Tag Archives: obesity

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

Weight loss, discussion by Tommy Wood MD, PhD

My friend and colleague, Dr. Tommy Wood, recently posted a terrific discussion on weight loss and the many factors to consider. You can read it here. Should Calorie Counting Be the Main Focus for Somebody Trying to Lose Weight (Body Fat)? | Nourish Balance Thrive

Tommy is the smartest physician I know. He researches a topic extensively and carefully separates bad science from good science.

If Tommy renders an opinion, you can take it to the bank.

Read the NBT post by Tommy at the link above and you will not be disappointed. Then sign up to receive short weekly e-mails with sound advice on health and nutrition.

I have discussed the importance of circadian rhythm, restorative sleep, hormonal effects of food choices, and the effects of stress. Tommy covers all of these and much more with links to scientific papers if you are interested in delving deeply into the issues. But if you just want sound advice on weight loss,  read the post and organize your life around improving your habits as he recommends.

Live clean, eat real food, spend time with friends and family, hug someone every day, engage in meaningful work, get sunshine early in the day, exercise in a green space and live in the moment.

Doctor Bob.

Cartoon humor: A Prescription for Health!

 

prescription-for-exercise-cropped

Hat tip to Tommy Wood MD, PhD for introducing me to this great cartoon.

So what would happen if your doctor prescribed this? Would you be shocked? Would you follow the advice? Sadly few doctors make such recommendations as explicitly as this cartoon and fewer patients follow the advice.

How important are the elements in this advice?

They are essential. We too often focus on dietary concerns at the expense of ignoring other important low hanging fruit. Early morning  outdoor exercise with exposure to natural light in a green space, even on a cloudy or rainy day, is essential for health. Why? There are many reasons. Click the link above to read fitness expert Darryl Edward’s discussion with references. In fact outdoor exercise in a greenspace is more beneficial than the same exercise indoors. The reasons are many, including but not limited to Vitamin D production.

Early daytime exposure to natural outdoor light helps to maintain our Circadian rhythm and align the biologic clock in all of our cells and organs with the central biological Circadian clock in our brain. Most folks do not know that we have a biologic clock deep within our brain and that all the organs and cells of our body also have clocks. They all need to be synchronized with each other and with the sun for optimal health. When they are not synchronized bad things happen. Night shift workers and other folks with disturbed sleep have higher rates of cancer , depressionhypertension, heart attack and stroke.

Maintaining our circadian rhythm is vital to achieving adequate high quality restorative sleep. In turn, obtaining adequate restorative sleep contributes to lower cardiovascular disease risk in addition to four traditional lifestyle risk factors.

Exposure to artificial light at night disrupts our circadian rhythm and impairs the onset of sleep.

In medical school I learned that our retina has two cell types, rods and cones. But advances in science have revealed a  third cell type called retinal ganglionic cells. 

These cells are  particularly sensitive to blue light and directly connected to our central biological clock . Exposure to artificial light, especially from TV screens, computers, cell phones and other electronic devices after sunset disrupts our sleep cycle and delays the onset of sleep. That is why wearing blue light filtering glasses in the evening helps many folks to improve their sleep quality and duration.

Sleep deprivation for even one night causes elevation in interleukin 6 levels the following day. Interleukin 6 suppresses immune function and excessive levels cause bone and tissue damage (especially cardiovascular). Sleep deprivation  increases  Stress hormones (cortisol, adrenalin), decreases prolactin and Growth hormone , and decreases the nightly production of ATP .

Melatonin , often called the sleep hormone, is produced most abundantly during restorative sleep and essential for tissue healing, immune function, cancer prevention, and defense against tissue oxidation. These are just a few of the roles melatonin and sleep cycles play in determining our health..

So exercise outdoors in a green space daily to help synchronize your biologic clock with the sun, dim the lights in the evening and if you must watch TV or work on electronic devices before bed wear Blue Light filter glasses .

Of course eating an abundance of colorful fresh organic vegetables and fruits, and practicing some stress reduction techniques every day are equally important and essential to health and functional status.

Finally, not mentioned in the cartoon above is another healthy lifestyle choice, intermittent fasting (IF). IF will be discussed in the next post.

Until then, sleep well, exercise regularly out doors in a green space environment, eat clean, learn and practice some regular stress reduction techniques and read the next post about IF.

Bob Hansen MD

The Obesity Code, a must read book by Dr. Jason Fung.

Doctor Jason Fung just published a terrific book titled The Obesity Code: Unlocking the Secrets of Weight Loss: 

Dr. Fung’s genius excels at simple, direct explanations with clarity and humor. His analogies are often hilarious and through his humor and logic he communicates simple but important truths. The major message is that obesity is a hormonal problem. Obesity is not a disease of excess caloric intake, nor is it a disease of sedentary lifestyle. Dr. Fung cites study after study in which obese patients (young and old alike) consumed less calories and exercised more with dismal results. He reviews the medical literature on the effects of refined carbohydrates and sugar on insulin and other hormones. He explains how sustained high insulin levels cause insulin resistance and weight gain. He clearly and decisively explains how 100 calories of sugar or flour effects the human body in a manner immensely different from 100 calories of broccoli.

“Have you ever seen anyone get fat from eating too much broccoli?”

Most importantly, Dr. Fung provides the solution that has helped hundreds of his patients. The solution is elimination of refined carbohydrates and sugar in combination with intermittent fasting. Intermittent fasting (consuming only water, coffee, tea, broth) for 24 -36 hours a few to several times per month helps to reset the brain’s set point for body weight. When combined with restriction of sugar and refined carbohydrate (foods made with flour) intermittent fasting presents a powerful tool to not only lose weight but to manage diabetes and prevent the many complications of obesity and diabetes.

Intermittent fasting increases the human metabolic rate, Your body actually burns more calories at rest per hour during fasting. The effects of intermittent fasting are distinctly different from what has been referred to as the “starvation response”. The “starvation response” ironically and confusingly refers to human studies that restricted (reduced) caloric intake but continued low calorie meals throughout the day.  It is unfortunate that those studies coined the term “starvation response” which is a decrease in resting metabolic rate. Caloric restriction diets reduce the human metabolic rate and therein lies the cause for the failure of all caloric restriction diets.

The confusion of these two approaches and their effects on human metabolism have clouded the discussion of obesity for decades.

Dr. Fung’s communication skills can be enjoyed by reading his book and viewing his many talks on YouTube.

His book and lectures should be mandatory for every medical student, physician, nutritionist and public health official. His book’s exhaustive medical references document the science that supports his theory and his clinical solution.

So take a leap, click on the link above for his book and the links below for some of his videos which are free on-line.

I think that Dr. Fung’s book is the most important book published on this topic in the 21st Century. His work will have profound influence during the next few decades. I encourage you to enjoy his genius.

Bob Hansen MD

The BigFatFix, a crowd funded film that explores the proper nutritional approach to diabetes epidemic

This new film created by a GP in UK, funded by small contributions, describes how elimination of added sugar and implementation of carbohydrate restriction can cure diabetes and result in weight loss. The film also covers how the low-fat craze, based on bad science (ignoring the full data) began with Ancel Keyes and evolved into arguably the worst public health disaster experienced by the modern world.

Bariatric surgery is NOT superior to lifestyle changes

There have been multiple studies comparing “lifestyle” interventions to bariatric surgery in treating obesity and diabetes. Repeatedly the authors conclude that bariatric surgery is superior to “lifestyle” interventions.

But none of these studies have utilized very low carbohydrate diets or medically supervised fasting as a lifestyle intervention. Instead, the diets employed for the “lifestyle” intervention are typically an ADA calorie restricted low-fat diet. I find this very frustrating as a physician.

The science in this area has demonstrated that very low carbohydrate diets consistently out-perform the low fat calorie restricted diet in terms of weight loss, blood sugar control, blood pressure control and lipid profiles.

Bariatric surgery carries a mortality rate of up to 3% depending on the surgeon, hospital and other circumstances. As an anesthesiologist and pain management physician I have seen multiple complications of bariatric surgery including but not limited to multiple chronic nutritional deficiencies (malabsorption), hernias, sepsis, renal failure, rhabdomyalisis, respiratory failure requiring prolonged ventilation, multi-organ failure requiring prolonged ICU care, and death.

And although many patients have profound weight loss in the first year after bariatric surgery many patients ultimately gain back most of the weight initially lost.

We need studies that compare bariatric surgery to very low carbohydrate and paleo diets. We need studies that compare bariatric surgery to intermittent medically supervised fasting. Until those studies are performed we should not conclude that bariatric surgery is superior to lifestyle interventions, particularly given the high complication rates of this surgery and the proven effects of VLC diets and medically supervised fasting.

Here are links to videos that discuss this topic.

They are all worth watching.

The SkinnyNews-Tim Noakes

The Aetiology of Obesity Part 1 of 6: A New Hope

The Science and Practice of Low-Carb Diets {Duke University Office Hours}

Prof. Tim Noakes; Medical aspects of the low carbohydrate lifestyles

Low-Carb Experts: Eric Westman, MD, MHS – Segment One (9:30)

Dr Eric Westman – Duke University New Atkins Ketogenic Diet for Weight Loss and Health

Dr Eric Westman about the new Atkins diet, part 1/2

Debunking Low Carb Myths with Dr. Eric Westman

Insulin Toxicity and How to Cure Type 2 Diabetes

How to Reverse Type 2 Diabetes Naturally

I have previously discussed the issue of carbohydrate restriction, diabetes and obesity with multiple scientific references provided in previous posts.

Peace,

Bob Hansen MD

 

 

Nutrition Journals and the influence of the food industry

Ever wonder why the public is so confused about nutrition recommendations? Just follow the money and you will understand that most of the professional societies that publish nutrition articles are funded by big food companies that are trying to sell more sugar, refined carbs and junk food. I recently read an excellent post about this topic here:

The Vilest Villain: American Society of Nutrition

This theme is repeated by medical journals that are “The Official Journal of the Society of >>>>>>” Just fill in the blanks for just about any medical society. Funding comes from big pharmaceutical companies the same way that funding in the nutrition Journals comes from large (junk) “food” manufacturers.

Don’t get me wrong, there are plenty of very valuable, life-saving drugs out there.

But most chronic human disease in developed societies is generated by various combinations of poor nutrition, lack of exercise, disruption of circadian rhythm, inadequate restorative sleep, stress and lack of social support systems.

The obesity and diabetes epidemics continue to worsen yet the failed dietary advise of major health organizations is slow to respond to the data. Excess refined carbs (especially in the form of “food” made with flour) and added sugar (especially in the form of HFCS) are the major driving forces for obesity, diabetes and cardiovascular disease. Red meat is not the culprit, provided the meat is properly sourced (hormone and antibiotic free, grass fed) and cooked in a manner that does not create carcinogens and inflammatory mediators (cook with slow, low, moist heat, high temperature grilling and smoking cause problems, but that topic  is for another post).

Americans consume an average 130 pounds per year of added sugar and 140 pounds per year of refined flour. Those are averages so there are many people who consume more. The added sugar is not the white stuff people put in their coffee. It comes in all sorts of forms but is found in energy drinks, soda, lattes and mochas, salad dressing,  ketchup, canned soups, canned vegetables, white AND whole grain breads, pasta (even “whole grain”), crackers, breakfast cereal,  just about any packaged food that has more than one ingredient on the label. These foods represent 70% of the American diet. The problems created by this situation are enormous and will bankrupt our “healthcare system”. This is a cultural and economic problem.

The solutions are simple but largely ignored in our society. We are creatures of habit and convenience.

Eat whole foods, nothing from a package that has more than one ingredient. Eat meat, seafood, poultry, fresh organic vegetables (6-9 servings per day), fresh organic fruits, and nuts. Meat should be hormone and antibiotic free (free range, grass fed). Seafood should be wild. Poultry should be free range and the eggs should come from free range chickens, ducks, geese.

Do not worry about eating fat as long as it comes from healthy animals and sources such as coconut oil, extra-virgin olive oil, avocado oil and clarified butter (ghee).

Do not use any “vegetable” oils (corn, soy, and other oils from grains or seeds) The vegetable oils are highly refined and inflammatory. They contain easily oxidized omega 6 fats that feed the production of inflammatory mediators in your body and create oxidized LDL leading to atherosclerosis.

Exercise daily, preferably outside in a green space. Twice per week spend 20-30 minutes  doing resistance training (lift weights, work against the resistance of bands, use your own body weight doing pushups, pull-ups etc)

Reduce stress with mediation, yoga, tai chi, dancing, engaging in fun sports and social activities. Walk on the beach, by a lake, river or stream, in the woods, listen to music.

Get some sunshine regularly especially during the morning to get your circadian rhythm in order and to produce adequate amounts of vitamin D.

Spend time with family, friends and colleagues who are supportive and fun to be around.

Sleep in the dark.

Get at least 7 hours of sleep per night. Avoid TV, computer screens and other electronic devices for at least 2 hours before bedtime.

Unplug from the internet, email, etc on a regular basis.

We evolved as hunter-gatherers.

Peace

Bob Hansen MD