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Alcohol and Obesity
Wednesday, February 13, 2013 6:26 pm Email this article
Overconsumption of alcohol is a significant factor in U.S obesity. Bariatricians should learn to ask their patients about the topic, with appropriate seriousness & politeness, in a way likely to garner an honest answer. I can explain how to do this--I may do so in the future--but honestly, the ability to talk to people should be the doctor's chief skill. If it isn't, they are in the wrong business.
My subject today is this: Without carbs you can't get a belly no matter how much you drink. The Germans proved that. They were lean for years (past WHO stats on the Internet), as long as they drank beer and ate sausage, a low carb diet. Now that they have turned to pizza and chips, like us, they, too, are getting fat. Meanwhile, the middle-age French remain leaner, drinking wine & eating a high-fat low-carb diet. (WHO statistics)
Here is why it works that way. Ethanol or "alcohol", a 2-carbon molecule, is oxidized to acetyl-CoA. At that point the body asks a question--what is the insulin level? If the insuliin level is low, acetyl-CoA enters the mitochondria where it is oxidized to two molecules of CO2, which are breathed out into the air. Gone.
If insulin high, however, an enzyme called malonyl synthetase diverts the acetyl-CoA to the synthesis of fat. The carbons go into fat, and there they stay as long as insulin is high, because insulin blocks lipolysis (the breakdown of fat).
So, if you are drinking too much alcohol, you should stop. Drink moderately or don't drink at all. But if you want to drink and not gain weight, keep the carbs low on the days you drink.
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