letpin senstivity and therefore insulin sensitivity. Some of these diets recommend eating 3 small-to-medium low-carb meals per day, that are at least 5 hours apart, and not eating after dinner. If these guys are correct that our hormones need at least 5 hours between meals to communicate their message to burn fat, I wondered if straight-up fasting could achieve the same benefit as the 5-hour rule, and if longer fasts (of up to 24-36 hours) would achieve prolonged (or even greater) benefits.
    After eating 5-6 times a day for a few years, I have tried this 3-meals x 5-hour rule for a only a few weeks, and am already feeling tons better. My blood glucose is becoming much more stable. If the the hours between meals are so crictical to leptin/insulin sensitivity, it seems that infrequent meals are a healthier option than scarfing up a few colories every 3-4 hours.
    Do you think there is really any benefit specifically associated with eating differently on alternate days, or do you think there could be as much benefit from eating on a more constant schedule, say one or two meals per day?
    In light of IF, is the don’t-skip-breakfast rule valid at all? I mean, if a person is eating intermittently, is there really any special value in eating a traditional breakfast (i.e. eating within a few hours after rising)?
    Do you have a recommendation for further information/reading about IF??
    I would greatly appreciate any comments or recommendations you can make about Intermittent Fasting. If you cannot comment here, I hope you will consider additional posts on the topic. Thank you!
    Yes, I am planning another post on intermittent fasting.
    I do think there is great benefit to altering meal schedules and in going for longer periods of time without eating. Doing so allows your liver to rest. Constantly presenting food means your metabolic system is constantly working – giving it a break for a few hours here and there is, in my opinion, important. More and more studies coming out on intermittent fasting appear to confirm the benefits garnered by this way of eating. And if you eat low-carb while you are intermittently fastin, it makes it even better.

  24. You are spot on with the Vitamin D. My kids have been on it for years and have not been sick or had to see a doctor in over 3 years for any type of illness. They are currently 12 and 10 years old. For that matter my husband and I have been on the Vitamin D also and have experienced the same effect. No doctor’s visit’s in years.
    Thanks Dr.Mike and MD for all the great advice over the years!!

    Everybody remember this? This segment was a three-ring circus guaranteed to make sure Taubes’ message was lost. Oz may have been serious about his message years ago, but he has become a near-charlatan. Read the info on the right from livinglowcarbman, on whose channel this is found.
    Every where we turn, misinformation on high fat, moderate protein eating seems to be the order of the day.
    Doesn’t it make sense that if you come from a temperate climate zone, such as Europe, fructose would have only been plentiful during the fall harvest–especially of fruit. Eating from this harvest coupled with eating high fat meat, would have put on the pounds, getting ready for the lean, perhaps snow-laden winter. Now, not only do we have all sorts of fructose heavy fruits and veggies year round, we have to contend with HFCS found in nearly every packaged product in the supermarket.
    I’ve come across the fructose-in-the-fall-fattens-us-for-winter theory, and it makes sense. But, on the other hand, Paleo man probably didn’t ‘harvest’ fruits in the fall; he probably fought for them with the birds and other fruit-eating creatures. I doubt they would have been around long.

  26. Dr. Eades,
    Please explain what you mean when you say that fructose helps the body deal with glucose? What shows us that this is the case? How does it bring this about? Is this true for all people including those with blood sugar problems such as IR or diabetes as well? Thank you. You provide more clear informative facts on this aspect of nutrition that anyone out there. Thanks for your generous work and gift of your time to those of us who would never be able to do this for ourselves.
    Studies have shown that a few grams of fructose helps the body ‘dispose’ of glucose by driving it into the cells more efficiently. Without going back and digging out the papers, I can’t remember whether the studies were on normal subjects or those with glucose intolerance and/or type II diabetes. My guess would be that it would work for all. But we’re talking a small amount of fructose here. Just a few grams – not the enormous amount consumed in the typical American diet.

  27. Hi Mike… I wonder if you meant to say Malonyl-CoA either reductase, Malonyl-CoA transacylase or even carnitine-palmitoyl-transferase (CPT), instead of just Malonyl-CoA as being an enzyme. Malonyl-CoA is in fact a substrate for a number of enzymes; the transacylase would use Malonyl-CoA to fuel into the steps of fatty acid synthesis (storing). On the other hand, Malonyl-CoA inhibits CPT, so that beta oxidation is then inhibited, because no derivatives of palmitate can be transported inside mytochondria (burning).
    With the rest, I agree completely. Increasing carbohydrate increases Malonyl-CoA, and because this substrate sits at the pivotal point between fat synthesis and fat burning (a nice example of a divergent metabolic pathway), its excess inhibits burning. I had a discussion a few years back with someone who argued that when we say that excess carbs end up as fat, we were wrong because the actual sugar molecule is not reassembled into a molecule of fat… what we were referring is the fact that excess carbohydrate, through the Maolnyl-CoA pathway does increase fatty acid synthesis. Later on de novo lypogenesis was also shown to occur with excess carbohydrates so maybe there is involvement of both mechanisms. If that is so, then that’s a double-whammy.
    Anyway, I just thought I’d offer that differentiation between Malonyl-CoA, the substrate, and the enzymes that transform that substrate into something else that fuels into fat synthesis or fat burning.
    Hey Gabe, thank God you caught my mistake. I’ve fixed it. You are absolutely correct – malonyl-CoA is not an enzyme but is a substrate for a number of enzymes. I am traveling, and I had limited time to get that post up. I was typing like crazy and it just slipped by my hurried proof reading, which really isn’t a valid excuse, but it’s the best one I have. Thanks again.

  28. I too heard a lot lately about this miracle substance called reservetol. Dr Mike, do you mind to reveal your age? Are you doing anything special other than diet to keep a youthful, exuberant look?

  29. ME
    “If we eat a medium-sized baked potato, we ingest about 50 grams of glucose (potato starch is made of pure glucose), which is more than ten times the amount regularly circulating in our blood. Our bodies quickly deal with this excess by increasing insulin and driving the glucose into the cells.”
    As I understand the dynamics of blood glucose we burn an average of about one teaspoon per hour (about 5 grams). So if we drive about 50 grams of glucose derived from the digestion of a baked potato into the the cells in the time span of a hour or less what happens to the other 45 grams of glucose? As far as I know the human body cannot store glucose. And the the influx of glucose in this instance greatly exceeds the burn rate. So what happened to the 45 grams of glucose?
    Vitamin D. I just found out you can get 50,000 IU tablets. Dr. Cannell of the Vitamin D Council recommends that to bolster immunity we can take a single dose of 500,000 IUs. A few years ago my grandmother told me that when one of her relatives was suffering from tuberculosis in the 1930s his MD recommended that a bed be put out in the yard and that he sun bath every day that the weather permitted. It seems that back in the days of horse drawn buggies MDs actually had horse sense.
    In the latest from Dr Oz and his buddy I have just learned that saturated fat is more deadly than trans fat. Wow! Who would have thought?
    The 45 grams of glucose is stored as glycogen, the storage form of glucose. If the glycogen stores are full, the glucose is converted to fat and stored as such in the fat cells.

  30. Dr. Eades said: “Studies have shown that a few grams of fructose helps the body ‘dispose’ of glucose by driving it into the cells more efficiently.”
    That makes sense to me. I have impaired glucose intolerance , but I can keep my BG in the normal range with a low sugar, low starch (& GF) diet and testing my BG. I can tolerate a bit of sugar with the glucose/fructose combination (as in very dark chocolate) far better than a bit of flour or starch (glucose only).

  31. A little off topic, but I just saw a seminar by Barry Sears in which he claimed that too little carbs and too much protein would elevate glucagon levels (which I understand) and elevated glucagon elevates cortisol which makes you fat. Any validity to this?
    Not in my opinion.

  32. Insulin (in the arcuate nucleus in the hypothalamus): 1) increases alpha MSH->binds to melanocortin 4 receptor induces satiety and 2) blocks AgRP and NPY w/c are 2 peptides that induce hunger. SCI.AM sept 2007 page 75 And considering the TG/FA cycle and the randle cycle, It appears that there must be an optimum dose of insulin needed to control appetite.

  33. I took the realage test and haven’t gotten pharmecutical ads. Did I do something wrong?
    I don’t know. Maybe they’re lying low until the scandal blows over. Or maybe you didn’t have any problems for the drug companies to exploit.

  34. Dr. Oz was one of my heart surgeons a few years back. He was wonderful. But as he becomes more and more overexposed he makes me increasingly uncomfortable with the stuff he’s pushing.

  35. I took the RealAge just now on a lark, and what a lark it was.
    I can’t believe how out of touch these guys are. “Dietary cholesterol causes heart disease”, “BMI”, “Eat more soy!”, etc, etc.
    And the self-reinforcing low-fat cycles continues. Sigh.

  36. An off-topic issue. I was one of those selected to preview the new book. I’ve started a blog to describe my experience. As I wasn’t asked to sign an NDA, I was thinking I should at least get a nod from you before going too far. As I wrote on my very first post, I won’t go into specifics of the plan. I think that doing so would be disrespectful and ungrateful. I do have links to your books at Amazon, however. If you or your legal department has any problem with this, I’ll take it down upon request. The blog can be see at

  37. Any idea if those ubiquitous OBEY ads for health / fitness are also big pharma data-collecting scams?
    I’m not familiar with them, so I don’t know.

  38. A. Rubin
    Hi, Mike! Re fructose, glucose, etc.–are you familiar with a sweetener called “Whey Low” that is supposed to be low-carb? The company’s info says the creator, a biochemist, developed it for his wife after she was diagnosed w/diabetes. It’s synthesized from glucose, fructose, and one other sugar (don’t remember now which), but in such a way that, according to the company’s claims, the carbs aren’t absorbed completely.
    Anyway, it’s supposed to be good for baking, but I’ve avoided it so far because I can’t seem to find any documentation that isn’t produced by the company itself. Do you know anything about this sweetener and its usefulness in a LC diet? Thanks!
    I’m not familiar with it, so I can’t comment.

  39. Hi Dr. Mike,
    I’m curious if you (or a knowledgeable reader) could clarify some things about the youtube video Bianca posted (Sugar: The Bitter Truth – link: It’s a very long talk (1.5 h!), but very well done – for the first time since converting to low carb, I’m questioning some of my knowledge. Unfortunately, I am not trained in biochemistry.
    Essentially, Dr. Lustig says that not all carbs are equal. He explains the various biochemical processes that occur when ingesting glucose, ethanol, and fructose, and claims that while fructose and ethanol are both essentially poisons, glucose is actually good for us (“the energy of life” that all living things can metabolize). His argument is mainly that it’s a volume problem – eating 120 calories of glucose (white bread) will produce maybe half a calorie of waste product (VLDL) in the liver, whereas nearly all ingested fructose will be expelled from the liver in some toxic form or other (VLDL, uric acid, etc). He also claims that fructose is less toxic when consumed with fiber, as in fruit.
    Now, I’ve been of the impression that all carbs are turned into sugar in the body, whether whole grain bread, potato chips, or donuts, and so they are all equally bad. Have I misunderstood? Would I have gotten similar benefits had I simply cut out all sucrose and fructose from my diet, rather than reducing ALL carbs?
    (I ask this because I have some stubborn – and overweight – family members who cannot comprehend life without bread despite my insistence. Convincing them to cut out sugar if they can still eat whole-grain bread might be a tad more effective 😀 )

  40. Well, it’s no surprise you get minus points for red meat and plus points for soy, raw veggies, etc. It’s a mainstream quiz for mainstream people.
    The idea is good, though. If there was a way to make a similar test but with better data, it’s be quite useful. But I guess that’s impossible without actually measuring biomarkers.

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