Tag Archives: blood sugar

Exercise as Medicine

For many chronic health problems, regular exercise is more effective than any drug.

Exercise as Medicine is a major movement at John’s Hopkins School of Medicine.

You can visit this website for links to many topics on the benefits of exercise.

You can find the top 10 things you need to know about exercise here. They include the following evidence based recommendations from the Physical Activity Guidelines for Americans.

any amount of physical activity has some health benefits. Americans can benefit from small amounts of moderate-to-vigorous physical activity throughout the day.

The benefits of exercise are cumulative, walk 10 minutes 3 times per day and you get the same benefit as a 30 minute walk. Walk  5 minutes 6 times and the benefit equals that of 30 minutes continuous walking. So you can break up your exercise in little pieces throughout the day. No requirement for a specific long period devoted to exercise.

New evidence shows that physical activity has immediate health benefits. For example, physical activity can reduce anxiety and blood pressure and improve quality of sleep and insulin sensitivity.

Exercise improves cognition, decreases cancer risk, decreases risk of depression, hypertension, diabetes, stroke and heart disease. It lowers risk of falls and injuries from falls. It decreases pain and helps a variety of conditions. Exercise reduces all cause mortality (death rates from all causes)

Here are some direct quotes from the second edition of the  Physical Activity Guidelines.

  • For youth, physical activity can help improve cognition,* bone health, fitness, and heart health. It can also reduce the risk of depression.
  • For adults, physical activity helps prevent 8 types of cancer (bladder,* breast, colon, endometrium,* esophagus,* kidney,* stomach,* and lung*); reduces the risk of dementia* (includingAlzheimer’s disease*), all-cause mortality, heart disease, stroke, high blood pressure, type 2 diabetes, and depression; and improves bone health, physical function, and quality of life.
  • For older adults, physical activity also lowers the risk of falls and injuries from falls.*
  • For pregnant women, physical activity reduces the risk of postpartum depression.*
  • New evidence shows that physical activity can help manage more health conditions that Americans already have. For example, physical activity can decrease pain for those with osteoarthritis, reduce disease progression for hypertension and type 2 diabetes, reduce symptoms of anxiety and depression, and improve cognition for those with dementia, multiple sclerosis, ADHD, and Parkinson’s disease.

You can choose from a variety of TEDtalks on exercise here.

I particularly enjoyed my friend Darryl Edwards talk here.

 

So sleep well, exercise often, eat clean, filter your water, avoid environmental toxins, get plenty of sunshine, and most important of all, stay connected with friends and family.

Doctor Bob

 

Sleep! You can’t live without it.

Circadian rhythm refers to the cycling of hormones according to the time of day. Every hormone cycles with daylight and darkness, each in it’s own way. Our brain has a master clock, called the circadian clock, controlled by specialized cells deep in the brain. There is a direct connection from our retina (in the back of the eyes) to the circadian clock in the brain. Blue light (part of the normal outdoor spectrum of light) stimulates very specific receptor cells in the retina which in turn communicates directly with the circadian clock telling the brain whether it is day or night. To synchronize our hormones and achieve restorative sleep, we must get outdoor light exposure to our eyes (without sunglasses, early in the day) and limit light exposure in the evening.

Artificial light, especially from cell phones and other devices that emit intense blue light, shift work, late night social activity, poor eating habits, sedentary lifestyle and at the opposite extreme, late evening workouts,  can all disrupt our circadian rhythm preventing adequate restorative sleep. A rare genetic illness called fatal insomnia that strikes adults at middle age prevents sleep and results in death within a few months, highlighting the importance of sleep. Sleep deprivation can kill a human quicker than starvation! Adequate amounts of deep non-REM sleep are required for tissue regeneration, healing, DNA repair and immune function. REM sleep with dreaming provides great benefit by organizing our memory, discharging the emotional content of traumatic events, and facilitating creative brain activity. One night of short-sleep produces a state of inattention and slow reflexes as dangerous as driving under the influence of alcohol intoxication. Chronic  short sleep and disrupted circadian rhythm results in increased risk of depression, cancer, hypertension, diabetes, dementia, obesity, metabolic syndrome, insulin resistance, heart attack and stroke, to name a few. Sleep interruption immediately halts weight loss during a calorie restricted diet (likely the result of hormonal disruption). So getting an adequate amount of restorative sleep every night is essential to good health. Here a few tips to help achieve a good night’s sleep each and every night.

  1. GET OUTDOOR LIGHT EXPOSURE ON YOUR EYES WITHOUT SUNGLASSES EVERY DAY, EARLY IN THE DAY. This helps set your biologic/circadian clock. Even on a cloudy day, outdoor light is much stronger and natural than indoor light. It is essential for setting your biologic/circadian clock. If you cannot get outside, stand or sit in front of a large window for 20-30 minutes in the morning, looking outside. Take a lunch break outside without sunglasses. Wear a shade hat instead of sunglasses. Your brain needs to experience natural outdoor light during the day.
  2. Avoid bright light in the evening, especially the light from TV, computer screens, cell phones, which all emit intense blue light and trick your brain into thinking it is daytime. Wear blue light blocking glasses/goggles for 2-3 hours before bed. (Amber tinted glasses which block blue light can be purchased on-line and can be worn over reading glasses) There is also software available that will decrease the blue light intensity of computer screens and cell phones in the evening.
  3. Practice time restricted eating. Limit all eating to an eight hour period, thus providing for an over-night fast of 16 hours. If that does not seem possible try to limit eating to a 10-hour period which provides a 14-hour overnight fast. This improves sleep, circadian rhythm, blood pressure, blood sugar and reduces stress hormones. NO SNACKS BETWEEN MEALS. NO FOOD FOR 2 HOURS BEFORE BED. For every hour decrease in eating time period from 12 hours to 8 hours you get health benefit.
  4. Eat an anti-inflammatory diet.
  5. If you snore, are overweight/obese, fall asleep during the day, or do not feel refreshed in the morning ask your doctor to order a sleep study. Obstructive Sleep Apnea makes restorative sleep impossible and increases risk of heart attack, stroke and most chronic diseases.
  6. Avoid alcohol altogether and avoid caffeine after late morning.  Alcohol in the evening may help you fall asleep but it results in a withdrawal from alcohol during the night. This disrupts normal sleep patterns.
  7. Sleep in a cold, dark, quiet room. Use black-out curtains, no night lights, no phone charger lights, no lights of any kind should be on in the room. Any amount of light in the room impairs the production of melatonin which facilitates sleep onset.
  8. Have a winddown time every evening. Develop habits of non-stressful activities, soft music, dim light, casual conversation, enjoyable reading. Do not spend evening time dealing with finances, conflict, or emotional activity.
  9. Try a magnesium supplement before bedtime. Magnesium glycinate, magnesium citrate, magnesium gluconate, are absorbed much better than cheaper supplements such as magnesium oxide. Magnesium L-Threonate is expensive, but it crosses the blood brain barrier into the brain with the greatest brain penetration of all magnesium supplements.
  10. Manage stress with yoga, meditation, regular exercise (but no intense exercise in the evening.) Perform most of your exercise outdoors in a green space. This provides much more health benefit than the equivalent exercise indoors.
  11. Regular contact with supportive family and friends is essential to health and reduces stress. The greatest predictor of health vs disease is the amount of social connectedness an individual experiences.
  12. Establish regular wake-up times and go-to-bed times. Regular sleep habits are essential. If you must rely on alarm clocks you do not have good sleep habits.

A few words about alcohol, caffeine and sleeping pills.

A drink or two in the evening may help you relax but it disrupts your sleep by causing a mild episode of alcohol withdrawal as your liver metabolizes the alcohol and your blood levels drop. Even this slight degree of alcohol withdrawal will impair a good night’s sleep.

Caffeine impairs sleep by blocking adenosine receptors in the brain. Adenosine is the neurotransmitter that increases gradually during the day creating a sate referred to as sleep pressure. Some people metabolize caffeine quickly, others slowly. The slower you metabolize caffeine the longer it takes to clear it from your adenosine receptors. Without adequate sleep pressure (adenosine receptors filled with adenosine in the brain) you cannot fall asleep. Many sleep experts recommend complete abstinence from caffeine and suggest that if you need caffeine to get started in the morning you are regularly sleep deprived.

Sleeping pills of all kinds interfere with normal sleep architecture. While they facilitate falling asleep, they impair your ability to achieve deep restorative stages of sleep and can produce many undesirable side effects including addiction, withdrawal symptoms, sleep walking, sleep driving, worsening of asthma and COPD, constipation, diarrhea, daytime drowsiness, burning and tingling sensations, unusual dreams, weakness, heartburn, etc…. Most importantly they all interfere with cycling through the various stages of sleep in a normal, restorative pattern!

If you want to explore these concepts in depth here are two excellent books that discuss sleep and circadian rhythm.

Why We Sleep, by Matthew Walker Ph.D.

The Circadian Code, by Satchin Panda Ph.D.

Eat clean, sleep well, spend time exercising out of doors, love one another.

Bob Hansen MD

The Broken Brain Docuseries is now re-running

Due to popular demand the producers of this terrific series are making it available again  on line this weekend. If you have not taken advantage of this information you can do it here:

Replay (YouTube) | Broken Brain

Enjoy

Bob Hansen MD

The Broken Brain on-line “docuseries” is running now.

I would encourage everyone to watch this series of daily interviews and discussions on lifestyle and brain health. This was organized and produced by Mark Hyman MD, director of the Functional Medicine Clinic at Cleveland Clinic, well known author, speaker and physician, Discussions cover many topics including environmental toxins (such as heavy metals and Roundup), nutrition, exercise, sleep, stress reduction, gut bacteria, and more with specific reference to the effects on your brain and risk for dreaded conditions such as Alzheimer’s and other forms of dementia, Parkinson’s disease, multiple sclerosis, etc. These conditions can be prevented and when present, they can be treated with interventions not usually employed by modern medicine, unless you are fortunate enough to be working with a Functional Medicine practitioner.

You can sign up to receive a daily email with a link to the on-line video. Each video in the series is available for 24 hours starting at 3 PM PST, 6 PM EST.

Here is the link to get started with the third episode in this series.

Episode 3: Dementia and Alzheimer’s [LIVE] | Broken Brain

To Your Health,

Bob Hansen MD

Obesity Epidemic Requires a Paradigm Shift

The obesity epidemic requires a paradigm shift. Several medical myths stand in the way of taking the most effective steps to safely help patients lose weight. The most important myth relates to saturated fat. Saturated fat consumption does not contribute to cardiovascular disease. This must be understood and accepted by the medical community so that sound advice can be given.

A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD.( Am J Clin Nutr. 2010 Mar;91(3):497-9. )

In fact, as early as 2004, Mozaffarian et. al. investigated the influence of diet on atherosclerotic progression in postmenopausal women with quantitative angiography and found that:

In multivariate analyses, a higher saturated fat intake was associated with a smaller decline in mean minimal coronary diameter (P = 0.001) and less progression of coronary stenosis (P = 0.002) during follow-up. (Am J Clin Nutr. 2004 Nov;80(5):1175-84)

In addition, they further found that:

Carbohydrate intake was positively associated with atherosclerotic progression (P = 0.001), particularly when the glycemic index was high.

            Polyunsaturated fat intake was positively associated with progression when replacing other fats (P = 0.04)

These findings should come as no surprise given the basic science of atherosclerosis. Oxidized and glycated LDL stimulate macrophages to become foam cells initiating the creation of plaque. Cellular receptors that allow macrophages to ingest oxidized LDL are specific for oxidized LDL. These receptors do not recognize normal LDL to a significant degree.

Holovet et. al. studied the ability of oxidized LDL versus the Global Risk Factor Assessment Score (GRAS) to detect coronary artery disease. GRAS identified coronary artery disease 49% of the time, while oxidized LDL was correct 82% of the time.

In a large prospective study, Meisinger et al found that plasma oxidized LDL was the strongest predictor of CHD events when compared to conventional lipoprotein risk assessment and other risk factors for CHD.

Polyunsaturated fats are easily oxidized, saturated fats are not. It is the polyunsaturated fatty acids (PUFA) in the membrane of LDL particles that become oxidized and then initiate the cascade of inflammatory events leading to atherosclerosis. The major source of these PUFA in the American diet are “vegetable oils” (corn oil, soy oil etc.)  rich in the omega-6 PUFA, linoleic acid.

So why is this important to understand relative to the obesity epidemic? Because the most effective weight loss “diet” is arguably a low carbohydrate/high fat (LCHF) diet. This approach does not require calorie counting. This approach has been demonstrated to spontaneously reduce caloric intake whereas low fat diets require calorie counting and result in persistent hunger.

When compared to low fat calorie restricted diets  the LCHF approach has been equal or superior with respect to weight loss, insulin sensitivity, blood pressure reduction, and lipid profiles whenever these parameters have been measured.

But LCHF has not been embraced by the medical community due to the perceived dangers of saturated fat consumption and a low-fat ideology that lacks legitimate scientific evidence.

Once we dispel the mythology of saturated fat, the safety and efficacy of LCHF will be more readily accepted by physicians, the media and the lay public.

The nutritional villains in our society are highly refined and easily oxidized “vegetable oils” filled with pro-inflammatory omega-6 PUFA (linoleic acid), added sugar (especially HFCS) so prevalent in most processed foods and soft drinks, and the nutrient poor wasted calories of processed flour foods. These three culprits are responsible for our epidemics of obesity, insulin resistance and metabolic syndrome. These three conspire together to generate fatty liver disease, atherosclerotic plaque, and chronic inflammation.

When a LCHF approach is combined with  eating only fresh whole foods and avoiding added sugar, refined flour, and unhealthy  “vegetable oils”, we have the perfect recipe for our obesity epidemic.

The following references provide examples of studies that have demonstrated the efficacy, safety and  usual superiority of the LCHF  approach to weight loss.

Dig Dis Sci. 2007 Feb;52(2):589-93. Epub 2007 Jan 12. The effect of a low-carbohydrate, ketogenic diet on nonalcoholic fatty liver disease: a pilot study. Tendler D, Lin S, Yancy WS Jr, Mavropoulos J, Sylvestre P, Rockey DC Westman EC.

Functional Medicine: Getting to the Root Causes of Illness, A cure for Alzheimer’s

Today I watched a great TED talk by Dr. Rangan Chaterjee discussing his own journey in the discovery and implementation of a functional medicine approach to caring for his patients. The concept of using basic science and clinical science to diagnose and treat the root causes of illness, rather than treating symptoms, has been around for more than two decades.  This approach has recently started to attract more attention, especially within the community of younger physicians who have become more dissatisfied with the frustrations of traditional allopathic medicine.

Here is the talk. Dr. Chatterjee covers lots of ground in a passionate and informative talk.

Enjoy this talk. If you would like to learn about how a functional medicine approach can CURE ALZHEIMER’S DISEASE then watch this video of Dr. Bredesen who gave this lecture at a meeting of the American College of Nutrition.

Doctor Bredesen, an acclaimed neuroscientist, researcher, and more recently a brilliant clinician, has been criticized by the academic research community for implementing a clinical research protocol that addresses more than one variable at a time! Unfortunately, medical science has been handcuffed by the drug-model of clinical research wherein only one variable (drug vs. placebo for example) is studied. But if an illness has many potential contributing root causes, changing only one variable is doomed to failure, as Dr. Bredesen explains in this lecture.

Sleep well, eat clean, get outdoors every morning to help keep your circadian rhythm and biological clock in order.

Bob Hansen MD

Interview with Dr. Ede about preventing Alzheimer’s

My friend and colleague, Dr. Georgia Ede, was recently interviewed concerning dietary interventions to prevent Alzheimer’s Dementia. Great interview, lots of information, references provided at the bottom of the transcript.

Here is the link.

Are You On The Road To Alzheimer’s? Interview With Dr. Georgia Ede – Choc & Juice

Another reason to eat a clean Paleo diet.

Eliminating sugar, flour foods, and fruit juices will also improve your gut flora and help to prevent dysbiosis.

Regards

Bob Hansen MD