Will There Be A Pill For Obesity Someday?Feb 14, 2014
In the United States, obesity and diabetes have risen to epidemic proportions. Dr. Jared Rutter, professor of biochemistry at the University of Utah, explains why our body’s metabolism wasn’t designed to cope with today’s diet, and how that leads to disease. He also talks about his research to combat obesity and diabetes by fixing problems with the body’s metabolism.
Announcer: Examining the latest research, and telling you about the latest breakthroughs, The Science and Research Show is on The Scope.
Host: One day will there be a pill that cures obesity? Jared Rutter, a professor of biochemistry at the University of Utah is researching ways to combat obesity and diabetes at their source by fixing problems with the body's metabolism. Dr. Rutter, what do you think about the argument that the reason that obesity and diabetes are such huge problems today is that our bodies' metabolism is really designed for our caveman ancestors' who lived in a very different world.
Dr. Jared Rutter: I remember when I first heard that concept and it just made so much sense to me. The pressures that our ancestors were under were completely different than the pressures we're under. When I say pressures, I mean from a survival sort of context and as a result, there was a much greater selector pressure to avoid starvation, because especially in a historical context, we may not eat for a couple of days and if we're not good at storing the energy we ate today, we may starve in 36 hours when we haven't eaten. And so our bodies are very good at taking the energy we consume and putting it into a storage form that can then be accessed over the course of the next days, week, months. And so now when we essentially have access to unlimited food, or many of us, most of us do, and don't have an imperative to do extensive exercise, that now puts our bodies in a situation as you said that they are not optimized for.
Host: It seems today the answer is fad diets. Every year there's a new one, the paleo diet, the Mediterranean diet, what's your opinion of fad diets?
Dr. Jared Rutter: There are obviously good aspects to all dietary regimes. At the end of the day, if that diet is a balanced diet that enables us to consume a smaller number of calories, that brings it more into balance with the number of calories we expend via exercise and our body's basal metabolism, then that's probably a good thing. I do think, however, that highly unbalanced diets that are focused around one key element or principle and don't enable us to have a balanced diet to provide our body with the nutrients we need, are probably unbalance, unhealthy and should probably be avoided.
Host: Why is it important to study metabolism? What do we still need to know?
Dr. Jared Rutter: We understand in most cases the steps, you know when we eat a carbohydrate, we understand most of the steps by which that carbohydrate is converted into energy that our body can use. What we don't know as well is how does the body do what it needs to do with the nutrients that we bring in through our diet. And how does that change when we've eaten a lot, how does it change when we haven't eaten, how does it change when we've just, you know, run 15 miles, how does it change when we're sitting on the couch watching TV? We need to understand what that difference is and what the body is perceiving to make that change and then how does it enact that change. And if we can understand that at a deep level, that may be where we can use therapeutics, be they behavioral therapeutics or pharmacologic, or other means to manipulate that process and maybe put us into a healthier state given our environment.
Host: So what exactly are you researching?
Dr. Jared Rutter: One major area of research interest for us is how does the cell decide, how does the body decide really what to do with the carbohydrates that we take in and one of the possible options for the fate for carbohydrates in our body is to convert them into fats. And that's done quite efficiently in, among other places, our liver. And we study the process by which that happens, and again how that is regulated, how the body decides when to do that, how much to do that. I think it's quite clear now, from studies around the world, that this process is fundamentally important in obesity and I think there's emerging evidence that it's fundamentally important also in diabetes. And I think there's emerging evidence that's not quite as clear yet, but that this process is also important in other diseases like cancer.
Host: So is there a particular pathway or a particular protein that you're focusing on?
Dr. Jared Rutter: Yeah, we focus on a protein that has the name PAS kinase and so its role is a regulatory role; it controls the activity of other proteins and enzymes that participate in this process of lipogenesis, this process of converting carbohydrates to fat among other things that it does so we are now are trying to understand how this regulator, PAS kinase, controls the activity of this lipogenesis process and how that relates to the disease processes of obesity and diabetes in people.
Host: So the idea is that if you understand how PAS kinase work, then you can manipulate that protein, or that pathway and possible influence how well lipids are made or how lipids are stored as fat?
Dr. Jared Rutter: Exactly. Yeah, that's exactly right. Unless we understand what's going wrong with the disease, we don't know what target we're shooting at, right? We don't know what to hit. What we have found is that we think this process is misregulated at the cellular level in context of obesity and diabetes and so, yeah, we think that we now understand enough that we know at least a few targets that we'd want to try and change the disease process in obesity and diabetes.
Host: But is that what we really want? Do we want a magic pill or a magic therapy. I mean, wouldn't it be best to just have people exercise more or eat a better diet?
Dr. Jared Rutter: There's no doubt that that would be the best thing to do. There are benefits to exercise that, in my opinion, will never be compensated by a pill. There are benefits to a healthy diet that will never be compensated by a pill. The sad reality, however, is that in spite of us understanding this, and we've really understood this for decades now, the importance of diet and exercise, globally, at least in our country, and in most others, that isn't working so well. And to deal with that, myself and many other scientists around the world are trying to come up with stop-gap measures that can keep us from having the devastating consequences of obesity and diabetes on a pandemic epidemic scale while we figure out how to encourage ourselves and especially our children to live a healthier lifestyle.
Host: So you must think this has real promise.
Dr. Jared Rutter: That seems like the best therapeutic strategy to me rather than you know, to use another analogy, putting a Band-Aid on the wound if we can really go to the heart of the wound and fix it that seems like such a better strategy than just trying to repair the damage that the disease causes. And so that's really the strategy I believe in and the strategy that my laboratory tries to take toward the understanding of the disease.
Host: What got you into studying metabolism?
Dr. Jared Rutter: Most of the reason is I've come to be convinced that alterations in metabolism lie at the heart of really almost every human disease and just like in any other area of human behavior there are fads and trends in science. And metabolism has been on the wrong side of the fad and trends for many, many years and it's just over the past five, ten years or so, is sort of seeing a reemergence and I decided that if I really want to make a contribution to understanding human physiology and human disease, that metabolism and really the underpinnings of metabolism and how it's regulated would probably be the best thing I could do. To some extent a scientist is like an explorer and we've really just been following our nose ever since that initial decision.
Announcer: Interesting, informative, and all in the name of better health. This is The Scope Health Sciences Radio.