May
16
2020

Cutting Out Bad Lifestyle Habits Increases Life Expectancy

A Jan. 8, 2020 study stated that cutting out bad lifestyle habits increases life expectancy. It was a publication in the British Medical Journal by the Harvard T.H. Chan School of Public Health. The senior author of the study was Frank Hu, chair of the Department of Nutrition at Harvard Chan School. The researchers looked at data collected from a large group of males and females that had been accumulated for 34 years. They found that a 50-year-old male or female who did not change their lifestyle habits had another 25.5 years to live for males and another 29 years to live for females.

Five bad lifestyles and life expectancy 

The 5 bad lifestyle habits were smoking, a body mass index above 25.0, excessive alcohol intake, less than 30 minutes of exercise per day and an unhealthy diet.

When people cut out all of those risky lifestyles, 50-year-old men and women had a life expectancy of 37.6 years for men and 43.1 years for women. This was an addition of 12 years of healthy life for men compared to controls who did not change their lifestyles. With regard to women there was an addition of 14 years of life compared to controls.

Diseases that kill prematurely

The research team wanted to know what diseases caused the most reduction in life expectancy when people did not change their bad lifestyle habits. Men and women who cut out all negative lifestyle habits were 82% less likely to die from cardiovascular disease. They also were 65% less likely to die from cancer. Bad lifestyles caused the two major diseases, cardiovascular disease (heart attack and strokes) and cancer, which increased overall mortality. The overall study time was about 30 years. The third major disease that can cost lives is diabetes. In addition, the research team identified chronic diseases as being another potential cause of people dying prematurely.

Additional life expectancy

When life expectancies were broken down according to diseases, the following was noticed.

For men:

When cancer free    When free of heart issues   Without diabetes

6 more years             9 more years                         10 more years

For women:

When cancer free    When free of heart issues   Without diabetes

8 more years            10 more years                       12 more years

Dr. Frank Hu, who chairs the department of nutrition at Harvard T.H. Chan School of Public Health said: ”We found that following a healthy lifestyle can substantially extend the years a person lives disease-free”. Those who do not shed their bad lifestyle habits will come down with one or more of the mentioned diseases and die prematurely. Others who cut out all their bad lifestyle choices live substantially longer.

Diseases caused by poor lifestyle habits

It is important to review the diseases that shorten life expectancy due to having poor lifestyle habits.

Cardiovascular disease

Smoking, lack of regular exercise and poor eating habits result in being overweight or developing obesity. All of these are risks with LDL cholesterol elevation and HDL cholesterol lowering that leads to heart attacks and strokes. Here is a study that shows how life is shortened after a heart attack.

It is clear from this how important it is to give up all of the poor lifestyle habits to avoid this from happening.

Cancer

90% of lung cancers are the result of cigarette smoking.

Heavy drinking can contribute and also lead to cancer of the liver, esophageal cancer, cancer of mouth and throat and cancer of the breasts in women. In addition, cancer of the colon and rectum are also caused by consuming too much alcohol in both sexes.

Diabetes

There are a variety of risk factors causing diabetes. Obesity, a lack of exercise, a bad diet with too much carbohydrates and the aging process are what contributes to the development of type 2 diabetes.

We see again that it is largely lifestyle issues that drive the onset of this disease. People who have developed diabetes need to control their blood sugar very closely to avoid complications of diabetes. This includes making healthier choices.

Otherwise complications of diabetes are diabetic nephropathy, blindness from macular degeneration of the cornea, heart attacks, stroke and diabetic neuropathy. In addition, vascular complications also include artery occlusions in the lower extremities with frequent foot or below knee amputations.

Chronic diseases

Often chronic diseases develop when there is generalized development of inflammation. COPD, chronic kidney disease and arthritis are examples of such conditions. In addition, Alzheimer’s disease, arthritis, asthma, Crohn’s disease, cystic fibrosis and diabetes belong into this category. All of these chronic diseases have in common that cytokines produce inflammation in the body. This keeps the chronic disease going and makes it more difficult to cure. When the person with a chronic disease makes poor lifestyle choices, the inflammation just becomes more chronic.

Smoking is one of the factors that makes chronic inflammation more chronic. Having a body mass index above 25.0 (being overweight) and above 30.0 (obesity) also creates more inflammation in the body. Excessive alcohol intake damages body cells and releases free radicals. These in turn cause inflammation and make the chronic disease more difficult to treat. An unhealthy diet tends to raise the bad LDL cholesterol, introduces pesticides and other chemicals into the system and adds to the chronic inflammation. Finally, a lack of exercise is not contributing to a healthy circulation and lowers the protective HDL cholesterol, paving the way for heart attacks and strokes.

Cutting Out Bad Lifestyle Habits Increases Life Expectancy

Cutting Out Bad Lifestyle Habits Increases Life Expectancy

Conclusion

Bad lifestyle habits are what causes us to get illnesses and die prematurely. Functional medicine and anti-aging medicine are at the frontier of modern medicine. These specialties are teaching us how to stay well and age gracefully. For decades conventional medicine has treated only symptoms, but not the causes of diseases. But this has not changed the mortality rates of heart attacks and cancer. Smoking, a body mass index above 25.0, excessive alcohol intake, exercising less than 30 minutes of exercise per day and an unhealthy diet are causes that make us sick. These bad lifestyle factors cause chronic inflammation in our system. They are the real cause of heart attacks, strokes, cancer and diabetes, the major killer diseases that prevent healthy aging.

Facing bad lifestyle habits

Bad lifestyle habits cause chronic inflammation. T he C-reactive protein blood test can measure the degree of inflammation that is present. A fasting insulin level can detect whether a person is in danger of developing diabetes and improved lifestyle habits can prevent this from happening. Men can add 12 years and women 14 years of healthy life by eliminating bad lifestyle habits. By eliminating chronic inflammation our new life expectancy, which is 79 to 80 years, now can reach 92 to 94 years. It is up to you how healthy you stay and whether or not you age gracefully.

Aug
10
2019

Fasting Mimicking Diet For 5 Days Every Month

In December 2017 I heard Dr. Longo speak at a medical conference in Las Vegas. He suggested the use of the fasting mimicking diet for 5 days every month. I am getting into the age group where a little help from nature would not harm (I am 74 years old). I started immediately in December 2017 to do a fasting mimicking diet (FMD) for 5 days.

Effects of fasting mimicking diet

In the beginning you just notice that you are not as hungry as you thought you would be, because you do take in three mini meals of about 200 calories each, which curbs your appetite. It is also important to consume enough liquids. Please note: liquids! Not liquor! Wine, beer or any alcoholic drinks are not part of the diet. You can drink water, but, this may get boring, and you can take water with lemon, herbal teas, black tea and coffee, as long as you stay away from sugar-laced drinks.

How the FMD works

Your total calorie intake will amount to no more than 600 calories per day for the 5 days where you do the fasting mimicking diet. Your body mass index (BMI) decreases between 0.1 and 0.4 per day to a total of 0.5 to 0.9 for the 5 days. This does not seem much, but if it is accumulating every month, a person who is obese now could have a normal weight within one year. The first day of this fast may present some challenges. I found that in the afternoon I felt hungry. What helped was a hot drink( tea, coffee, clear broth). Day two was better, and from day three it has become a routine. There are  no ferocious hunger pangs, no headaches or feelings of weakness or tiredness. I am always surprised that my energy level is improving when I do the fasting mimicking diet for 5 days every month.Dr. Longo suggests not to exercise during the fast. It is obvious that this time is not suitable for half- marathons or taxing hikes, but I found that thirty minutes of aerobics and thirty minutes of weight training felt good. Listen to your body! If you feel lightheaded at any time, stop! The emphasis is on “moderate”.

Dr. Longo noticed the following findings in a mouse model as well as on humans. I summarized this before in a previous blog:

Specific results when on the fasting mimicking diet for 5 days every month

  • Obesity diminishes, because of the weight loss effect due to missing calories.
  • Diabetes: insulin resistance becomes lower and blood sugar levels drop.
  • High blood pressure reduced: many patients were able to reduce their medications or discontinue them
  • Pain conditions improve as all kinds of pain disappears, an effect for which there is no explanation at this point
  • Autoimmune diseases like MS and rheumatoid arthritis improve, likely because of the effect of increased stem cell circulation
  • Prevention of heart attacks and strokes because of reduction of LDL, triglycerides and CRP
  • Cancer cure rates improve by protecting normal cells, the bone marrow and stimulating the immune cells
  • Longevity improved in mice with a 3-fold increase of their life span. Telomere length in humans was increased. Increased stem cells will find defective areas that need repair. This effect leads to less disease in older age.

Meal samples of fasting mimicking diet

Dr. Longo developed a kit containing all pre-packaged foods for 5 days under the name “ProLon Fasting Mimicking Diet”. The package is not larger than a shoebox, and the diet is plant-based, has some nutrition bars, drinks as well as freeze-dried soups. You can argue about the nutritional value, as it has an average rating of 3.5 out of 5. It also comes in at a hefty price of 300.00 USD. In reality it is a matter of calorie-math to consume very little food. There are plenty of tables available on the Internet that tell you the nutritional value of foods, and it does not take much effort to compose your own menu.

Here is a fairly typical list of foods

Breakfast: A typical breakfast consists of 2 slices of rye crisp bread (Wasa or Ryvita) with a bit of almond butter on it, a cup of coffee and either black or with stevia and milk.

Lunch: 8 oz. of tomato soup and coffee or tea.

Dinner: A tossed salad with organic bell peppers, ½ tomato, and two thin slices of avocado, vinegar and 1 tablespoon of olive oil.

Here is an alternative meal sample:

Breakfast: Eat a nutrition bar that is based on nuts. It should not be more than 250 calories. Alternatively make your own! Have tea or coffee.

Lunch: 8 oz. of homemade vegetable soup without the addition of pasta or beans.

Dinner: Miso soup and 4 rice crackers, alternatively a small tossed salad with olive oil and vinegar.

Results of fasting mimicking diet for 5 days every month

Here are typical results that I found over several months. I am using body composition scales every day to measure my weight, body fat percentage, visceral fat percentage, muscle percentage, calories burnt and the BMI.

One month the BMI went from 21.9 to 21.1 during a 5-day FMD. Another month the BMI experienced a reduction from 21.7 to 21. 2. Here is a list of the some of the 5-day losses of my BMI on a couple of occasions: 0.8, 0.4, 0.9, 0.7, 0.6, 0.5, 0.7 and so on.

It is important that you are not going on an eating binge after those five days. The FMD conditioned your body to be content with very small amounts of food. Enjoy your food, but stick to moderate portions.

Discussion of fasting mimicking diet for 5 days every month

An intermittent fasting mimicking diet was shown to have a diversified positive health effect in both animal models and humans. For instance, inflammatory bowel disease improves on FMD by improving the bowel microbiota and by promoting the intestinal regeneration.

Intermittent fasting, as this article shows, can prevent age-associated diseases.

This article suggests that T-killer cells that attack cancers are promoted by the intermittent fasting mimicking diet.

A FMD in type 1 diabetic patients has been shown to restore insulin generation in islets of the pancreas of these patients. The result was an improvement of their type 1 diabetes.

More research data on fasting mimicking diet

A clinical trial with 100 subjects was undertaken by Dr. Longo and his research team. He measured markers after 3 cycles of a fasting mimicking diet for 5 days every month. They found that the FMD reduced aging markers, improved diabetes and reduced susceptibility for cancer and cardiovascular disease. In another publication Dr. Longo and co-authors describe how autoimmune diseases can be improved by the use the fasting mimicking diet for 5 days every month.

Another publication by Dr. Longo describes that “age-related disorders including diabetes, cardiovascular disease, cancers and neurological disorders such as Alzheimer’s disease, Parkinson’s disease and stroke” can be prevented by fasting mimicking diet for 5 days every month.

Even cancer prevention and cancer treatment can be helped by the fasting mimicking diet.  The FMD makes chemotherapy more tolerable.

Fasting Mimicking Diet For 5 Days Every Month

Fasting Mimicking Diet For 5 Days Every Month

Conclusion

I have shown that with the fasting mimicking diet (FMD) done for 5 days in every month you can lower your body mass index (BMI) by 0.4 to 0.9 units. On the long-term this helps you to keep your BMI stable and in the 21.0 to 22.0 range. Dr. Longo has researched the effect of the FMD in both mice and humans. He found that you age better with less age-related diseases. In addition, inflammatory bowel disease, autoimmune diseases like MS, rheumatoid arthritis and type-1 diabetes improve. Cancer patients who need chemotherapy tolerate it better. Their immune system also produces more killer T cells that destroy cancer cells. The FMD prevents heart attacks, strokes and cancer. Dr. Longo also has shown that there is stimulation of stem cell production and telomeres are increasing in length. Telomeres are important for longevity, which allows you to age healthier with less disease.

Jul
27
2019

Occasional and moderate drinkers have lower mortality rates

A recent study showed that occasional and moderate drinkers have lower mortality rates. The study came from the Columbia University, New York and was done with a senior population in the US. (7,904 seniors born between 1931 and 1941). The researchers followed this population for 16 years, from 1998 to 2014. There were 5 categories of drinking.

5 drinking patterns

Lifetime abstainers: had less than 12 drinks in their lives.

Current abstainers: they drank in the past, but were abstainers during the present observation period.

Heavy drinkers: drinking 3 glasses or more per day or binging more than 5 drinks in a single day. For women heavy drinking was defined as having more than 2 drinks per day or binging more than 4 drinks in a single day.

Moderate drinkers: they drank 1 to 3 (men) or 1 to 2 (women) drinks per day 1 or more times per week.

Occasional drinkers: they drank less than 1 day per week (for instance once or twice per month) and drinking a maximum of 3 drinks for men and 2 drinks max for women.

Binge drinkers were incorporated into the heavy drinker category.

Findings

The key findings were that over 16 years occasional and moderate drinkers had a lower mortality than lifetime abstainers or current abstainers. Heavy drinkers had a higher mortality as well. The researchers depicted their data as survival curves in a graph. They also tabulated them as data.

A male moderate drinker had a 35% lower mortality, a male current abstainer had a 73% increased mortality, a male lifetime abstainer had a 19% increased mortality and a male heavy drinker had a 20% increased mortality. The researchers set the male occasional drinkers as the reference at 100%.

Women had the following results: a female moderate drinker had a 29% lower mortality, a female current abstainer had a 98% increased mortality, a female lifetime abstainer had a 71% increased mortality and a female heavy drinker had a 11% increased mortality. Again the female occasional drinkers were the reference set at 100%.

Comments about the limitations of the study

The researchers pointed out that the findings of the current abstainers were surprising. However, they were of the opinion that the volunteers in that group likely had health reasons why they quit drinking. If there were cardiac, pancreatic or liver problems (cirrhosis of the liver), these conditions may well have become the reason why they died earlier than the other groups.

They also pointed out that various confounding factors could interfere with the study. Such factors as mental health, body mass index (BMI) or socioeconomic status could interfere with the findings of the study. Further, the researchers found that smoking status in men showed less influence on mortality than it did in females.

Confounding factors

The authors of the study pointed out that it went on for 16 years with many assessments of the drinking status on an ongoing basis. Other studies were one-point assessments, which are not as reliable.

The authors were studying the effects of confounding factors, such as other diseases. They found that lung disease, depression, high blood pressure, stroke, heart disease, cancer and arthritis had their own effects on mortality figures. In addition they looked at the effects of daily activity difficulties, BMI, smoking status, education, age and race/ethnicity on mortality. When all of these confounding factors were normalized, occasional and moderate drinkers still had the lowest mortality.

Graph regarding percentage of survival as a function of time

One of the most convincing findings is the depiction of the data as a percentage of survival plotted as a function of time. This clearly shows that all the time over the entire 16 years the occasional and moderate drinkers had the longest survival times. It also shows clearly that the moderate drinkers lived longer than the occasional drinkers.

Discussion

We know from other studies that moderate alcohol consumption prevents fatty deposits in coronary arteries. Over the centuries pathologists found that the arteries of alcohol consuming individuals were entirely clear of fatty deposits, although they died of other diseases. However, in heavy drinkers the balance tips and cardiovascular disease is more prominent. The biggest effect of reducing mortality likely comes from a reduction in cardiovascular disease. However, alcohol can also cause various cancers. Because of this you will want to keep alcohol consumption in the lower ranges.

Occasional and moderate drinkers have lower mortality rates

Occasional and moderate drinkers have lower mortality rates

Conclusion

An important large study involving 7,904 seniors in the US that lasted 16 years has shown the following findings: Occasional and moderate drinkers had a lower mortality rate than lifetime abstainers or current abstainers. Heavy drinkers had a higher mortality rate as well. The researcher examined possible confounding factors, but after normalizing for these, the findings were still the same.

The French paradox answered

This study may explain the French paradox: the French eat cholesterol-rich foods. However, they live a long life without heart attacks. The difference to the US is probably that they consume red wine regularly. The study described here seems to indicate that occasional and moderate alcohol consumption prolongs life. It does not give anybody a ticket to overindulge, because “it is good for you”. The importance is the dosage: stay under the limit with your alcohol intake. Be an occasional consumer and don’t exceed the limit of moderate consumption. In this case you can raise a glass to your health!

Jun
01
2019

More Obesity In Rural Areas

A new study was published May 2019 in the magazine Nature showing that there is now more obesity in rural areas. In the mid 1980’s when the first reports came out about obesity, this was not the case. It actually was the opposite: there were more cases of obesity in cities compared to rural areas. The study was also reviewed in Medical News Today.

The new worldwide obesity study was done by the Imperial College London in the United Kingdom. Researchers studied 112 million adults. The study population came from 200 countries and territories. The study covered 32 years from 1985 to 2017. More than 1000 scientists conducted this study worldwide.

Findings of the obesity study

Circumstances changed regarding obesity since the 1980’s

The previous finding in the mid 1980’s that the urban population was leading the obesity wave was now reversed. There is now more obesity in rural areas while the urban population is eating more balanced meals. The population in rural areas of low- and middle-income countries are now accounting for 80% of the word obesity.

Objective increase of BMI over 32 years

The degree of being overweight or obese is best determined by the body mass index. This is the person’s weight in kilograms, divided by the height in meters, but squared. On this scale a normal BMI is 20.0 to 25.0, being overweight is from 25.1 to 29.9 and obesity is 30.0 or higher.  Women’s BMI has increased by 2.0 kilograms per square meter (kg/m2), while the men’s BMI has risen by 2.2 kg/m2 for both sexes over the study period. In rural areas the BMI has risen by 2.1 kg/m2 while in urban areas, the average BMI of women rose by 1.3 kg/m2 and for men by 1.6 kg/m2.

Healthier lifestyle in cities compared to rural areas

The BMI in high-income countries has grown particularly in rural areas. Prof. Ezzati commented to this: “In fact, cities provide a wealth of opportunities for better nutrition, more physical exercise and recreation, and overall improved health.”

More obese women in urban centers of sub-Saharan Africa

In sub-Saharan Africa there is an opposite trend compared to other countries. In Africa the women in urban centers are getting obese while their counterparts in rural Africa have less problems with obesity. The researchers thought that this is due to city women moving less and sitting at desks etc. In contrast women in the rural areas of sub-Saharan Africa are doing more physically demanding tasks.

What are the issues about obesity?

The problem is that people who turn obese eat the wrong foods. The problem is often that they eat too much sugar and too many starchy foods. Here is my remedy to prevent obesity.
1. Cut out sugar. Cut out highly refined starches. This prevents diabetes, heart attacks and strokes.
2. Avoid red meat and processed meats: this reduces the risk of colorectal cancer.
3. Eat clean foods: organic vegetables or your own vegetables grown in your garden; organic salad; grass-fed beef once per week (not more often); organic chicken and turkey; bison meat once every week or every two weeks; wild salmon two to three times per week.
4. If you exercise regularly on top of eating healthy foods, you can drastically reduce many illnesses and diseases compared to those who don’t.

Remove the majority of starchy foods from your diet

I wrote about avoidance of highly refined starches. I cut out starchy foods as they digested into sugar and give you an insulin response causing hyperinsulinism, inflammation in your arteries, strokes, heart attacks and Alzheimer’s. If you can do it and you don’t want those diseases: cut out wheat and wheat products especially white flour; pasta, bread, baked good. Potatoes, white rice and refined cereal are also problematical. I have avoided this since 2001 and lost 50 pounds. I kept my weight down since. My body mass index is between 21 and 22. I have energy, work out, and I don’t miss these items. Re-evaluate your food habits, and next clean out your pantry!

More Obesity In Rural Areas

More Obesity In Rural Areas

Conclusion

An international study examined the rate of obesity in 200 countries, involving 112 million people over a long time span, namely over 32 years. While in the mid 1980’s most obese patients lived in big cities around the world, this pattern has changed. Now there is more obesity in rural areas. People in the cities are learning more about healthy nutrition and they have more access to fitness centers. In order to tackle the obesity problem people must learn the difference between nutritious food and junk food. You need to cut out sugar as much as possible. It is the biggest offender and contributes to a list of health problems. But you need to remove processed food from your diet, because it contains sugar and unhealthy fats. Red meat and processed meats are also unhealthy and should be removed.

What to eat

Eat clean foods such as organic vegetables or your own vegetables grown in your garden. Buy at farmers’ markets, if they are in your area. Consume organic greens. If you cannot live without red meat, limit your consumption to grass-fed beef once per week (not more often); organic chicken and turkey; bison meat once every week or every two weeks, and enjoy wild salmon two to three times per week. It is easier to do than you think, prevents obesity and keeps you healthy until a ripe old age.

Mar
04
2017

Weight Loss Surgery Is Unnecessary

Dr. Flavio A. Cadegiani gave a talk saying that weight loss surgery is unnecessary. Dr. Cadegiani is the director of a weight loss clinic with the name Corpometria Institute in Brasilia, Brazil. He is board certified in endocrinology and metabolism and in internal medicine. He presented his talk at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended.

Here are the main topics that he presented.

Weight measurements are wrong when based on the BMI

Dr. Cadegiani stated that we do not understand obesity, because we look at it from the wrong angle. Current dietary approaches have failed. But obesity research is still proceeding in the wrong way. If all else fails, weight loss surgery is finally the last resort. But this is wrong.

The problem with body mass index (BMI) is that people would consider an athletic body type “obese”, because the BMI exceeds 30.0. However in a very muscular person the reason for the elevated BMI is an increased muscles mass, not fat. Body composition scales reveal that, but a simple weight measurement does not.

Dr. Cadegiani recommended measuring waist circumference with <94 cm (37 inches) for men and <88 cm (34.65 inches) for women being normal.

10 reasons why we are misled by the BMI

  1. The inventor of the BMI was a mathematician. He explicitly stated that the BMI would not predict the level of fatness of an individual. The other factors are bone mass and muscle mass.
  2. Because the BMI ignores the waist size, it is scientifically invalid.
  3. There are physiological reasons why it is wrong: studies did not factor in the relative proportion of the bone, muscle and fat content.
  4. The BMI gets the logic wrong: the CDC site claims that the BMI “is a reliable indicator of body fatness for people”. This is simply not true!
  5. The BMI is based on bad mathematics: the formula assumes low muscle mass and high fat content.
  6. The BMI is lying by scientific authority: Dr. Cadegiani said it has an “air of scientific authority, but it is mathematical snake oil.”
  7. The BMI suggests that there are distinct categories of underweight, ideal, overweight and obese. It assumes sharp boundaries that hinge on a decimal place. All of this is nonsense.
  8. Cynical people could suspect that medical insurance companies lobby for the continued use of the BMI as it keeps their profits high. Sometimes insurance companies charge higher fees for people with an elevated BMI.
  9. Doctors can contribute to the continued use of the BMI, if they don’t feel the need to use another way of assessing their obese patients.
  10. It is embarrassing that we still base the assessment of obesity on a 200-year-old mathematical formula when we know of  more reliable measures.

Bariatric surgery done too easily

Dr. Cadegiani noted that publications on bariatric surgery (=weight loss surgery)

underreport surgical complications and deaths. The bariatric industry is rich, and 90% of the booths during obesity conferences belong to bariatric-related companies. Long-term follow-up studies are lacking. Those who do follow-ups report an increase of pancreatic tumors after 10 years following bariatric surgery.

Long-term follow-ups also describe a 70% increase of psychiatric disorders including depression and alcoholism. Those who had bariatric surgery experience a 200% increase in suicides.

Overcoming weight centered approach

Here is how to avoid the weight-centered approach that would lead the clinician to wrong conclusions.

There are four factors that need consideration:

  1. The assessment includes metabolic blood markers
  2. The assessment incorporates body composition scales
  3. The patient participates by measuring waist circumference and body weight
  4. The clinician incorporates clinical signs and symptoms

Classic metabolic markers are liver enzymes and hormone levels like testosterone, Thyroid (T3) LH and IGF-1. Apo B and triglyceride levels have to come into consideration  for a lipid metabolism assessment. The physician monitors inflammation through a combination of uric acid levels, ferritin and C-reactive protein (CRP). An oral glucose tolerance test and fasting insulin level can predict diabetes 5 to 10 years before it will occur clinically. Other metabolic markers are homocysteine and metalloproteinases. There are newer tests to measure insulin resistance.

Oxidized LDLc is the only marker that is linked to diabetic retinopathy. Another marker, resistin is an independent marker for obesity-related cancer, cardiovascular disease and overall mortality. A triglyceride-waist circumference index has been found to be the best predictor for future development of diabetes.

Body composition analysis

The patient measures his/her own waist circumference and body weight on body composition scales. This gives additional information about fat and muscle composition. Dr. Cadegiani’s team likes to understand what is really going on in terms of what triggers fat excess.

Questions are: what is the level of emotional overeating? How much anxiety is there in the patient’s life that leads to overeating? What is the social and cultural environment? What were previous weight loss attempts? And what is the family history in term of excessive weight?

Other important factors are to check for binge eating disorders or night eating syndrome. In addition any patient planning to go for weight loss therapy should be checked for depression, mood disorders and suicide potential.

Otherwise body composition scales by electrical bioimpedance were found to be very useful in assessing fat and muscle percentage as well as visceral fat percentage.

Aggressive clinical approach improves metabolism

Dr. Cadegiani and his group have published their own research paper in February 2017 showing that an aggressive clinical approach can prevent the need for bariatric surgery.  This publication describes that in a group of 43 subjects who were thought to be bariatric surgery candidates only 3 patients (7%) went on to have the procedure done. 93% of the subjects were able to shed pounds with the method offered and avoided bariatric surgery.

They documented that clinical parameters and blood tests all improved on their program. The researchers focused on triggers that caused obesity in their patients. The measured markers were oxidized LDL cholesterol, triglycerides, the liver enzymes ALT and μGT, fasting glucose, Hemoglobin A1C, uric acid and CRP. All of these parameters improved with the modification in food intake. 81.2% of the weight loss was from the reduction of fat mass. 46.5% of patients had a normal waist circumference measurement at the end of the trial. They also achieved normal body fat and visceral fat percentages. As already stated 93% of all the patients in this trial avoided weight loss surgery, called bariatric surgery.

Dr. Cadegiani suggested that obesity should be approached with a scientifically based and responsible method. This will change the way we manage obesity.

Weight Loss Surgery Is Unnecessary

Weight Loss Surgery Is Unnecessary

Conclusion

Attention to detail of the patient with weight problems will allow the patient to reduce fat percentage. Waist measurements should be regularly performed as well as body composition scales measurements. This way the physician can follow the fat and muscle percentages. Key to success is to reduce the refined carb contents of food intake (sugar and starchy foods) and have a calorie deficit diet. Exercise is also an important component. An aggressive clinical approach to obesity can improve the clinical outcome and can prevent bariatric surgery.

Oct
15
2016

Commuting Affects Your Health

A research report from Great Britain was recently reviewed by CNN; it revealed that commuting affects your health.

The longer we commute to work and back the more downtime we have where we do not move our muscles. But we also are exposed to more unhealthy snacks and sugary drinks that make us deposit more fat. The original research report was published here. What were the elements of this study?

Commuting affects your health, study design

Three consecutive annual waves of the British Household Panel Survey were utilized. These are longitudinal surveys of nationally representative households in Great Britain. The sample years were 2004/2005, 2005/2006 and 2006/2007. There were 15,791 participants in the study; of these 4,056 entered the study. The main mode of travel to work was determined at each time point. The self-reported height and weight was taken to calculate the body mass index (BMI) at baseline and at 2 years. Attention was paid to switches of transportation mode (that is from active to sedentary and vice versa).

Commuting affects your health, results of study

  1. Switching from car commute privately to active travel (walking, bicycling) or public transport resulted in a significant loss in BMI. There were even larger reductions of BMI’s in those who enrolled in the first year in active transportation, because of the longer exposure. Those with the longest journeys who used active transportation had significant weight losses.
  2. A group of 787 people switched from active travel or public transport to the use of their private cars as transportation. This resulted in a significant BMI increase.
  3. The study concluded that any interventions that would allow private car commuters to switch to an active mode of transportation could contribute to the population’s BMI being reduced significantly.

Commuting affects your health, Cambridge experiment

In a 2016 study from Cambridge (Great Britain) a similar experiment was done. They studied traffic patterns in the county of Cambridgeshire. The city compared 1143 adults working in the city with 1710 people who used the Cambridgeshire Guided Busway. The public had access to a new bus network that has connections with pedestrian pathways and cyclists since 2011. Longer commuting journeys incorporated walking and cycling, for which otherwise people used a private car and public commute. When officials explained the benefit of active travel to people, there was a 1.8-fold increase of active travel. There was also a 2-fold decrease of commuting solely by car. The weekly cycling commuting time had increased to 1.34-fold compared to the previous level.

Active commute most beneficial

People who at baseline were the vast majority in being inactive in their commute, were the ones who appreciated an active commute most. There was an association of active commuting, greater overall physical activity with an improvement of health and weight loss.

Commuting affects your health, US study

A multi-city study involved the largest 3,914 municipal jurisdictions, which were located in 473 of the most populous U.S. counties. This involved 48 states and the District of Columbia. In order to encourage more active commuting (walking, cycling) many municipalities developed pedestrian zones or pedestrian-friendly zones with adjacent bus transportation. A new concept of transit-oriented developments or districts (TODs) was adopted. TODs are higher density areas that are compact. They are mixed use areas, which you find around transit stops. This encourages walking. The study was completed in 2016. It showed that the TOD zones had higher occupancy rates. Many house owners had no car as they commuted using public transportation only.

Summary about transit-oriented developments or districts (TODs)

TOD zones were more populous, people in it had higher income, and they were more racially diverse and younger. The occupants of TOD zones had a 2.1-fold higher rate of using public transportation and they also had a 2.48-fold higher rate of using active transportation to work.

Commuting affects your health, general comments

The majority of commuters in England and Wales spent 56 minutes in their cars going to and from work in 2013. In London this daily commuting time is 79 minutes. The US data are similar.

With a well-developed public transportation system the authorities developed various programs designed to replace at least some part of the commute by active commuting. This is good for your metabolism, it is good for your cardiovascular status and it gets you away from snacking junk foods driving in your car.

Commuting leads to stress

A survey from London, England polled more than 1500 commuters. 55% reported increased stress levels, 33% reported increased snacking, 29% admitted to fast food consumption, 36% complained about sleeping problems, 41% said that they reduced physical activity and 44% reported that they had less quality time with their friends and family. 58% felt that flexible work hours would improve their health and wellbeing. Remember that how you are commuting affects your health.

My own experience watching commuting in various cities

Over the years I have traveled extensively in Germany, Austria and the US. In Europe it is interesting how many years ago the pedestrian zones in the old town centers have reshaped the commuting. The U-Bahn (subway) and commuter trains have intermingling networks that shoot you out to pedestrian zones. There is no escaping from it, you have to walk before you can catch a connecting bus or tram.

Vienna (Austria)

Vienna (Austria) for instance allows you to get out at the U-Bahn station of Stephansplatz, which is a pedestrian zone around the Stephan’s Church (Stephanskirche). There is an amazing array of shops and in a side alley you can even find a Starbucks, if this is what you are looking for. When you walked enough, you hop onto any of the U-Bahn connections. This brings you where you need to be. If you are too far from your goal, hop onto a tram and enjoy the sightseeing. There are also buses that can get you there. It is all covered under the same Vienna card, which I appreciated as a visitor. It is best to park your car in the periphery and use the commuting network to get you to where you want to go.

Munich (Germany)

Munich (Germany) has a lot of cycle paths, which run parallel to the pedestrian paths. I was interesting to see business people in black suits cycle to work. Otherwise there are the U-Bahn, S-Bahn, trams and buses that all interconnect.

Münster (North Rhine-Westphalia, Germany)

Münster (North Rhine-Westphalia, Germany) has an extensive network of cycle paths and pedestrian walks. Buses and trams are also constantly running. The old historic town is a pedestrian zone, but anybody can commute to anywhere between walking or using the bus/tram. I found it astonishing this spring when I visited; there were hundreds of people, young and old cycling to and from work. The employers are providing huge metal racks where people can attach their bikes to with a lock.

Berlin

Berlin is another multi level commuting city in Germany. You can use the U-Bahn, S-Bahn (commuter train), bus or tram to get to work. Here is an informative video that explains.  I did not see many cyclists there. But hundreds of people are walking. Yes, there are many pedestrian zones and they interconnect with all of the commuter options. Berlin spreads over a vast area, so the S-Bahn, which is a local commuter train is particularly important. For the shorter connecting trips people commute by the U-Bahn (subway). Buses and trams plus walking do the fine-tuning to get to your destination.

Vancouver (BC, Canada)

Vancouver (BC, Canada) has some cycle pathways in the West end, close to Stanley Park. Otherwise there is a network of buses, the Skytrain, Sea Bus (between North Vancouver and downtown) and the West Coast Express (a commuter train). For the size of the city I think that Vancouver could benefit from studying some of the transportation modalities in Europe to entice the car travelers to use public transportation. When I travel to Vancouver, I use my own car, as it is so much faster to reach any goal. Public transportation is at this point not effectively connecting all the areas in this city.

Commuting Affects Your Health

Commuting Affects Your Health

Conclusion

In the past we often heard that there was nothing that could be done about traffic jams and commuter stress. Think again. Revitalization of city cores all over Europe, Great Britain and in the US has taken the TOD concept to heart and active commuting has become a reality. Whenever you can, use alternatives like cycling, walking and public transit to get to and from work. Studies have even shown that when you become an active commuter you likely will also become more active after work. Even using public transit makes the commute more active, as you are not sitting for an hour or more in your vehicle.

Use public transit, not your own car to commute

You have to get out and walk in order to catch a connection. This all helps to keep you physically more fit than the commuting style, where you sit in a vehicle and possibly dip into junk food. It is not only about body mass index reduction and decreasing your waistline. Active commuting is also a lot less stressful than the passive modality, where traffic jams add to frustration and stress at the beginning and at the end of a workday.

May
21
2014

Forty Percent Of Premature Deaths Can Be Prevented

A new report from the CDC (Center of Disease Control) in the US has revealed that up to 40% of premature deaths could be prevented by simple lifestyle changes. As this link shows every year about 900,000 premature deaths occur in the US, which are due to 5 major diseases that in the opinion of the CDC can be prevented by 20 to 40%. Here are the diseases that kill: cancer, heart disease, COPD/emphysema, stroke and accidents/injuries. These conditions were responsible for 63% of all deaths in the US in 2010.

Let’s discuss each of these conditions and how one could lower the risk of dying from them.

1. Cancer:

The Framingham Heart Study has shown that smoking and cancer are closely related. Smokers who quit can significantly reduce their risk of getting cancer. We also know that exercise and prophylactic supplements like fish oil and vitamin D3 have cancer preventative effects.

Antioxidant supplementation that included beta-carotene, vitamin A, vitamin C, and vitamin E daily or on alternate days for 1 to 12 years, along with selenium supplementation reduced the incidence of cancer of the esophagus, colon, pancreas, stomach or the liver. Insulin resistance due to sugar and starch overconsumption is causing cancer, particularly breast cancer, colorectal cancer and endometrial cancer. I have discussed this in a recent blog.

Pollution has been linked to increased lung cancer risks as discussed here.

2. Heart disease:

Heart disease can be caused by several factors in combination. Lifestyle issues are important: Smokers need to quit smoking as the Framingham Heart Study has shown more than fifty years ago that smoking causes heart attacks. Obesity and diabetes also contribute significantly to the risk of heart disease. Often these are connected to faulty nutrition, which is another lifestyle issue that comes to mind when too much sugar and starchy foods are taken in; your liver will convert these into fatty acids, triglycerides and elevated, oxidized LDL cholesterol, which gets deposited under the lining of the arteries. A lack of exercise adds to this problem as a lack of exercise lowers the protective HDL cholesterol and fat is deposited under the lining of the arteries. Start exercising and your protective HDL cholesterol will rise, your total cholesterol to HDL ratio will lower to healthier levels and your risk for hardening of the arteries and for getting a heart attack will fall. If you have diabetes, it is important that you manage your blood sugars well; this means that if you inject insulin, you want the blood sugar tests to be within the normal range and the hemoglobin A1C values to be below 5.5%. Poorly controlled diabetes is an important cause of heart attacks and strokes. High blood pressure is also an important cause of developing heart attacks and strokes. It is important to control your blood pressure by taking blood pressure lowering pills and also by exercising regularly. Exercise seems to send a signal to relax the blood vessels thus lowering the blood pressure, which in turn prevents heart attacks.

Forty Percent Of Premature Deaths Can Be Prevented

Forty Percent Of Premature Deaths Can Be Prevented

 

3. COPD/emphysema:

Chronic obstructive pulmonary disease (COPD) or emphysema is mostly caused by chronic exposure to cigarette smoke from smoking. The earlier you can quit, the better your chances that your breathing will not be the limiting factor when you age. But it is also important to avoid exposure to other noxious gases, such as from welding and from exposure to pollution. This may involve a decision to move to a less polluted area. Or it might involve a job retraining. Those who are suffering from COPD can be helped to a certain extent by a portable oxygen tank with nasal prongs.

4. Stroke:

As mentioned before, quitting smoking, controlling high blood pressure and controlling blood sugar, if you suffer from diabetes have been shown to stabilize your blood vessels including the ones that supply your brain. The key is to prevent hardening of the arteries by a healthy lifestyle. Exercising and keeping your weight under a body mass index of 25.0 have been shown to be effective stroke prevention. Healthy nutrition as indicated above under “heart disease” is equally important for stroke prevention. Go green (eat more vegetables, consume more green smoothies), cut down grains, sugar and starchy foods and you will live longer without strokes and heart attacks. Remember, what’s good for your heart is good for your brain!

5. Unintentional accidents/injuries:

Wearing helmets when bicycling, wearing seat belts when driving in a car, avoiding risky behaviors are all measures that save lives. One factor stands out in all of this: if you drink too much, you run the risk of being involved in unintentional accidents or injuries. People may not like to hear this, but your brain lacks the natural inhibitory impulses when you are under the influence of alcohol, so you become more daring and you may not pay attention for the split second that could have prevented an injury or accident. People react very differently to alcohol. Some people feel inebriated after only ½ a glass of wine or beer whereas others can drink more before they make mistakes. The best is to be sober when you drive, ski, use power tools or walk in traffic. Even climbing ladders requires a clear mind!

Conclusion:

As the CDC said 20 to 40% of premature deaths (deaths that occurred before the age of 80) could have been prevented, if the above-mentioned recommendations were followed. Let me rephrase this: 180,000 to 360,000 premature deaths every year in the US before the age of 80 could have been prevented! Curative medicine cannot help with these statistics as a heart attack or stroke has happened when it has struck you. Cancer and end stage lung disease are similar conditions that you are suddenly faced with when they occur and unintentional accidents just seem to happen. This is where the importance of prevention can be seen, because these little baby steps every day are adding up to something formidable, a force to be reckoned with. Be part of the solution, think prevention!

More information on:

1. Cancer mortality: http://nethealthbook.com/cancer-overview/overview/cancer-mortality-rate/

2. Higher vitamin D3 intake lowers mortality from heart attacks, strokes, cancer, fractures due to osteoporosis: http://nethealthbook.com/news/higher-vitamin-d-levels-associated-lower-risk-mortality/

Last edited Nov. 8, 2014

Dec
14
2013

Pollution And Soaring Lung Cancer Rates

In early 1900 lung cancer was unheard of. This was before the cigarette industry started to mass-produce and market cigarettes.

However, ever since the arrival of the industrial revolution air quality has suffered. In China poor air quality has now reached such enormous values that the specialized cancer agency of the World Health Organization, the International Agency for Research on Cancer (IARC) has labeled poor air quality as one of the causes of lung cancer.

When you rank countries by average air pollution measurements, one sees that Europe, the US and South America overall have good ratings, whereas the Middle Eastern countries, China and India have poorer ratings.

However, when the pollution index of cities where the population is much denser than in the countries at large, are tabulated a much different picture emerges: Cities in Iran, India and Pakistan stand out as particularly bad followed by cities in China, Eastern Europe, Paris, London, Berlin, cities in California (the populous State), Chicago and New York.

Pollution does not stay local, but travels through the stratosphere around the globe. The result is that now 10 to 15% of lung cancer in the US occurs in patients who never smoked. This translates into 16,000 to 24,000 deaths annually of never-smokers in the US.

In certain cities such as Beijing the lung cancer rates have doubled in 9 years between 2002 and 2011. As this article shows lung cancer in never smokers can be caused from exposure to radon, to second-hand tobacco smoke, and other indoor air pollutants can also cause such cancers. But the outdoor air quality has been a problem ever since the industrial revolution, which started around Europe in the 1800’s and first part of the1900’s. In the latter half of the 1900’s much of the industrial wave has migrated to the Middle East, to India and China. But the air quality of the whole world has suffered as the jet stream and other air currents carry pollution in the stratosphere all around the globe.

Pollution And Soaring Lung Cancer Rates

Pollution And Soaring Lung Cancer Rates

History of pollution in various regions

1. In Germany’s  Ruhr district (“Ruhrgebiet”) in North Rhine-Westphalia, a highly populated industrial area, pollution reached a peak in the late 1950’s. From 1963 onward many of the coal mines, iron ore mines and other mineral mines closed down. 50 years ago the German Chancellor, Willy Brand was concerned about the environment and promised that blue skies would return to the Ruhr district again.  A special task force was initiated and maximally allowable limits were established for industries’ pollution emissions and enforced by the German government. Government and industry were co-operating in developing anti-pollution measures, which have cleared up a lot of the pollution since. With regard to car emissions lead free gasoline was introduced and carburetors ensured more complete burning of exhaust gases. This is now common and accepted anywhere except for diesel fume exhaust, which nobody wants to address despite proven carcinogenicity.

Now Germany is one of the leaders in green technology, which is also important for tourism.

2. England has its own legacy of pollution in soil and air from the industrial revolution. The soil of moorland, which soaked up acid rain for decades, is more acidy than lemon juice and it will take a long time despite industrial complexes having closed long time ago, before the soil quality will be returned to normal.

3. Hamilton in Ontario/Canada has had a longstanding pollution problem, which I witnessed from 1976 until my departure in 1978. It is well known that Stelco, the local steel plant downtown Hamilton is sending polluting emissions into the air. In 1976 a vising professor from Australia gave an interesting talk about a study that was done at that time regarding the risk of developing bronchogenic carcinoma (a synonym for lung cancer) in the immediate surroundings of the Stelco plant. He said that this was one of the first studies to show that the distance of people’s houses from the source of pollution mattered as that determined how concentrated the air pollution was (the closer the more polluted the air). This  affected cancer rates: they were much higher in the immediate surrounding of Stelco when compared to the average rate in the rest of Hamilton. This difference was very significant within a radius of 1 kilometer (= 0.62 miles) from the Stelco plant.

Just in May of 2013 the local cancer agency of Hamilton announced that the lung cancer rate in Hamilton was higher than elsewhere in Ontario because of a combination of poor air quality and of a higher percentage of people smoking. Then in August 2013 the city of Hamilton announced a new air pollution bylaw for stricter pollution measures to improve the air quality in the downtown area. It is just a pity that Hamiltonians had to wait until 2013 before the city approved an anti-pollution bylaw that could have been passed 50 years earlier like in Germany’s Ruhr district!

4. In 2008 Pittsburg, a former steel manufacturer town like Hamilton, Ont. outdid Los Angeles with regard to small particle air pollution.

Lung cancer prevention by the authorities

As mentioned before up o15% of lung cancer is caused by environmental exposure. So, we ourselves can only prevent 85% of lung cancer by not smoking and not exposing ourselves to industrial emissions or to smoke from incense. However, in many cities around the world you will get exposed to air pollutants that are well above the safe limits, so the risk of getting lung cancer from just breathing the air there can be much higher than in rural areas where there is no industry.

Technologies to control air pollution are widely available. We need to exert pressure on politicians to show leadership around the world. Government regulations to lower emission rates need to be put into place and inspectors need to ensure the rules and regulations are adhered to. Without reducing emissions of cancer producing gases and chemicals right at the source (open burning of cuttings in orchards or burning cut trees), cutting emissions of cars, planes, ships, diesel cars, locomotives, electric generator plants etc. the air quality will not improve. Despite some costs involved industry, governments and individuals have to work together to make clean air happen.

The residents of those countries that have low pollution values will not benefit, if pollution continues to occur in other parts of the world as it just travels in the stratosphere around the globe until it arrives right here at home! We need an international pollution police. Satellites can be used to monitor where pollution occurs and this can be followed up through the local regulatory bodies with penalties and remedial actions.

What can I do personally to prevent lung cancer?

1.The most obvious step is to quit smoking and ask smokers who come to your place to smoke outside (not in your home).

2.Consider moving away from the city, if the air quality is unacceptable to a place where there is low air pollution.

3.Vitamin D3 has been shown to prevent colorectal cancer, but as there are vitamin D receptors found on the surface of various cells in tissue around the body including the lungs, many researchers feel that this vitamin in higher doses (2000 IU to 5000 IU) has probably a wider applicability in preventing cancers, even lung cancer.

4.Cutting out sugar and adopting a Mediterranean type diet is a prudent thing to do; also cutting down your calories to the maintenance you need (mildly ketogenic diet). If you bought body composition scales, it would display what your daily calorie consumption is and you should not exceed this, or else you’ll gain weight. An aging man who is overweight will experience hormone changes as fat is being metabolized and the enzyme aromatase contained in fatty tissue will turn male hormones (testosterone, DHT, androstenedione) into estrogen. Estrogen (particularly estradiol) is a known carcinogen that has been proven to cause breast cancer in women and prostate cancer in men. However lung cancer is also being promoted in women by estrogen as discussed in this link. In men one needs to remember that lung cells have estrogen receptors and there is concern in aging men with higher estradiol levels that this can promote cell divisions in existing lung cancer. So, it is important to maintain a normal body mass index between 21 and 24 (well below 25.0 and well above 18.5, which are the official accepted limits). This way there is no problem with insulin resistance (too high an insulin level), and other metabolic substances (cytokines, growth hormone like factors and tumor necrosis factor-alpha from body fat) that are cancer promoting.

5. If testosterone deficiency is present, which is common in older men, testosterone will have to be replaced with bioidentical hormones. It is a myth that testosterone would cause prostate cancer. Testosterone in males is necessary to maintain a normal metabolism including the immune system, which then can fight lung cancer and any other cancers.

6. Exercise and reducing beef consumption are also often mentioned in terms of preventing lung cancer.

7. Here are several recommendations from the LifeExtension Foundation that I found very useful in terms of lung cancer prevention. This link shows that antioxidant vitamins such as vitamin C, alpha tocopherol, the minerals selenium and zinc are also helping to reduce the lung cancer rate. Drinking green tea has also been shown to be effective in a dose-response curve manner (more tea protecting more from lung cancer). Vitamin B12 and folate have been shown to reduce abnormal bronchial cell growth in smokers as shown by repeat bronchoscopy studies.

8. Those who have been smokers in the past and those who have been around heavy smokers for more than 10 years in the past should consider having a preventative bronchoscopy done by a lung specialist (also called respirologist or pulmonologists). This way any suspicious areas with precancerous lesions can be biopsied during the procedure and attended to.

Hopeful research for new lung cancer treatments

Lung cancer is a disease that is best prevented. Once a person gets lung cancer, the prognosis is still very poor. However, cancer researchers are getting close to newer treatments involving genetically modified T-cells (killer cells) as was recently achieved for leukemia. Similar research is going on regarding ovarian cancer, melanoma, lung cancer and pancreatic cancer.

More information about lung cancer: http://nethealthbook.com/cancer-overview/lung-cancer/

Conclusion

It is not acceptable to let pollution take its course , the way politicians around the globe have handled this in the past 6 decades with a few notable exceptions mentioned. We all suffer a higher risk of getting lung cancer, even if we have been life-long non-smokers. Right now up to 15% of lung cancer in most populations are of this type. However, in Beijing this number is already much higher. The technology is available; Germany has led the way in the Ruhr district in the 1960’s and beyond. In my opinion the G8 meetings should have this high on their agendas and send technological aid to all the regions that have higher than the average world pollution index under the mandate of a special UN commission. This should be supported by the major industrial players with the knowledge that they will prevent the death of millions of potential consumers down the road, which will on the long-term pay off the relatively minor investment of installing pollution controls, before lung cancer levels rise even more.

Last edited Nov. 7, 2014

Nov
09
2013

Successful Diabetes Treatment Requires Patient’s Discipline

90% of all diabetes cases are due to type 2 diabetes, which is associated with being overweight or obese. The other 10% are due to type 1 diabetes, which is caused by an autoimmune disease within the pancreas destroying the insulin producing beta cells. Diabetes, type 1 often occurs in childhood (hence the name “juvenile diabetes”), while type 2 diabetes is a condition of the middle aged and older population. There is however an alarming trend: overweight or obese youngsters are also being diagnosed with type 2 diabetes. Here I am discussing type 2 diabetes.

Causes that trigger diabetes

There is not just one way to get diabetes; it usually is a multifactorial disease. Sure, genetics play a minor role. But you need to have epigenetic factors to trigger the genes to develop diabetes: eating too much sugar, eating wheat and wheat products, drinking soda drinks that contain sugar or high fructose corn syrup. Alcohol binges can also cause diabetes as can accumulation of excessive weight (a body mass index above 25.0). Even when there is no genetic risk in your family (your family tree has nobody that came down with diabetes and all your ancestors lived into their 90’s), you can still develop diabetes, if you are exposed to one or more of the risk factors mentioned.

What is the reason why diabetes occurs?

At a Keystone Symposium from Jan. 27 to Feb.1, 2013 in Keystone, Colorado (Ref.1) leading scientific researchers gathered to discuss exactly this question. There seem to be several mechanisms, all of which lead to diabetes. It has been known for some time that in type 2 diabetes insulin resistance develops that renders the cells incapable of absorbing blood sugar (glucose) from the blood into the cells. It is because of this insulin resistance that doctors can diagnose diabetes when blood sugar levels are high.

Successful Diabetes Treatment Requires Patient’s Discipline

Successful Diabetes Treatment Requires Patient’s Discipline

There are at least 5 mechanisms that are presently known that can cause insulin resistance (and thus diabetes) by itself or in combination. For a deeper understanding of diabetes it is crucial to be aware of these. Without knowing the enemy, you cannot fight it.

1. When a person eats too much sugar or fructose the liver converts this into excessive fat that is accumulated in the body’s cells. As a result insulin receptors are becoming inefficient in absorbing sugar from the blood, and blood sugar levels stay high. The pancreas reacts to this by making even more insulin, which after a few years will cause the pancreas to fail in producing insulin. At this point the patient requires insulin or else gets into a diabetic coma.

2. Chronic inflammation is another mechanism that has been shown to cause insulin resistance. Obesity, the metabolic syndrome and diabetes have a common inflammatory denominator that results in insulin resistance. With the aging process there is also deterioration of mitochondrial function (mitochondria are the mini batteries inside of every cell that are responsible for you having energy). This causes fat accumulation and also insulin resistance. Exercise and weight loss are effective in combatting insulin resistance. Fasting has also been shown to improve insulin sensitivity.

3. The metabolism of visceral fat (the type of fat causing the apple appearance in obesity) is highly active and is associated with an increased risk for heart attacks and developing diabetes. The pear shaped woman runs less of a risk, as the fat around the hips is not metabolically active. On the other hand when these women enter into menopause, they also develop abdominal fat (apple-like fat distribution) with a high secretion of inflammatory substances causing insulin resistance, heart attacks and strokes.

4. Another mechanism of causing inflammation comes from invasion of organs with fat cells. The development of fat toxicity from these displaced fat cells can also cause insulin resistance. Heart cells have been shown to die from fat toxicity and in the pancreas the insulin-producing cells can be killed by fat toxicity as well causing diabetes or making existing diabetes worse.

5. Interestingly another line of research, namely researching binge drinking, has revealed that there is a short-term insulin resistance that lasts for several days until the alcohol has been properly metabolized. It is of concern that adolescents who are experimenting with binge drinking are very vulnerable to develop brain damage from this habit.

Consequences of insulin resistance

We know that insulin resistance is the cause for adult onset, type 2 diabetes. It is entirely preventable. But there are powerful influences on people’s lives that will allow one or more of these factors mentioned to cause diabetes. The most common cause is putting on excessive weight. The reason for this is that people like to eat fast foods, drink sugar-containing sodas, and feast on processed foods, bagels and cookies. The end result is a change of the metabolism with an increase in triglycerides from the liver, an increase in LDL cholesterol, particularly the very low-density lipoprotein sub fractions of cholesterol. It has been known for some time that this is the connection to the high, premature death rates from heart attacks in diabetics, in people with obesity and in people with the metabolic syndrome. Hardening of the arteries is accelerated by the deposition of foam cells in the walls of arteries. These are scavenger cells (macrophages) that have engulfed noxious fats. This leads to narrowed coronary arteries and also a general narrowing of arteries all over the body including the brain vessels. In diabetics hardening of the arteries is accelerated and leads to premature strokes, heart attacks and heart failure, kidney failure, blindness and amputations of limbs.

Important tests for borderline diabetics

I you have a fasting blood sugar that is above 100 mg/dL (5.5 mmol), but less than 126 mg/dL (7 mmol) you are considered to be prediabetic or “borderline diabetic”. In this case rather than waiting for disasters in terms of cardiovascular disease, take action and ask your doctor to do the following three tests.

a) Arrange for a glucose tolerance test where you are given 75 grams of glucose; then blood tests are taken at one, two and three hours after this challenge dose. These blood tests are checked for blood glucose levels and insulin levels and tell the doctor exactly what is going on in terms of your sugar metabolism. It shows the glucose clearance and also the insulin response from your pancreas.

b) Have a hemoglobin A1c test done: it shows how your blood sugars have been controlled over the last 2 to 3 months.

c) You also need a VAP (vertical auto profile) test, which tests your lipid profile. Both prediabetics and overtly diabetics have been shown to have lipid profile disorders. Apart from low values in sub fractions of HDL cholesterol this test will also measure the very-low density lipoproteins (VLDL), which has been shown to be responsible for heart attacks and strokes.

With these three tests your doctor can  tell you more accurately what treatment protocol you require to succeed in controlling or curing your pre diabetes or diabetes.

Conventional treatment of diabetes

The conventional treatment of diabetes is to send the patient to a dietician, to ask the patient to do regular exercises and to either start them on hypoglycemic drugs or on insulin injections. Unfortunately the dietician often will encourage the patient to eat “healthy multigrain bread”, which will stimulate your taste buds to eat more sugar, high fructose corn syrup and starchy foods making weight loss impossible. Often the treating physician is satisfied that a hemoglobin A1c of 7% or less is good enough for the diabetic. But non-diabetic people have a hemoglobin A1c of 4% and 5.6%. This should be your goal or you will suffer the consequences of uncontrolled diabetes.

This is what I would call the conventional, symptomatic treatment approach. This may be the approach for patients who are not willing to seriously change their lifestyles, but it is more powerful on the long-term to treat diabetes by treating the underlying causes.

Alternative treatment approach for diabetes

Based on the above discussion regarding the various causes of insulin resistance, it is important to analyze what would be the main contributory factors in your particular case of diabetes.

Here are some suggestions:

1. If you are on the typical North American diet, also known as Western diet, it would be important to face the fact that wheat, wheat products in processed foods and sugar including high fructose corn syrup are the main culprits in stimulating your appetite and making you a sugar and wheat addict. Ref. 2 describes this in detail and offers 150 recipes to overcome this addiction. For more information just follow this reference text. Essentially it is a wheat-free Mediterranean type diet without rice, pasta and bread. You will shed significant amounts of pounds within a short period of time and feel a lot more energetic (due to revitalization of your mitochondria). At the same time insulin resistance is disappearing, because the insulin receptors are fully functional again. The insulin production of the pancreas will go down to normal levels and fat from the visceral fat storage gets melted away resulting in less inflammatory substances circulating in your blood.

2. A regular exercise program in a gym with an aerobic component (30 minutes of treadmill for instance and 20 to 30 minutes of isometric machine exercises) will help you to lower the triglycerides, and increase the healthy HDL cholesterol. It will also improve insulin sensitivity and control inflammation in your body. The best is to exercise 7 days per week. Remember your body works for you 7/7 every week, but for those of you who need a little rest in between 5 days per week is still very good. You may have to adjust your medication and insulin dose downwards, ask your physician about that.

3. Cut out alcohol. This may sound radical to you, but studies show this to be true. I have not mentioned cutting out smoking (it is causing inflammation and insulin resistance), because this is an absolute must that is given. When it comes to alcohol, the famous 1 drink per day for cardio protective purposes may not show up statistically as a bad effect, but your body will nevertheless get the message and let you age somewhat faster than a person who stays sober all the time. Staying sober will allow your brain to think clearly and adhere to your overall lifestyle approach in treating diabetes. Cutting out alcohol protects your brain (including the hypothalamus), liver and pancreas and prevents the prolonged periods of insulin resistance mentioned above that last for days. By keeping your hypothalamus in good working order, your hormone balance will stay stable for as long as possible until you reach menopause (for women) or andropause (for men). When you reached this milestone, I suggest you engage in bioidentical hormone replacement, which I have reviewed here. Hormones are essential to keep you younger for longer.

4. It is useful to monitor your blood sugar with a home glucometer, as this will show you when your blood sugar normalizes. Stay in touch with your doctor at all times, as this will help you in your overall management of your diabetes. Also, you will want to discuss with your doctor that you should have a blood tests called “hemoglobin A1c” measured every three months to see how well your diabetes is controlled. It should be below 7% for sure, but better below 6%. Non-diabetic people have levels of 4% and 5.6%. You may not know that hemoglobin A1c is actually measuring the amount of advanced glycation end products (“AGE”) of red blood cells. These AGE substances essentially are firmly bound sugar/protein compounds that shut down the cell metabolism wherever they are formed. In my opinion it is best to aim at a hemoglobin A1c level of non-diabetic people (4% and 5.6%) to avoid the consequences of tissue damage of all vital organs, which is the reason why long-term diabetics have a life expectancy of 15 to 20 years shorter than non-diabetic persons. Some diabetic patients may benefit from the oral hypoglycemic drug, metformin (brand name: Glucophage), which has anti-inflammatory properties and is used in patients with type 2 diabetes and a high fasting insulin level, but this is a decision requiring your physician’s input.

5. Supplements: There are some supplements that are useful to take as an adjunct, like chromium, which helps insulin to transport glucose into the cell; alpha-lipoic acid, an antioxidant, which is useful to prevent glycation (formation of a complex between sugar and protein, which prevents normal cell functioning); and coenzyme-Q10, which supports your heart (A4M recommends 400 mg per day, higher than Dr. Weil’s link). Other supplements of merit are curcumin, cinnamon, genistein and silymarin (standardized extract of milk thistle), which suppresses a pro inflammatory molecule, which in turn helps to fight insulin resistance (Ref. 1). Omega-3 fatty acid supplements are anti-inflammatory and will improve insulin resistance as well (dosage 1000mg or more per day). According to Ref. 3 vitamin D3 is useful as a supplement for diabetics, because it activates DNA, is involved in cellular repair and deficiency of it is known to lead to higher mortality rates in diabetics. Ref. 3 recommends between 1000 and 4000 IU of vitamin D3 daily and suggests doing blood tests to measure effective vitamin D3 levels (keep 25-OHD in the blood between 30 and 80 ng/mL).

6.Patients whose pancreas no longer produces insulin will need insulin injections, but instead of using long-acting insulin once per day the best results in getting blood sugar control is by injecting insulin three or more times per day using short acting insulin. It is important to always monitor the blood sugar lowering effect by glucometer readings; the injections are best given just before meals (recombinant human insulin is the preferred insulin to be used). Ask your physician or diabetic coach for more details.

Conclusion

Diabetes used to be a dreadful disease that caused premature heart attacks, strokes, blindness, kidney failure, and limb amputations. With aggressive management of diabetes as well as strict lifestyle intervention this has changed. A diabetic who treats the causes of the illness can have a normal life expectancy. In many cases the initial diagnosis of type 2 diabetes can disappear, when treatment was started early enough and insulin resistance could be stopped in its tracks. Without the patient’s full co-operation disciplining him/herself to follow through on all of these recommendations the caregiver will fail in controlling the patient’s diabetes. It is the patient who owns the problem; it is the patient who needs to make every possible effort and follow through on all of the details of dieting, exercising, blood sugar monitoring using a glucometer and taking the required supplements.

More information on diabetes: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

Reference

1. http://www.lef.org/magazine/mag2013/oct2013_2013-Keystone-Diabetes-Symposium_01.htm

2. William Davis, MD: “Wheat Belly Cookbook. 150 Recipes to Help You Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2012.

3. Rakel: Integrative Medicine, 3rd ed. © 2012 Saunders. Integrative Therapy; Supplements.

Last edited Dec. 17, 2014

Jan
22
2013

Long-Term Multistep Weight Management

In February of 2001 my wife and I attended an anti-aging conference in San Diego. The keynote speaker was Dr. Barry Sears who is the inventor of the zone diet. We had read a book from him before the conference and were excited to hear him speak in person. We liked the book; we liked the talk, so we cut out sugar, starchy foods and stuck to a diet where the calories derived 50% from low-glycemic, complex carbohydrates, 25-30% from lean meat, poultry and fish. Calories derived from fat were reduced to about 15-20% (there is hidden fat even in lean meat). No butter, but instead some lean cheeses and olive oil for cooking and in salad dressings. We shed both 50 pounds within 3 months without any hunger pangs. Our energy increased and this has stayed  this way ever since. There was no problem getting down with our BMI’s (body mass index) to 23.5 or 24.0, which is usually viewed as normal by the medical profession. We noticed, however, that when we did not exercise, there was a problem maintaining our normal weight.  We are under the care of an anti-aging physician who did special tests like fasting insulin, C- reactive protein, and hormone tests. They were all normal. We took up ballroom dancing really seriously having been inspired by “Dancing With the Stars”. This was 6 years ago. What started innocently with only a few basic ballroom lessons three times per week has now blossomed into dancing more than 10 different dance styles 5 times per week.

Long-term Multistep Weight Management

Long-term Multistep Weight Management

3 ½ years ago both of our energy levels were slowly going down, particularly after a long night of dancing. Hormone tests revealed the initial stages of age-related hormone deficiencies which did not come as a surprise , as  decreasing hormone levels was a topic discussed  in detail at the conference in San Diego in 2001 (we also attended several other anti-aging conferences on a yearly basis from 2009 onwards). With bioidentical hormone replacements these levels normalized within one year, our energy was back and our weight stayed normal. We enjoy travelling, but there can be problems with our multistep weight management program. We need to watch our diet (no toxins, preferably only organic food), and physical exercise may be less regimented. In 2008 we read Suzanne Somers’ book “Breakthrough”. We ordered urine tests for toxic metals and we were shocked that we had noticeable levels of mercury and lead. Since then we started to cut our salmon consumption from 3 to 4 times per week down to once or twice per week. To get rid of the heavy metals we started intravenous chelation treatments with vitamin C (10 Gm) and Glutathione (1250 mg) every two weeks. In July 2012 there were reports of radioactive salmon from the Japan nuclear disaster earlier that year in the Canadian media. After this news we stopped eating all fish and other seafood, not only because of radioactivity, but also because of other toxins like mercury, cadmium, PBC’s etc.  We do take high doses of molecularly distilled omega-3 fatty acids along with our other supplements. We also started eating mostly organic foods as we do not want to ingest insecticides, herbicides and other toxins.

We acquired body composition scales, which give information about fat percentage including visceral fat percentage, muscle mass percentage, BMI, weight and the basic metabolic rate. We wanted to define the end point of what our ideal body weight would be. We noticed that our dance program was not good enough to lower the BMI below about 23.5; using the body composition scales we noted that our body fat content was still too high and the visceral fat percentage was still in the 6% range. It took a prolonged trip to the US where we could not find enough dance events to decide that we would introduce a one hour gym program consisting of 30 minutes of treadmill, 15 minutes of upper body circuits, and 15 minutes of lower body circuits every day as a basis to our exercise program. Any dance activity would be just an additional exercise on top of the base exercise from the gym. It took only about 2 months before our fat composition decreased, our muscle mass increased, the visceral fat went to a normal at 5% and the BMI was now stabilized at the 21.5 to 22.0 range. We feel a lot more confident in managing our weight long-term without really thinking much about the weight. It is now a routine we follow, like an athlete would do to stay in shape. While nobody has a permanent guarantee to everlasting health, we do it to prevent the diseases we do not need in our retirement like diabetes, arthritis, heart attacks, strokes, cancer or Alzheimer’s.

What we did not know until after the 20th A4M Anti-Aging Conference in Las Vegas (mid December 2012) was that inadvertently we were protected from exposure to chemically modified wheat from 2001 onwards as we had cut out all refined carbohydrates and starchy foods (including wheat) since then. Unfortunately many Americans still expose themselves unknowingly to larger or smaller quantities of wheat, suffer from leaky gut syndrome with the associated changes in the immune system and the development of autoimmune diseases.

Personally, I believe that long term weight management is possible: you can turn older and hopefully wiser…not wider. The good news: it can be done. The bad news: this is not an instant fix, but a program that needs to be part of your lifestyle package.

More information on weight loss: http://nethealthbook.com/health-nutrition-and-fitness/weight-loss-and-diet/

Last updated Nov. 6, 2014