By Dr. Jeffrey Eisenberg, MD

Fat is the preferred fuel of the body

Our body will burn whatever we offer it when it comes to burning fuel. It has no choice... unless we give it that choice. When we were hunters and gatherers we flourished on healthy fat (in the form of free roaming antibiotic free meat, seeds, and nuts) along with any fruits and vegetables we could find. When food was sparse we broke down our fat stores and used this quite efficiently and successfully as fuel until the next meal could be obtained. Obesity, heart disease, and Diabetes did not exist.

Fast forward a few hundred years and what we now burn as fuel is predominantly sugar and processed carbohydrates. Our food choices are overwhelmingly laden with added sugar…and we are addicted to this sweet but not so innocuous molecule. One of the interesting results of the overconsumption of sugar is the resulting staggering increase in our insulin levels. If one measures the fasting insulin levels in the Maasai and Inuit cultures, where there is no access to added sugar or processes carbs, their levels range between 2.0 and  5.0. The average fasting insulin level in the U.S. Is 9.8. The majority of the levels I obtain in my overweight and obese patients are between 20 and 50! We are walking around with insulin levels that are orders of magnitude higher than our predecessors. And we spend a trillion dollars/yr combating the metabolic consequences of our diet in the form of those diseases our ancestors avoided.

While it is true our brain primarily relies on glucose to function, it can do quite well using the stores of glycogen in our liver, from gluconeogenesis (the production of glucose from protein),  and from ketones (the break down product of fatty acids).  We don't need carbohydrates to survive…they are not essential. I believe our body wants to burn fat as a fuel. It can achieve this cleanly and efficiently and without the health risks associated with our current sugar/carb rich diet.

One last caveat. If you want to lose weight you must lower your insulin levels. Insulin is your storage hormone. It locks excess energy in the form of fat in your fat cells…and it throws away the key! You cannot access that fat as energy as long as your insulin levels are elevated. As insulin falls (by avoiding the overconsumption of sugar) you can utilize that “freed” fat as energy. The more keto-adaptive you become the more weight you will lose; you are on your way to a longer, healthier, and more productive life!

By Dr. Jeffrey Eisenberg, MD

Which blood test to order and how to interpret them

When I am caring for a child or young adult who is overweight or obese there are specific lab tests that are appropriate to obtain. In particular, I need to know how many criteria of the Metabolic Syndrome this patient may have, as this correlates with future risks of chronic disease. What criteria determines the Metabolic Syndrome?

-fasting blood glucose > 105

-blood pressure > 135/90

- triglycerides > 150

-HDL <40(male), <35(female)

*waist circumference >40in (male), >35in (female)

A patient with 3 of the 5 above criteria has Metabolic Syndrome. More than 1/3 of Americans satisfy this diagnosis, increasing their risk for diabetes, heart disease, obesity, cancer, and neurodegenerative disease.

Notice that total cholesterol is absent from the above criteria. Remember, 90% of the cholesterol in our blood is produced by the liver; the level is relatively unaffected by dietary intake. Unless you suffer from one of the hereditary forms of hyperlipidemia, cholesterol levels correlate poorly with subsequent risk of heart disease. (50% of patients with myocardial infarction have normal cholesterol and 50% of patients with abnormal cholesterol levels have normal hearts). In fact, barring other lipid abnormalities, studies show that people with higher cholesterol levels live longer with less dementia, Alzheimer’s disease, or neurodegenerative disease. Too many patients are reflexively placed on statins for an elevated cholesterol level. (white males with previous heart disease have been shown to benefit from statins). We need cholesterol for our cell membranes and for our myelin sheaths that allow communication between neurons. This is a topic for future blogs but the over prescription of statins leads to side effects such as fatigue, muscle aches, a loss of libido, and all the symptoms associated with low Vit D. Only the pharmaceutical companies prosper.

Traditionally, HDL has been considered your “good” cholesterol while LDL has denoted your “bad” cholesterol. However this nomenclature, while easy to remember, is not quite accurate as there are particle subsets of both categories that are both good and bad. Healthy fat consumption increases the good subsets of HDL and LDL while sugar consumption increases the bad subsets. Most labs aren't set up to differentiate the particle subsets of HDL and LDL.

LDL type A: large buoyant fluffy; travel through blood vessels harmlessly

LDL type B: small dense; excavates vessel walls leading to inflammation and plaques

HDL 2: large buoyant; anti inflammatory and protective

HDL 3: small dense: inflammatory

Thus if a patient’s LDL is elevated, one way to determine if the elevation is due primarily to the good or bad particle fraction is to examine the triglyceride to HDL ratio. A ratio less than 2.0 is an indicator the LDL level is good; a ratio greater than 3.0 suggests the LDL level is bad and is a predictor of insulin resistance. In my practice for example, it is quite commonplace for an obese patient to have triglyceride levels of 180 and HDL levels of 35, yielding a very unhealthy ratio of > 5.0. These patients need to be monitored closely for all those disease states resultant from the Metabolic Syndrome.

In addition to lipid analysis ( triglycerides, HDL, LDL, and cholesterol) it is prudent to check for pre-diabetes as 37 % of Americans fall into this category. Typically a physician will order a fasting glucose and HGB-A1C. The later test is an average of the patient’s last 3 months of blood glucose. Unfortunately, these tests can miss the pre-diabetic patients because their pancreas is pouring out oodles of insulin to keep these labs in the normal range! A better test to pick up patients who will ultimately show signs of diabetes is the fasting insulin level. The higher this level the harder your pancreas is working to counter what would otherwise be elevated glucose levels. If one looks at insulin levels from from cultures and tribes who have no access to sugar or processed carbohydrates (Maasai, Kitava, Inuit) they are routinely <5.0. The average american’s fasting insulin level is 9.8. My patients who are obese have fasting insulin levels between 20 and 40! (Incidentally, the quoted upper normal ranges for fasting insulin are way too high and should not be considered a target goal) We have become a society dependent on sugar and processed food and we have insulin levels that are orders of magnitude above normal. Hyperinsulinemia is associated with a host of disease states ranging from diabetes to hypertension, obesity, cancer, nonalcoholic fatty liver disease, hyperlipidemia, reflux……

Other lab tests to consider:

-ALT: a liver function test that correlates with fatty liver disease

-CRP: assesses inflammation and cellular damage

-fibrinogen: assesses inflammation and cardiovascular disease

-ferritin: assesses cardiovascular disease

-homocysteine: associated with heart disease and alzheimer’s disease

-Uric acid: correlates with fructose consumption… associated with Metabolic Syndrome (HTN)

-Vitamin D: associated with osteoporosis, heart disease, diabetes, obesity, cancer, immunity….

So next time you are due for blood work ask your physician which labs are appropriate for your current health profile!

By Dr. Jeffrey Eisenberg, MD

Sugar and Reflux

Americans spent 13 billion on acid reducers in 2006. GERD (gastroesophageal reflux disease) can lead to esophageal scarring, constriction, ulceration, and cancer. Physicians prescribe these antacids to lower the acid content in the stomach so that when reflux occurs the resultant backwash into the esophagus becomes less harmful. However, there are problems associated with the chronic use and promotion of antacids.

You see, the stomach is supposed to have an acidic environment. It needs that low ph to properly digest food and absorb nutrients. Chronically low stomach acid from antacid use is associated with serious health complications since the stomach is no longer sterile; harmful bacteria are allowed to survive! Sugar intake can lead to the “leaky gut syndrome “ whereby undigested proteins and harmful bacteria leak into our circulation causing a cascading effect of inflammation, ultimately leading to autoimmune disease and a host of other maladies.

GERD is associated with dysfunction of the lower esophageal sphincter (LES). This valve is supposed to be “one way”, allowing food from the esophagus to enter the stomach. So in people with a “leaky” LES what is the driving force that propels the stomach acid to go the “wrong way”, backwards into the esophagus? And shouldn't physicians direct their attention and treatment of reflux to this actual force, rather than prescribing chronic antacids to mitigate the side effects of acidic backwash?

I first became interested in this causal effect when I noticed that my reflux symptoms all but abated when I stopped consuming excess sugar. I was able to stop my antacids for the first time in over a decade! A review of the literature suggested a plausible answer: it turns out that excess sugar is fermented into hydrogen gas. This accumulation of hydrogen gas results in increased pressure in the stomach and is the propellant that drives the acid contents backwards into the esophagus. People with GERD frequently admit to excess belching.

So, GERD diminishes if one avoids excess sugar consumption. While more research is ongoing in this area, it seems wise to at least highlight the association. We, as a nation, can save billions in drug related costs and become healthier “gut wise” if we decrease our reliance and dependence on sugar!

By Dr. Jeffrey Eisenberg, MD


Did you know we have 100 trillion bacteria in our gut? Yep, over 10,000 species of these little critters…some of them transient nomads and some permanent residents. It's not an area most of us dwell on, but our Microbiome supports every conceivable aspect of our health. It is an organ in and of itself and determines if we live robustly to a ripe old age.

So what do these bacteria do for us?

(1). Aid in digestion and the absorption of nutrients

(2). Create a physical barrier against potential invaders

(3). Act as a detoxification machine preventing infection

(4). Influences our immune system (80% of our immune system is in the gut)

(5). Produce vitamins (B12) and neurotransmitters (serotonin)

(6). Helps fight inflammation

Clearly, we don't want our gut overrun by unfriendly bacteria. We want the good guys....diverse,  beneficial bacteria!

What forces can derail our Microbiome?

(1). Exposure to chemicals in food ( gluten, sugar) and drugs like antibiotics

(2). Poor nutrition ( low fiber, low healthy fats, high sugar)

(3). Stress and inflammation

You see, anything that interferes with the integrity of our intestinal wall creates havoc. Have you heard of the “leaky gut syndrome”? Our intestinal lining is only one cellular layer of thickness. When that tight junction becomes permeable, the gatekeepers can no longer protect us and bacterial pathogens, undigested proteins, and lipopolysaccharides (LPS) gain entrance into our circulation. And this results in a firestorm of inflammatory diseases:

(1). Arthritis

(2). Inflammatory bowel disease ( crohns and ulcerative colitis)

(3). Asthma, eczema, food allergies

(4). Celiac disease

(5). Alzheimer's and cognitive impairment

(6). Mood disorders (anxiety and depression, chronic fatigue)

(7). Autoimmune disease

So how do we keep our gut happy and functioning properly?

(1). Probiotics: live good bacteria found in fermented foods (kefir, sauerkraut, Kimchi, yogurt, Tempeh, pickles, Kombucha)

(2). Prebiotics: nondigesible fiber that act as food or fuel for the good bacteria (acacia gum, chicory root, Jerusalem artichoke, dandelion greens, garlic, leeks, onion)

(3). Go Low- carb, high quality fat

(4). Polyphenols: powerful antioxidants found in black and green tea, red wine, dark chocolate

(5). Intermittent fasting (a topic of intense recent interest)

Remember, a healthy gut leads to a more healthy, more productive, and longer life.  Treat those good bacteria well and they will return the favor a thousand fold!

How Much Sugar Can You Avoid Today?

Sunday Review | Op-Ed Columnist


The typical American diet includes far too much added sugar. Can you stay under a healthy limit?

I’ve recently tried to reduce the sugar I eat, having been persuaded by the research on its damages — and alarmed by how much sugar has snuck into our diet. To give you a sense of how common it is, we’ve created a challenge: Construct a day’s worth of eating, from items at a typical supermarket we visited, that meets the guidelines for added sugars.

Health experts recommend most adults eat no more than 50 grams (that’s 12-and-a-half teaspoons) of added sugars per day — and, ideally, closer to 25. Unfortunately, food companies aren’t (yet) required to disclose how much added sugars are in their products. They must disclose only total sugars, including the natural ones in fruits, vegetables and dairy.

But that still lets you make good decisions. That’s because while the reality is that natural sugars aren’t much healthier than added sugars, experts focus on added sugar because Americans don’t tend to overeat fruit and vegetables. A useful rule of thumb is: Don’t worry about anything with only natural sugar. (In this challenge, we haven't.)

So get to work. Pick food for three meals and, if you’d like — and have the sugar to spare — a snack and dessert. Good luck!

U.S. Life Expectancy Drops

Life Expectancy In U.S. Drops For First Time In Decades, Report Finds

One of the fundamental ways scientists measure the well-being of a nation is tracking the rate at which its citizens die and how long they can be expected to live.

So the news out of the federal government Thursday is disturbing: The overall U.S. death rate has increased for the first time in a decade, according to an analysis of the latest data. And that led to a drop in overall life expectancy for the first time since 1993, particularly among people younger than 65...... read more at

When Food Banks Say No To Sugary Junk, Schools Offer A Solution

Heard on Morning Edition

This is the time of year when donations to food banks spike. But, some food banks are getting pickier about what they'll accept.

Earlier this year the Capital Area Food Bank announced it would "dramatically" cut back on junk food it receives and distributes. This means saying "no" to donations such as sheet cakes, holiday candy, sugary sodas and other processed, bakery items.

"Our core business — in helping those most in need — needs to be not only getting people food, but getting them the right food," says Nancy Roman, the CEO of the Capital Area Food Bank.

Roman says about half of the people that the CAFB serves have high blood pressure or other cardiovascular conditions, and about one in four clients have diabetes in their households. Given the epidemic of lifestyle and diet-related diseases, "we have a moral obligation to get our act together," Roman says.

Other food pantries are following a similar strategy. At the Share food pantry in McLean, Virginia, there's an effort to limit how many donations of sugary calories it accepts from donors such as supermarkets and restaurants.

"We've gotten calls from grocery stores saying, we have one-hundred cupcakes or sheet cakes, will you take them?" Therese Dyer-Caplan of Share told us. "The answer is no."

Share accepts pies during the holidays, since families enjoy a treat. Dyer-Caplan says she also accepts breads and a limited number of baked goods, but she tries to shift the overall balance towards healthier items.

So, where does Share find the kind of donations they're looking for? It turns out, the elementary school across the street has become a key partner, giving the food pantry about a hundred pounds of foods each week.

The donations are unopened leftovers from the cafeteria that would otherwise be tossed out. "Everything from cheese sticks, yogurts, and milks," gets donated says David Duggal, a 6th grader at Franklin Sherman Elementary. There's also hummus and fresh fruit, including apples and bananas. "It's a lot of food!"

"It's a win-win," says Josh DeSmyter, Assistant Principal at the school. He says the food no longer goes to waste, and the students learn the value of helping others.

Student Nicola Hopper says he thinks this is a big improvement. He says he felt guilty before they started donating their leftovers. "All of it just got wasted."

There are lots of reasons kids don't eat everything on their trays. They either pack too much, don'

The idea to recover unused food from elementary schools is the brainchild of a mom in this school district. When she visited her kids' own school several years ago, she was shocked by how much food was wasted.

"It was a mountain of food and it had to be tossed out. That was the regulation," says Kathleen Dietrich, founder of Food Bus. For food safety reasons, Dietrich explains, most school cafeterias don't allow food that's been purchased to be returned to the line. This means, in most cases, once a food is on a student's tray, it must be eaten or tossed.

At Franklin Sherman elementary alone, there's more than 3,000 pounds of food that is now salvaged during the school year. And when you consider that there's thousands of schools around the country, many of which are also tossing away food, "It's a lot of waste," Dietrich says.

Dietrich was determined to help solve the problem. She arranged to have the students start collecting their unopened leftovers instead of throwing them away. She also arranged to purchase extra refrigerators to store the perishable items. Once a week the students haul all the food they've collected over to the food pantry to be distributed.

At the Share food pantry, Therese Dyer-Caplan says the donations from the students are a godsend. "We're so grateful, and our clients are so grateful."

The model is spreading. Dietrich started the program in her own children's school. Now, it's up and running in more more than 40 schools across the country.

Dietrich has developed a toolkit to help schools get started. Each school must have refrigerators to store the food, and they need to find a local food pantry that can accept the donations.

Nancy Roman, at the CAFB, says she's thrilled to see more organizations popping up around the country that are focused on recovering nutritious food that would otherwise go to waste. Food Bus's mission fits nicely with the goal of the food pantry community - which is to provide healthier food. "Everybody understands we need to eat better," Roman says. And the foods that Food Bus schools are distributing - everything from fruit to cheese -to hummus -are exactly what many food banks are looking for.

"I'll take hummus over sheet cake any day," Roman says.

PUT OLD ON HOLD Journal: "Suckered By Sugar"

"...Consuming refined sugar is ingesting poison. The interesting thing is that even today, when  anyone suggests sugar may be a causative agent in cancer, particularly breast cancer, that accusation is laughed off the planet as 'not scientific'...Perhaps a new book will help change the perception that refined sugar is harmless. The book is titled Suckeredby Dr. Jeffrey Eisenberg and Sandra Canosa. The case for condemnation of sugar made by the authors is sobering."

To read the full article written by Barbara Morris, click HERE.

The Telegraph: "'Eat fat to get thin': Official diet advice is 'disastrous' for obesity fight, new report warns"

"Processed foods labelled 'low-fat', 'lite', 'low cholesterol' should be avoided at all costs and people with Type 2 diabetes should eat a fat-rich diet rather than one based on carbohydrates, the report urges...Dr Aseem Malhotra, consultant cardiologist and member of the Public Health Collaboration, a group of medics, said dietary guidelines promoting low-fat foods 'is perhaps the biggest mistake in modern medical history, resulting in devastating consequences for public health'."

Read the full article at

Information for this image provided by and

Takepart: "Other Countries Restrict Predatory Junk-Food Ads, but America Won't Budge"

"So, Why Should You Care? In 2010, the World Health Organization published 16 pages’ worth of recommendations for ways in which United Nations member states could reduce the influence of junk-food marketing to children. The document cites a study from the U.K. that revealed that 62.5 percent of all advertisements during children's programming were for food products, compared with 18.4 percent during prime-time programming, and that 'the majority of adverts seen by children around the globe are for heavily processed foods high in fat, sugar, salt and calories.'...More than one-third of all American children and adolescents are overweight or obese, and as of 2014, the U.S. has the fifth-highest childhood obesity rate in the world. Different economic and political structures are at play, but whether it's South Korea or the U.K. or Russia or the U.S., childhood obesity is similarly problematic and deserves to be addressed."

Read the full article at Click here for more information on policies regarding advertising to children.

McDonald's Happy Meal ad for the Disney film 'Home.' (Photo: Getty Images)

McDonald's Happy Meal ad for the Disney film 'Home.' (Photo: Getty Images)

The New York Times: "An Old Idea, Revived: Starve Cancer to Death"

"...Unlike healthy cells, growing cancer cells are missing the internal feedback loops that are designed to conserve resources when food isn’t available. They’re “addicted to nutrients,” Dang says; when they can’t consume enough, they begin to die. The addiction to nutrients explains why changes to metabolic pathways are so common and tend to arise first as a cell progresses toward cancer: It’s not that other types of alterations can’t arise first, but rather that, when they do, the incipient tumors lack the access to the nutrients they need to grow...(Warburg) believed that most cancer was preventable and thought that chemicals added to food and used in agriculture could cause tumors by interfering with respiration...'it really is insulin itself that’s getting the tumor started.' (said Lewis Cantley, the director of the Meyer Cancer Center at Weill Cornell Medical College)."

To read the full article, go to New York Times Magazine.

Hoppmann: Deadly sugar discovered to alter hundreds of genes in your brain

"A new study from life scientists at University of California – Los Angeles (UCLA) has found that hundreds of genes in the brain are damaged by fructose consumption."

Diseases linked to these changes range from diabetes, cardiovascular disease, Alzheimer’s, ADHD, Parkinson’s, depression, bipolar, along with the areas of the brain responsible for metabolism, cell communication, and inflammation.



Burke: Sugar is the new tobacco

Written by Patrick Burke for the Democrat & Chronicle

"...The sugar problem finds its way into the costs of doing business with “our annual health care spending on issues of weight ($190 billion) now exceeds those caused by smoking.”  On an individual basis, average annual medical bills for obese men are $1,152 more than for non-obese. For women, the gap is more than $3,600.  Dr. Eisenberg goes further, suggesting obesity in the marketplace reduces worker productivity.

The addition of refined sugar and high-fructose corn syrup have exploded in processed foods and soda over the last 50 years to where the average American currently consumes 130 pounds of sugar annually, which is 60 percent above the toxic level of 80 pounds.  Sugar is the new tobacco."...

Read the whole article written by Patrick Burke for the Democrat & Chronicle at:


Written by Jeffrey Eisenberg, MD, Author of Suckered

A telomere is a sequence of DNA at the end of our chromosomes. These end caps are protective as they preserve genetic information. However, telomeres shorten with each cell division. They burn down like a candlewick, leaving the chromosomes vulnerable to damage. Eventually the telomere length “runs out” and the cell can no longer rejuvenate. The result is cellular death.

It is hypothesized that humans can live to be 122 years old based on the study of telomere length. So why do the overwhelming majority of us fall so short of these expectations? Well, it turns out that inflammation, stress, and sugar accelerate the rate at which telomeres shorten. This speeds up the rate of biological aging, and is linked to heart disease, obesity, diabetes, cancer, and neurodegenerative disease.

The American Journal of Public Health (10/16/14) was the first study to show that soda consumption is associated with telomere shortening and cellular aging. It is based on the work of Elizabeth Blackburn, a USCF researcher who received the Nobel Prize in 2009, who calculated that the daily consumption of a 20oz sweetened sugary beverage (SSB) was associated with 4.6 years of accelerated biological aging. (Comparable to the effect of smoking)

So telomere length is epigenetically influenced by nutrition. If we can eat more healthily, (avoiding excess sugar and processed carbohydrates while maximizing our exposure to antioxidants and anti-inflammatories) we may be able to slow down the rate of telomere shortening, repair damaged telomeres, and even lengthen these same telomeres. Be like a Vulcan: “Live long and prosper!”