Life Extension Magazine®

Issue: Nov 2005

The Perricone Weight Loss Program

Life Extension members know that chronic inflammation is a significant cause of heart attack, stroke, cancer, and a host of age-related disorders. In an exclusive excerpt from his new book The Perricone Weight-Loss Diet, Dr. Nicholas Perricone provides innovative techniques to suppress inflammatory reactions and induce weight loss.

By Nicholas V. Perricone, MD.

Nicholas Perricone, MD

Nicholas Perricone, MD, is the author of the New York Times bestsellers The Wrinkle Cure™, The Perricone Prescription™, and The Perricone Promise™.

A board-certified clinical and research dermatologist, adjunct professor of medicine at Michigan State University’s College of Human Medicine, and long-time member of the Life Extension Foundation, Dr. Perricone has been the subject of a member profile (April 2003) and has shared his expertise in an “Ask the Doctor” column in Life Extension magazine (June 2004).

Much like the Life Extension Foundation, Dr. Perricone focuses on preventing the effects of aging and extending the healthy human life span by applying dietary and nutritional strategies to minimize inflammation, glycation, and oxidative stress.

The following article is excerpted from his new book, The Perricone Weight-Loss Diet (Random House, 2005), which explores the link between inflammation and excess weight, and outlines a detailed strategy for losing fat, preventing wrinkles, and alleviating the effects of aging.

Excerpted from The Perricone Weight-Loss Diet by Nicholas V. Perricone, MD. Copyrighted 2005 by Nicholas V. Perricone, MD. Reprinted by arrangements with The Random House Publishing Group. For more information, visit www.nvperriconemd.com.

Scientists are rapidly acknowledging the role of inflammation in many diseases and chronic conditions. However, I believe this will be the first book that will clearly demonstrate how this subclinical, microscopic, invisible inflammation is responsible for a great number of metabolic problems, resulting in accelerated aging, serious health threats, unwanted weight gain, and obesity.

If this was not bad enough news for adults, there is now alarming new evidence that this diet-related inflammation is also causing weight gain and obesity in young children and adolescents, resulting in diseases and conditions such as type II diabetes and metabolic syndrome, which normally do not manifest until much later in life.

My research has shown that the chief therapeutic intervention to prevent weight gain (regardless of age) is the anti-inflammatory diet. I have observed significant weight loss in thousands of individuals who follow the simple formula of avoiding foods that are pro-inflammatory and choosing in their place foods with anti-inflammatory properties.

What is of particular interest to me is the fact that the same foods (those with anti-inflammatory properties) that fight many diseases, aging, sagging skin, and wrinkling, also cause significant weight loss—and they are safe for everyone, children and adults alike. At the same time, the foods that accelerate aging and put us at risk for disease and the loss of cognitive abilities (the pro-inflammatory foods) also cause weight gain. These foods and beverages also interfere with the body’s natural ability to metabolize foods properly, making it increasingly difficult to lose unwanted weight.

Perhaps the worst dietary craze belongs to the 1980s, which heralded the age of the no-fat diet. Supermarket shelves were flooded with high-glycemic carbohydrate foods, offering little in the way of nutrients, but plenty in the way of empty calories. These foods became dietary mainstays for many people, especially women, who found themselves indulging in snack foods such as reduced-fat “baked” potato and corn chips, and fat-free rice and corn cakes, cookies, pretzels, and crackers. Suddenly millions of Americans were placing themselves in a chronic inflammatory condition. Why? Because eating these foods provokes a pro-inflammatory rapid rise in blood sugar, resulting in elevated insulin levels.

Insulin is an important hormone that helps the body utilize blood sugar for energy or store it as glycogen or fat. But if the insulin is released too quickly, it has a pro-inflammatory effect. After a rapid rise, there will be a precipitous drop in blood sugar, resulting in feelings of hunger, which can lead to a vicious cycle of overeating. This is why a diet centered on breads, baked goods, snack foods, sweets, and other sugary, starchy foods results in unwanted weight gain and great difficulty in losing weight. Ironically, in this instance, it is not the caloric value of the foods causing the weight gain. In fact, a rice cake only has around 40 calories.

However, because it is rapidly converted to sugar in the bloodstream, resulting in the insulin release, it will cause you to store body fat. An insulin release can result in the storage of body fat.

Keeping It Simple

Some scientists and researchers believe that many of the health problems of today are caused by our departure from the hunter-gatherer diet, which consisted of nuts, seeds, berries, wild greens, roots, fruits, fish, fowl, and game. This is a fascinating theory and I do agree with the premise that natural, unprocessed foods are always the best choices.

To be healthy and maintain normal weight, we need all of the food groups—but not those that come from the laboratory. Our protein source needs to be pure, fresh (when possible) wild fish and other seafood, and free-range chicken and turkey that are hormone and antibiotic free. Our carbohydrates need to be fresh fruits and vegetables, preferably organic. And we need good fats, such as those found in salmon, sardines, and other cold-water fish, extra virgin olive oil, nuts, seeds, avocado, and açaí (a Brazilian berry whose fatty-acid ratio resembles that of olive oil). These “good” fats will help us absorb nutrients from our vegetables and fruits, keep our cells supple, our skin glowing and wrinkle-free, our brains sharp, and our mood upbeat. We also need dietary fat to burn fat.

By upsetting the delicate balance with extreme fad diets and ridiculous concepts, whether it is no-carb or no-fat or whatever, we create ongoing physical and mental health problems, including obesity, accelerated aging, and wrinkling, sagging skin. It is no coincidence that the rise of antidepressants such as Prozac® occurred during the nonfat food craze of the 1980s—after all, our brains are comprised mainly of fat, and when we starve our brains of valuable nutrients, we become depressed. Salmon, with its rich complement of essential fatty acids, has been shown to be an excellent treatment for depression. Some studies have shown that it is more effective than powerful drugs in treating depression—without the side effects (moderate regular exercise is also great for depression, especially when combined with the salmon-rich anti-inflammatory diet).

Inflammation 101

Let’s take a look at what I mean by inflammation. Inflammation, which is the response of the body’s immune system to infection or irritation, exists in a very wide spectrum. At the extreme end, it causes visible redness and swelling, such as in sunburn or an injured finger. On the low end of the spectrum, the inflammation is invisible; we can’t see it and we can’t feel it. But it does exist, and it causes a host of health-related problems. The bright red and painful sunburn that exists at the extreme high end is usually present for only a short period of time. Physicians refer to this type of inflammation as “acute inflammation.” The invisible inflammation that exists at the low end of the spectrum is usually present for longer periods of time and is termed “chronic inflammation.”

The question you may be asking is, “If it is invisible, and we can’t feel it, then how do we know that this low-grade inflammation exists?” The answer is simple: some of this inflammation can be detected under the microscope. However, low-grade inflammation can also be invisible even with a microscope because it exists on a molecular level, but it can be detected through chemical tests using special instruments.

Research indicates that the effects of this chronic, low-grade, invisible inflammation is at the basis of aging and age-related diseases such as cardiovascular disease, diabetes, certain forms of cancer, Parkinson’s, Alzheimer’s, and autoimmune diseases—and even wrinkled, sagging skin.

However, it doesn’t stop there. I am now categorically stating that this same chronic, low-grade, invisible inflammation is at the very basis of excess body fat, out-of-control appetites, food cravings, food addictions, diabetes, and the inability to lose excess body weight.

If that is the case, you may be thinking, “Why don’t I just go ahead and take an ibuprofen tablet and get thin?” Unfortunately, it is not that simple—especially when you consider this inflammation is not just a one-time event reacting to a one-time cause. Our bodies are under a constant barrage, a continual assault of physical insults resulting in this inflammation—beginning with that bag of potato chips and ending with the creation of a veritable factory in our body whose one job is to grow more fat cells and produce more inflammatory chemicals.

The effect of this low-grade, invisible inflammation (also referred to as “subclinical” inflammation) has been at the cutting edge of medical science for the last decade, and it has been the focal point of my own research for the past two decades. After years of either being ignored or relegated to a “by-product” of the disease process, cellular inflammation is finally coming to the attention of the mainstream media, and in fact, was the topic of a cover story in Time magazine.

THE MECHANISM OF A VICIOUS CYCLE

What follows the damage to the cell plasma membrane is a kind of domino effect that, in the end, causes a vicious cycle of increased inflammation. Here’s how it goes:

• The cell plasma membrane is made up of a double layer of fats called a “lipid bi-layer,” and this fragile film is easily and rapidly oxidized by the free radicals. This leads to the breakdown of the membrane that produces a substance known as “arachidonic acid.”

• Arachidonic acid is further oxidized by enzyme systems to produce very active chemical products with pro-inflammatory activity such as “prostaglandins.” Arachidonic acid can also leak into the interior of the cell and get into the mitochondria, the tiny furnace used for energy production.

• Arachidonic acid then disrupts energy production of the cell, which is critically needed for cellular repair.

• The fats in the cell plasma membrane can also become oxidized and mimic chemical messengers in the body, such as platelet-activating factor (PAF), which also triggers a series of inflammatory events on a cellular level.

• All of these events, cumulatively known as “oxidative stress,” lead to increased production of free radicals inside the cell, with the activation of tiny messengers called transcription factors such as AP-1 and nuclear factor kappa B, or NfkB for short. When NfkB detects oxidative stress, it translocates to the nucleus of the cell, which contains the DNA (which in turn contains the master instructions of the cell). NfkB attaches to a portion of the DNA and instructs the cell to make inflammatory chemicals such as interleukins 1 and 6 and tumor necrosis factor, types of cytokines (intercellular chemical messenger proteins released by white blood cells as well as other cells) that create further inflammation and damage.

• When NfkB is activated in skin cells along with another transcription factor called AP-1, it can lead to wrinkles in the skin.

• When NfkB is activated in the brain, it can lead to Alzheimer’s disease, and activated in other organs it can lead to cancer.

• When NfkB is activated in the pancreas, it can lead to the destruction of the B-cells of the pancreas, which are the sole source of insulin, resulting in diabetes.

• NfkB blocks the ability to utilize insulin effectively, which leads to the storage of body fat, causing us to gain weight and have great difficulty shedding the pounds.

Dangers of Inflammation

Acute inflammation is a protective response of tissue to irritation, injury, or infection and is characterized by pain, redness, swelling, and sometimes loss of function. It is, under normal circumstances, beneficial, and helps the body repair the effects of trauma or infection. However, prolonged, excess, or chronic inflammation becomes harmful.

When low-grade invisible inflammation occurs in the very cells that comprise our organ systems, a concept I introduced in my first book, The Wrinkle Cure (2000), we are placed at great risk for a host of degenerative, age-related diseases. This is because cells that are attacked by self-generated inflammation will not function properly (meaning that we did something to precipitate a pro-inflammatory response in our cells, thus causing malfunction and sometimes complete breakdown).

In other words, cells respond to the way we treat them. If we keep them healthy and free of injury, if we give them the proper nourishment, they keep us alive and running at top form. If we don’t, if we expose them to too much sun, to environmental toxins, to extended periods of stress, or to high-glycemic sugars and starches, the cells will react by producing inflammatory chemicals as a deviation of the normal defense mechanism. And if we mistreat our cells in this way on a regular basis, we can end up with organ system failure and diseases like the ones listed, including metabolic syndrome, which can lead to diabetes and obesity.

This hidden inflammation is a novel and previously unrecognized “missing link” in our obesity epidemic.

This past decade has seen a complete turnaround in the way scientists regard white adipose tissue—better known as body fat. They no longer look upon it as an inert deposit of fat cells, stored as the result of overeating. They now realize that areas of fat storage are actually an active endocrine organ. Fat produces hormones, as do our pancreas, thyroid, parathyroid, adrenals, pineal, pituitary, and testes/ovaries, the organs that comprise the endocrine system. We are beginning to define body fat as a group of cells communicating with other organ systems such as the brain, the liver, the bone marrow, skeletal muscle, the adrenal cortex, the sympathetic nervous system, and the complete immune system. And the message they are communicating is not good.

This is extremely important because the body fat itself controls how much body fat is going to be stored. It also affects our appetite, our energy expenditure, and our immune system. Body fat accomplishes this by secreting hormones known as adipokines. Adipokines are proteins that act as messengers throughout the body (more examples of the communications network). Like certain types of cytokines, those chemical messengers that have pro-inflammatory activity, adipokines can contribute to systemic, low-grade, chronic inflammation.

This becomes even more frightening when we begin to understand that the greater amount of fat we have stored, the greater its negative influence on the entire body, an extremely destructive, inflammatory influence.

In fact, it would not be too great a stretch to compare excess body fat storage to a tumor, for several valid reasons. A large store of body fat can be so overwhelming to the system that the fat cells have to secrete hormone-like substances to increase blood vessel growth necessary to feed the accumulation of fat. In addition, like a tumor, blood vessel growth cannot keep up with the rapidly growing mass of fat cells, which then begin to become oxygen-starved. These oxygen-starved cells start releasing inflammatory chemicals to further trigger blood vessel growth. These same events are seen in tumor growth, as well.

Most overweight people, especially the obese, have chronic high levels of insulin that will begin to drop as soon as they start dieting. This is a two-edged sword, as low insulin levels decrease inflammation, which allows us to utilize body fat for energy. However, insulin is required to bring protein into the cells to maintain muscle mass. The overweight or obese person has cells that are insensitive to insulin due to their chronic high levels. That is, their body is so used to the overly high levels, it cannot recognize these new lower levels, thus it is unable to trigger the amino acid uptake needed to maintain muscle mass (insulin is needed to take up both sugar and amino acids into the muscle).

This is why it is critical to take a powerful anti-inflammatory approach to dieting. Remember, it is the inflammatory chemicals, such as NfkB, that block the effects of insulin—whether it is to metabolize blood sugar or to nourish muscles with amino acids. Over-exercising can further put us into a catabolic state (in which complex molecules are broken down into simpler ones) because of the higher requirement of nutrients needed for active muscles.

Inflammation, Body Fat, and Heart Disease

Scientists and physicians now recognize that heart disease is mediated by inflammatory chemicals. In fact, forward-thinking cardiologists are now measuring C-reactive protein, a marker of inflammation, to identify patients at risk for heart disease. This is proving to be significantly more accurate than looking at cholesterol. In fact, many cardiologists now report that elevated C-reactive protein is four times more accurate in predicting heart disease than elevated cholesterol.

C-reactive protein is a special type of protein produced in high amounts by the liver during episodes of acute inflammation. High circulating levels of C-reactive protein also indicate stomach inflammation. Researchers at UC Davis recently found that endothelial cells (the delicate lining of the circulatory system) also produce C-reactive protein, a key finding that helps to explain how plaque formation is initiated. This is particularly important because endothelial cells are supposed to protect the arteries from the effects of C-reactive protein. Researchers also found that C-reactive protein can cause these endothelial cells in our arteries to produce a substance called plasminogen activator inhibitor, which leads to blood clot formation.

C-reactive protein can also lead to activation of white blood cells in the lining of the arteries to promote plaque formation. These findings begin to explain why those individuals with excess body fat are at a higher risk for cardiovascular disease. Scientists have discovered that excess weight leads to low-grade chronic inflammation; low-grade, chronic inflammation leads to mildly elevated C-reactive protein, which can lead to heart disease. As the pieces of the puzzle began to come together, I began to understand why people were losing weight on my anti-inflammatory diet. The foods and supplements that I had been recommending to reduce wrinkles and slow down the aging process were also inhibiting the inflammation that causes insulin resistance and body fat storage.

DANGERS OF ELEVATED NfkB

What happens (besides elevating our risk for disease) when people who are carrying excess fat have elevated levels of NfkB?

• It interferes with the body’s ability to use insulin,
• increasing our blood sugar levels,
• which then further increases inflammation,
• and makes us store body fat.

As mentioned, I advocated eating ample quantities of cold-water fish like wild Alaskan salmon, sardines, anchovies, mackerel, herring, shad, and trout—ideally, one fish meal per day. I also strongly recommended the use of nutritional supplements like omega-3 fish oil, alpha lipoic acid, carnitine, CLA (conjugated linoleic acid), glutamine, coenzyme Q10, astaxanthin, and dimethylaminoethanol (DMAE).

Why are these foods and supplements so effective? Because they all have high anti-inflammatory properties. Brightly colored fruits and vegetables signal the presence of antioxidants, nature’s natural anti-inflammatories. Wild Alaskan salmon also contains a powerful antioxidant, anti-inflammatory (responsible for its deep pink/red coloring) known as astaxanthin, reported to be more than 100 times stronger than vitamins C and E combined. Further, I realized that the single most powerful causative agent for reducing inflammation was the high levels of essential fats that I was recommending. These fats, particularly the omega-3 essential fatty acids found in high-fat fish and fish oil, act as powerful, natural anti-inflammatories.

Recognizing that a great many Americans were overweight, and their diets were practically devoid of the omega-3s, I asked myself the following questions: Could it be that low levels of the essential fatty acids exacerbate inflammation and promote weight gain? And could it then be that high levels of essential fatty acids also reduce the inflammation that is found in people with excess body fat, thereby accelerating that loss?

Perhaps we can find the answer in the huge increase of overweight people that has its roots in the no-fat and low-fat craze of the 1980s and continues to escalate to this day. Women in particular have suffered from the ridiculous and dangerous notion that all fat is bad and must be avoided at all costs. Not only did they not lose weight, this dangerous fad accelerated the development of wrinkles and contributed to an epidemic of mental depression and obesity.

The reason for this is twofold. First, the onset of the low-fat diet deprived brain cells of the critically essential healthy fat needed for normal brain function. When I say “normal” brain function, I refer to the production of those important chemical messengers known as “neurotransmitters” that allow brain cells to communicate with one another. We all know from television and magazines that low levels of serotonin, the classic “feel good” neurotransmitter, can lead to chronic depression. By depriving the brain of the healthy fats it needs to produce serotonin and other neurotransmitters, we are effectively opening the door to depression and a host of other mental, behavioral, neurological, and psychological maladies.

Second, in addition to the damage done by the deprivation of healthy fats, the 1980s saw the rise in the ingestion of massive quantities of fat-free, high-glycemic carbohydrates, such as the ubiquitous rice or corn cake, baked potato chips, nonfat cookies, and so on, which has played a significant role in the epidemic of both obesity and type II diabetes.

When we eat these high-glycemic carbohydrates, we deplete our precious reserves of serotonin. For example, a breakfast consisting of a low-fat muffin or bagel with fat-free cream cheese and jam, and a glass of fruit juice, will cause a rapid rise in blood sugar. This results in a release of serotonin in the brain, giving us a warm, fuzzy feeling as the carbohydrates are rapidly converted to glucose (sugar) by our digestive system. High levels of sugar are now circulating in our bloodstream, which signals the pancreas to secrete insulin to help bring down these high levels of sugar. The problem begins when the insulin pushes the blood sugar levels down to levels too low. The result is a rapid decline in serotonin levels, a quick drop in energy—and an almost irresistible craving for more sugar and carbs.

In other words, we need another “fix” in order to get back the warm, fuzzy feeling. In fact, many women “self-medicate” with high-glycemic carbs in their rational desire to simply feel good. I say “women” here because women generally tend to have lower levels of serotonin than men. And these levels drop even lower during parts of the menstrual cycle and when they are postmenopausal. To compensate for this, women resort to consuming larger amounts of high-glycemic carbohydrates than their male counterparts. Since many women place themselves on calorie-restricted diets, they then tend to forgo healthy proteins and healthy fats to make up for the calories contained in the carbohydrates.

This often results in women looking older than men of their same age group, because healthy fats and protein are necessary for cellular repair, while high-carb diets accelerate the aging process. The fluctuating blood sugar and insulin levels place them in a constant battle with excess weight gain, while the depletion of their serotonin leaves women at greater risk for depression.

This sorry state of affairs is contributing to the breakdown of the mental and physical health of men, women, and children at an escalating rate. We are overweight, we are depressed, we are fatigued, and we are stressed. And more and more of us, children and adults alike, are turning to chemical and pharmacological solutions to the problem. However, these “solutions” treat the symptom while ignoring the underlying problem. There is a better way.

I soon learned that when you consume food, its energy (measured as calories) can take one of two paths in the body:

  • Food calories can be burned in the mitochondria for production of ATP (adenosine triphosphate), a high-energy phosphate molecule used to store and release energy for work within the body. This entire process is known as “oxidative phosphorylation.”
  • More often as we get older, the food can go on to be stored as body fat (triglycerides in adipose tissue) or stored as glycogen in the liver and muscles (glycogen is the form in which foods are stored in the body as energy). If we can “uncouple” the oxidation from the phosphorylation, food calories can be burned off by thermogenesis. Thermogenesis bypasses the ATP-mediated energy. If the majority of food we ate was transformed into body heat, we would stay slim and trim.

This research led me to create the anti-inflammatory diet, where I discovered that the omega-3 essential fatty acids (EFAs) were powerful anti-inflammatories.

One important role of EFAs turned out to be their effect on insulin levels. High levels of insulin are pro-inflammatory; this is one of the reasons people gain excess weight and cannot seem to lose it when they diet. Chronically high levels create an “insensitivity” to the insulin. Excess insulin continues to be released into the bloodstream, resulting in the storage of fat.

When we add omega-3 essential fatty acids to our diets, we begin to “sensitize” our cells to insulin. Insulin receptors are found in the cell’s plasma membrane, which controls the passage of substances in and out of the cell. Essential fatty acids keep this critical and fragile portion of the cell flexible, thereby keeping these receptors intact and sensitive to fluctuations in insulin levels. The correct balance of dietary EFAs enables the receptors to respond to even small amounts of insulin, helping us to maintain healthy blood sugar levels and ensure an adequate uptake of sugar and amino acids into cells to build muscle and minimize fat storage.

I then discovered that the essential fatty acids found in cold-water, high-fat fish and fish oil possess a number of even more astonishing properties. These essential fats, particularly the omega-3s, are extremely important in energy production within the mitochondria. Omega-3 EFAs also inhibit the production of the enzyme fatty acid synthase, which plays a role in the storage of calories as body fat. In addition, the essential fatty acids are responsible for a phenomenon known as “fuel partitioning.”

When fuel partitioning is working efficiently, EFAs direct our bodies to store carbohydrates in the form of glycogen, rather than as hard-to-lose body fat. Glycogen is mainly stored in the liver and muscles and releases sugar (glucose) into the blood when needed by cells. It is the chief source of stored fuel in the body, and is the first place the body turns to when it needs quick energy between meals or when energy needs cannot be met by food intake alone, such as during intensive bouts of physical or mental activity. It is the glycogen stored in the muscle that directly affects how hard and how long we can exercise. In short, omega-3s facilitate the temporary storage of calories as glycogen, which is used for immediate energy needs, while encouraging the burning of stored body fat.

The most exciting moment of my quest, however, has to be when I came across a groundbreaking study that held the long-awaited answer I had been searching for—clear evidence that omega-3 fatty acids can increase thermogenesis, thereby dissipating calories in the form of increased body heat, instead of storing them as body fat. Ongoing research suggests that EFAs may be able to directly influence important metabolic genes in our cells—genes that control how we synthesize glycogen and how we store and burn fat. This may be due to a steroid-like substance in our bodies called PPARs (perixosome proliferator-activated receptors), which, when bound to fats like EFAs, can “switch on” key genes involved in burning fat. Further research also suggests that omega-3s switch on a protein called uncoupling protein-3, which plays an important part in energy metabolism. Higher levels of uncoupling proteins result in more energy being dissipated as heat, increasing energy expenditure and decreasing stored fat. This is a critical function because stored body fat is very difficult to lose, as millions of unsuccessful dieters know. Could omega-3s be the uncoupling agent I had been searching for?

Nutritional Factors Hold the Key

Amazingly, it seems that we don’t need some new super-drug as the solution to the weight-loss problem. For the first time, science had proven beyond a doubt that nutritional components of our diet can directly control and influence key metabolic genes in our cells. That means the EFAs we consume can significantly affect the way we store and burn fat. This nutritional aspect was particularly compelling because it meant that the effects would be physiological—that is, they would work with the body, as opposed to against it, the way a drug would. This also meant that the positive, beneficial effects of these essential fatty acids would always have efficacy; unlike a drug, we would not build up a tolerance or resistance to their therapeutic properties. These omega-3 fatty acids would always be on the job, helping us to burn excess fat, while simultaneously decreasing our propensity for fat storage.

Unfortunately, when most of us do consume essential fatty acids, they tend to be omega-6, which is found in grains and vegetable oils such as corn and safflower. In fact, very few of us are getting the proper ratio of omega-3 to omega-6, which may account for the growing prevalence of serious health conditions like heart attacks, cancer, asthma, lupus, schizophrenia, depression, accelerated aging, ADHD (attention deficit/hyperactivity disorder), Alzheimer’s disease, metabolic syndrome, obesity, and diabetes in our society.

This imbalance upsets the proverbial fat-metabolizing apple cart. An overabundance of omega-6 is inflammatory and interferes with the body’s ability to use omega-3s—a serious situation because of the positive effects of omega-3s we talked about earlier: they inhibit the calories we consume from being stored as body fat, while promoting the burning of body fat we already have.

It’s important to realize that the processes described here do not happen overnight. As soon as you begin taking in omega-3s (from foods and/or supplements), they start exerting their anti-inflammatory effects. It does take time, however, for EFAs to influence your thermogenesis and fuel partitioning, which is why I recommend that you do not delay introducing omega-3s into your diet. The reason that traditional low-calorie diets fail is that they lack omega-3s, which are essential for healthy metabolism. If you follow the anti-inflammatory diet and ensure the intake of plenty of omega-3 fatty acids, you will successfully lose weight. The powerful anti-inflammatory properties of the omega-3 essential fatty acids hold the key to the weight-control puzzle.

HOW OMEGA-3s AID WEIGHT CONTROL

As you can see, essential fatty acids affect and trigger a number of different obesity-fighting processes. Here is a short but comprehensive overview of what they are and what they do:

• Reduce inflammation that promotes weight gain.

• Enable burning of dietary fats by transporting fatty acids into the mitochondria of our cells for burning as fuel.

• Enhance “fuel efficiency” by exerting positive influences on the process of fuel partitioning.

• Improve blood sugar control by sensitizing our cells and enabling receptors to respond to even small amounts of insulin.

• Stimulate the secretion of leptin, a peptide hormone that is produced by fat cells. Leptin acts on the hypothalamus to suppress appetite and burn fat stored in adipose tissue (fat cells).

• Improve fatty acid balance by reducing conversion of dietary omega-6 EFAs to arachidonic acid.

• Influence key anti-obesity genetic switches (nuclear transcription factors) that govern both inflammation and conversion of food to body fat. They:

— Activate perixosome proliferator-activated receptors (PPARs), which increases the burning of body fat, increases thermogenesis, increases insulin sensitivity, and decreases levels of inflammation.
— Prevent activation of NfkB.
— Omega-3 (and omega-6) block the release of sterol response element binding protein-1 (SREBP-1), which switches on the gene that codes for fatty-acid synthase, an enzyme that helps create body fat.

• Omega-3 and omega-6 enhance the body’s ability to transport glucose from our blood to our cells via an “insulin responsive transporter” called GLUT4; they do this by optimizing the fluidity of cell membranes.

Stress, Stress-Related Weight Gain, and Obesity

Stress is highly destructive—not just emotionally, but also physically. Unfortunately, in today’s world, we all experience significant amounts of stress, and it does not appear to be going away anytime soon.

Many circumstances create stress in our daily lives. Arguing with family, friends, or colleagues, not getting enough sleep, worrying about everything from our family to our finances, constant pressure to keep up with the home and office demands; even playing too hard can all create stress. Weekend warriors, making up for a week of inactivity by spending hours engaged in strenuous activity, are also setting themselves up for a stress response.

Cortisol, the Stress/Death Hormone

When we are under stress, our adrenal glands produce hormones. These include the fight-or-flight hormones, epinephrine (adrenaline) and norepinephrine (noradrenaline), as well as cortisol.

Cortisol is a glucocorticoid, one of a group of steroid hormones that include cortisone. Cortisol is involved in carbohydrate, protein, and fat metabolism, and has anti-inflammatory properties. As we age, the “youth” hormones such as testosterone, estrogen, and human growth hormone decline. Cortisol, however, increases as we age and too much cortisol can also become pro-inflammatory.

When we experience stress (whether from fear, anxiety, physical or emotional trauma, or overexertion), the stress hormones epinephrine and norepinephrine will return to normal levels as the stress subsides. In a young person, cortisol levels will also return to normal within a few hours. Because cortisol levels continue to rise with age, the older person’s cortisol levels will remain elevated for long periods of time. This has earned cortisol the dubious distinction of being known as a “death” hormone, because high levels of cortisol exert a catabolic or muscle-wasting, deteriorating action on the body. Simply put, it breaks down tissue.

How Stress Promotes Weight Gain

Cortisol stimulates fat and carbohydrate metabolism for fast energy (the fight-or-flight response), thereby stimulating insulin release to keep pace with the rising blood sugar levels. This results in an increase in our appetite. If we experience chronic stress, with chronically high levels of cortisol, we may end up hungry all the time, causing us to overeat.

Cortisol also influences where that weight will be deposited. A fascinating study on the effects of the release of cortisol during acute and chronic stress in non-overweight women was published in the journal Psychosomatic Medicine in 2001. The study clearly demonstrated that this excess cortisol contributes to the deposition of visceral fat, particularly in the abdominal region. As we know, there are two types of fat: subcutaneous (under the skin) and visceral (found in the abdomen and surrounding our vital organs).

Central obesity sets the stage for a host of health concerns such as heart disease, strokes, and diabetes. Because of its serious threat to health, this has also been referred to as “toxic fat.” Traditionally, women worried about the size of their hips. However, when it comes to overall weight gain, it is preferable to have it on the hips as opposed to the stomach area—if not from an aesthetic point of view, then from a health point of view. Studies indicate that women (and men) who store their weight in the abdominal area have higher cortisol levels and higher stress levels than those whose weight is stored on the hips.

The Cholesterol Component

In addition, visceral fat is metabolized by the liver, which turns it into cholesterol that circulates in the blood. This is the so-called “bad” cholesterol, low-density lipoprotein or LDL, which collects in the arteries forming plaque (deposits of fats, inflammatory cells, proteins, and calcium material along the lining of arteries). The plaque builds up and narrows the artery, resulting in atherosclerosis. Researchers have also found that consuming a lot of saturated fats such as butter and the fats found in red meats can lead to the accumulation of visceral fat. The high omega-3 content found in wild Alaskan salmon, anchovies, sardines, and other cold-water fish, along with fish oil capsules, will help you to get rid of this deadly form of fat because the essential fatty acids found in these foods can decrease cortisol levels.

To sum up, elevated cortisol levels produce a host of negative effects that include:

  • increased inflammation
  • increased insulin secretion
  • increased appetite
  • storage of fat, particularly in the abdomen
  • increased risk of acne flare-ups.
  • Acne is a systemic inflammatory disease and stress precipitates and aggravates acne breakouts.
  • the death of brain cells. High levels of stress actually shrink the brain and other organs.
  • destruction of the immune system
  • decreased muscle mass
  • accelerated aging.
10 FOOD “SUPERGROUPS”

In order for any weight-loss program to 1) work, and 2) become a lifelong lifestyle, there have to be plenty of options available. If you feel hungry or deprived, you are on the wrong program.

I have put my favorite foods into what I call “SuperGroups.” Each SuperGroup is comprised of a different family of healthy, anti-aging, anti-inflammatory, anti-obesity choices. The food I consider to be the healthiest choice in each group is labeled “Top Choice(s)” and is followed by other healthy (and tasty) choices I call “Runners-Up.”

SUPERGROUP #1: RICH COLD-WATER FISH

FUNCTIONAL WEIGHT-CONTROL FACTOR: Omega-3s
TOP CHOICE: Wild Alaskan Salmon
RUNNERS-UP: Sablefish, Sardines, Anchovies, Herring, North Atlantic Mackerel, Trout, Tuna

SUPERGROUP #2: FAVORITE FRUITS

FUNCTIONAL WEIGHT-CONTROL FACTORS: Fiber, Anti-inflammatory Antioxidants, and other Phytonutrient Obesity-Fighters
TOP CHOICES: Apples, Pears, Grapefruit
RUNNERS-UP: All Berries, Peaches, Plums, Cherries, Pomegranates

SUPERGROUP #3: FATS FROM FRUITS TO FIGHT BODY FAT

FUNCTIONAL WEIGHT-CONTROL FACTORS: Anti-inflammatory Antioxidants, Monounsaturated Fats
TOP CHOICES: Avocado, Açaí, Olives
RUNNER-UP: Coconut

SUPERGROUP #4: SPICE THINGS UP TO KEEP WEIGHT DOWN

FUNCTIONAL WEIGHT-CONTROL FACTORS: Anti-inflammatory Antioxidants and other Phytonutrient Obesity-Fighters
TOP CHOICE: Cinnamon
RUNNERS-UP: Turmeric, Fenugreek, Cloves, Allspice, Nutmeg, Bay Leaf

SUPERGROUP #5: HEAT THINGS UP FOR BURNING FAT

FUNCTIONAL WEIGHT-CONTROL FACTORS: Anti-inflammatory Antioxidants, Fiber, and Phytonutrient Obesity-Fighters
TOP CHOICE: Chili Peppers
RUNNERS-UP: Cayenne, Chili Powder, Red Pepper Flakes

SUPERGROUP #6: SEEDS AND NUTS TO FILL YOU UP

FUNCTIONAL WEIGHT-CONTROL FACTORS: Anti-inflammatory Antioxidants, Essential Fats, Protein, Fiber, Lignans
TOP CHOICES: Sesame Seeds, Flaxseed
RUNNERS-UP: Almonds, Walnuts, Hazelnuts, Sunflower Seeds, Pumpkin Seeds

SUPERGROUP #7: BEANS AND LENTILS (LEGUME FAMILY)

FOR STABILIZING BLOOD SUGAR
FUNCTIONAL WEIGHT-CONTROL FACTORS: Fiber, Resistant Starch, Starch Blockers, and Phytonutrient Obesity-Fighters
TOP CHOICES: Dried Beans, including Kidney, Pinto, Navy, Red, and Black Beans, Lentils, Chickpeas, Mung Beans
RUNNERS-UP: All are recommended

SUPERGROUP #8: LOW-FAT PROBIOTIC DAIRY FOODS WITH CALCIUM FOR WEIGHT LOSS AND BONE HEALTH

FUNCTIONAL WEIGHT-CONTROL FACTOR: Nutraceutical Obesity-Fighters
TOP CHOICE: Low-Fat Yogurt
RUNNERS-UP: Low-Fat Kefir, Acidophilus Milk

SUPERGROUP #9: OLD-FASHIONED WHOLE GRAINS

FUNCTIONAL WEIGHT-CONTROL FACTORS: Fiber, Anti-inflammatory Antioxidants, and Other Phytonutrient Obesity-Fighters
TOP CHOICES: Buckwheat, Oats
RUNNER-UP: Barley

SUPERGROUP #10: VIBRANT VEGETABLES

FUNCTIONAL WEIGHT-CONTROL FACTORS: Fiber, Low-Calorie/Low-Glycemic Nutrition, Anti-inflammatory Antioxidants, and other Phytonutrient Obesity-Fighters
TOP CHOICES: Garlic, Spinach, Kale, Broccoli Sprouts, Cruciferous Vegetables
RUNNERS-UP: Aromatic Culinary Herbs (e.g., Parsley, Mint, Rosemary, Thyme, Basil, Oregano)

12 Nutritional Supplements That Facilitate Weight Loss While Maintaining Muscle Mass

The Perricone Weight-Loss Diet anti-inflammatory nutrients work in a special way to enhance loss of body fat, preserve muscle mass, and regulate levels of blood sugar and insulin, which are critical in the prevention and treatment of obesity.

These nutrients all have powerful anti-inflammatory and antioxidant activity. They’re an important adjunct to any health regimen, and particularly important for a weight-loss program.

Many of my patients have asked me over the years if it is possible to get all of the necessary nutrients from a healthy diet. Unfortunately, the answer is no. Alpha lipoic acid, for example, is one the most powerful and beneficial anti-inflammatory antioxidants and a very important nutrient for fighting aging and weight problems. However, there are no really adequate food sources for this nutrient. For optimum health and weight management, we do need to supplement. I always recommend that my patients take a complete spectrum of vitamins and minerals.

Fortunately, there are a number of outstanding supplements that really do help facilitate weight loss and maintain muscle mass. Each supplement has a distinct function, and they are all an important part of my own personal daily supplement regimen.

SUPERSTAR SUPPLEMENT #1: OMEGA-3 FISH OIL

Omega-3 fish oil supplements (as well as eating the fish itself) are extremely important to the success of any weight-loss plan, the Perricone Weight-Loss Diet included. I truly believe that they may be one of the most perfect anti-inflammatories we have discovered thus far. However, it is still important to take a variety of nutritional supplements to ensure optimum protection and benefit.

The incredible anti-inflammatory power of omega-3 essential fatty acids found in the high-fat fish and in fish oil can accomplish the following:

  • reduce inflammation in all organ systems
  • accelerate the loss of body fat
  • elevate mood
  • improve attention span
  • stabilize blood sugar levels
  • lower insulin levels
  • create and maintain healthy serotonin levels
  • stop the roller-coaster effects of the carbohydrate highs and lows
  • decrease appetite
  • increase radiance to skin
  • increase health of the immune system
  • increase energy levels
  • decrease symptoms and severity of rheumatoid arthritis
  • reduce symptoms and severity of chronic skin conditions such as eczema
  • decrease cardiovascular risk

Omega-3 Fish Oil Tips

  • To avoid any dietary side effects from the omega-3 fish oils (such as belching or stomach upset), divide the dose into three. For example, if you are taking 3,000 mg per day of fish oil, take one 1,000 mg capsule with a meal three times per day.
  • Even though fish oil is basically a “food,” always check with your primary health-care professional before embarking on any new supplement. Any therapeutic intervention, even nutritional supplements, can be contraindicated in certain health conditions. This is especially true with heart patients. Numerous studies have shown that fish oil helps protect against sudden cardiac death and abnormal heart rhythms called arrhythmias. However, according to a study in the June 2005 Journal of the American Medical Association, fish oil supplementation actually increased the rate of arrhythmia among patients who had an implanted cardioverter defibrillator (ICD).

DOSAGE RECOMMENDATION:

For a regular weight-loss diet, take one 1000-mg capsule three times per day. If you need to lose a lot of weight or are trying to improve athletic performance, take three 1,000-mg capsules three times per day for a total of nine per day. Check with your physician before taking the larger dose.

SUPERSTAR SUPPLEMENT #2: ALPHA LIPOIC ACID (ALA)

Alpha lipoic acid is a potent antioxidant and anti-inflammatory. It is found naturally in the body, locked inside the mitochondria. Lipoic acid is part of an enzyme complex called the pyruvate dehydrogenase complex, making it intimately involved in the energy production of the cell. Alpha lipoic acid, like many of the other nutrients including acetyl-L-carnitine, carnitine, and CoQ10, enhances our ability to metabolize food into energy.

Unlike many other antioxidants such as vitamin C, which is strictly water soluble, or vitamin E, which is strictly fat soluble, alpha lipoic acid is soluble in both water and fat. This means that alpha lipoic acid can go to all parts of the cell, including the lipid (fat) portions such as the cell plasma membrane, as well as the interior of the cell (known as the cytoplasm) where water-soluble chemicals reside. Because of this unique property, alpha lipoic acid is often referred to as “the universal antioxidant.”

Needless to say, the amazing properties of alpha lipoic acid have placed it near and dear to my heart, both as a powerful ally in the anti-aging realm and also as an integral part of the Perricone Weight-Loss Diet. On a cellular level, alpha lipoic acid exerts a wide variety of positive actions, all of them anti-inflammatory. It also blocks the activation of transcription factor NfkB as well, if not better than, any other antioxidant/anti-inflammatory thus far discovered.

In addition to its function as a powerful antioxidant/anti-inflammatory, alpha lipoic acid increases the body’s ability to take glucose into the cells. This insulin-sensitizing effect is also seen in some of the other nutrients that we have discussed. These nutrients all work synergistically to increase sensitivity to insulin, resulting in decreased blood sugar levels. Like carnitine and acetyl-L-carnitine, alpha lipoic acid is also very powerful in preventing glycation.

ALA works synergistically with CoQ10, carnitine, and acetyl-L-carnitine to protect and rejuvenate the mitochondria. If we recognize that an aging cell is characterized by decreased energy production, it is easy to see the importance of any substance that can increase energy levels in the cell, allowing the cells to repair themselves in the same way that young cells do. ALA also works synergistically with other antioxidants to raise levels of vitamins C and E, CoQ10, and glutathione in the cell.

Alpha Lipoic Acid Tips

  • In the metabolic cycle, alpha lipoic acid acts as a coenzyme in the production of energy by converting carbohydrates into energy (ATP).
  • ALA is the only antioxidant that can boost cellular levels of glutathione, the body’s most important antioxidant to overall health and longevity.
  • Take with meals.

DOSAGE RECOMMENDATION:

Because alpha lipoic acid is found only in trace amounts in food, it must be taken as a supplement.

SUPERSTAR SUPPLEMENT #3: ASTAXANTHIN

Astaxanthin comes from the microalgae Haematococcus pluvialis, found in abundance in arctic marine environments, and is a natural carotenoid (any of a class of yellow to red pigments, including the carotenes and the xanthophylls). Carotenoids are one of the most abundant molecules in the world and give nature its wide variety of colors—from carrots to flamingos. Astaxanthin is an amazingly powerful antioxidant and is often referred to as “red gold from the sea.”

Astaxanthin is one of the xanthophyll group of the carotenoid family. Xanthophylls help to protect vitamin A, vitamin E, and other carotenoids from oxidation. It is the most potent of all of the carotenoids—in fact, it is 10 times stronger than beta-carotene and 100 times stronger than vitamin E. Wild Alaskan salmon, lobster, rainbow trout, shrimp, crawfish, crab, and red caviar all owe their rich colors to their astaxanthin-rich diets—just one of the reasons wild salmon tops my SuperFood list. The variety of wild Alaskan salmon known as “sockeye” delivers the greatest amount of astaxanthin, with 4.5 mg per four-ounce serving. To put this in antioxidant perspective, 4.5 mg of astaxanthin is equal to 450 mg of vitamin E. Astaxanthin is also superior to many other antioxidants due to the unique role it may play in protecting the cell membrane.

Astaxanthin Tips

  • Because astaxanthin has been proven to cross the blood–brain barrier (see carnitine), it offers protection to the brain, the central nervous system, and the eyes.
  • It increases physical endurance and reduces muscle damage.
  • It reduces eye fatigue and improves visual acuity.
  • It provides wrinkle reduction by internal supplementation.
  • It reduces hyperpigmentation (better known as age spots).
  • It provides cytokine regulation, inhibiting the expression of inflammatory cytokines and chemokines.
  • It improves gastric health and reduces infection/inflammation of H. pylori, spiral-shaped bacteria that can damage stomach and duodenal tissue, causing ulcers.
  • Astaxanthin is an exceptional anti-inflammatory, making it an important component of the Perricone Weight-Loss Diet. Its ability to protect muscles and increase physical endurance is a wonderful asset for everyone needing to start and maintain a regular exercise program.

DOSAGE RECOMMENDATION:

One to two capsules, 2 mg each, per day.

SUPERSTAR SUPPLEMENT #4: CARNITINE

Carnitine is a nutrient that was once classified as an amino acid, but we now know that is incorrect. Carnitine is a water-soluble nutrient, very much like a B vitamin, that allows us to convert fat into energy. Carnitine and its derivative, acetyl-L-carnitine, are two of the most important nutrients for weight loss. However, for carnitine to have optimum effect, we must have adequate essential fatty acids (such as omega-3s) present in the diet. Carnitine is critical for energy formation and an active metabolism. Small amounts of carnitine can be obtained from foods such as meats and dairy products, but to get an adequate supply, we must take carnitine supplements.

You’ll remember that fats provide an important source of energy within the body, especially for muscles such as the heart, as well as vital organs such as the liver. In order for fat to be turned into fuel, it has to be carried into the energy-producing portion of the cell known as the mitochondria. It is the role of carnitine to transport the fatty acids from our blood into the cell for this energy production.

Carnitine also provides anti-aging benefits in that it enhances energy production in the cell, which is needed for cellular repair. Studies have also shown that carnitine helps prevent muscle loss during illness and also prevents the muscle loss associated with aging, known as sarcopenia. Carnitine is protective of liver function and enhances and protects the immune system, especially under stressful conditions.

Carnitine Tips

  • For carnitine to have optimum effect, make sure you have an adequate omega-3 intake.
  • Do not take carnitine in the evening, as it may interfere with sleep.
  • Carnitine may be taken with or without food.
  • For better utilization of fat for energy, take omega-3 fish oil with carnitine.

DOSAGE RECOMMENDATION:

The recommended dose for an adult under the age of 30 without ill health or obesity is approximately 500 mg per day. For those who are obese or have other health problems, the recommendation is 1500 to 2000 mg per day, taken in 500-mg doses three or four times per day.

DAMAGING EFFECTS OF GLYCATION

You have been advised to avoid high-glycemic foods as a surefire way to decrease inflammation and facilitate weight loss. However, there is another reason to steer clear of these foods. I have explained that these foods cause sudden spikes in blood sugar levels, resulting in the release of insulin into the bloodstream that then causes us to store, rather than burn, fat.

However, that is not the only negative by-product. As we know, when sugars and starches are eaten, they cause a burst of inflammation throughout the body. These sugars (and foods that rapidly convert to sugar) can permanently attach to the collagen present in our skin and other parts of the body through a process known as “glycation.” At the point of attachment, there is a small mechanism creating inflammation, which then becomes a source of inflammation in its own right. This inflammation produces enzymes that break down collagen, resulting in wrinkles. In addition to inflammation, glycation also causes cross-linking in our collagen, making it stiff and inflexible where it was once soft and supple.

But it is not just the skin we have to worry about. These “sugar-bonds” can occur throughout the body as we age. The sugar molecule attaches itself to our collagen as well as our arteries, veins, bones, ligaments, even our brains, resulting in the breakdown of organ systems and the deterioration of the body. Glycation creates “free radical” factories known as advanced glycation end products (AGEs), which also increase cellular inflammation. Because the Perricone Weight-Loss Diet is anti-inflammatory, it will prevent glycation, stop inflammation, keep the brain functioning properly, and facilitate weight loss. The alternative? Being wrinkled, depressed, and overweight.

SUPERSTAR SUPPLEMENT #5: ACETYL-L-CARNITINE

Acetyl-L-carnitine is synthesized from carnitine by the addition of an acetyl group to the carnitine molecule. While this synthesis means that it cannot be found in food, the good news is that this form of carnitine can pass through the blood–brain barrier, which separates the blood vessels from the central nervous system. The barrier has a protective effect, but it can stop the passage of therapeutic substances along with the harmful ones. Since acetyl-L-carnitine can penetrate this barrier, it has a particularly beneficial effect on the brain cells. In fact, acetyl-L-carnitine is extremely neuroprotective and should be used on a daily basis to prevent the neurological decline seen with aging.

Like carnitine, acetyl-L-carnitine improves mitochondrial function, but to an even greater degree, because it can pass through the mitochondrial membrane. And like carnitine, acetyl-L-carnitine functions best when there is adequate dietary intake of omega-3 essential fatty acids. Acetyl-L-carnitine is a natural anti-inflammatory that enhances the effects of antioxidant systems within the body. These anti-inflammatory properties protect the cell plasma membrane (the cell’s first line of defense) and prevent the conversion of arachidonic acid into inflammatory chemicals.

Acetyl-L-carnitine can also help repair the mitochondria, boost levels of the antioxidants glutathione and coenzyme Q10, and work synergistically with alpha lipoic acid, another powerful antioxidant/anti-inflammatory. Both acetyl-L-carnitine and carnitine have been known to actually improve the lipid profile within our blood by reducing the level of triglycerides and raising levels of HDL (good) cholesterol.

Both forms of carnitine are important in a weight-loss regimen because they act as natural anti-inflammatories, and they aid in transportation of fats into the mitochondria to be burned. They also enhance the sensitivity of insulin receptors, helping to decrease blood sugar and circulating levels of insulin. As we have learned, high levels of insulin are inflammatory and “lock” our body fat in place. Both carnitine and acetyl-L-carnitine help prevent glycation.

Acetyl-L-Carnitine Tips

  • Carnitine and acetyl-L-carnitine are not to be used by people with bipolar disease (manic depression) or those who are susceptible to seizures (epilepsy) unless recommended by their physician.
  • Do not take acetyl-L-carnitine after 3 p.m., to prevent any difficulties with sleeping.
  • Exercise naturally increases our levels of acetyl-L-carnitine; however, if we are obese, over 30, or have other health problems, it will not raise them to therapeutic levels; therefore supplementation is necessary.
  • Acetyl-L-carnitine may be taken with or without food.
  • For better utilization of fat for energy, take omega-3 fish oil with carnitine.

DOSAGE RECOMMENDATION:

500 mg per day; however, individuals on a weight-loss program may take up to 1500 mg daily.

SUPERSTAR SUPPLEMENT #6: CONJUGATED LINOLEIC ACID (CLA)

CLA is a fatty acid that is found in many of the foods we eat. At one time, beef and lamb were exceptional sources; however, when their diet was changed from grass to grain, levels of CLA dramatically decreased in meat and dairy products. When CLA is present, it is found in the fatty portion of milk. Drinking skim milk prevents us from receiving the benefits of CLA.

However, since CLA levels are now so low in animal products, skim vs. full-fat milk is a moot point.

When taken in effective doses, CLA decreases body fat, especially in the area of the abdomen. There are several mechanisms of CLA’s activity that accomplish these feats:

  • CLA actually concentrates in the cell membrane, stabilizing it and thus preventing the breakdown of arachidonic acid into a pro-inflammatory prostaglandin. It helps the insulin receptors remain intact, thus increasing insulin sensitivity, which will then decrease blood sugar and circulating insulin levels.
  • Remarkably, studies show that CLA also helps block the absorption of fat and sugar into fat cells (adipocytes). It even induces a reduction in the actual size of the fat cells (one reason people gain weight as they age is that their fat cells literally become fatter).

CLA Tips

  • When taken with sesame seeds, the effects of CLA are enhanced.
  • The average diet provides no more than a gram (1000 mg) of CLA per day.
  • CLA may be taken with meals.

DOSAGE RECOMMENDATION:

1000 mg, up to a maximum of 4000 mg per day, taken in one or two doses.

SUPERSTAR SUPPLEMENT #7: COENZYME Q10 (COQ10)

Coenzyme Q10, also called ubiquinone, is a powerful antioxidant/anti-inflammatory with many benefits for treating and preventing obesity. It acts similarly to acetyl-L-carnitine in that it assists in energy production within the mitochondria. As we have learned, energy production declines as a cell ages, and that means that the cell’s ability to repair itself also declines. Working synergistically with acetyl-L-carnitine, carnitine, and alpha lipoic acid in the mitochondria, CoQ10 enhances the metabolism, giving us greater energy and endurance, and a greater ability to lose body fat, while preventing the energy decline seen in aging cells.

CoQ10 also works synergistically with other antioxidants to elevate cellular levels of vitamins C and E and glutathione and to help regulate blood sugar and enhance insulin sensitivity. CoQ10 also maximizes the burning of foods for fuel, helping to normalize fats in our blood.

Hundreds of studies document the effectiveness of CoQ10 in protecting all vital organs of the body, including the brain, heart, and kidneys. Because of its powerful anti-inflammatory effects, CoQ10 is extremely protective of the cardiovascular system. It keeps the heart muscle healthy and also prevents inflammation in the arteries, which leads to arteriosclerosis.

Although CoQ10 can be found in small amounts in fish such as sardines or salmon, as well as in nuts, I recommend supplementation for optimal anti-aging and weight-loss benefits. CoQ10 supplementation is of particular importance for women because they tend to have lower levels than their male counterparts.

CoQ10 Tips

  • This supplement should be taken by anyone over 40, as tissue levels of CoQ10 decrease as people get older.
  • CoQ10 is best taken with food.

DOSAGE RECOMMENDATION:

I recommend a minimum of 30 mg per day. For those with health problems, under the supervision and recommendation of their physician, up to 300 mg per day. About three weeks of daily dosing are necessary to reach maximal serum concentrations of CoQ10.

SUPERSTAR SUPPLEMENT #8: CHROMIUM

Chromium is a critical nutrient in our effort to control and reduce excess body fat. By supplementing our diets with chromium, we can effectively lower blood sugar and insulin levels—the key to the anti-inflammatory weight-loss diet. The reason people are overweight is because they’re in an inflammatory state that has put a “lock” on their fat-burning mechanism. Our goal is to reverse this. Chromium helps decrease inflammation, thereby unlocking the enzymes that aid in fat metabolization. Chromium not only affects blood sugar and insulin levels, it can also help normalize blood lipids such as triglycerides and cholesterol, increasing levels of the HDL “good” cholesterol and lowering total cholesterol and triglycerides, making it cardioprotective.

Experts in the field of nutrition report that the general population of the United States is deficient in chromium, and low levels of chromium are associated with type II diabetes and cardiovascular disease. Studies have also been published noting that increased consumption of sugar depletes our body stores of chromium, placing us at further risk for hyperglycemia and hyperinsulinemia (too much blood sugar, too much insulin).

Chromium Tips

  • Chromium is an essential nutrient required for normal sugar and fat metabolism.
  • Chromium is important for energy production, and also plays a key role in regulating appetite, reducing sugar cravings, and lowering body fat.
  • Chromium absorption is made more difficult when milk, as well as foods high in phosphorus, are eaten at the same time.
  • Don’t take chromium with foods rich in phytic acid (unleavened bread, raw beans, seeds, nuts, grains, and soy isolates) as this may decrease its absorption.
  • The recommended type of this supplement is chromium polynicotinate.

DOSAGE RECOMMENDATION:

I suggest 100 micrograms (mcg) per day for the average person over 40 and up to 200 mcg per day for those on the Perricone Weight-Loss Diet.

Borage (Borago officinalis)

SUPERSTAR SUPPLEMENT #9: GAMMA LINOLENIC ACID (GLA)

GLA is an important omega-6 essential fatty acid. The average Western diet has an excess of the omega-6 EFAs. And this is true when we are speaking of linolenic acid, found in many vegetable oils, grains, and seeds. However, GLA is an omega-6 that is well worth taking in a supplemental form. The body rapidly converts GLA into dihomogamma-linolenic acid (DGLA), the precursor of prostaglandin E1, a powerful anti-inflammatory hormone-like compound that helps to regulate inflammation, blood pressure, and many other bodily processes. Because of the increased production of prostaglandin E1, GLA has been found in many studies to lower total cholesterol, as well as lower blood pressure. GLA can also increase the metabolic rate, an effect that causes the body to burn fat, resulting in weight loss.

The average American diet causes a deficiency of GLA because of the large amounts of trans fatty acids, sugar, red meats, and dairy products that are consumed. GLA is very difficult to find in the diet, but is found in high amounts in borage, black currant, and evening primrose oils.

GLA Tips

  • Take GLA with meals to increase absorption.
  • GLA improves cell sensitivity to insulin, reducing our chance of developing diabetes, heart disease, and excess body fat.
  • Borage oil is the richest supplemental source of GLA.
  • As with omega-3 fish oil supplementation, results do not happen overnight and may take up to six months. Don’t let this dissuade you from adding this vital essential fatty acid to your diet as soon as possible.

DOSAGE RECOMMENDATION:

200 to 400 mg of GLA per day—one to two 1,000-mg capsules of borage oil.

SUPERSTAR SUPPLEMENT #10: GLUTAMINE

Glutamine is an extremely important dietary supplement for anyone wishing to lose weight. It is an amino acid that is classified as “conditionally essential,” meaning that we are able to synthesize it, but only within certain limits that are controlled by a variety of factors (including the dietary supply of the appropriate precursors and the maturity and health of the individual). Glutamine is primarily stored within muscles and is the body’s most abundant amino acid. (Amino acids are the basic building blocks of a protein. There are 20 different amino acids commonly found in proteins. There are eight essential amino acids: isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. Our bodies actually need 20 different amino acids, but we are able to make the other 12 kinds from these eight, which we must get from food.)

While the majority of the glutamine we need is synthesized in our muscle cells, we can also obtain a significant amount of glutamine from several dietary sources, including poultry, fish, dairy products, and legumes.

However, under certain stressful conditions, glutamine is used up very quickly and our body cannot make as much as it needs. For example, prolonged and intense cardiovascular workouts, such as running and aerobics, can cause the body to burn muscle for energy, exhausting our glutamine supply.

It appears that glutamine plays an important role in keeping the muscles functioning properly and in helping to reduce muscle deterioration. One reason is that glutamine is the only amino acid that contains two nitrogen molecules. Because of this additional molecule, glutamine can transport, or shuttle, the nitrogen to where it is needed most. Nitrogen is one of the building blocks of muscle cells; glutamine is the delivery system for getting the nitrogen to those cells. Glutamine can also transport excess nitrogen out of the body—a critical function because nitrogen can act as a toxin. The optimal state for muscle growth is when glutamine is working properly, and nitrogen intake is greater than nitrogen output.

When we are overweight and in an inflammatory state, we need even more glutamine—so the body breaks down the muscle tissue to get the extra glutamine it needs—and we lose muscle mass. Making sure we have enough glutamine enables us to both lose weight and retain muscle mass.

Glutamine plays a number of vitally important roles in many other functions as well. It is absolutely essential to the support of our immune system and immune response, where it is utilized by white blood cells. Glutamine is also anti-catabolic, which means that it is critical in the prevention of muscle breakdown caused by extreme stress, including physical trauma or injury, severe burns, disease, mental or psychic stress, overwork or overexertion, poor nutrition, and dieting.

Glutamine has such extraordinary anti-catabolic properties that it has been used to help prevent stress ulcers in severe burns. Scientists have also found that patients who have had major surgery or trauma do not lose muscle mass during the recuperative period when they are given supplemental glutamine, even if they are inactive! This prevention of muscle breakdown is the reason that I so strongly recommend that you take glutamine throughout the day as part of the anti-inflammatory diet.

Glutamine is also very supportive of our digestive system. The health of the gut is of critical importance because it is the point of fuel and nutrient entry. Glutamine nourishes the cells that line the stomach, intestines, and digestive track, which actually use glutamine as a fuel. Studies have shown that supplemental glutamine may protect against aspirin-induced gastric lesions and enhance healing of painful peptic ulcers. In fact, an old folk remedy for ulcers is fresh cabbage juice—which is high in glutamine. Glutamine may also be helpful in healing the stomach problems arising from colitis and Crohn’s disease. In summary, glutamine can be used whenever there are any stomach problems, as simple as overindulging in alcohol (alcoholic-induced gastritis) to ulcers, viral-induced diarrhea, or even severe problems such as inflammatory bowel disease.

It is difficult to overstate the importance of glutamine to our body’s antioxidant system. In combination with other amino acids,

N-acetyl cysteine and glycine, glutamine promotes the synthesis of glutathione in the liver. Glutathione is the body’s primary antioxidant defense system; it is required for the smooth functioning of all cells. It is involved in protein synthesis, amino acid transport, and in the recycling of other antioxidants, such as vitamin C. In fact, it is so effective in preventing inflammation in the body that glutathione is being used to treat people with HIV infection who suffer from high levels of inflammation and body wasting.

Glutamine will reduce cravings for high-glycemic carbohydrates and will make your weight-loss program much easier. Glutamine can help prevent both depression and fatigue and can also help us synthesize neurotransmitters in the brain, which naturally relax us while elevating our mood. In the brain, it is converted to glutamic acid and increases the concentration of GABA (gamma-aminobutyric acid). Both glutamic acid and GABA can be considered “brain fuel,” as they are essential for normal mental function. Studies have also shown that glutamine supplementation helps prevent the damaging effects of alcohol on the brain and may also reduce alcoholic (as well as food) cravings.

Glutamine Tips

  • Once mixed in water, glutamine deteriorates rapidly, so take it immediately upon mixing in the water.
  • Do not store glutamine solution, as it may become inactive or possibly toxic.
  • Mix fresh for each serving.
  • Check with your primary care physician before beginning any supplementation program—this is mandatory if you are being treated for any disease or kidney, liver, or other health problem, are pregnant, or nursing.
  • Glutamine may cause constipation in some individuals; to protect from this, increase your water and soluble fiber intake. This can be accomplished by adding one gram of pectin to a glass of water.

DOSAGE RECOMMENDATION:

One-half teaspoon of glutamine dissolved in water three times a day.

ANABOLIC VS. CATABOLIC

The term “anabolic” means to build up tissue; the term “catabolic” means to break down tissue. Our goal is to always be in an anabolic state. Anabolic stimulating substances are made by the body and they include the growth hormones and the sex hormones such as testosterone.

The catabolic state is also termed as “the clinical wasting syndrome or cachexia,” a syndrome that is characterized by unintended and progressive weight loss, weakness, and low body fat and muscle. This catabolic state can occur in diseases such as cancer and AIDS.

Inflammation puts our body in a catabolic state, even though we may not be seriously ill. The anti-inflammatory diet and anti-inflammatory supplements, such as alpha lipoic acid, CoQ10, and glutamine, are extremely important forms of protection as we embark on a weight-loss program.

SUPERSTAR SUPPLEMENT #11: MAITAKE MAGIC

The Maitake SX-Fraction™ is a special supplement derived from the maitake mushroom. There is a solid body of scientific evidence establishing it as a powerful tool in preventing metabolic syndrome, a dangerous quartet of metabolic imbalances that increase our risk of cardiovascular disease and diabetes: 1) high blood pressure, 2) elevated levels of insulin, 3) excess weight (especially around the abdomen), and 4) “dyslipidemia” (low levels of HDL “good” cholesterol, high levels of LDL “bad” cholesterol, and high levels of triglycerides [meta-bolized dietary fats that end up in our blood, organs, and tissues]). Metabolic syndrome is a by-product of Americans’ sedentary lifestyles in conjunction with an inflammatory diet high in sugars, starches, and processed “junk” foods.

The Maitake Grifron SX-Fraction™ has been developed based on a newly discovered active fraction from the Maitake mushroom (Grifola frondosa) in collaboration with Harry G. Preuss, MD, of Georgetown University.

The study at Georgetown University started in 1997 based on a previously discovered compound, X-Fraction, which Japanese scientists demonstrated had anti-diabetic activity. Searching for a better compound, researchers developed an improved method to successfully fractionate and identify another active compound from maitake, named SX-Fraction.™ Studies on SX-Fraction™ have been conducted at Georgetown University and New York Medical College. Results show that SX-Fraction™ does indeed possess a more potent ability to enhance insulin sensitivity for controlling blood sugar levels and lowering high blood pressure than X-fraction. This is another exciting, therapeutic tool to add to our arsenal of substances that can positively affect out-of-control blood sugar and all of its negative ramifications.

Leading experts believe that the Maitake SX-Fraction™ may be very helpful not only in prevention, but also for those who suffer from chronic disorders associated with the aging process due to malfunction of blood glucose/insulin metabolism. A recent study conducted at four clinics in Japan gave 33 diabetic people, who were on a stable drug regimen, nine tablets of SX-Fraction™ daily. Both blood sugar and cholesterol markers were improved significantly. In addition, they lost six pounds in a two-month period, without dieting. While this is not dramatic, it is statistically significant and future studies may show that in addition to preventing metabolic syndrome, SX-Fraction™ may serve as a safe and reliable weight-loss supplement—even without additional behavior modifications, such as decreased caloric intake and increased exercise.

It appears that the Maitake SX-Fraction™ may be the first dietary supplement of this kind specifically targeting metabolic syndrome with abundant scientific validation behind it. And the research continues to this day.

Maitake SX-Fraction™ Tips

  • Recent studies suggest that this active constituent may help maintain healthy cardiovascular function and a healthy circulatory system.
  • For optimum effect, take between meals.

DOSAGE RECOMMENDATION:

I recommend that you select the Grifron SX-Fraction™ of Maitake Mushroom Extract Supplement because this is the standardized product used in the studies. For general support for healthy blood sugar maintenance, take one tablet within 30 minutes after each meal. For maximum impact, you may double or triple the general dose.

A WORD ABOUT ANTIBIOTICS

According to the Union of Concerned Scientists (www.ucsusa.org), more than 68% of all seafood consumed in the United States is imported, and most of it is industrially produced. Many of these commodities are farm-raised and often involve little oversight regarding antibiotic drug use. While the US government has standards that should ban imports with high levels of antibiotics in seafood, there is essentially no enforcement. Farmed salmon has more antibiotics administered by weight than any other form of livestock.

HOW TO EAT TO LOSE WEIGHT

• Remember, every meal or snack must include: protein, low-glycemic carbs, AND essential fatty acids.

• Always eat your protein first. Reach for that shrimp cocktail or smoked salmon appetizer first—and when your Thanksgiving dinner entrée arrives, eat the turkey first, followed by your green salad and vegetables. Why? Because by eating your protein first at every meal, you are helping to suppress your appetite. Proteins are digested much more slowly than carbohydrates—even carbohydrates that are high in fiber. Also, protein is neutral in terms of its effect on blood sugar.

• Save the fresh fruit for the end of the meal. This way, you will prevent the natural sugars found in the fruit from causing a spike in blood sugar. Our goal is to avoid spikes in blood sugar, which trigger insulin release. Remember this fact: insulin release = stored fat!

SUPERSTAR SUPPLEMENT #12: DIMETHYLAMINOETHANOL (DMAE)

DMAE is a naturally occurring nutritional substance with powerful anti-inflammatory properties. It is found in fish, including wild Alaskan salmon, anchovies, and sardines. Back in the 1950s, DMAE was a prescription drug used as a treatment for central nervous system problems such as attention deficit disorder. Although it is no longer used for this purpose, it is being sold as a nutritional supplement for improving cognitive function, with additional benefits of improved memory and increased problem-solving ability. DMAE is important in the production of neurotransmitters, especially acetylcholine, which is essential in the communication from one nerve to another and between nerves and muscles. In order for your muscles to contract, the message must be sent from your nerves to your muscles via acetylcholine. DMAE also has membrane-stabilizing effects and can also help reduce body fat, most likely from its activity as a precursor to acetylcholine as well as its anti-inflammatory activity.
Taking DMAE as a supplement will not only improve your cognitive function, it will help increase skin firmness and muscle tone. In fact, recent studies have confirmed that topically applied DMAE lotion turned out to be extremely efficacious—in other words, it had positive effects on the skin, greatly increasing the appearance of radiance, tone, and firmness, while decreasing the micro-inflammation in the skin.

DMAE Tips

  • For optimum health, beauty, and weight-loss benefits, I recommend eating fish rich in DMAE, taking DMAE supplements, as well as applying a topical lotion containing DMAE to face, neck, and body.
  • It is thought that DMAE can make epilepsy and bipolar depression worse; thus, it is advised that those with these health problems avoid DMAE.
  • DMAE can also be over-stimulating for some people, perhaps causing muscle tension or insomnia, so individuals experiencing such difficulties are advised to discontinue use of DMAE.
  • Take with meals for optimum effect.

DOSAGE RECOMMENDATION:

My recommended dose is 50 to 100 mg per day. For certain therapeutic uses, such as lowering cholesterol, larger doses may be recommended. As always, consult your physician.

EAT FIBER TO FIGHT FAT

•For maximum fiber, eat lots of raw fresh fruits and vegetables. Adding fiber to the diet helps regulate blood sugar levels, which is important in avoiding diabetes, metabolic disorders, and unwanted weight gain. Eat the skins of your fruits and vegetables if they are organic and unwaxed; the greatest fiber and antioxidant/anti-inflammatory properties are in the skin.

•The recommended fiber intake per day is 25–30 grams. Do not forget to drink six to eight 8-ounce glasses of water every day—this is vitally important—especially because increased fiber can cause constipation if you don’t drink enough water.

•Fiber can help prevent gallstones and kidney stones as well as high cholesterol. Fiber-rich foods slow down the digestive process, preventing a rapid release of glucose (sugar) into the bloodstream.

•Fiber can offer protection from certain types of cancer, such as breast cancer, ovarian cancer, and uterine cancer.

•Fiber can help prevent heart disease. Soluble fiber, which is found in oats, for example, can exert a positive effect on cholesterol, triglycerides, and other particles in the blood that influence the development of heart disease.

The Perricone Weight-Loss Diet is not just about the foods we do or do not eat. It is also about understanding the actions we do in our daily lives that are pro-inflammatory, and learning how to change them. Many have a direct link to obesity and weight gain, as well as accelerated aging, wrinkles, the thinning of skin, the killing of brain cells and shrinking of the brain, and a weakened immune system.

PRO-INFLAMMATORY FOODS TO AVOID

A simple rule of thumb is to consider the following: if it contains flour and/or sugar or other sweetener, it will be pro-inflammatory. For the most part, avoid the following foods:

• Bagels
• Baked goods
• Breads, rolls
• Cake
• Candy
• Cereals (except old-fashioned oatmeal)
• Cheese (except, sparingly, hard cheeses such as Romano and Parmesan, soy, feta, and cheese made with goat or sheep’s milk)
• Cookies
• Corn bread, corn muffins
• Cornstarch
• Corn syrup
• Crackers (except flaxseed crackers)
• Croissants
• Egg rolls
• Donuts
• Fast food
• French fries

• Fruit juice—eat the fruit instead
• Granola
• Flour
• Fried foods
• Honey
• Hot dogs
• Ice cream, frozen yogurt, Italian ices
• Jams, jellies, and preserves
• Margarine
• Molasses
• Muffins
• Noodles
• Pancakes
• Pasta
• Pastry
• Peanut butter made with hydrogenated oils
• Pie
• Pita bread
• Pizza

• Popcorn
• Potatoes
• Pudding
• Relish
• Rice
• Sherbet
• Shortening
• Snack foods, including potato chips, pretzels, corn chips, rice and corn cakes
• Soda
• Sorbets
• Tacos
• Tortillas
• Vegetable oils (other than olive or coconut)
• Waffles