Mark Shields was a political columnist, a television commentator, and an election campaign advisor to numerous democratic candidates. He was a regular commentator and analyist on the PBS NewsHour for 32 years from 1988-2020. He was one of CNN’s Capital Gang for 17 years from 1988-2005, and was a regular on Inside Washington on PBS and ABC until the show ended in 2013.
Shields died from kidney failure at age 85, on June 18, 2022. No further details were given to the press, and I have never seen his medical records, but the most common cause of kidney failure is diabetes, Several photos of Shields show that he had a large, protruding abdomen which is associated with a significantly increased risk for diabetes. People with this “apple” shape also often have small buttocks, and having both a large belly and small buttocks puts a person at extremely high risk for diabetes.
How Diabetes Often Leads to Kidney Failure
One in three diabetics develop severe kidney damage caused by:
• A high rise in blood sugar causes sugar to stick to and damage the outer membranes of cells. When sugar binds to protein or fat it is termed an Advanced Glycation End product (AGE).
• AGEs can form in blood vessels by binding to collagen which decreases vessel wall elasticity. Inelastic blood vessels result in high blood pressure that can damage kidneys directly.
• The AGE cell damage turns on a person’s immune system to cause inflammation that produces cells and chemicals that specifically damage the kidneys
The Diabetes-Big Belly Connection
More than seventy percent of North American adults will become type II diabetic or prediabetic; diseases that are curable with lifestyle changes but not curable with drugs. Insulin insensitivity (failure to respond to insulin) causes the majority of all cases of type II diabetes and prediabetes, and insulin insensitivity is usually caused by excess fat in the liver (J Clin Invest, May 19, 2020; Endocrine Reviews, Dec 1, 2008;29(7):939–960).
• Sugar-added foods and drinks and refined carbohydrates increase risk for a high rise in blood sugar
• Your pancreas releases insulin to lower high blood sugar by driving sugar from your bloodstream into your liver
• However, if your liver is full of fat, your liver does not accept the sugar, blood sugar levels rise higher, and the extra blood sugar is converted to fatty triglycerides
• Extra triglycerides damage your blood vessels, so to help protect you, insulin lowers high triglyceride levels by driving the fatty triglycerides from your bloodstream into your liver, fat cells and muscles
• Your liver cells fill up with fat and you develop a fatty liver
• Fat in your liver prevents your liver from accepting sugar from your bloodstream, so you stop responding to insulin and become insulin insensitive (Gastroenterology, 2008;134(5):1369–1375)
• The more fat you have in your liver, the greater your insulin resistance (Gastroenterology, 2008;135(1):122–130)
• The higher your insulin levels, the more fat you deposit in your liver (Hepatology, 2014;59(6):2178–2187) because insulin resistance causes even more fat to be deposited in your liver (J Clin Invest, 2020;130(3):1453–1460)
• Insulin resistance causes you to deposit fat in your belly so that you end up looking like an apple with a large belly and small buttocks (J Clin Invest, 1986;78(6):1648–1657)
• Since sugar can barely get into a fatty liver, your blood sugar rises higher and higher and you become diabetic. It is the liver fat specifically that is the primary cause of insulin-resistant diabetes (Proc Natl Acad Sci USA, 2009;106(36):15430–15435)
• Being fat without having excess fat in your liver does not cause diabetes (Obesity, 2010;18(8):1510–1515)
How a Fatty Liver Can Cause Kidney Failure
• A high rise in blood sugar causes sugar to stick to the outside membranes of cells and damage them.
• Insulin resistance and the resultant high blood sugar levels can damage every cell in the body to cause inflammation that causes kidney damage, heart attacks and cancers (Diabetes, 1992;41(3):368–377)
• As a person loses weight, liver fat is reduced and the person becomes better able to respond to insulin (Cell Metab, 2016;23(4):591–601)
Protecting Your Kidneys
A healthful plant-based diet can help to cure type II diabetes if you already have it, or help to protect you from developing diabetes in the first place. People who eat the healthful plant-based foods — vegetables, fruits, whole grains, beans, nuts and other seeds — are far better protected than those who eat the “unhealthful” plant-derived foods, such as refined grains (flour), fried potatoes and sugar-added foods (Diabetologia, April 8, 2022).
If you want to prolong your life, you should get excess fat out of both your fat cells and your liver. To prevent excess fat from being stored in your liver, you have to prevent blood sugar levels from rising too high after meals. You can do this by:
• Exercising before or after you eat. Contracting muscles remove sugar from your bloodstream without needing insulin (J Physiol, 2001 Sep 1; 535(Pt 2): 313–322).
• Basing your diet on vegetables, fruits, whole grains, beans, nuts and other seeds (J Geriatr Cardiol, 2017 May; 14(5): 342–354).
• Severely restricting foods with added sugar and all sugared drinks including fruit juices, mammal meat, processed meats, and fried foods. If you are overweight, also restrict sources of refined carbohydrates such as bakery products, pastas, white rice, milled corn, and most dry breakfast cereals (Metab Syndr Relat Disord, 2019;17(8):389-396).
Dr. Gabe Mirkin is a Villager. Learn more at www.drmirkin.com.