Dr. Phil Shares: 8 Bad Habits That Kill Your Metabolism

You may already suspect your metabolism slows as you age. According to research published in the Public Health Nutrition journal, you’re right. In a review of data on energy expenditure, researchers found simply getting older is associated with progressive declines in basal metabolic rate. On top of that, there are many daily habits that can drain your metabolism even further.

But you don’t have to go down without a fight. Cut out the below habits and watch your metabolism and energy levels improve.

Eating a nutritious breakfast is always a good way to start your morning. Because your metabolism slows down during sleep, eating can fire it up and help you burn more calories throughout the day. According to Rush University Medical Center, “When you eat breakfast, you’re telling your body that there are plenty of calories to be had for the day. When you skip breakfast, the message your body gets is that it needs to conserve rather than burn any incoming calories.”

OK, so it’s about more than just eating something in the morning. If you grab a sugary donut or eat a muffin in the car, you’re setting yourself up to crash later. Instead, choose something with filling protein and fiber like eggs, yogurt and berries or whole-wheat toast topped with peanut butter.

Going from your office chair to your car to your couch can lead to a very sedentary routine. And sitting for extended periods puts your body into energy-conservation mode, which means your metabolism can suffer. According to the UK’s National Health Service, “Sitting for long periods is thought to slow metabolism, which affects the body’s ability to regulate blood sugar, blood pressure and break down body fat.”

Cardio is great, and it can quickly burn calories, but once you’re done running or cycling, your calorie burn quickly returns to normal. When you do HIIT and resistance-based workouts, however, your calorie burn stays elevated for longer as your muscles repair themselves. Per the American Council on Exercise (ACE): “Strength training is a key component of metabolism because it is directly linked to muscle mass. The more active muscle tissue you have, the higher your metabolic rate.” And, according to ACE, a pound of muscle burns an additional 4–6 calories each day compared to a pound of fat.

Protein feeds your muscles, promotes satiety and is an important component to sustaining a healthy weight. Eat too little, and you may have trouble building or maintaining muscle mass — and per the above, we know muscle’s importance to metabolism. Also, protein requires more energy to break down than carbs or fat, so you’ll actually burn more calories during digestion.

One bad night’s sleep is enough to leave you feeling sluggish and impair your cognitive processing. String together several nights in a row — or a lifetime of inadequate sleep — and science shows decreased metabolism and hormonal imbalances may follow.

In a study published in The Journal of Clinical Endocrinology & Metabolism, researchers found drinking 500 milliliters of water (about 2 cups) increases metabolic rate by 30%, and that spike lasts for more than an hour. So, drink water throughout the day to stay hydrated, and you’ll get the added benefit of a boosted metabolism.

When stress levels increase, your body produces a hormone called cortisol. Cortisol leads to increased appetite, makes us crave comfort foods, decreases our desire to exercise and reduces sleep quality — all things that negatively impact metabolism. So, while you can’t always control your stress levels, managing stress can go a long way toward protecting your body’s internal fire.

by Kevin Gray

Shared by Dr. Phil McAllister @ Forward Health Guelph

SaveTagscreating healthy habitslosing weightmetabolism

Dr. Phil Shares: Prevent Winter Slip Ups!

Stay Standing This Winter!

Falling on ice can leave you red-faced with embarrassment, or far more seriously, hurt badly from taking a knee to the ice or falling awkwardly on icy snow. Slippery sidewalks, driveways and icy parking lots can be risk factors for falls in winter. Avoid a bad fall with these top tips!

Walk like a penguin

  • The penguin waddle helps you keep a center of gravity over the front leg as you step, instead of split between the legs. Short strides also help keep your center of gravity, which help avoid falls. When walking, extend your arms out from your sides to increase your centre of gravity. Don’t keep your hands in your pockets!  Walk slowly, with short strides and try to land your steps with a flat foot.

Keep walkways clear

  • Shovel snow and scrape ice as soon as possible. Liberally sprinkle ice melt product or sand onto walkways to provide foot traction and to make sure surfaces don’t turn to ice. This not only protects you and your family, but also postal carriers and others when they’re walking around your property. Where possible install or use handrails for extra support.

Take all precautions

  • Be extra cautious walking after a storm. Tap your foot on potentially icy areas to see if it is slippery. Hold a railing while walking on icy steps. Stay steady by wearing proper winter footwear. Lightweight boots with a thick, non-slip tread sole will provide good traction on ice. If a sidewalk is icy down the middle, walk on the snow beside it to avoid slips.

Lighten your load

  • Carry fewer bags on snow days, since excess baggage can throw off your balance and make it tougher to regain your balance once you lose it. Keep your hands free by putting away your phone while walking – you may need to catch yourself!

Boost balance with exercise

  • You can’t control the weather, but you can improve your balance through regular exercise. Exercise is an ideal way to help you stay safely on your feet because it helps improve balance, flexibility and strength. Talk to a chiropractor about ways to improve your balance and strength in order to prevent falls.

Visit your chiropractor

  • Don’t let a fall get you down. If you do take a tumble, visit your chiropractor. They’ll get you back to doing the things you love to do and will work with the rest of your care team to help prevent future falls.

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.

Dr. Phil Shares: 11 Signs That You’re Falling In Love, According To Science

If you’re stressed out or suddenly trying yoga, you may just be falling in love.

Knowing you’re in love feels different for everyone. Some have been in love often and know the feeling well, and others may be not so sure if it’s love or just a deep infatuation.

Luckily, your body has some pretty sneaky ways of tipping you off to whether these feelings for your partner are more than just a passing phase. Keep an eye out for these tell-tale signs the next time you catch yourself wondering if you’re actually in love.

You can’t stop staring at them.

If your partner has ever caught you staring at them lovingly, it could be a sign that you’re head over heels. Eye contact means that you’re fixated on something, so if you find that your eyes are fixed on your partner, you may just be falling in love.

Studies have also found that couples who lock eyes report feeling a stronger romantic connection than those who don’t. It goes the other way too: when a study had strangers lock eyes for minutes at a time, they reported romantic feeling towards each other.

You feel like you’re high.​

It’s completely normal to feel out of your mind when falling for someone.

A study from the Kinsey Institute found that the brain of a person falling in love looks the same as the brain of a person who has taken cocaine. You can thank dopamine, which is released in both instances, for that feeling.

This is a good explanation for why people in new relationships can act absolutely nonsensically.

(Getty Images/iStockphoto)

You always think about them.​

If you love someone, you may feel like you can’t get them off of your mind. That’s because your brain releases phenylethylamine, aka the “love drug” when you fall in love with someone.  This hormone creates the feeling of infatuation with your partner.

You may be familiar with the feeling because phenylethylamine is also found in chocolate, which may explain why you can’t stop after just one square.

You want them to be happy.​

Love is an equal partnership, but you’ll find someone’s happiness becomes really important to you when you’re falling for them.

So-called “compassionate love” can be one of the biggest signs of a healthy relationship, according to research. This means that you’re willing to go out of your way to make your partner’s life easier and happier.

If you find yourself going out of your way to keep your partner dry when walking in the rain or making them breakfast on a busy weekday morning, it’s a sign you’ve got it bad.

You’ve been stressed lately.

Although love is often associated with warm and fuzzy feelings, it can also be a huge source of stress. Being in love often causes your brain to release the stress hormone cortisol, which can lead you to feel the heat.

So if you’ve noticed your patience is being tested a little more than normal or you’re kind of freaking out, you may not need to carry a stress ball just yet; you may just be in love.

You don’t feel pain as strongly.​

Falling for someone might be painful, but if you’ve noticed that literally falling doesn’t bother you as much anymore, it could be a big sign you’re in love.

A study conducted by the Stanford University School of Medicine had participants stare at a photo of someone they loved and found that act could reduce moderate pain by up to 40%, and reduced severe pain by up to 15%.

So if you’re getting a tattoo, you may want to keep a photo of your partner handy. Just in case.

(Getty Images/iStockphoto)

You’re trying new things.

Everyone wants to impress their date in the beginning of their relationships, but if you find yourself consistently trying new things that your partner enjoys, you may have been bitten by the love bug.

In fact, a study found that people who have claimed to be in love often had varied interest and personality traits after those relationships. So even if you hate that square-dancing class you’re going to with your partner, it could have a positive effect on your personality.

Your heart rate synchronizes with theirs.

Your heart may skip a beat when you think about the one you love, but a study showed that you may also be beating in time with each other. A study conducted by the University of California, Davis, suggests that couples’ hearts begin to beat at the same rate when they fall in love.

Although you may not be able to tell if this has happened without a few stethoscopes, feeling a deep connection to your partner is a good a sign as any that you’re in love.

You’re OK with the gross stuff.

If you’re a notorious germaphobe and totally cool kissing your partner after just watching them pick their nose, you might just be in love. In fact, a study by the University of Groningen in the Netherlands found that feelings of sexual arousal can override feelings of being grossed out.

So that means if you’re super attracted to your partner, you may just let them double dip. That’s love, baby.

You get sweatier.​

If you’re nauseous and sweaty, you either have a bad stomach bug or are falling in love. A study found that falling in love can cause you to feel sick and display physical symptoms similar to that of anxiety or stress, like sweat.

Although this feeling will probably pass once you really get comfortable with your partner, it may be a good idea to carry around an extra hanky, just to be safe.

You love their quirks​

If you really get to know a person, chances are you’ll pick on the little things that make them uniquely them. And if you’re in love with them, these are probably some of the things that attract you most about them.

A study found that small quirks can actually make a person fall deeper in love with someone rather than just physical attributes because people have unique preferences. So although you may have judged your partner a little harshly on first glance, if you find that you’re suddenly in awe of their uniqueness, you might be in love.

By Kristin Salaky

Shared by Dr. Phil McAllister @ Forward Health Guelph

Dr. Phil Shares: 5 Quick + Easy Ways To Incorporate Wellness Into Your Week

With all of the go, go, go that comes with being a busy, working woman, sometimes our own health falls to the wayside. We get it, not everyone has the time to hit a two-hour Pilates class every day…we certainly don’t! We’re all about striking a balance here and figuring out simple ways to improve our health on the daily. Let’s keep it simple and dive right into our five quick and easy wellness tips to improve your week.

easy wellness tips

Increase Your Intake of Hydrating Foods

Every wellness article you read is going to tell you to drink your body weight in water, and you should! But just in case you’re not the best at guzzling gallons of water in one sitting, try snacking on it! Foods like cucumbers, watermelon, strawberries, tomatoes and zucchinis are about 95 percent water. Increase your intake of these tasty snacks and you’ll kill two birds with one stone. We also love mixing in a shot of this hydrating inner beauty boost into our water!

Micro-Dose Your Vitamin D

Set a timer on your phone, write it on your to-do list, do whatever you need to do to incorporate fresh air into your day. Before lunch each day, head outside for a 15-minute walk and soak up the sunshine. Fifteen minutes may not sound like much, but it’s enough to get your blood pumping and also shift your mindset. Pencil in a minimum of one walk per day, but if you can swing more, do it!

Eat Mindfully

So many of us (*guilty hand raised*) eat like it’s just something else to check off our to-do list. We often eat our lunch at our desk in front of a computer, or at home in front of the television. This often leads to overeating or mindless snacking! When it’s time to eat a meal, choose somewhere intentional to sit that doesn’t involve devices with screens. This will help you feel mindful as you eat, breathing between bites, and taking note of when your body is satisfied.

Try Dry Brushing

Never heard of dry brushing? It has a surprising number of benefits, including lymphatic system stimulation. The lymphatic system is responsible for collecting and transporting waste to the blood. Dry brushing can stimulate the lymphatic system as it stimulates and invigorates the skin. It helps with everything from improving the appearance of skin to supporting digestion. Try our favorite brush here

Do Bedtime Yoga

This is one of our favorite ways to end the day. You literally do yoga in your bed, what could be more relaxing? We follow this routine, but feel free to find one that you look forward to doing each night!

Shared by Dr. Phil McAllister @ Forward Health Guelph

Dr. Laura: Epstein Barr Virus Linked to Several AutoImmune Diseases

The Epstein Barr Virus (EBV) we know mostly as “mono” yields connections to several autoimmune diseases.

Who Gets EBV?

More than 90% of the world’s population is infected with EBV. The age of contraction varies and for many it lays dormant for years. Like other human herpes forms of virus (EBV is HHV4), it reactivates in times of stress or trauma. Typical symptoms are what you hear from the college student and their “kissing disease” – tired, sleep a lot, muscle aches and pains, swollen glands/lymph nodes, altered sense of taste and the list goes on.

It seems that if such a large percentage of the population has EBV, it’s easy to pin it to any disease. Recent research at the Cincinnati Children’s Hospital sheds some light on how EBV affects our genome.

What Diseases Link to EBV?

  • Systemic Lupus Erythematosus (SLE)
  • Multiple Sclerosis (MS)
  • Rheumatoid Arthritis (RA)
  • Juvenile Idiopathic Arthritis (JIA)
  • Inflammatory Bowel Disease (IBD)
  • Celiac Disease
  • Type 1 Diabetes
  • Graves and Hashimotos thyroiditis

“This discovery is probably fundamental enough that it will spur many scientists around the world to reconsider the role of this virus in these disorders,” said John Harley, MD, PhD, director of the Center for Autoimmune Genomics and Etiology (CAGE) at Cincinnati Children’s.

How does EBV Increase Risk for Autoimmunity?

EBV alters the human DNA in ways that weaken the immune system’s ability to combat certain diseases. We all have imperfect genes with variances called SNP’s (pronounced “snips”) that may give us advantage or risk over others in certain situations. EBV tends to change the genetic transcription of DNA to suit its own vitality and puts us more at risk for certain diseases.

What Can Increase the Risk of EBV Sickness?

  • Stress
  • Trauma
  • Poor nutrition
  • Eating the wrong foods
  • Lack of exercise
  • Poor  sleep
  • Lack of spiritual connection

More research is required in this area of science for our full understanding of how to combat this detrimental virus. A Naturopathic Doctor like Dr. Laura M. Brown, ND can help balance lifestyle, diet, nutrition and immune boosting profile to keep the Epstein Barr and other forms of Human Herpes Virus (warts, shingles, cold sores) dormant in your system. Dr. Laura M. Brown, ND can also order and inert genetic tests to help you evaluate your risk for certain autoimmune diseases. Knowing your risk factors can contribute to proactive wellness plan that is tailored specifically to you.

 

Dr. Phil Shares: 6 Most Important Tips for Building Muscle

6 Most Important Tips for Building Muscle

Whether your goal is to get bigger and stronger, or improve power and explosiveness for sports, you want to see progress — and pronto.

But building muscle efficiently requires more than just putting in time at the weight rack. Along with your strength training regimen, diet and lifestyle choices all play important roles.

But before you even start thinking about how to build muscle, it’s instructive to know the primary factors that determine just how much of it you can gain.

3 Factors Affecting Muscle Growth

These are the main criteria dictating increases in muscle size, or hypertrophy — and two of them are outside your control.

Sex

Simmer down — we’re talking gender. The male persuasion unsurprisingly has a decided advantage when it comes to building muscle. That’s due in large part to far greater levels of testosterone and a higher red blood cell count among men than women, who typically have to go to more extraordinary lengths to gain size.

Genetics

Similar to the way it governs how much hair you get to keep, heredity determines how much muscle you can develop. Thanks to genetics, a segment of the populace is born with a higher number of type II, or fast-twitch, muscle fibers, which have the greatest potential for growth.

Training Specificity

The factor you can change — and the one we’ll spend much of this article focusing on — is the approach you take to your workouts overall. There are different protocols that distinguish lifting for mass from lifting for strength.

Generally speaking, lifting very heavy weights in low volume is how to gain strength, and lifting moderately heavy weights in high volume is how to gain muscle.

Woman doing benchpress

How to Build Muscle: The 6 Most Important Things You Can Do

For those seeking tips on how to gain muscle, here are some strategies to get you started.

1. Perform multi-joint exercises

Resistance training is the most efficient way to build lean mass — especially if you pack your workouts with big, compound (multi-joint) moves like the squat, bench press, lunge, and pull-up.

“You can certainly build muscle with all types of moves, but a strong base in multi-joint efforts, at least some of the time, is a good idea,” says Michael Ormsbee, Ph.D., interim director of the Institute of Sports Science & Medicine at Florida State University.

Science agrees: Compound exercises cause the greatest increase in testosterone, a key muscle-building hormone, according to researchers at the University of Connecticut.

2. Eat more protein

Now that you’re lifting weights, you need to consume more protein to promote muscle repair, recovery, and growth since amino acids (the building blocks of protein) are necessary to build muscle tissue.

When you’re planning your high-protein meals, 20 grams of protein is the optimal amount generally accepted for muscle growth. Research has found that the body doesn’t use much more than 20 grams for muscle-building at any one sitting. Around 80 grams of protein per day (or, four meals containing 20-grams of protein each) is about right for most people.

If you want to calculate the optimal protein amount for you and your goals, Beachbody recommends 0.5 to 0.9 grams of protein per pound of desired lean bodyweight per day, depending on exercise intensity. (The harder the workout, the more protein is needed for growth and recovery.)

If you have ambitious muscle-building goals, such as committing to Beachbody’s Body Beast program, shoot for the higher end of the range by adding one or two additional protein-rich snacks to your day.

Shakeology is a great way to sneak in additional calories and nutrients and contains 16 to 17 grams of protein (depending on the flavor).

3. Don’t just lift heavy

When you lift heavy weights or do explosive exercises like sprinting, you target the type-II muscle fibers we discussed earlier. But studies show that type-I fibers (a.k.a. slow twitch — the kind used in endurance activities ) also have growth potential, so don’t ignore them.

Once every week or two, target those type-I fibers with low weight, high rep work (e.g., 3-4 sets of 15 or more reps per exercise). Or simply follow a Beachbody program such as Body Beast21-Day Fix, P90X, 22-Minute Hard Corps, or The Master’s Hammer and Chisel, which have that kind of variation built in.

4. Get plenty of shut-eye

Shoot for a minimum of seven hours a night. Getting less than that on a regular basis can cause you to rack up sleep debt, which can put the brakes on protein synthesis (a.k.a. muscle growth) and increase protein (read: muscle) degradation, according to a study by Brazilian researchers.

Plus, you won’t reap the full benefits of human growth hormone, the levels of which spike while you’re in dreamland. Have trouble sleeping? Try these natural tips on how to get good sleep tonight.

5. Increase weight responsibly

You need to challenge your muscles to trigger growth, but you also need to be smart about how you go about it. If you increase the amount of weight you’re lifting too quickly, you’ll increase your risk of injury. But if you do it too slowly, you’ll shortchange your results or hit a plateau.

So how do you strike a balance? Pay attention to the effort you’re exerting. If you’re lifting with perfect form, and your last few reps an exercise feel similar to your first few, you know it’s time to reach for a heavier weight.

6. Allow time for recovery

Muscles grow between workouts, not during them, so make recovery a priority. In practice, that means eating healthier, consuming more protein, and not overtraining. Take at least one to two days off per week to allow your muscles to fully recover.

“Training too often or at too-high an intensity too frequently — without rest and recovery — can actually hurt your muscle-building efforts,” says Ormsbee.

Your move: Take at least one to two days off per week to allow your muscles to fully recover, and maximize the effectiveness of your downtime by doing light cross training (e.g. hiking, cycling) or activities like foam rolling and yoga.

If you are patient, focused, and consistent with your workouts and recovery, you will see results.

In addition to consuming more protein, there are a number of nutritional steps you can take to bulk up responsibly.

1. Increase calories

“No one can be in a significant calorie deficit and gain muscle,” says Albert Matheny, M.S., R.D., C.S.C.S., co-founder of SoHo Strength Lab.

To find out how many more calories you should consume to gain weight, determine how many calories you need to maintain your current weight — your baseline — then add 300. And if you’re following a muscle-building program like Body Beast, add the recommended calories outlined in the guide.

2. Strike the right mix of macros

Whether your calories come from carbs, fat, or protein goes a long way in determining whether your weight gain comes from muscle or from fat.

An easy and relatively fast way to gain muscle is bulking first, then leaning out, which is the idea behind programs like Body Beast. Using this method, you only have to focus on one thing at a time — building, then getting lean, versus trying to increase mass while simultaneously limiting fat gain.

To increase weight gained from fat, your macros should emphasize carbohydrates and fat, since it’s the most calorically dense macronutrient. The bulk of that fat should come from unsaturated sources such as avocado, olive oil, and salmon.

3. Focus on post-workout nutrition

Generally, you should consume about 20 grams of protein with some carbs shortly after a workout. One way to get the right mix is with Beachbody Peformance Recover, which combines time-released proteins and phytonutrients to aid recovery and reduce muscle breakdown.

During the post-workout anabolic window, you’ll also want to limit fats, which can slow the absorption of protein. While there is some recent research that suggeststhe window may actually extend up to several hours following exercise, there’s no harm in getting nutrients in early as long as you’re sticking to your overall caloric and macronutrient goals.

Shared by Dr. Phil McAllister @ Forward Health Guelph

Dr. Laura: 5 Major Factors in Menopausal Weight Gain

Menopausal weight gain is troublesome and annoying.

Menopausal weight gain can increase risks for cardiac events and insulin dysregulation.

5 Major factors in menopausal weight gain:

  • Genetics
  • Sex hormone changes
  • Sleep
  • Depression
  • Stress
  • Diet

Figure out what’s going on in your body!  Learn how hormone levels, including the thyroid estrogen and progesterone, sleep hygiene, physical activity, diet and stress play a role in menopausal weight gain.

Sex hormone changes trigger menopausal weight gain

  • When the years leading to menopause set in, ovulation slows down before it stops. Ovulation is required before progesterone can be released. If you don’t ovulate, it creates irregular balances of estrogen and progesterone in the body.
  • Chemicals like BPA (plastics), cadmium, phthalates (soaps, detergents), and pesticides contribute to estrogen dominance.
  • Low progesterone against pre-declining estrogen makes for relative estrogen excess compared to progesterone. This means estrogen dominance for a time.
  • Estrogen dominance leads to poor thyroid hormone availability, reducing metabolism
  • If thyroid function is sluggish, this leads to poor estrogen clearance, more estrogen builds up in the body
  • Poor thyroid function can lead to weight gain and increase in LDL cholesterol. Elevated LDL cholesterol is linked to increase risk in cardiovascular disease.
  • As menopause progresses, estrogen declines. Estrogen decline leads to deposition of fat around the mid section.

Contributing factors to thyroid dysfunction:

  • Sagging adrenals (chronic stress)
  • Estrogen dominance
  • Low iron, selenium, iodine or zinc
  • Poor liver function
  • Poor intestinal flora.

Factors in sleep disturbance that contribute to menopausal weight gain

Poor sleep leads to disruption in balance of hormones and time for healing in the body. Lack of sleep itself can contribute to weight gain. The years of menopause are riddled with hurdles to a good night sleep:

  • decline in estrogen can disrupt sleep due to hot flushes
  • Hormone rhythm imbalance from changes in LH, FSH, estrogen and progesterone are thought to contribute to disrupted sleep patterns.
  • From a Chinese Medicine point of view, the Liver Yang rises in menopause, which explains why the sleep is typically disrupted between the hours of 1-3 am. This is why, naturopathically, we look to calm the liver, cool the body and build Yin. Acupuncture and specially blended plant medicines can be very helpful.
  • sleep apnea (in you or your partner) more prevalent in those who are overweight
  • too much technology before bed, or worse yet, in the bedroom inhibits natural melatonin let down. Relative excess of cortisol as it is unopposed by melatonin disrupts sleep and contributes to midsection weight gain

Factors in depression that contribute to menopausal weight gain

Low mood and lethargy generally lend to poor motivation for exercise and healthy habits, which leads often to weight gain.

Here are some common factors in depression and menopause:

  • declining estrogen
  • sluggish thyroid
  • poor nutrient intake
  • imbalance in the intestinal bacteria
  • inflammation in the brain (usually as a result of imbalance in the intestinal bacteria)

How  Stress Relates to Menopausal Weight Gain

In menopause, the ovaries retire and  hand over their hormone duties to the adrenal gland. This is why it is important to support the adrenals at this time. How healthy the adrenals are will dictate how well our bodies will manage the stress and the change in hormone levels. Areas we may not think about in stress that could contribute to adrenal fatigue:

  • sleep disruption
  • inflammation from infections, intestinal dysbiosis, autoimmune conditions
  • too much or too little exercise
  • poor eating habits
  • conditioned stress response (post traumic stress disorder)
  • relationships with others
  • alcohol intake
  • medications and drugs
  • overwork
  • not enough fun & play time

How diet affects menopausal weight gain

  • Generally with age, metabolism slows down and less caloric intake is required. If activity slows or stays the same and intake is not adjusted, subsequent weight gain is likely.
  • Our intestinal tract flora changes as we age, and this changes how estrogen is metabolized.

It is evident that menopausal weight can happen for a lot of reasons. Some of it is a bit of a chickened an egg, like the estrogen dominance and poor thyroid function. It doesn’t matter what comes first, but if not corrected, they build on one another.  A naturopathic doctor’s role is to look at the individual as a whole, remove obstacles, rebuild the body and stimulate natural mechanisms of healing. Women who maintain a healthy habits, hormones and weight will help stave off risks for osteoporosis, cardiovascular disease and cancer.

Solutions to menopausal weight gain include healthy diet, exercise, sleep hygiene, hormone balancing with acupuncture and plant medicines, nutritional and hormonal supplementation.

Dr. Laura M. Brown, ND

References:

Jung SY, Vitolins MZ, Fenton J, Frazier-Wood AC, Hursting SD, Chang S. Risk Profiles for Weight Gain among Postmenopausal Women: A Classification and Regression Tree Analysis Approach. Hsu Y-H, ed. PLoS ONE. 2015;10(3):e0121430. doi:10.1371/journal.pone.0121430.

Franklin RM, Ploutz-Snyder L, Kanaley JA. Longitudinal changes in abdominal fat distribution with menopause. Metabolism. 2009 Mar; 58(3):311-5.

Gietka-Czernel M. The thyroid gland in postmenopausal women: physiology and diseases. Przegla̜d Menopauzalny = Menopause Review. 2017;16(2):33-37. doi:10.5114/pm.2017.68588.

Van Pelt RE, Gavin KM, Kohrt WM. REGULATION OF BODY COMPOSITION AND BIOENERGETICS BY ESTROGENS. Endocrinology and metabolism clinics of North America. 2015;44(3):663-676. doi:10.1016/j.ecl.2015.05.011.

Williams LT, Hollis JL, Collins CE, Morgan PJ. The 40-Something randomized controlled trial to prevent weight gain in mid-age women. BMC Public Health. 2013;13:1007. doi:10.1186/1471-2458-13-1007.

Zheng Y, Manson JE, Yuan C, et al. Associations of Weight Gain From Early to Middle Adulthood With Major Health Outcomes Later in Life. JAMA. 2017;318(3):255-272. doi:10.1001/jama.2017.7092.

Karvonen-Gutierrez C, Kim C. Association of Mid-Life Changes in Body Size, Body Composition and Obesity Status with the Menopausal Transition. Parthasarathy S, ed. Healthcare. 2016;4(3):42. doi:10.3390/healthcare4030042.