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.

Fruit juice – as bad as soda?

Do you drink a glass of orange juice every morning with your breakfast? Does apple juice quench your thirst during the day? Those of you who would avoid soda or candy consumption are essentially consuming the same thing when you pour a glass of orange juice. After years of being touted as a health food, even by the government’s dietary recommendations, fruit juice has now become the latest and most surprising target in the nation’s obesity epidemic. It has been assumed that we should always drink orange juice because it is healthy and contains vitamin C. Unfortunately, that is a serious misconception. Juice of any kind is not particularly healthy, and contains as much sugar as a can of soda, which is the last thing you need if you are struggling with obesity or diabetes. Remember, consuming sugar leads to elevated insulin levels. Elevated insulin levels lead to increased fat deposition in your midsection. Furthermore, high insulin levels lock your fat cells, making it very difficult to lose weight. Even 100 percent juice does not match the level of nutrition in whole fruit because it’s higher in calories and sugars and lacks the fiber to satisfy appetite. So while eating an apple or orange is filling, drinking juice offers calories without satiety. It is always healthier to eat whole foods versus processed foods. Many health experts feel that drinking juice is just as bad as drinking soda. Unfortunately, most people think it is healthy. According to a beverage comparison by Harvard University, 12 ounces of Fanta orange soda and Minute Maid 100 percent orange juice each contain 165 calories. So if you are trying to lose weight or working on lowering your blood sugars stay away from juice. I can hear many of you thinking, well if I cannot drink juice, what can I drink? (By the way, diet soda is also unhealthy – another subject for another article!) The number one drink you should be consuming is water. Most people do not nearly drink enough water every day. It has no sugar and no calories. Add a slice of lemon, lime or orange to your water for flavoring. Carbonated water is another good choice. There are also naturally sweetened waters available, which have little sugar or calories. Unsweetened iced tea is another good option. Not only does it not have any sugar, it is loaded with many healthy anti-oxidants including polyphenols. Iced coffee without added sugar is another good option. So, in conclusion, avoid the juice and improve your health.

Having trouble losing weight? Insulin may be the culprit.

Are you having difficulty losing weight? Do the pounds just seem to stick to your middle section no matter how little you eat? Why is this? An elevated insulin level may be the culprit. Insulin is a hormone.  Hormones are chemical messengers that are secreted directly into the blood, which carries them to organs and tissues of the body to exert their functions. Insulin is secreted by groups of cells within the pancreas. The pancreas is an organ that sits behind the stomach and secretes other hormones in addition to insulin.  Insulin’s main function is to allow our body’s cells to absorb glucose (sugar) from the blood. Carbohydrates (or sugars) are absorbed from the intestines into the bloodstream after a meal. Insulin is then secreted by the pancreas in response to this elevation in blood sugar (blood glucose). Most cells of the body have insulin receptors which bind the insulin that is in the circulation.  When a cell has insulin attached to its surface, the cell activates other receptors designed to absorb glucose (sugar) from the bloodstream into the inside of the cell.

 Interestingly, insulin also prevents the utilization of fat as an energy source. Insulin locks your fat cells so the fat inside cannot be released and used as energy. This makes weight loss almost impossible. When insulin levels are maintained at a low level, the body begins to use fat as an energy source. High levels of insulin tell your body to gain weight around the belly and you become more apple-shaped over time. In essence, insulin is the get fat hormone. Toxic effects of too much insulin include: increased fat storage, increased inflammation levels, high blood pressure, dyslipidemia (high triglycerides and low HDL), poor sex drive, infertility, increased risk of cancer, Alzheimer’s disease, and depression. The best way to lower your insulin level and keep it down to promote weight loss is to remove sugar and simple (refined) carbohydrates from your diet. Sugar or anything quickly turned into sugar (bread, rice, pasta, sweeteners, pastries, and pretzels) will quickly raise insulin levels. Eating a diet of lean protein, healthy fats, and complex carbohydrates (carbohydrates with a large amount of fiber, which slows the release of sugar into the intestine) is the best way to eat to keep your insulin levels low and to finally get rid of those difficult to lose pounds.

Diabesity – the leading cause of most chronic disease.

Diabesity is a term that describes the continuum of metabolic abnormalities that ranges all the way from mild blood-sugar elevation to insulin resistance to full-blown type II diabetes mellitus. It is during this time period that a large amount of damage is taking place. Nearly all people who are overweight already have pre-diabetes, which is an early stage of diabesity that carries significant risks of disease and death. Interestingly, even those who are not overweight can have diabesity. These are the “skinny fat” people. They are “under lean”, not enough muscle, instead of overweight and often carry a little extra weight around the middle.

Diabesity and insulin resistance are the leading causes of most chronic disease in the 21st century. 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. This problem is caused by 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 usually complain of getting tired after meals, craving sweets, and having trouble losing weight. When the insulin receptor becomes over-saturated, due to inflammation or insulin resistance, sugar cannot get into the cells and the glucose/sugar level in the blood begins to elevate. In essence, the root problem in pre-diabetes and type II or adult-onset diabetes is not too little insulin in the bloodstream, but actually too much circulating insulin.  In fact, elevated insulin levels can be the earliest detectable sign of developing abnormalities.

While there are some predisposing genes, pre-diabetes and type 2 diabetes are almost entirely caused by environmental and lifestyle factors. Therefore, a search for the diabetes gene and the magic-bullet drug or gene therapy to treat it are useless. While understanding our genes can help us personalize our approach to metabolism and weight loss, it can also shift our focus away from the most important target: the modifiable lifestyle and environmental factors that are driving this epidemic.

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 of it 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. This combination leads to a multitude of downstream effects including increased weight in the mid-section, inability to lose weight, high blood pressure, high cholesterol and triglycerides, 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, include whole real foods, like lean protein (chicken or fish), veggies, fruits, nuts, seeds, beans and whole grains. It is also important to incorporate regular aerobic exercise into your regimen.

You are responsible for taking back your health. No single change will completely allow you to take back your health. Pharmaceutical companies continually promise the next breakthrough on diabetes, obesity and heart disease, although we inevitably end up disappointed. Furthermore, the food and diet industry peddles quick fixes and gimmicks, but they are never completely effective or permanent. 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 and save yourself a couple dollars in the long run.

Can oils be part of a healthy lifestyle?

It is important to understand that oils are not whole foods. Nutrients and fiber are removed when pressing plant foods into oil. Eating olives is healthier than consuming olive oil.  Eating nuts is healthier than consuming nut oil. Therefore, it is healthier to swap whole plant based fats such as seeds, nuts, and avocados for oil.  Eating the whole plant based fats allows you to get a lot more fiber, phytonutrients and plant sterols. These are all removed during processing. Oils should be thought of as condiments, flavoring, and a way to cook food. Also remember that oils are 100% fat.  All oils contain about 120 calories per tablespoon.  The more oil you eat, the more weight you are likely to gain.  The goal is choose your oils carefully and to use sparingly. The best oils are the monounsaturated oils and omega 3 oils. Olive oil contains monounsaturated fat (Omega 9 fat).  Extra virgin olive oil (EVOO) is a mainstay of the Mediterranean diet.  It contains antioxidants and flavonoids that help prevent LDL from oxidizing. (Oxidized LDL is the dangerous type that damages the blood vessel wall.) It cannot be heated to high temperatures, so be careful to cook on low heat. The best olive oil is cold pressed and unrefined. Avoid oils that have been processed with chemicals, exposed to high heat, or deodorized (such as canola oil). The best oils are expeller pressed.  Buy the best quality oils possible. Macadamia nut oil is also a monounsaturated oil and can also be used for low heat cooking. It has a higher smoke point than olive oil and can be used up to temperatures around 425 degrees Fahrenheit. Flax oil is an omega 3 oil. It is a good choice for adding flavoring to food. Walnut oil and hemp oil both have favorable omega 3 to omega 6 ratios and can be used for flavoring foods. Coconut oil is a plant-based saturated fat. Plant based saturated fats can be used in moderation. (It is not the same as animal based saturated fat. Unprocessed and unrefined coconut foods have not been found to be harmful.) It can be used for high temperature cooking without the risk of oxidizing. The oils to avoid are the omega 6 oils. These oils lead to elevated inflammation levels in your body. These oils include soybean, corn, safflower, and sunflower oils. Avoid all processed foods with these oils. (See previous articles.) Furthermore, avoid cooking with these oils, which also leads to increased inflammation. Most fried foods are fried in omega 6 oils! So remember, healthy oils can be used in moderation as part of a healthy lifestyle. More importantly, remember that eating the whole plant based fat is a much healthier alternative.

 

Is a super low fat diet the healthiest?

Low fat diets have been advocated for several decades now in the United States. Despite lowering fat in their diets, Americans do not seem to be getting any healthier. In fact, obesity rates are now at an all time high. The main reason for the failure of low fat diets is that Americans have replaced fat with processed, simple carbohydrates. (Remember Snackwell cookies. People felt they could eat unlimited amounts because they were fat free!) Increasing the amounts of sugar and simple carbs in the diet leads to increased insulin levels. As discussed in previous articles, increased insulin leads to obesity and increased inflammation levels. Increased inflammation leads to an increased risk of heart attacks, stroke and cancer. The goal should be to reduce inflammation levels. Just as there are good and bad carbs, there are good and bad fats. Omega 3 fats are the healthiest. Omega 3 fats, which are found in fish such as salmon, flaxseeds, and walnuts reduce inflammation, keep your blood from clotting excessively, maintain the fluidity of cell membranes, lower the amount of lipids circulating in the bloodstream, prevent excessive blood clotting, inhibit thickening of the arteries, and cause arteries to relax and dilate.  Any diet shown to promote good health, including the Mediterranean diet and the Okinawan diet, are loaded with Omega 3’s. Monounsaturated fats are also healthy. Studies show that eating foods rich in monounsaturated fats (MUFAs) improves blood cholesterol levels, which can decrease your risk of heart disease. Research also shows that MUFAs may benefit insulin levels and blood sugar control, which can be especially helpful if you have type 2 diabetes.  Olive oil and avocados are major sources of monounsaturated fat. The majority of fat in your diet should be omega 3 and monounsaturated fats. On the other hand, Omega 6 fats (corn oil, cottonseed oil, soybean oil, sunflower oil, and safflower oil) should be avoided, as they are pro-inflammatory.  Saturated fat (found in meat and dairy products) also tends to be pro-inflammatory – especially if the animals were grain fed. (Pasture raised or wild animal products tend to be healthier).  Finally, trans fat is the deadliest. It is imperative to avoid any food product that contains hydrogenated or partially hydrogenated oils. Overall, any diet that excludes one the major macronutrients (protein, carbohydrates, and fat) just doesn’t work.  A healthy diet should be loaded with a variety of fresh and unprocessed foods. This type of diet will ultimately include all 3 macronutrients.

 

Insulin resistance – What is it and why is it so bad?

Insulin resistance is a condition characterized by an inability of the body to utilize the hormone insulin properly. When you eat, food is broken down into glucose to be used for energy. Insulin, a hormone produced in the pancreas, tempers the amount of sugar in the bloodstream by helping glucose get into muscle, fat and liver cells. Insulin is a “key” that opens doors to the body’s cells, so glucose can enter. With insulin resistance, it’s like having locks that do not work. The keys won’t turn, and glucose can’t get into the cell. The pancreas, alarmed by the increase in blood sugar, cranks out more insulin. This cycle then feeds on itself, leading to higher and higher inulin levels in your blood.

 

People who have high levels of circulating insulin (hyperinsulinemia) in the body are called insulin resistant. This is because their pancreas continues to pump out more and more insulin in an effort to lower rising blood glucose levels. When an individual can no longer produce enough insulin to compensate for the rise in blood sugar, type 2 diabetes develops.

 

For those of you having difficult losing weight, high insulin levels make it very hard to lose those extra pounds because it “locks” the doors to fat cells.

 

Excess insulin is also highly inflammatory. As noted in previous articles, high levels of inflammation can lead to heart attacks, strokes, and cancer.

 

An estimated one in three Americans is insulin resistant, a condition that puts them at high risk for developing type 2 diabetes, hypertension, obesity, heart disease, and stroke.  Insulin resistance can be diagnosed based on medical history, risk factors, and lab tests. Abdominal obesity is a significant risk factor for insulin resistance. It is defined as a waist circumference of 102 cm (40 in) or more in men and 88 cm (35 inches) or more in women.

 

The following lab results suggest a diagnosis of insulin resistance syndrome:

 

  • A fasting glucose level between 100 and 124 mg/dl
  • Triglycerides of 150 mg/dl or higher.
  • HDL cholesterol of < 40 (men) or < 50 (women).
  • A blood pressure of 130/85 mmHg or higher.

 

The good news is that insulin resistance is reversible. Losing weight is the best natural way to treat insulin resistance. Many people think they need to lose large amounts of weight (50lbs or even 100lbs) to reverse insulin resistance. This is not necessarily true. Losing even small amounts of weight (15-20lbs) can significantly lower blood sugar levels and insulin levels. The best long-term diet or life style is one that is low in sugar, simple carbohydrates, and processed foods. Simple carbs such as bread, rice, flour, pasta, and cereals are quickly turned by the body into sugar and thus raise insulin levels. Eating complex carbs such as fruits, vegetables, and beans are slowly digested and do not raise insulin levels. Complex carbs tend to have a lot of fiber, which will help lower blood sugar and insulin levels. Your daily goal should be at least 30 grams of fiber a day. (See prior article on fiber.) Combining protein and healthy fats with your meals will also slow down digestion of sugars and help keep your insulin levels from rising too much. Finally, aerobic exercise is also a great way to burn off extra glucose in your blood stream and lower your insulin levels naturally. Regular aerobic exercise such as walking, jogging, swimming, bicycling, and rowing for 20-30 minutes at a time 4-5 times a week can significantly lower both blood sugar levels and insulin levels.