Why Excess Weight Kills
Why Excess Weight Kills

Gabe Mirkin, M.D.

Of the many factors causing more than 40 percent of Americans to die 
of heart attacks and 35 percent to become diabetic, the strongest 
are eating too much and exercising too little. 

Being Fat Makes You Even Fatter
Having diabetes is one of the strongest risk factors for heart 
attacks and premature death. Before insulin can do its job of 
driving sugar from the bloodstream into cells, it must first attach 
to special hooks on cells called insulin receptors. Only then can 
insulin drive sugar into cells. When fat and muscle cells fill with 
• these cells fail to respond adequately to insulin,
• blood sugar levels rise,
• insulin levels also rise,
• insulin converts sugar to fat,
• more fat deposits in fat and muscle cells, and
• you become even fatter.

How Being Fat Blocks Insulin Receptors
After sugar enters a cell, it can be 1)Used for energy, 2)Stored 
as muscle sugar called glycogen, or 3) be converted to fat. Once a 
muscle cell fills with glycogen, no more sugar can be stored in that 
cell so what is not burned for energy is converted to fat. 
•The cell then fills with fat,
• fat blocks insulin receptors,
• sugar is prevented from entering cells,
• blood sugar levels rise,
• sugar sticks to the outside surface of cell membranes, where
• sugar is converted to sorbitol,
• which destroys the cell to cause
• Blindness, deafness, MI, stroke, kidney failure, and all the other side effects of diabetes.

How Exercising after Fasting Prevents Diabetes
More than 90 percent of diabetes is caused by fat blocking insulin 
receptors so a diabetic cannot respond adequately to insulin. 
Emptying muscle cells of their stored fat helps them to respond to 
insulin and clear sugar from their bloodstreams. One major key to 
preventing and treating diabetes is to empty cells of fat. 
Contracting muscles burn mostly fat and sugar for energy. Muscles 
have only a limited amount of sugar stored in them and a virtually 
unlimited supply of fat. If you can exercise long enough to reduce 
the stored sugar called glycogen, in muscle cells, your muscles will 
be forced to use their stored fat. Emptying muscle cells of fat 
helps them to respond better to insulin. Exercising after fasting 
empties cells of glycogen rather quickly. This forces muscle cells 
to burns fat. This empties fat from muscle cells to increases a 
cell's response to insulin, which lowers high blood sugar levels 
(Journal of Physiology, November 2010)

Exercising Muscles Do Not Need Insulin
Furthermore, contracting muscles can draw sugar from the bloodstream 
without requiring insulin. Resting muscles cannot do this. The 
maximum effect lasts during exercise and up to one hour afterwards 
and disappears completely at around 17 hours. That's why you have to 
exercise every day to have your muscles respond maximally to insulin. 
(Am J Clin Nutr 2008(July);88(1):51-57. J Appl Physiol 2005;99; 
338-343 & 2005;8750-7587. Am J Physiol Regul Integr Comp Physiol 
1983;245(5). Journal of Applied Physiology, February 2010).

Dietary Factors That Cause High Blood Sugar
Eating sugared foods and drinks can cause a high rise in blood sugar 
levels that damages cells and sugar in drinks are far more damaging 
than sugar in food. When you eat, the pyloric sphincter at the end 
of your stomach closes to keep food in your stomach. Then food is 
mixed in your stomach and must stay there until it is converted to a 
soup that is squeezed into the intestines. Sugared drinks pass 
readily into your intestines to cause a high rise in blood sugar. 
Sugared foods take much longer to raise blood sugar levels. For 
example, fruit juices and sugared soft drinks enter the intestines 
immediately to cause a rapid rise in blood sugar (JAMA, August 25, 
2004). Furthermore sugared drinks increase diabetes risk, while 
fruits decrease risk (Am J Clin Nutr, 2008 (July);88(1):51-57) 

Losing Weight Is More Important than Reducing Cholesterol and 
Saturated Fat
High blood pressure and cholesterol are two major risk factors for 
heart attacks and premature death. A diet that gets you to lose 
weight is more effective in preventing diabetes and heart attacks 
than all other factors. A study from the University of Toronto put 
people with high blood cholesterol levels on three different diets:
1) Fruits, vegetables, and nuts,
2) fruits, vegetables and nuts plus grains and low-fat diary 
  products and
3) the National Cholesterol Therapeutic step-2 diet that is very low 
on saturated fat and cholesterol and is recommended by many doctors 
to treat high cholesterol and blood pressure (Epidemiology: March 
2006;17(2):128-130). After just two weeks, people who ate only 
fruits, vegetables and nuts had the greatest drop in the bad LDL 
cholesterol because it restricts calories the most. 

Drop in LDL/HDL after two weeks on 3 diets
1) Fruits, vegetables, nuts: LDL -33%; LDL/HDL -24%
2) Fruits, vegetables, nuts, grains & low-fat dairy: LDL -23% LDL/HDL -12%
3) National Cholesterol Therapeutic step-2 diet LDL -7% LDL/HDL -5%

Eating only fruits, vegetables & nuts is the most effective way to 
lower high cholesterol and blood pressure. It makes it very 
difficult to meet your needs for calories, and is the same as what 
humans' ancestors ate 4 to 7 million years ago. Human ancestors had 
to spend all their time foraging and eating and often died in their 
teens because they couldn't get enough food. If you go on this diet, 
chances are thst you will be eating all the time just to meet your 
needs for calories. Adding low-fat diary products and whole grains, 
barley, oats and dried beans to a fruit-vegetable-nut diet yields a 
low saturated fat and low cholesterol diet: the basis of therapeutic 
diets. However it is much less effective than the 
fruit-vegetable-nut diet that forces a person to limit calories. 

Restricting Calories More Important than Restricting Saturated Fats 
and Cholesterol
Saturated fat raises cholesterol only when you take in too many 
calories. If you reduce your caloric intake by one third and ate 
nothing but fatty meats and diary products, your blood cholesterol 
level will drop (European Heart Journal Supplements, 
1999;1(S):S19-S23). Saturated fats are broken down in your liver 
to 2-carbon units. Ingesting excess calories causes your liver to 
make cholesterol and blood cholesterol rises. If not enough calories 
are available, these 2-carbon units are burned for energy and do not 
raise in cholesterol (Brit J of Spts Med. July, 2008).

Saturated Fats from Plants Do Not Raise Cholesterol
Saturated fats in meat and chicken raise cholesterol and are 
associated with increased risk for heart attacks. However, saturated 
fats from plants (coconut, palm and palm kernel oils) can raise 
cholesterol a little but have not been shown to increase heart 
attack risk (Am. J. Clin. Nutr. August, 1981). 

The most effective way to help prevent heart attacks and diabetes is 
to prevent extra fat from being deposited in your cells. You can 
exercise more and eat less. A healthful diet includes: 
• Unlimited: fruits, vegetables, whole grain, beans, seeds & nuts.
• Moderate: fat-free or low-fat diary products, fish & poultry
• Restrict: red meat; sugared beverages & foods; processed & fried 
foods; & those with added salt.

Knowledgeable nutritionists today recommend a diet that includes 
plenty of fruits, vegetables and nuts and restriction of
• excess calories,
• refined carbohydrates,
• red meat,
• fried foods and
• (for non exercisers) salt.

Additional references

American Journal of Epidemiology, 2003:58(3):243-250
Whole grains prevent diabetes because they do not cause a high rise 
in blood sugar.

American Journal of Clinical Nutrition. 2003;l 78(5):965-971
Whole grains increase insulin sensitivity to help prevent diabetes 
and myocardial infarctions, but they provide easily absorbed extra 
calories to fill up fat cells and block insulin receptors.

Arch of Int Med. March 2009
A study of more than 500,000 Americans over 40 shows that those who 
consume the equivalent of at least a hamburger a day have a 30 
percent increased chance of dying during the next 10 years, mostly 
from heart disease and cancer. Eating fish, chicken, turkey and 
other poultry decreased the risk of premature death.

Strokes: Stroke. Pub online December 16, 2010
Heart attacks: Circulation August 2010
Cancer: PLoS Med 2007;4(12): e325 & e345.
Premature death: Arch Int Med. Mar 2009
Studies on association of diseases with red meat

Proc Nat Acad Sci.Sept 29, 2003
Almost 30 years ago, Prof Ajit Varki, of the U. Cal/San Diego, 
discovered a sugar-protein he called Neu5Gc, that is made by the 
tissues of every mammal except humans.

Glycobiology 2008; 18(10):818-830
Humans have many antibodies to Neu5Gc, setting up a susceptibility 
for chronic inflammation.

Proceedings of the National Academy of Sciences, 11/13/08
Fed Neu5Gc to mice that lacked the Neu5Gc and caused tumors. Mice 
given Neu5Gc antibodies grew large and faster growing tumors Control 
mice not treated with antibodies, the tumors were smaller and less 

Checked 8/19/12