Dr. Kyle: Diet Do’s and Don’ts for 2019

 

Looking to start a new diet in 2019? Here are a few tips on what to avoid and what to incorporate into your nutritional regime this year.

FATS ARE GOOD

The human body is designed to process and burn fats as one of its primary energy sources. Fat enhances food digestion and nutrient absorption. Accompany sides of vegetables with a fat source to increase nutrient bioavailability.

Try cooking with animal fats, organic grass-fed butter and coconut oil. Avoid trans fats and poly-unsaturated vegetable oils like canola oil.

Add some wild-caught salmon into your diet to balance out the ratio of omega-3’s to omega-6’s. The typical western diet has an abundance of omega-6’s so eating salmon 1-2 per week will boost your levels of anti-inflammatory omega-3’s.

DON’T SHY AWAY FROM CHOLESTEROL

Cholesterol is vital for the synthesis of hormones and vitamin D. It also helps form cell membranes and other structural components.

Eat whole foods and at least 1 yolk with your egg whites. This will give you a better nutrient profile and a healthy dose of cholesterol.

RED MEATS

Red meats have almost everything you need to not only survive but thrive. They are one of the most micronutrient dense fuel sources on the planet. Red meats are high in b-vitamins, iron, zinc, magnesium, and creatine.

Red meat also includes Lamb! It is an excellent source of heme-iron as well.

GET YOUR PROTEIN

It is most commonly recommended that daily intake should be 1g of protein per pound. Older athletes will need more due to less efficient protein absorption.

Keep in mind that dietary needs will fluctuate based on physical demands and training goals. Athletes trying to put on mass should eat 40g before bed to maintain protein synthesis throughout the night.

20g per meal will provide 90% of muscle protein synthesis. 40g will provide 100%.

Carbohydrates

Some carbs are better then other! So, we want to pick the right ones.

Avoid refined sugars (obviously). Include variation and eat 2 forms of carbs at a time for faster absorption. I recommend sweet potatoes, spinach, red peppers and carrots. These foods have plenty of micronutrients and produce low levels of gas.

Add a side of white rice to your meat and vegetable dish. White rice is easy to digest, and can help supplement your macronutrient intake. Oats on the other hand can be hard to digest – soak them in warm water overnight or add yogurt.

Remember, carbohydrates are used to fuel workouts! Getting adequate carbs to sustain your athletic performance will protect against muscle tissue breakdown.

As always, ask a healthcare professional for dietary recommendations that best suit you. Some foods that work well for others may not sit well for you. Listen to your body.

Stay healthy and good luck achieving all your health and wellness goals for 2019!

Dr. Kyle: Debunking the Salt Myth

Do you pay attention to how much sodium you take in?

Maybe you should!

It turns out that sodium may not be as bad as we previously thought. In fact, sodium is essential for many metabolic processes. Sodium is responsible for regulating blood pressure, maintaining blood volume and is required for neuron function and signal transduction.

Many believe that high (or adequate) salt intake will lead to high blood pressure. Most cases of hypertension are actually a result of genetics or stress. A small percentage of the people who are sodium sensitive may experience an increase in blood pressure, but an overwhelming benefit for the rest of the population cannot be ignored.

Sodium has several benefits including:

• Increased performance
• Increased stamina / endurance
• Increased blood volume
• Increased recovery

During high intensity exercise, the body actually responds better to a higher blood volume. This improves delivery of oxygen and nutrients to the working cells of the body. High blood volumes are also optimal for kidney filtration and removal of toxins and metabolic waste products.

Low dietary sodium and elimination diets can have detrimental effects for high performance athletes. Low salt intake will decrease overall blood volume, making the blood thicker. This can cause muscle weakness, cramps and lethargy.

What Type of Salt?

I recommend iodized salt. Iodine helps with thyroid function and regulates metabolism. Unbleached, pure Himalayan salt is also a good option.

So if you are hitting a wall during your workout it may be due to sodium depletion. Bottom line, make sure you are drinking plenty of water, eating sufficient carbs for your training needs, getting a balance of micronutrients from a variety of whole foods, and don’t be afraid to sprinkle a little salt on your meals every once in a while!

Dr. Phil Shares: Menopause Belly: Why Fat Accumulates & How to Tackle It?

 

Many women notice after age 45 that fat seems to accumulate readily at the waist. There are even terms for it, like menopause belly, muffin top, or “meno-pot.” What does the science tell us about menopausal belly fat and how to get rid of it? What are the hormonal drivers and are they amenable to change with personalized lifestyle medicine? Certainly belly fat, specifically subcutaneous and visceral abdominal fat, increases during menopause,1-3 when the changing hormonal environment can bring with it a remodeling of fat storage patterns. Abdominal fat, especially visceral fat, is biochemically different and more metabolically active than fat stored in other areas, secreting more pro-inflammatory cytokines and adipokines.4 That means preventing or reversing belly fat is not just a vanity project, it’s a meaningful step in managing a woman’s overall health, as abdominal fat has been consistently linked with insulin resistance, impaired glucose control, and overall higher cardiometabolic and breast cancer risk. Practitioners are often asked ‘How can I get rid of menopausal belly fat?’, and it is important to remember that effective management is multifaceted – encompassing an understanding how changes in sex steroids interact with other endocrine systems and also with lifestyle choices, and recognizing the best time to implement a lifestyle medicine approach is in the years before a woman’s final menstrual period.

The changing hormonal environment

A robust understanding of the hormonal changes associated with perimenopause and menopause can guide women toward effective intervention. Here are the top five hormonal changes associated with the menopausal transition.

  • Changes in estrogen and estrogen dominance: Menopause is often framed simply as the loss of estrogen, but the road from pre- to post-menopausal estrogen levels is not necessarily smooth. Although loss of estrogen itself is linked with increasing abdominal fat,2,3 paradoxically the estrogen dominance that occurs in perimenopause and that may continue into menopause is seen clinically as a culprit in expanding abdominal fat mass.5 Between age 35 and 45, most women are beginning to run low on ripe eggs and experience hormonal changes linked with advancing reproductive age.6 During this time reduced progesterone coupled with high and erratic estrogen occurs.6,7 Estrogen declines but is in relative excess to progesterone. This is the definition of estrogen dominance: having a progesterone level that’s less than 100X the level of estrogen, creating an imbalance in the estrogen-progesterone partnership and essentially an inadequate level of progesterone to keep estrogen in check. Local estrogen production in adipose tissue can also contribute to estrogen dominance during this time. For example, aromatase enzymes, responsible for converting androgens to estrogens, are more active in visceral adipose tissue of post-menopausal women in response to cortisol.8

 

  • Cortisol: Dysregulation of the HPA axis and cortisol excess can manifest as increased central and visceral fat mass and metabolic disturbances such as insulin resistance.9,10 Increased production of cortisol,11 and conversion of cortisone (inactive) to cortisol (active) has been described in post-menopausal women,12 indicating that increased cortisol synthesis and conversion could contribute to metabolic dysfunction in these women. Cortisol is regulated in part by sex steroids, and estrogen down-regulates the expression and activity 11β-HSD1, the enzyme involved in converting inactive cortisone to active cortisol13 – so higher estrogen, lower 11β-HSD1 and less active cortisol formed. Declining estrogen levels during menopause can have a knock-on effect on cortisol formation, and 11β-HSD1 has been shown to be upregulated particularly in visceral fat in post-menopausal compared with pre-menopausal women. 1,11,12 As well as contributing directly metabolic dysfunction, higher cortisol can feed back to hormonal environment and contribute to estrogen dominance occurring at this time through cortisol-induced aromatase activity.8,14

 

  • Insulin: Fat cells accumulating in the abdomen is linked with insulin resistance. The pro-inflammatory cytokines produced by abdominal fat interferes with insulin signaling.15 This results in insulin resistance where cell response to insulin is lost, which creates a cycle where greater production of insulin is required to manage blood glucose levels. Insulin is a gatekeeper of metabolism, and rising insulin levels can set off a chain reaction that ultimately leads to a cycle of weight and abdominal fat gain. Insulin can lower production of sex hormone binding globulin (SHBG) in the liver.16,17 Lower SHBG results in greater free androgens and estrogens in circulation, and is linked with visceral fat and insulin resistance in menopausal women.18,19 In addition, insulin resistance can have a knock-on effect on leptin, insulin’s cousin.

 

  • Leptin: Leptin is the put-down-your-fork hormone, the one that tells you when you are full.20 Elevated insulin levels eventually lead to elevated leptin, which despite what you may think, does not mean you are more likely to put down your fork and stop eating. Instead, consistently elevated leptin levels lead to a dysfunction of leptin receptors and they stop sending signals to the brain to tell you to stop eating – this is called leptin resistance.21 The mechanisms driving leptin-resistance are complex, but high intakes of refined carbohydrates have linked with its development.22

 

  • Thyroid hormones: Thyroid hormones, which regulate how quickly we burn calories and maintains our metabolism, can becomes unbalanced with age, a trend that has been labeled ‘thyropause’. If the thyroid becomes underactive, this can lead to symptoms including weakness, fatigue, and weight gain.23

What can be done?

One of the biggest myths in women’s health is that once hormones change with menopause, abdominal adiposity is immovable – however addressing modifiable hormones such as cortisol and insulin in the following ways can have an impact.

  • Make foundational changes to dietary intake. When evaluating diet, consider factors that influence insulin levels, such as high carbohydrate intakes or intake of refined carbohydrates which require greater insulin response to manage spikes in plasma glucose. Remove inflammatory or trigger foods, as inflammation can contribute to insulin resistance.31 Add in foods rich in antioxidants which promote detoxification. Eliminate alcohol which robs you of deep sleep and lowers metabolism by more than 70% for 24 hours. Choosing when to eat during the day can also make a positive impact to insulin levels and insulin sensitivity. Time-restricted feeding (TRF) protocols, a type of intermittent fasting, where food is consumed during a limited number of hours per day (often 6 or 8) has been shown to reduce body weight and abdominal fat32 and improve insulin sensitivity even without weight loss.33

 

  • Add more movement to the day. Sitting is like the new smoking. Approximately 35 chronic diseases and conditions are associated with sedentariness, and sedentary behavior makes people more prone to gain body fat.24 High intensity interval training (HIIT) is effective at reducing abdominal and visceral adiposity, as well as improving insulin sensitivity and building muscle.25,26 Studies in post-menopausal women show that HIIT training results in greater abdominal and visceral fat mass loss compared to continuous exercise programs (where heart rate was maintained at a constant level)27,28 showing that HIIT is a time-efficient strategy for improving central obesity in this population. In addition to HIIT programs, practicing yoga can be recommended for menopausal women, showing significant reductions in menopausal symptoms.29 In broader populations, interventions that included yoga asanas were associated with reduced evening and waking cortisol levels, as well as improved metabolic symptoms.30

 

  • Support reparative sleep. A primary step to losing belly fat is to get enough sleep and to make it quality sleep. Epidemiological studies have repeatedly shown links between sleep duration and the risk of obesity and central adiposity.34 People sleeping 7-8 hours/night night have been shown to accumulate less visceral fat mass than those sleeping for ≤6 hours/night.35 Sleep debt leads to changes in leptin and other hormones related to satiety, greater feelings of hunger, dietary indiscretion and poor food choices, as well as reduced physical activity and insulin resistance.34 In other words, getting that solid sleep needs to be a priority. As well as sleep quantity, sleep quality has to be considered, as poorer sleep quality is associated with higher visceral fat mass.36 Subjective poor sleep quality is linked with altered cortisol response37 and insulin resistance in postmenopausal women.38

by Sara Gottfried, MD and Annalouise O’Connor, PhD

Shared by Dr. Phil McAllister @ Forward Health Guelph

Citations

  1. Yamatani H et al. Association of estrogen with glucocorticoid levels in visceral fat in postmenopausal women. Menopause. 2013;20(4):437-442.
  2. Shen W et al. Sexual dimorphism of adipose tissue distribution across the lifespan: a cross-sectional whole-body magnetic resonance imaging study. Nutr Metab (Lond). 2009;6:17.
  3. Lovejoy JC et al. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes (Lond). 2008;32(6):949-958.
  4. de Heredia FP et al. Obesity, inflammation and the immune system. Proc Nutr Soc. 2012;71(2):332-338.
  5. Prior JC. Progesterone for symptomatic perimenopause treatment – progesterone politics, physiology and potential for perimenopause. Facts Views Vis Obgyn. 2011;3(2):109-120.
  6. Hale GE et al. Hormonal changes and biomarkers in late reproductive age, menopausal transition and menopause. Best Pract Res Clin Obstet Gynaecol. 2009;23(1):7-23.
  7. Hale GE et al. Endocrine features of menstrual cycles in middle and late reproductive age and the menopausal transition classified according to the Staging of Reproductive Aging Workshop (STRAW) staging system. J Clin Endocrinol Metab. 2007;92(8):3060-3067.
  8. McTernan PG et al. Glucocorticoid regulation of p450 aromatase acitivty in human adipose tissue: gender and site differences. J Clin Endocrinol Metab. 2002;87(3):1327-1336.
  9. Paredes S et al. Cortisol: the villain in metabolic syndrome? Rev Assoc Med Bras (1992). 2014;60(1):84-92.
  10. Incollingo Rodriguez AC et al. Hypothalamic-pituitary-adrenal axis dysregulation and cortisol activity in obesity: a systematic review. Psychoneuroendocrinology. 2015;62:301-318.
  11. Li S et al. Effects of menopause on hepatic 11β-hydroxysteroid dehydrogenase type 1 actvity and adrenal sensitivity to adrenocorticotropin in healthy non-obese women. Gynecol Endocrinol. 2011;27(10):794-799.
  12. Andersson T et al. Tissue-specific increases in 11β-hydroxysteroid dehydrogenase type 1 in normal weight postmenopausal women. PLoS One. 2009;4(12):e8475.
  13. Andersson T et al. Estrogen reduces 11β-hydroxysteroid dehydrogenase type 1 in liver and visceral, but not subcutaneous, adipose tissue in rats. Obesity (Silver Spring). 2010;18(3):470-475.
  14. McTernan PG et al. Gender differences in the regulation of P450 aromatase expression and activity in human adipose tissue. Int J Obes Relat Metab Disord. 2000;24(7):875-881.
  15. Castro AV et al. Obesity, insulin resistance and comorbidities? Mechanisms of association. Arq Bras Endocrinol Metabol. 2014;58(6):600-609.
  16. Plymate SR et al. Inhibition of sex hormone-binding globulin production in the human hepatoma (Hep G2) cell line by insulin and prolactin. J Clin Endocrinol Metab. 1988;67(3):460-464.
  17. Loukovaara M et al. Regulation of production and secretion of sex hormone-binding globulin in HepG2 cell cultures by hormones and growth factors. J Clin Endocrinol Metab. 1995;80(1):160-164.
  18. Davis SR et al. The contribution of SHBG to the variation in HOMA-IR is not dependent on endogenous oestrogen or androgen levels in postmenopausal women. Clin Endocrinol (Oxf). 2012;77(4):541-547.
  19. Janssen I et al. Testosterone and visceral fat in midlife women: the Study of Women’s Health Across the Nation (SWAN) fat patterning study. Obesity (Silver Spring). 2010;18(3):604-610.
  20. Klok MD et al. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obes Rev. 2007;8(1):21-34.
  21. Engin A. Diet-induced obesity and the mechanism of leptin resistance. Adv Exp Med Biol. 2017;960:381-397.
  22. Harris RBS. Development of leptin resistance in sucrose drinking rats is assocated with consuming carbohydrate-containing solutions and not calorie-free sweet solution. Appetite. 2018;132:114-121.
  23. Diamanti-Kandarakis E et al. Mechanisms in endocrinology: aging and anti-aging: a combo-endocrinology overview Eur J Endocrinol. 2017;176(6):R283-R308.
  24. Levine JA. Sick of sitting. Diabetologia. 2015;58(8):1751-1758.
  25. Boutcher SH. High-intensity intermittent exercise and fat loss. J Obes. 2011;2011:868305.
  26. Maillard F et al. Effect of high-intensity interval training on total, abdominal and visceral fat mass: a meta-analysis. Sports Med. 2018;48(2):269-288.
  27. Maillard F et al. High-intensity interval training reduces abdominal fat mass in postmenopausal women with type 2 diabetes. Diabetes Metab. 2016;42(6):433-441.
  28. Nunes PRP et al. Effect of high-intensity interval training on body composition and inflammatory markers in obese postmenopausal women: a randomized controlled trial. Menopause. 2018;Oct 1.
  29. Cramer H et al. Yoga for menopausal symptoms-a systematic review and meta-analysis. Maturitas. 2018;109:13-25.
  30. Pascoe MC et al. Yoga, mindfulness-based stress reduction and stress-related physiological measures: a meta-analysis. Psychoneuroendocrinology. 2017;86:152-168.
  31. Caputo T et al. From chronic overnutrition to metainflammation and insulin resistance: adipose tissue and liver contributions. FEBS Lett. 2017;591(19):3061-3088.
  32. Gabel K et al. Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: a pilot study. Nutr Healthy Aging. 2018;4(4):345-353.
  33. Sutton EF et al. Early time-restricted feeding improves insulin sensitivity, blood pressure, and oxidative stress even without weight loss in men with prediabetes. Cell Metab. 2018;27(6):1212-1221.e3.
  34. Koren D et al. Role of sleep quality in the metabolic syndrome. Diabetes Metab Syndr Obes. 2016;9:281-310.
  35. Chaput JP et al. Change in sleep duration and visceral fat accumulation over 6 years in adults. Obesity (Silver Spring). 2014;22(5):E9-12.
  36. Sweatt SK et al. Sleep quality is differentially related to adiposity in adults. Psychoneuroendocrinology. 2018;98:46-51.
  37. Huang T et al. Habitual sleep quality and diurnal rhythms of salivary cortisol and dehydroepiandrosterone in postmenopausal women. Psychoneuroendocrinology. 2017;84:172-180.
  38. Kline CE et al. Poor sleep quality is associated with insulin resistance in postmenopausal women with and without metabolic syndrome. Metab Syndr Relat Disord. 2018;16(4):183-189.

 

Sara Gottfried, MD

Sara Gottfried, MD is a board-certified gynecologist and physician scientist. She graduated from Harvard Medical School and the Massachusetts Institute of Technology and completed residency at the University of California at San Francisco. Over the past two decades, Dr. Gottfried has seen more than 25,000 patients and specializes in identifying the underlying cause of her patients’ conditions to achieve true and lasting health transformations, not just symptom management.

Dr. Gottfried is the President of Metagenics Institute, which is dedicated to transforming healthcare by educating, inspiring, and mobilizing practitioners and patients to learn about and adopt personalized lifestyle medicine. Dr. Gottfried is a global keynote speaker who practices evidence-based integrative, precision, and Functional Medicine. She has written three New York Times bestselling books: The Hormone Cure, The Hormone Reset Diet, and her latest, Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years.

Annalouise O’Connor, PhD, RD

Dr. Annalouise O’Connor is the R&D Manager for Therapeutic Platforms and Lead for Cardiometabolic and Obesity platforms at Metagenics. Her role involves research coordination, as well as developing formulas for targeted nutrition solutions and programs to assist practitioners in the optimal management of their patients’ health. Annalouise trained as an RD and worked in clinical and public health settings. Dr. O’Connor completed her PhD in the Nutrigenomics Research Group at University College Dublin (Ireland) and postdoctoral work at the UNC Chapel Hill Nutrition Research Institute.

 

Dr. Phil Shares: Staying Keto over the Holidays

It’s the most wonderful time of the year, but for those following a diet, the holidays may stir up stress and anxiety around food. The ketogenic diet is not the most “social” diet, but there are ways to stick to it, even in the most daunting of times, such as holiday celebrations.

If you can’t eat keto, at least aim for low-carb

Your holiday party may not be stocked full of keto-friendly foods, but there is a high probability that you can nibble on some low-carb options. The cheese platter is, more often than not, a pretty safe bet for cheese (of course!), but also for other low-carb foods such as nuts and meats. Just stay clear of candy-coated nuts, dried fruits, and cured meats you suspect may have added sugar!

Another low-carb holiday party go-to is the veggie platter. Lucky for you, this usually gets the least attention by guests, thereby giving you full access to it. Stick to the low-carb vegetables options such as broccoli, cauliflower, celery, and cucumber. If your event is serving dinner, opt for the meats or any salads (without sugar-loaded dressings), and low-carb vegetables. Things to stay away from are the mashed potatoes, any bread/pastry-like foods, sauces, and, of course, the sweets. Sticking with low-carb as opposed to ditching the diet completely will make transitioning back into ketosis much easier.

Prepare for success and give yourself options

If you are uncomfortable not knowing what food options will be available at your holiday gathering, prepare some food in advance. Better yet, prepare a keto-friendly dish to share with everyone! Take a high-fat dip to pair with that veggie platter and a salad dressing you can pour on any dry salads to avoid sugary dressings. You can also pack some snacks such as high-fat nuts (e.g. macadamia nuts) to graze on throughout the evening. Additionally, medium-chain triglyceride (MCT) oil is a great tool for ketogenic living. Fill a small jar with MCT oil to take with you and use on any dish or in beverages. MCTs are highly ketogenic and have even been shown to increase ketone production without carbohydrate restriction.1

The popularity of the ketogenic diet has made it simple to find recipes that anyone can enjoy. Consider making a ketogenic dessert to bring and share so you can “indulge” too, while also preventing you from caving into the temptations of sugar-laden treats.

Stay positive and remember your “why”

It can be difficult to gain the support of those around you when your dietary choices are perceived as something as radical as a ketogenic diet may seem to some. You may even be tempted to ditch the diet for the sake of your peers or those family members who just won’t back down from having you try “just one bite.” Be prepared to explain to others what the ketogenic diet is and why you follow it. Remember that there is no one-size-fits-all diet, and it is perfectly fine to have different views from others. Just stay true to yourself, remember your “why,” and stay positive, because there is nothing worse than engaging in a debate over food choices!

Tips for alcohol

Alcohol isn’t generally conducive to living a ketogenic lifestyle, and if you have no problem abstaining from it completely, that is your best option. If having a drink in your hand makes you feel more comfortable in a crowd, take club soda and sliced lemon with you; this will help you feel less segregated. With all this said, celebrations may be times when you can make exceptions (within reason). There are ways to enjoy a drink or two and stick to your goals; you just have to know what to look out for. For wines, opt for the driest you can find, white or red, and avoid sweet wines such as rosé. Most liquors are acceptable on their own or enjoyed with club soda or sugar-free beverages. Beers typically contain more carbohydrates, and they should probably be limited to one. If nutrition labels are available, check to see what the lowest-carbohydrate beer options are. Coolers and ciders are to be avoided due to their high sugar content.

Be kind to yourself and don’t overthink it

If you take into consideration all of the recommendations above, there is no reason to be stressed or anxious about your diet as you enter into the holidays. You are following a ketogenic diet to improve your health, right? Well, being kind to yourself is part of healthy living, and sometimes that means accepting that your diet can’t always be perfect. Also, keep in mind that you can always jump right back into the swing of things; a few days of indulging does not mean you have “failed.” There is more to health than simply what you put in your mouth, so do the best you can, be prepared, but most importantly, don’t get down on yourself if things don’t go as planned. Instead of focusing on your food options, focus on enjoying your time with loved ones over this holiday season.

As we said, the holidays are the most wonderful time of the year, and your diet shouldn’t change that for you.

General Wellness, Ketogenic

Shared by Dr. Phil McAllister @ Forward Health Guelph

Resources:

  1. McCarty MF et al. Lauric acid-rich medium-chain triglycerides can substitute for other oils in cooking applications and may have limited pathogenicity. Open Heart. 2016;3(2):e000467.

Dr. Phil Shares: Insulin Resistance Causes and Symptoms

One in three North Americans—including half of those age 60 and older— have a silent blood sugar problem known as insulin resistance. Insulin resistance increases the risk for prediabetes, type 2 diabetes and a host of other serious health problems, including heart attacks, strokes and cancer.

What is Insulin Resistance?

Insulin resistance is when cells in your muscles, body fat and liver start resisting or ignoring the signal that the hormone insulin is trying to send out—which is to grab glucose out of the bloodstream and put it into our cells. Glucose, also known as blood sugar, is the body’s main source of fuel. We get glucose from grains, fruit, vegetables, dairy products, and drinks that bring break down into carbohydrates.

How Insulin Resistance Develops

While genetics, aging and ethnicity play roles in developing insulin sensitivity, the driving forces behind insulin resistance include excess body weight, too much belly fat, a lack of exercise, smoking, and even skimping on sleep.4

As insulin resistance develops, your body fights back by producing more insulin. Over months and years, the beta cells in your pancreas that are working so hard to make insulin get worn out and can no longer keep pace with the demand for more and more insulin. Then – years after insulin resistance silently began – your blood sugar may begin to rise and you may develop prediabetes or type 2 diabetes. You may also develop non-alcoholic fatty liver disease (NAFLD), a growing problem associated with insulin resistance that boosts your risk for liver damage and heart disease. 5

Signs and Symptoms of Insulin Resistance

Insulin resistance is usually triggered by a combination of factors linked to weight, age, genetics, being sedentary and smoking.

– A large waist. Experts say the best way to tell whether you’re at risk for insulin resistance involves a tape measure and moment of truth in front of the bathroom mirror. A waist that measures 35 inches or more for women, 40 or more for men (31.5 inches for women and 35.5 inches for men if you’re of Southeast Asian, Chinese or Japanese descent)increases the odds of insulin resistance and metabolic syndrome, which is also linked to insulin resistance.

– You have additional signs of metabolic syndrome. According to the National Institutes of Health,in addition to a large waist, if you have three or more of the following, you likely have metabolic syndrome, which creates insulin resistance.

  • High triglycerides. Levels of 150 or higher, or taking medication to treat high levels of these blood fats.
  • Low HDLs. Low-density lipoprotein levels below 50 for women and 40 for men – or taking medication to raise low high-density lipoprotein (HDL) levels.
  • High blood pressure. Readings of 130/85 mmHg or higher, or taking medication to control high blood pressure
  • High blood sugar. Levels of 100-125 mg/dl (the prediabetes range) or over 125 (diabetes).
  • High fasting blood sugar (or you’re on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes.

– You develop dark skin patches. If insulin resistance is severe, you may have visible skin changes. These include patches of darkened skin on the back of your neck or on your elbows, knees, knuckles or armpits. This discoloration is called acanthosis nigricans.8

Health Conditions Related to Insulin Resistance

An estimated 87 million American adults have prediabetes; 30-50% will go on to develop full-blown type 2 diabetes. In addition, up to 80% of people with type 2 diabetes have NAFLD.9 But those aren’t the only threats posed by insulin resistance.

Thanks to years of high insulin levels followed by an onslaught of cell-damaging high blood sugar, people with insulin resistance, prediabetes and type 2 diabetes are at high risk for cardiovascular disease. Insulin resistance doubles your risk for heart attack and stroke – and triples the odds that your heart attack or ‘brain attack’ will be deadly, according to the International Diabetes Federation.10

Meanwhile, insulin resistance and metabolic syndrome are also linked with higher risk for cancers of the bladder, breast, colon, cervix, pancreas, prostate and uterus.11, 12  The connection: High insulin levels early in insulin resistance seem to fuel the growth of tumors and to suppress the body’s ability to protect itself by killing off malignant cells. 13

How You Can Prevent or Reverse Insulin Resistance

Losing weight, getting regular exercise and not skimping on sleep can all help improve your insulin sensitivity. Don’t rely on dieting or exercise alone: in one fascinating University of New Mexico School of Medicine study, published in the International Journal of Obesity, overweight people who lost 10% of their weight through diet plus exercise saw insulin sensitivity improve by an impressive 80%. Those who lost the same amount of weight through diet alone got a 38% increase. And those who simply got more exercise, but didn’t lose much weight, saw almost no shift in their level of insulin resistance.14 

Turn in on time, too. In a study presented at the 2015 meeting of the Obesity Society, researchers found that just one night of sleep deprivation boosted insulin resistance as much as eating high-fat foods for six months.15

Written by

Dr. Kyle: Sport Injury Rehabilitation

 

There are many factors to consider before clearing an athlete to return to sport. Time since injury, improvements in range of motion and increases in joint stability are all good metrics to evaluate before giving an athlete the green light.

Many rehabilitation programs focus primarily on enhancing maximal muscle strength. Current research suggests that Rate of Force Development (RFD) may actually be a better predictive factor in determining whether an athlete is ready for sport.

Common athletic maneuvers such as pivoting, jumping and stop-and-starts require rapid stabilization of the joints in the lower limb. This requires almost instantaneous muscle activation to prevent joint displacement and avoid re-injury. Factors such as neural activation, fiber composition and muscle contractile properties influence RFD and the body’s ability to absorb load on the joint. Therefore, it may not matter how strong the muscle is, but rather how fast the muscle can fire.

So how might this change rehabilitation programs?

Most physical rehabilitation protocols help build strength but fail to include an explosive component. Because athletic demands are often variable and unpredictable, it is important for the muscles to be able to react to any situation. Incorporating explosive plyometric exercises and a variation of sport specific drills will improve RFD and prevent future injury.

Take home points for sport-injury rehab:

• Allow sufficient time to for healing process to occur
• Recover full range of motion and flexibility
• Progressively overload the muscle to build strength
• Explosive training to enhance ability of muscle to generate force rapidly.
• Incorporate plyometric and sport specific drills to complement athletic demands.

As always, the best way to stay in the game is to avoid injury in the first place. So don’t wait for the pain to start before implementing an effective strength AND conditioning program.

If you or someone you know is suffering from a sport injury, call and book an appointment today for a complete musculoskeletal assessment!

 

Reference:
Buckthorpe, M., & Roi, G. S. (2018). The time has come to incorporate a greater focus on rate of force development training in the sports injury rehabilitation process. Muscles, ligaments and tendons journal, 7(3), 435-441. doi:10.11138/mltj/2017.7.3.435

Dr. Phil Shares: The Impact of Ketogenic Diet on Body Composition During Resistance Training

Ketogenic protocols have become an important therapeutic option for a variety of health issues including weight management, cardiometabolic dysfunction, and epilepsy.1 The potential of the ketogenic diet (KD) to help optimize body mass has important implications for the reduction of metabolic syndrome and its related chronic disease aspects such as heart disease, fatty liver, and type 2 diabetes (T2D).

Additionally, the ketogenic dietary approach has gained widespread attention within the professional sports performance and wellness communities for its ability to enhance weight loss and optimize body composition, both critical components in accomplishing training goals for this population.2-3 However, concerns exist in the sports performance community regarding the impact of a KD, including the possibility that lowering total body mass may reduce the ability of an individual to optimize muscle hypertrophy through resistance training (RT) due to increased central fatigue and other related factors.3

To learn more about the effects of a KD in combination with RT, a randomized, controlled, parallel arm, prospective study was conducted, with results published in the Journal of International Society of Sports Nutrition.3 The study’s authors hypothesized that, “a KD with caloric surplus in combination with RT in trained men would have a positive impact in fat reduction, and it would benefit the gains in lean body mass (LBM)”.3

Healthy, athletic men (N=24) from Spain (average age: 30, weight: 76.7kg, BMI: 23.4) with at least 2 years of continuous overload training experience were randomized into 1 of 3 groups: KD, non-KD, or control group.3 The participants followed their approved diets for 8 weeks along with supervised hypertrophy training protocol 4 days/week: 2 days of upper body and 2 days of lower body workouts. The KD group was monitored weekly by measuring urinary ketones with reagent strips to ensure they achieved and remained in ketosis. Body composition was assessed using DXA.

Participants all consumed a similar number of calories, which was set for a moderate energy surplus of 39 kcal/kg/day.3 The KD group consumed 20% of calories as protein (2g/kg/day), 70% as fat (3.2g/kg/d), and <10% of their calories as carbohydrates (approximately 42g/d).3 The non-KD consumed the same 20% of calories as protein (2g/kg/day), 25% as fat, and the remaining 55% as carbohydrates.3 Both groups were encouraged to eat 3-6 meals per day, and individuals in the control group were asked to maintain their current exercise and dietary routines throughout the study.

Results:3

  • KD: ↓ fat mass (FM) and ↓ visceral adipose tissue (VAT); non-significant reduction in total body weight; non-significant increase in lean body mass (LBM)
  • Non-KD: No significant changes in FM or VAT; significant ↑ in total body weight and ↑ LBM
  • Control: No significant changes in FM, VAT, total body weight, nor LBM

The overall results indicate the KD intervention was able to achieve a positive change in body composition with a decrease in body weight (non-significant) and reduction in FM and VAT.3 LBM did not increase significantly in the KD group, and the results indicate that LBM may be enhanced through an adequate carbohydrate intake (as was provided in the non-KD and control group diet protocols of this study) while also consuming a calorie surplus with a higher protein intake to support muscle hypertrophy.3

In summary, the implementation of a KD in male athletes taking part in regular resistance training may lead to lowering of VAT and FM, both important factors for body mass optimization and reducing risk of cardiometabolic disease processes.3 However, the lack of lean body mass accrual in this study indicates that the KD  may not be an optimal strategy for building muscle mass in trained athletes when utilized alongside a resistance training program.3 Longer study duration with larger samples, both genders, and less fit individuals (e.g. overweight) would be valuable for further exploration.

Why is this Clinically Relevant?

  • KD in trained men combined with resistance training protocols may improve VAT and FM levels, both risk factors for cardiovascular disease3
  • Trained men desiring to increase LBM and increase muscle hypertrophy may need to consider a dietary approach which includes a calorie surplus with high protein content along with adequate carbohydrate intake

View the article

Citations

  1. Paoli A et al. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr. 2013;67(8):789–796.
  2. McSwiney FT, Wardrop B, Hyde PN, Lafountain RA, Volek JS, Doyle L. Keto-adaptation enhances exercise performance and body composition responses to training in endurance athletes. Metabolism. 2018;81:25-34.
  3. * Vargas S, Romance R, Petro J, et al. Efficacy of ketogenic diet on body composition during resistance training in trained men: a randomized controlled trial. J Int Soc Sports Nutr. 2018;15:31.

*Note: In the Vargas S et al. 2018 article, there are discrepancies in body composition outcomes in the written Results section of the article, however, the quantitative results in Table 2 and the Abstract are correct and are summarized above.

Shared by Dr. Phil McAllister @ Forward Health Guelph

Written by Bianca Garilli, ND

Dr. Laura on Detoxification

Detoxification is a continual process. This happens at a cellular level throughout the body especially in the liver, kidney, lungs, skin, gastrointestinal tract and emotions.

Cellular toxins

When a cell encounters a toxin, be it too much sugar or alcohol, pesticides, BPA, lead, mercury, cadmium, arsenic, nickel, chemical flame retardants, phthalates, viruses, bacteria, fungi or parasites it mounts a cell danger response (CDR).  This load triggers a series of protective reactions that slows the transport of   goods across the cellular membrane. The membrane walls thicken just like our ancestors ravaged in war, built their walled cities for protection. This response to cellular danger is a fundamental component of innate immunity and can be helpful in times of distress.

Seasonal influence on detoxification

There comes a time when things must come and go from this walled city.  Seasonal influence provide an important basis for organ focus. For example, in the height of summer, the emotions, digestive and energy movement are most active. Autumn is more a time for the lungs and large intestine.  Winter brings the kidney and bladder centre stage. Finally in spring the liver and gallbladder are most ready to clear out the build up from the cold winter months.

Long term effects of toxic exposure

Long term toxic exposure with little support leads to chronic disease. This is when the cells continually want to keep their walls of protection. This is not healthy. Garbage builds up, and the inward flow of nutrients slow down. We also get this feeling after the long, cold winter months as we have hibernated inside, put the heat on and slowed our movement in and out of the house. It is always interesting what tends to happen at human levels of behaviour are also reflected at levels of cellular behaviour.

With this in mind, it might be proactive to think about more outside activities to keep your cells and energy from becoming too stagnant. The kidneys and urinary bladder are likely more open to accept attention in the winter time.  The urinary bladder is pretty straight forward in its function; eliminating water soluble waste that has been prepared by the supporting organs in the body. The kidneys themselves are responsible for blood filtration, mineral and acid base balance. They decide what gets filtered out and what gets recycled back into the body. In Chinese Medicine, the kidneys include the adrenals, our body’s organs that help us adapt to stress.  It is important through the winter months to also ensure the adrenal glands are well supported.

Near the end of one season and the beginning of another, during equinox, the need for the organs shift. So in late winter, early spring, the stage prepares for the kidneys, adrenals and bladder to fade and the liver and gallbladder begin to take centre stage. If the flow of energy through these organs is not smooth, it generally results in a lack of creativity and feelings of irritability and nagging frustration.

Organ System Screening

Electro dermal screening (EDS) can provide insight into the health of your detoxification organs. Much like an EKG on the heart or EEG on the brain, nervous system conductance related to each organ may be captured at peripheral points of the nervous system on the hands and feet. The onsite EDS equipment at Forward Health is German engineered, precise and needle free. 

Detoxification Plan

Together with sensitive body biofeedback from the EDS equipment and understanding what’s bothering you, Dr. Laura M. Brown, ND can create a clear detoxification plan to help you relax those walls you and your cells have built, and get the river of life flowing smoothly once again.

Resources:
Teeguarden, Ron. 1984. Chinese Tonic Herbs. Japan Publications New York.
Naviaux, Robert. 2013. Metabolic Features of the Cell Danger Response. Mitochondrion Volume 16, May 2014, Pages 7-17 https://doi.org/10.1016/j.mito.2013.08.006.

 

Dr. Laura: Can Fasting Heal Auto Immune Disease?

Fasting is known to initiate cellular clean-up, reduce inflammation, heal leaky gut and reset the immune system. What better formula could we ask for when it comes to autoimmune disease?

Can Fasting Really Help AutoImmune Suffering?

After a recent talk at Goodness Me! I did on the safety of fasting, I was left with more questions on how fasting could help those suffering with autoimmune conditions like multiple sclerosis, Sjogren’s, celiac, diabetes type I, Hashimoto’s thyroiditis, ulcerative colitis, psoriasis and rheumatoid arthritis.

In the interim I have played with intermittent fasting over the past couple of months and my body says “thank you!” My digestion has not been this good for years and the persistent scalp psoriasis has all but disappeared. Even when I eat tomatoes, a common trigger for me. It seems anacdotal, however fellow colleagues in the the functional medicine industry like Mark Hyman, Amy Myers, and Courtney Sperlazza all agree.

What Kind of Fasting?

There are many kinds of fasting. We fast when we exclude a single food or types of foods from our diet. So the 30-day reset with no grains, sugar or dairy is a type of fast. This is a good start. The Ketogenic diet is a type of fast too. A Keto diet for a while may be helpful because it switches the body from a carb burning engine to a fat burning engine. But here I am talking about intermittent and more extended fasts to give complete
digestive rest
. When the body is not busy digesting and sorting out where to use or store the blood sugar, it can focus on cellular clean up and repair. Of course when you do eat, nutrient dense foods are a must because you are eating less overall and will need to pack the nutrients you need into less meals. If you are sensitive to foods, like tomatoes, dairy, wheat and sugar for me, that doesn’t mean I go back to eating them all the time. If at all. My excuse was I was in beautiful Italy and learning to make a succulent Bolognese sauce.

Can Anyone Fast?

No. Fasting isn’t for everyone. Not for children or pregnant mothers, those who are malnourished or those with anorexia or bulimia – that’s just playing with fire. Fasting also has to be monitored if you are on medications or have certain medical conditions. Medical complications include gout, cardiac arrhythmia, and postural hypotension.

How Long to Fast?

There is nothing written in stone about the perfect length of fast. And if you ever feel nauseous, dizzy or unwell you should eat. This isn’t about starvation. It’s about digestive rest. It’s about resetting insulin sensitivity and the immune system. Also, we know where the food is and have access to it if we need it. So it’s not starvation.

What Foods are Allowed?

As I mentioned above there are no real rules and there are many different  types and lengths of fasts. If you are on the thinner side and can’t stand to loose some weight, then you better consider bone broth fasts, where there are some nutrients and fat going in. If you have a little loving around that waist line, you likely can feed off that for a while and have coffee, tea and of course LOTS OF WATER.

For more information on whether fasting is right for you, and how to do it, book an appointment with Dr. Laura M. Brown ND. 519.826.7973.

 

Dr. Laura: Cough and Cold Relief, Naturally.

Naturopathic medicine offers much in line with cough and cold relief. The common cold and sinusitis are classic respiratory tract illnesses.

Respiratory Tract

The respiratory tract can be affected by many different cold viruses which  cause coughs due to inflammation, pain, and irritating mucous. The typical respiratory virus lasts 7-10 days.

Prevention

  • wash hands
  • avoid cross contamination
  • strengthen immune

First line is prevention. Washing hands regularly with soap and water is key. Also keep unwashed hands away from common sites of viral and bacterial entry: the nose, eyes, ears and mouth. Medicinal mushrooms, herbal formulas geared to the immune system, garlic, vitamin C may all be used to help strengthen the immune system.

Early signs

At early signs of throat tickles or glandular reactions, there are homoepathics and essential oils, mineral and botanical sprays that can nip things before they take off. Wet socks can also be helpful to boost white blood cells.

Naturopathic Treatments for Cough and Cold

Relieve blocked sinuses

There are acupuncture points to help balance heat and cold in the body, as well as ones that activate and release the sinuses. Even a single treatment can provide significant relief. At home hydrotherapy is always useful. A nasal saline rinse, wet socks or steam inhalation can all help you breath and sleep better at night and breathe better through the day. Steam inhalation with essential oils of thyme, lavender or eucalyptus allows antimicrobials to come in direct contact with the respiratory tract mucosa and the heat will help loosen the mucous. Herbal remedies blended to suit the symptoms of the cold and cough are very helpful to reduce the severity and duration. They offer antimicrobial factors, reduce inflammation and soothe irritated tissues. Mucolytics are neutracueticals which help break up mucous. Dr. Laura will work with you to find the best combination of remedies for you.

Relieve cough

  • Herbal remedies to soothe and reduce inflammation of mucous membranes
  • Homeopathic remedies prescribed for the specific nature

As mentioned above, custom blended herbal and homeopathic remedies can reduce the intensity and duration of the respiratory virus. Often, in upper respiratory tract infections, it is the post nasal drip of mucous from the sinuses that produces the cough. In lower respiratory tract infections, there is also irritating mucous involved. In both cases, it is important to treat the mucous congestion as mentioned above and soothe the tissues.

Treat lingering cough

  • Nebulized Glutathione

Nebulized or inhaled glutathione may be helpful to nourish and restore respiratory tract tissue. It is useful in any trauma to respiratory tract including smoke and fume inhalation and treatment can reduce and even avoid the post viral cough. Glutathione offers antioxidant protection and immune support while avoiding influence on plasma levels.

Alterations in the levels of glutathione in the lung and alveoli are widely recognized in many inflammatory lung diseases. Glutathione in the lining fluid of the lower respiratory tract is the first line of defence against oxidative stress.

 

Dr. Laura M. Brown ND

 

References:

The treatment of pulmonary diseases and respiratory-related conditions with inhaled (nebulized or aerosolized) glutathione. Evid Based Complement Alternat Med. 2007;5(1):27-35.

https://ndnr.com/bacterialviral-infections/post-viral-cough-clinical-considerations/