Dr. Phil Shares: Why You Should Get up and Walk After Dinner

Why You Should Get up and Walk After Dinner

When you eat a heavy meal, it can often make you feel sluggish afterward and even disrupt sleep. But getting up and taking a short walk after eating can help combat this. Not only is walking a great low-impact activity to help you stay healthy overall, it can specifically aid digestion and control blood sugar levels — preventing crashes in energy. Here, a look at the research and why evening walks are particularly beneficial for digestion and controlling blood sugar:

EFFECTS OF HIGH BLOOD SUGAR

Chronic high blood sugar can negatively affect your health. Over time, it can cause damaged blood vessels, nerve problems, kidney disease and vision issues. Chronic high blood sugar can also lead to insulin resistance and impaired glucose tolerance, risk factors for Type 2 diabetes.

HOW WALKING AFTER EATING HELPS

While walking any time of the day can have positive effects on health, taking a stroll after a meal may be especially effective for managing blood sugar levels. A study published in Diabetes Care found walking for 15 minutes after a meal three times a day was more effective in lowering glucose levels three hours after eating compared to 45 minutes of sustained walking during the day.

Walking at night might be the most beneficial since many people eat their largest meal in the evening and then tend to sit on the couch or lay down after. Another study focusing on individuals with Type 2 diabetes found that even 20 minutes of walking post-meals may have a stronger effect on lowering the glycemic impact of an evening meal in individuals with Type 2 diabetes, compared to walking before a meal or not at all.

HOW IT CAN HELP DIGESTION

Individuals suffering from digestion problems and discomfort may also see some benefits from walking. A small 2008 study found walking increased the rate at which food moved through the stomach. Other research has found that walking after a meal may improve gastric emptying in patients with longstanding diabetes, where food may typically take longer to digest and empty from the stomach.

THE BOTTOM LINE

Walking is one of the most studied forms of exercise, with research demonstrating it’s an ideal activity for improving health and longevity. Try going for a brief walk after a meal (especially in the evening) to help with digestion and blood sugar control.

Amp up your walking in general with these 50 tips to get more steps.

by Sarah Schlichter and myfitnesspal

shared by Dr. Phil McAllister @ Forward Health Guelph

Dr. Phil Shares: All of Us Really Are A Miracle

Sometimes we take our body’s for granted, so I found the illustrations and captions below, put it all into perspective.

Heart
http://en.bcdn.biz/Files/2015/8/27/41a7d347-67ee-4d23-860c-34893d8f2b49.JPG
Cancer
Brain
Stomach
Eyes
Energy
Red Blood Cells
Skin
Hair
Words
Liver
Saliva
Testicles
Kidneys
Hair
Digestion
Regeneration
Final Slide

Shared by Dr. Phil McAllister @ Forward Health Guelph

Thanks to My Mother for sharing this with me.

Dr. Laura: Drugs that affect the microbiome

Drugs are one of the major factors that affect the microbiome. The impacts vary depending on the drug and duration of treatment.

The environmentfoodstress and drugs  all contribute to changes in the microbiome. This is why it is important to recognize and address any contributors that cause troubles.

Clinical intake and tests flushes out root causes and provide clarity. 

Why should I care?

Unique patterns in the microbiome link to different diseases. An unhealthy microbiome links to depression, anxiety, autistic disordersvitamin and mineral status (nutrient absorption)hormone production,  eczemadiabetes, obesity, arthritis and inflammatory bowel psoriasis and other autoimmune, conditions, heart healthcholesterolnon-alcoholic fatty liver disease (NAFLD), diseases.  Research continues to expand this list.  

What is the microbiome?

The human microbiome exists in the gastrointestinal/urogenital tract and the skin. The trillions of cells that make up our microbiome actually out number the human cells that we have in our body by tenfold. Are we microbes having a human experience?

Healthy microbiome?

A healthy regular stool is not always indicative of a healthy microbiome. History of autoimmune conditions, food sensitivity, sugar cravings, gas, pain, bloating, bad breath, candidiasis, brain fog, mood changes, weight issues, skin issues, joint pain, trauma, stress, headaches, use of birth control or other hormones, frequent use of antibiotics and certain drugs can all be factors or indicators of microbiome disruption. 

What drugs affect the microbiome?

Your microbiome may be out of balance if you are currently, or have history of taking, any of the following drugs:

  • Antibiotics
  • Cancer Therapies
  • Antihistamines
  • Antidiabetic drugs
  • Anti-inflammatory drugs
  • GI disorder drugs
  • Non-steroidal Anti-inflammatory drugs
  • Anti-psychotic drugs
  • Anti-coagulants
  • Hormones: estrogen, birth control, thyroid hormone

Find out more…tests available

One helpful test to look at the key players of the microbiome is the comprehensive stool and parasitic analysis. Knowledge of the landscape certainly helps streamline the treatment. 

Food sensitivities often rise when the microbiome is off balance. It is important to recognize the foods that are bothersome. Then remove them for a while and do the work to remove unwanted microbes and replace with healthy ones while repairing the gastrointestinal tract lining. Protocols are patient specific based on the microbiome the lining of gastrointestinal tract and the overall health of the patient. 

Dr. Laura M. Brown ND is a Naturopathic Doctor with a functional medicine approach. She is a Certified Gluten Practitioner, a HeartMath Certified Practitioner and is a graduate of Adapt Level 1 at Kresser Institute of Functional Medicine. Essentially, Dr. Brown helps people better digest their food and the word around them. More at www.naturalaura.ca and  www.forwardhealth.ca

Dr. Laura: Dangers of Proton Pump Inhibitors

Proton Pump Inhibitors, or PPI’s may help gastrointestinal reflux (GERD) in the short term, but they increase risk of many long term negative effects.

Long Term Side Effects of PPIs

When proton pump inhibitors are taken for an extended length of time, they can ™cause a shift in the gut microbiome that –increases risks for:

  • liver disease like alcoholic liver disease, non-alcoholic fatty liver disease (NAFLD), and non-alcoholic steatohepatitis
  • increased risk for cardiovascular events, kidney disease and dementia. 
  • Nutritional deficiencies, especially B12 and iron.


GERD

™Gastro-esophageal reflux disease (GERD) is caused from a faulty lower esophageal sphincter valve. ™Backs up content of stomac acid burns™ the esophageal lining. For many, a trip to the conventional doctor mean a prescription of proton pump inibitors – a drug that often ends in an -prazole. Like omeprazole, pantoprazole, for example.

Causes of GERD

  • bacterial overgrowth
  • lazy sphincter
  • food sensitivity

Interesting fact is the real cause of GERD may be from not enough stomach acid, rather than too much. If this is the case, taking a proton pump inhibitor, which lessens stomach acid can actually make the problem worse. Tests for H. pylori, a bacteria that can sometimes overgrow in the stomach may be necessary. H. pylori likes to reduce the level of stomach acid so it can thrive. Lower stomach acid means food is not properly digested and this can lead to fullness in the stomach and regurgitation or GERD.

The gastric-esophageal sphincter may be lazy and in need of tonification. Proton pump inhibitors won’t address this issue, however botanical medicine can often help.

Another reason to skip the proton pump inhibitor and look for the root cause is that GERD is often a result of food sensitivity. Food sensitivities related to GERD can be more than the typical caffeine, peppermint, spicy foods and citrus that commonly aggravate the issue.

For help with this and more digestive concerns, book online, contact drlaurambrown@forwardhealth.ca or call 519 826 7973 to book your appointment today.


Dr. Laura: Boost your energy

The energy powerhouses of cells are called mitochondria. These tiny organelles are derived solely from our mother’s DNA and are reposible for generating the energy our bodies need to run.

Mity Mitochondria

  • Make up about 10% of our body weight
  • 200-2000 per body cell
  • relies on the fats, carbohydrates and proteins we eat
  • loves to run on ketones
  • Needs nutrients like calcium, B vitamins, CoQ10, N-Acetyl-Cysteine, Magnesium, Alpha lipoid acid, lysine

Energy Drains

Fatigue comes from drains on the mitochondrial function. This can happen with any type of toxic burden:

  • long term nutrient deficiency
  • poor sleep habits
  • hormonal disruption
  • eating too much in general
  • eating too much sugar
  • excessive exercise
  • heavy metals
  • viruses and spirochetes (Lymes)
  • pesticides
  • plastics, PCB’s
  • drugs
  • mold

Signs of Mitochondrial Dysfunction

Unexplained fatigue, the need for more than 8 hours of sleep on an ongoing basis, poor exercise recovery, impaired sense of smell or taste, headaches, poor motivation, depression, anxiety, brain fog, forgetfulness, extra sensitive to light and noise – are all indicators of poor mitochondrial dysfunction. While other things may be at play like poor thyroid function, hypothalamus, pituitary or adrenal function, it is important to also consider the mitochondria.

Boost Your Energy

Support the mitochondria and reclaim your energy. An initial naturopathic appointment will start the process to understand the source of your energy drain. Together a same day plan could initiate the changes required to boost energy.

Dr. Laura M. Brown, ND

Dr. Laura on Potassium Levels

Potassium is a mineral that dissolves in water and carries and electrical charge. Easy to see how it can act as an electrolyte.

Nerve, muscle, and heart function all depend on the appropriate level of potassium.It is absorbed in the small intestine and excreted mostly in the urine, and some in the sweat and stool.

The kidney is the main regulator of potassium levels, so if it is healthy and you are getting regular food sources of it, there likely is no reason to be concerned about the levels of potassium in the body.

Potassium’s role in the body.

  • fluid and electrolyte balance
  • maintains nerve and muscle growth
  • balances pH (acid/base balance)
  • contributes to heart function
  • assists in the use of carbohydrates and proteins
  • interacts with blood pressure
  • supports healthy metabolism and blood sugar regulation.

 

Food sources of potassium

  • acorn squash
  • artichokes
  • bananas
  • citrus
  • dried fruits
  • dark leafy greens
  • dried beans
  • legumes
  • nuts
  • potatoes (white and sweet)
  • soy
  • tomatoes
  • cod
  • salmon

Low levels of potassium

Potassium deficiency, or hypokalemia may be noted by fatigue, weakness, muscle cramps, heart palpitations, cardiac arrhythmia’s, hypertension, and postural hypotension. Trouble is, low potassium looks very much like high potassium, however it is more likely to have low levels

Low serum potassium can be caused by inadequate dietary intake, certain drugs, dialysis, plasmapheresis, increased potassium entry into the cells, decreased potassium exit from cells, and increased losses in the urine, gastrointestinal tract, or sweat.

High levels of potassium

Hyperkalemia rarely produces physical symptoms. Excessive potassium can disturb heart and skeletal muscle function, cause nausea, fatigue, muscle aches and weakness and increased respiratory rate.

Some medications can lead to higher than normal potassium levels:  ACE (angiotensin-converting enzymes), some antibiotics, anticoagulants, ARBS (angiotensin-receptor blockers), beta-blockers, COX-2 inhibitors, cyclosporine, antifungals, NSAIDs (non-steroidal anti-inflammatory drugs- Advil, Motrin), and potassium sparing diuretics.

Fasting, high blood sugar, metabolic acidosis, kidney insufficiency are all contributors to high levels of potassium.

Measuring potassium

Unless there is a state of severe deficiency, it can be difficult to assess proper levels of potassium. Blood serum levels may be normal, while blood cellular levels deficient. Beyond this, levels in the muscles may not reflect either the levels of blood cell or serum.

So long as the kidneys are functioning well and no drugs (as mentioned above) interfere,  there is generally no need to worry about higher intakes of potassium, as it will be sufficiently excreted.

References:

Kresser, Chris. 2018 Adapt Level One Blood Chemistry Manual. www.kresserinstitute.com

Lavalle, James. 2013 Your Blood Never Lies. Square One Publishers Garden City Park, NY.

Gaby A. 2011 Nutritional Medicine. Fritz Perl Publishing Concord, NH.

Dr. Laura: 5 ways to strengthen your immune system

Immune system need a boost? Support it with one or a combination of these top five natural ways. A strong immune system means less colds and flu, especially through this winter and early spring season.

As a start, be sure to wash your hands regularly with soap and water keep indoor humidity around 45-50%. Then, visit your naturopathic doctor to find what is the best combination of these five following things you need to strengthen your immune system.

1. Probiotics

2. Adaptogens

3. Medicinal Mushrooms

4. Vitamins

5. Minerals

 

Probiotics

We know that 70% of your immune system resides in the gastrointestinal tract, so it makes perfect sense to keep a healthy balance of your microflora. Research in probiotics is very active and there may be new strains available to help you balance yours.

Adaptogens

The adrenal glands are little hat like glands that sit atop the kidneys.  When you think of cold weather, think of hats and think of adrenal support. Resilience to stress can keep illness at bay but when we are constantly under stress at work, at home and toxins build up from pesticides, environmental factors, drugs, allergens – we need help. There are a number of adaptogenic herbs like holy basil, ashwagandha, ginsengs, liquorice, schisandra, codonopsis, astragalus and rhodiola that can be custom blended to support your needs.

Medicinal Mushrooms

Medicinal mushrooms can be an amazing support for the immune system. Helpful are hot water extracts of mushrooms like maitake (Grifola frondosa), reishi (Gandoderma lucidum), Cordyceps, shitake (Lentinus edodes), turkey tail (Coriolus versicolor), and sun mushroom (Agaricus blazei). It is possible to get these in different combinations and even in packets to make a “tea”.

Vitamins

Vitamin A, C, E top the list for immune support. Oranges, citrus and bell pepper provide Vitamin C.    The beta-carotene in orange and red vegetables will convert to Vitamin A in most people. Cod liver oil is a viable direct source of vitamin A.  Wheat germ oil and almonds pack a punch of vitamin E. There are formulas available that combine these vitamins with some minerals and they can often be a sure way of getting the support you need every day.

Minerals

Zinc, Selenium and Magnesium are truly critical for the immune system to function. A varied diet will often provide enough. Bone soup broths are a great, as are pumpkin seeds for the zinc, brazil nuts for the selenium and dark leafy greens for the magnesium.

 

This blog does not constitute medical advice. Natural products can interfere with existing medical conditions and prescription drugs. Be safe and get the knowledge and advice of a naturopathic doctor.

From the heart and mind of Dr. Laura M. Brown, ND

Dr. Phil Shares: Not Taking a Multivitamin? Here Are the Top 5 Reasons You Should Be

You try to eat well to feel good and stay healthy. While it’s optimal to get your nutritional needs from the foods you eat, it’s not always possible. There is conflicting information out there on the benefits of supplements, but the Dietary Guidelines for Americans 2015-20201 say that supplements may be useful for providing the nutrients you may be lacking from diet alone.

Still on the fence? Consider these top five reasons to add a multivitamin to your daily regimen.

  1. Healthy aging. As we get older, our bodies have a harder time absorbing nutrients from food. The National Institute on Aging notes that starting around age 50, people begin to require increased amounts of certain vitamins and minerals.1 In fact, according to a study published in the June 2009 issue of the American Journal of Clinical Nutrition, researchers found that taking a daily multivitamin & mineral supplement may help improve micronutrient deficiencies associated with aging.3
  2. Making up for eliminated food groups. While some people have to cut certain foods like nuts or gluten out of their diets due to allergies, many eliminate particular foods or food groups from their diet voluntarily. This can cause vitamin deficiencies that would be helped with a multivitamin.
    Trying a paleo diet? You might risk a shortage of calcium or vitamin D by eliminating dairy or grains. Cutting back on red meat? A multivitamin will replace the iron and B12 you would normally get from diet.
  1. Getting the RDAs you’re not getting from food.You’ve probably heard that the typical Western diet doesn’t include nearly enough daily fruits and vegetables. As part of that, you don’t always get the vitamins those natural foods supply. Supplementing with a multivitamin containing phytonutrients from fruit- and vegetable-derived ingredients may help. In addition, it’s important to keep in mind that RDA levels are set to prevent nutrient deficiencies. But there’s a wide range between taking enough vitamin C to avoid scurvy and the optimal amount you can benefit from.
  2. Getting that extra energy to get through the day. In today’s “go-go-go” society, one of the top complaints is a general lack of energy. Instead of reaching for that third cup of coffee, remember that your cells require certain vitamins and minerals to power your busy life; especially if you’re not getting a full eight hours of sleep or eating a balanced diet, a multivitamin can help provide the nutrients you need to feel energetic throughout the day.4
  3. Managing stress. Daily life stressing you out? You’re not alone. But vitamins and micronutrients play a significant biochemical role in improving your brain’s cognitive processes, and studies have shown that a daily multivitamin—particularly one with high doses of B vitamins—can help to reduce stress and support a healthy mood.5

Ready to add a daily multivitamin to your diet? Be sure to check with your healthcare practitioner to see if he or she has a recommendation and to ensure that any medications you’re currently on won’t interfere with their effectiveness.

Shared by Dr. Phil McAllister @ Forward Health Guelph

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.