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Podcast: Weight, Weight, Don't Go Away
Length: 7 min 35 seconds
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Weight, Weight, Don’t Go Away - A look into how disease impacts muscle mass
With strange diets like the Bacon Diet, we may wonder what’s next? Having exhausted virtually every food combination, will the tide turn to disease? Controlling Calories through Cholera or perhaps Flush your unwanted weight with dysentery! As odd as it sounds, people have promoted the disease approach. In the early 1900’s, you could mail order tapeworms. You can see this advertisement in museums like California’s Bodie State Historical Park and Ghost Town. Other fin de siécle suggestions included eating cotton balls, drinking alcohol, or smoking cigarettes. Believing that obesity resulted from too much sex, Sylvester Graham promoted abstinence which surprisingly did not take off. Think on that next time you munch on his famous snack, the Graham cracker. But we digress.
With weight loss, we must differentiate good weight loss from bad
Why does disease sheds weight so dramatically? It’s easy to say that the disease takes a toll on the body, but what mechanism drives weight loss beyond what we can account for by appetite suppression? Let’s examine how certain diseases trigger sudden weight loss and when to increase a pet’s protein intake and when not to.
To begin with, we must differentiate good weight loss from bad. Good weight loss equates to less body fat and as a result, less harmful adipose hormones. The result, a longer happier life. Muscle atrophy hallmarks bad weight loss and associates itself with a loss of strength and physiologic reserve.
Weight Loss from Infections
Infection represents a reversible and common cause of bad weight loss. Infection taxes the system by way of the liver. Don’t be hard on the liver though, its efforts to save your life is what results in your loss of muscle tone. When faced with infection, the liver knows that it may need to generate vast quantities of acute phase proteins, and building blocks for antibodies, hormones and cytokines. As a result, it sequesters or holds the amino acids from other uses. Thus, the liver interrupts the muscles normal rebuilding process, and muscle atrophy ensues.
In the face of infection, increased calorie, protein, and vitamin consumption support the animal. However, while more protein helps, we cannot choose just any protein. When pet owners or even veterinarians inquire if they can just feed cooked hamburger and rice to their pet, the opportunity to educate presents itself. Diseases such as infection, cancer, and diarrhea increase the body’s need for non-essential amino acids like glutamine. Shifting ratios of aromatic and branch-chain amino acids also help pets struggling with infection, diarrhea or liver disease. Enhancing the levels of certain vitamins like Vitamin A, anti-oxidants like lipoic acid, minerals like selenium, and other nutrients like carnitine can speed recovery and protect against relapse. Many prescription diets account for these and other considerations.
Weight Loss from Chronic Renal Disease
With Chronic Renal Disease (CRD) or kidney failure, cats demonstrate progressive weight loss through muscle atrophy. Naturally alarming to pet owners, many people wonder if the restricted protein diets their vets prescribed contribute to or even cause the weight loss. With intense research, also known and Googling, pet owners can find substantial evidence that high protein does not damage failing kidneys. While scientific debate on this exists, high protein in the face of CRD does unquestionably diminish how the pet feels by raising the Blood Urea Nitrogen (BUN) levels. More importantly, higher protein does not prevent the continued weight loss. Metabolic acidosis, not restricted protein, generates muscle breakdown while suppressing muscle synthesis. Thus, utilizing specific prescription diets provides the correct type and level of protein, adjusts for pH aberration, and supports the body through additional nutrients like DocosaHexaenoic Acid (DHA), carnitine, and phosphorus restriction, etc.
Weight Loss from Liver Disease
Liver disease provides our last example of an altered protein requirement. As we learned, the liver directs the metabolism and use of amino acids, the building blocks of protein. The liver carries out hundreds to over a thousand different functions depending on how you look at it. Indeed, the liver so important that in bygone times, poets described it as the seat of Love itself. Without this background and in the absence of cannibals, the Much Ado About Nothing quote, “If ever love had interest in his liver” makes little sense. Additionally, Shakespeare’s Henry the Fourth quote, “My knight, I will inflame thy noble liver” has little to do with Hepatitis B and everything to do with passion.
So, when you pump iron to impress your significant other with your gun show, remember that it is your liver that ultimately performs the heavy lifting. It metabolizes and provides the amino acid building blocks that make up your biceps. Thus, when stressed, sick, or inflamed, we need to control which types of protein we ask the liver to process. We must consider both amounts and ratios of essential and non-essential amino acids along with overall branch-chain and aromatic types. Boiled chicken and quinoa will not suffice. Veterinary nutritionists work hard to produce prescription diets that support liver disease.
Summary at looking into how disease impacts muscle mass
Sex, weight loss, and livers – over the centuries our understanding of these continues to evolve, confuse, and fascinate us. What we do know for sure is that the simple mantra of “Protein good, carbohydrates bad” provides insufficient understanding when looking at patient care. Whether restricting or bolstering dietary protein for dogs and cats, we must ensure the proper types along with a litany of other nutrients. Utilizing boarded nutritionists, we can simply our approach, thereby freeing our time for other aspects of patient care.
- Hand, M. S., & Lewis, L. D. (2010). Small animal clinical nutrition. Topeka, Kan.: Mark Morris Institute. Page 94
- Hog, B. (2012, November 12). The Bacon Diet. Retrieved January 20, 2018, from https://bacontoday.com/the-bacon-diet/
- Rodriguez, R. V. (2011, November 22). 11 Weirdest Diets in History. Retrieved January 20, 2018, from https://www.active.com/nutrition/articles/11-weirdest-diets-in-history
- Shakespeare, W., & Kemble, J. (1971). Henry IV, part 2. London: Cornmarket Press.
- Shakespeare, W., & Trenery, G. R. (1924). The works of Shakespeare: Much ado about nothing. London: Methuen.
- Wang, X. H., & Mitch, W. E. (2014). Mechanisms of muscle wasting in chronic kidney disease. Nature Reviews. Nephrology, 10(9), 504–516. http://doi.org/10.1038/nrneph.2014.112