Does One Size Fit All?

Does one diet work for everyone? Is there one best way of eating? Is one diet better than all the others? The answer to all these questions is no. There are clear healthy eating habits everyone should follow. This includes avoiding processed foods, eating real/whole foods, avoiding sugar, and avoiding processed oils. The exact composition of a healthy diet can vary depending on one’s age, metabolism, and genetics. Most children are highly sensitive to insulin. This means they can eat carbs all day long and still remain thin. Furthermore, most children have a good metabolism. Unfortunately, as we get older things change. Most people, as they age, become less sensitive to insulin. This means that excess sugar is not burned by the body’s cells, but instead gets stored as fat. Insulin sensitivity varies from person to person. Some people can cut their carbs to 100grams a day and can lose weight and remain thin. Other people need to lower their carbs to under 25grams a day to lose weight. If you are on a low carb diet and not losing weight, you may need to cut your carb intake even more. Remember that everyone’s metabolism is different. Some people can eat a large amount of food and remain thin. Others are not as lucky. As we get older and lose muscle mass our metabolism slows down. We burn less calories at rest compared to when we were younger. A good way to naturally increase your metabolism is to increase muscle mass by lifting weights. More muscle mass leads to a higher metabolism and more calories burned at rest. The take home message is that everyone is different. Do not believe anyone who claims their diet is the best for everyone. What works for others, may not work for you. The key is to experiment and find what does work for you. Again, you can never go wrong avoiding processed food and sugar in your diet. A good rule of thumb that everyone can follow includes a diet of unprocessed, whole foods that your body recognizes as food. For most people, including a good amount of protein in every meal can help with weight loss. As noted above, cutting back on carbs is also important in losing weight. However, the exact amount will vary from person to person. Therefore, experiment a little with your diet if you are not having success. Keep a food diary if needed. Find what works specifically for you. One size does not fit all.

What is the number one cause of disease? What is the cure?

Diabesity is the leading cause of most chronic disease in the 21st century. Diabesity describes the continuum of metabolic abnormalities that ranges all the way from obesity to full blown diabetes. It includes mild blood-sugar elevation and insulin resistance. Those with diabesity are at an increased risk of heart disease, stroke, dementia, cancer, high blood pressure, and kidney failure.

Before a person becomes a diabetic, they go through a stage called insulin resistance. This means that their cells require more insulin than usual to force sugar into the cells. They have elevated resting blood sugars (greater than 100mg/dL. This problem is caused by many different lifestyle factors including physical inactivity, eating too many calories, high sugar and high starch snacks and meals, and a lack of dietary fiber. People in the insulin resistance stage complain of constantly being hungry, craving sweets, having trouble losing weight and enlarging bellies.

While there are some predisposing genes, diabesity and type 2 diabetes are almost entirely caused by lifestyle factors. Nutrition is the most important modifiable lifestyle factor. When your diet is full of empty calories and an abundance of quickly absorbed sugars such as liquid calories including sodas, juices, sports drinks or vitamin waters and refined or starchy carbohydrates including bread, pasta, rice and pastries, your cells slowly become numb to the effects of insulin. Your body thus needs more and more insulin to balance your blood-sugar levels. This leads to insulin resistance, pre-diabetes, and eventually full-blown diabetes.

Elevated insulin levels and insulin resistance are the most important factors leading to rapid and premature aging and all its resultant diseases. Increased levels of insulin, the fat-storage hormone, tell your body to lose muscle and gain weight around the belly. High insulin levels also drive inflammation and oxidative stress. These lead to many health issues including increased weight in the mid-section, inability to lose weight, high blood pressure, high triglycerides and low HDL (good cholesterol), low libido, erectile dysfunction, infertility, joint aches and pain, hair growth in women, poor sleep, increased risk of cancer, Alzheimer’s disease and depression. These conditions are all directly caused and worsened by elevated levels of insulin and inflammation.

Since insulin resistance and diabesity are a direct result of poor diet and lifestyle, the condition is reversible in the majority of cases. Most people just need to eliminate the things that are sending their body out of balance and include what’s needed to help the body rebalance itself. For most, the interventions required are extremely simple and extraordinarily effective. Simply, eliminate sugar and processed carbohydrates. Instead, eat whole real foods. These are foods without labels. Meals should include protein, healthy fats, vegetables, fruits, nuts, seeds and beans. Regular physical activity is also important. Incorporate regular aerobic activities into your days. This means going for regular walks, swimming, playing tennis, or any other aerobic activity you enjoy.

You are responsible for taking back your health. No single change will completely allow you to take back your health. It is the hundreds of little choices you make every day that will transform your overall health and make a difference. Start making changes today and take back your health.

Want to lose weight? Eat more protein.

Eating adequate protein is essential for achieving your health and weight goals. Protein is one of three major classes of foods called macronutrients—the other two are fats and carbohydrates. Protein is made up of amino acids, also known as the “building blocks of protein.” We get protein primarily from poultry, beef, lamb, pork, fish and seafood. We also get it from animal products such as eggs, milk and cheese. Protein also comes in vegetable form, including soy, seeds, and nuts.

Protein furnishes the raw materials your body needs to make muscles, organs, hair, enzymes and just about anything else necessary to keep it running like a well-oiled machine. Without protein you would die. (The same cannot be said, by the way, of carbohydrate, but that’s another story. There is no requirement for carbohydrates. Our bodies can manufacture what we need.)

Protein plays a role in weight loss and weight management. Of all the macronutrient, protein is the most satiating, and higher protein diets consistently result in the greatest inadvertent reduction in calories. You don’t consciously stop eating. You’re not fighting your desire for food. You simply don’t want it. That’s the perfect antidote to insatiable hunger.

Compared to carbohydrate, consuming protein has less of an effect on insulin (which drives fat storage), a greater effect on glucagon (which drives fat release) and a considerably greater increase in metabolic rate. Several studies demonstrate greater body-fat loss on a high-protein diet than on a high-carb one. Increasing intake of protein relative to carbohydrates fills you up more, so you wind up eating less. A recent study showed that even eating snacks with a higher protein and lower carbohydrate composition could reduce the amount of food you eat at the next meal. Furthermore, eating protein boosts your metabolic rate. (The technical term is thermogenesis.) In fact, one study showed that healthy young women experienced 100 percent higher thermogenesis after eating high-protein meals—even two and a half hours later 5 than when they ate a “conventional” high-carbohydrate meal.

Try making sure protein is included in each of your daily meals. For breakfast, have some cottage cheese, unsweetened Greek yogurt, turkey sausage/bacon, or eggs. For lunch, have some turkey or chicken wrapped in cheese and lettuce. (Just do not eat the bread!) Add tuna, chicken or turkey to your salad. For dinner have a small amount of lean protein such as lean meat, poultry or fish. For a snack, eat a small amount of nuts or seeds. By adding more protein to your diet you will feel less hungry, eat less calories, and keep your insulin levels down. This is a perfect recipe for good health and weight loss.

My triglycerides are high. Should I be worried and what can I do to decrease them?

Triglycerides are fats in the blood. They are directly measured in a standard lipid panel that your doctor runs on your annual visit. A healthy triglyceride level is less than 100. Having high triglycerides is very worrisome. High triglyceride levels lead to elevated VLDL levels in the blood, which are direct precursors to small, dense LDL particles. Small dense LDL particles (or type “B” particles) are highly “atherogenic”. This means that they cause blockages to be formed in the arteries, and subsequently heart attacks and strokes. So how do triglyceride levels become elevated? They are formed from excess sugar in the bloodstream. Too much sugar is toxic to the body. The body can only store a small amount of sugar as glycogen in the liver and muscles. To protect the body from toxic excess sugar, the liver turns extra sugar directly into triglycerides. Thus, eating a lot of carbohydrates directly leads to elevated triglycerides. Your body can then store extra triglycerides as fat in your belly. This is how you get fat. The best natural way to lower your triglycerides is to lower your intake of carbohydrates and sugar. Your body is taking all that pasta, rice, potatoes and pretzels you have been eating and turning them directly into triglycerides. This is making you fat and leading to an increased risk of a heart attack or stroke. The good news is that medications are usually not needed to improve the situation. Just decrease your carbohydrate intake and you will see a significant decrease in your triglyceride levels on your next blood draw.

Having difficulty losing weight? Not sure why? Read on.

I have talked with several people in the past few weeks who were frustrated that they were not able to lose any weight. They have been watching what they eat very closely. They have been exercising frequently. But still the scale still has not budged. They were becoming discouraged. I asked each of them to keep a food diary. I wanted to know their daily carb intake. Some used online counters; others found apps on their phones or I pads to help analyze their daily carb intake. They brought in the results for me to review. What we discovered is that each person was consuming a lot more grams of daily carbs than each realized. All were above 100 grams of carbs a day. Some were above 200grams a day and one was above 300grams a day. It was no wonder they could not lose weight. With their elevated daily carb intake levels, their insulin levels were also surely sky-high. Elevated insulin levels make weight loss very difficult if not impossible. We looked at the foods they were consuming including large amounts of whole wheat bread, oatmeal, and brown rice. Most were consuming large amounts of fruit, including daily bananas. We looked at ways to cut their daily intake below 100 grams a day to promote weight loss. Some people may need to cut down their daily carb intake to 50 grams a day. Everyone is different. If you are having trouble losing weight, count your daily carb intake. If you are not losing weight at your current carb intake level, cut down until the weight starts coming off. You need a low enough daily carb intake level to decrease your insulin levels low enough to promote weight loss. Once it does, be patient. Eating healthy is a lifestyle change, not a diet.

Set goals to become healthy in 2015!

Many of you are regular readers of this column. You read all the articles and understand how to become healthy. Unfortunately, it stops there. Another year passes and you have not lost any weight, reduced your blood pressure, or reduced your blood sugar levels. Your medication list is getting longer. You know what needs to be done, but never take any action. (You know who you are – I have lectured you in the office!) Now is the time to take action and make this year different!

If you want to succeed, you need to set goals. Without goals you lack focus and direction. Goal setting not only allows you to take control of your life’s direction; it also provides you a benchmark for determining whether you are actually succeeding. To accomplish your goals, however, you need to know how to set them. You can’t simply say, “I want” and expect it to happen. Goal setting is a process that starts with careful consideration of what you want to achieve, and ends with a lot of hard work to actually do it. In between there are some very well defined steps that transcend the specifics of each goal. Knowing these steps will allow you to formulate goals that you can accomplish. Here are 5 steps to help you out.

First of all, find a goal that motivates you. This is important. If you have little interest in the outcome, or your goals are irrelevant given the larger picture, then the chances of you putting in the work to make them happen are slim. Motivation is key to achieving goals. What are your priorities? Do you want to lose weight, reduce your blood sugar levels, get off one of your medications, reduce your dress or pant size, or just look better? Goal achievement requires commitment, so to maximize the likelihood of success, you need to feel a sense of urgency and have an “I must do this” attitude. When you don’t have this, you risk putting off what you need to do to make the goal a reality.

The second step is to set SMART goals. Make sure your goals are Specific, Measurable, Attainable, Relevant, and Time bound. First of all, your goals must be specific. Your goal must be clear and well defined. (For example, I want to lose 20lbs.) Vague or generalized goals are unhelpful because they don’t provide sufficient direction. (For example, I want to lose weight or I want to lower my blood sugar.) Remember, you need goals to show you the way. Make it as easy as you can to get where you want to go by defining precisely where you want to end up. Examples include: I want to lower my hemoglobin A1c 1 point, or I want reduce my pant size 2 sizes, or I want to get off one of my diabetes medications. Second, your goals need to be measurable – include precise amounts, dates, and so on in your goals so you can measure your degree of success. If your goal is simply defined as “To lose weight” how will you know when you have been successful? Without a way to measure your success you miss out on the celebration that comes with knowing you have actually achieved something. Third, your goals need to be attainable. Make sure that it’s possible to achieve the goals you set. If you set a goal that you have no hope of achieving, you will only demoralize yourself and erode your confidence. (For example, I want to lose 100lbs.) Fourth, make sure your goal is relevant to your life. Your goals need to be about you, not your friends, family, or spouse. Finally, make sure your goals are time bound. Your goals must have a deadline. Again, this means that you know when you can celebrate success. When you are working on a deadline, your sense of urgency increases and achievement will come that much quicker.

The third step is to write your goals down. This step is important. The physical act of writing down a goal makes it real and tangible. You have no excuse for forgetting about it. Post your goals in visible places to remind yourself every day of what it is you intend to do. Put them on your walls, desk, computer monitor, bathroom mirror or refrigerator as a constant reminder.

The fourth step is to make a plan. This step is often missed in the process of goal setting. You get so focused on the outcome that you forget to plan all of the steps that are needed along the way. Plan what days and time you will exercise. Plan your grocery lists ahead of time. Plan your meals. What needs to be done to achieve your goals?

Finally, the fifth step is to stick to your goals. Remember, goal setting is an ongoing activity not just a means to an end. Build in reminders to keep yourself on track, and make regular time available to review your goals. Think how you are going to feel when you have lost those extra 20lbs, when you are off your blood pressure medications, or when your have dropped 2 pant sizes. Visualize success.

Now is the time to take action to get healthier. This is the year you are finally going to make a change. Do not put this off any longer. Do not procrastinate any more. You are going to succeed. Get started now on some goals to improve your health and change your health forever.

How many carbs should I eat a day to lose weight?

Reducing the amount of carbohydrates in your diet is one of the best ways to lose weight. By reducing the carbohydrates in your diet, especially simple carbs, you will lower your insulin levels. Insulin is the storage (get fat) hormone. Lowering insulin levels keeps your body from storing excess sugar as fat. Furthermore, lowering your insulin levels allows fat to be released from your fat cells to be used as energy. Reduced-carb lifestyles also have benefits that go beyond just weight loss. They naturally lower blood sugar, blood pressure and triglycerides. They raise HDL (the good cholesterol) and improve the pattern of LDL (the bad cholesterol) from type B to type A.

There is no clear definition of exactly what constitutes a low or reduced carb lifestyle. Furthermore, what is low for one person may not be low for another. An individual’s optimal carb intake depends on multiple variables such as age, gender, body composition, activity levels, and current metabolic health. People who are physically active and have more muscle mass can tolerate a lot more carbs than people who are sedentary. Metabolic health is also a very important factor. When people become insulin resistant, obese, or type II diabetic, the rules change. People who fall into this category can’t tolerate the same amount of carbs as those who are healthy. They become “carbohydrate intolerant”. If you are overweight with belly fat, chances are you are carbohydrate intolerant.

For most people, I would recommend starting in the range of 50-100 grams of carbohydrates a day. This range is great if you want to lose weight effortlessly while allowing for a bit of carbs in the diet. It is also a great maintenance range for people who are carb sensitive. This level corresponds to eating lots of vegetables, 2-3 pieces of fruit per day, and minimal if any starchy carbohydrates.

For some though, the 50-100 gram range may not be enough to see benefit. Those who are significantly carbohydrate intolerant, pre-diabetic, insulin resistant, diabetic, or significantly obese may need a lower range to see benefit. If the 50-100 gram range is not working, try the 25-50 gram range. At this level, you can eat plenty of low-carb vegetables, some berries, and minimal carbs from other foods. This range can be difficult for some people to maintain.

Remember, everyone is different. You will need to experiment to see what level works best for you. You may need to start out at a fairly low level, but subsequently you may be able to increase your daily intake as you lose weight and become more carbohydrate sensitive. If you want to try out a reduced carb lifestyle, I recommend initially tracking your food intake for a few weeks to get a feel for the amount of carbs you are eating.

Very important: if you are a diabetic or on diabetes medication, you will need to discuss your diet changes with your primary care physician or endocrinologist first. This is critical. You will need to monitor your blood sugars closely, and most likely reduce your diabetes medication. Your blood sugars will drop fairly quickly and you do not want to become hypoglycemic. Do not try without your personal physician’s guidance.

If you are trying to become healthier and lose weight, give this dietary lifestyle a try. Most people’s metabolisms are just not able to handle the amount of carbohydrates they are ingesting on a daily basis. Lowering your daily carbohydrate intake will make you healthier, naturally, subsequently reducing the need for medications.