| Ideal Weight 101 From the beginning of my medical training I have heard that people are unable or unwilling to follow common-sense advice regarding diet and exercise. I have seen far too many successes and failures to believe that this is universally true. Clearly, there are some willing to change their outlook and subsequently their behavior. I hope to produce evidence that demands a simple "yes" or “no”. Do you choose to live more and more each day or do you choose to die? The greatest journey begins with a single step. During my internship my father had a cardiac bypass operation. He was told that he could prepare for more of the same over the next few years and that he could anticipate trouble from his heart after about five years. He asked his doctor about dietary change and what it may offer in terms of improved prognosis. He was told that no one followed a proper diet and therefore it was foolish to pursue the matter. He refused to accept that and began the “Pritikin Program” which severely limited fats to less than 10%. He remains a stubborn engineer to this day without heart problems sixteen years later. His father, similarly, adopted a nutritional program to combat cancer and survived 10 years beyond what was expected and was vital until very near the end. I’m sure you have your own stories as well. It is my hope that a simple program for the enhancement of spiritual, emotional and physical health can be adopted by people who are not in dire straits. I see the consequences of poor lifestyle choices every time I work in the emergency department and have determined that few come there to have their lifestyles appraised and improved. It troubles me to know that there are few resources even for those who desperately want to make a change. Ideal Weight 101 is a collaborative effort by my wife, colleagues and myself to be a part of positive change in the lives of all those we touch. Welcome aboard. Perceptions and Reality Truth never changes. Science continues to “advance.” Marketing has played an ever-increasing role in the making of public and scientific opinion. From video news releases (VNRs) to classroom content on “Channel ONE” the impact of advertising cannot be avoided in daily activity. Corporate sponsorship of entire cities has been accomplished. A mile-long satellite streamer had been planned to reflect a logo the size of the moon until the public outcry became too intense! The volume and pervasiveness of marketing can be understood in light of some really interesting examples:
Would an expert medical opinion be of some benefit? Medical opinion is often formed from collected data in peer-reviewed journals. Every other page and sometimes three and four-in-a-row are advertisements for patented medications. Advertising to the public and professional world has increased to the point where illnesses seem to be a deficiency of drugs. This is obviously ridiculous. When watching certain ads it seems that the only way to true happiness is with a “new and special chemical” in your bloodstream! These ads are meant to create a sense of peacefulness or harmony. Your responses to environmental cues are probably linked to marketing in some way. Resisting these programmed responses will be one of the keys to freedom from poor food choices. How Sweet it is! Sugar is so prevalent in our food supply that it is difficult to avoid it unless you are very careful. Awareness of the scope of the sugar problem is critical. Beyond the basics like tooth decay and worsening of diabetes the contribution of simple sugar to disease is immense. The short list goes something like this:
Graceful Aging Like making peanut brittle, oxidized or ”cooked” sugar makes a solid brown mass that is quite resistant to breakdown by the body’s systems. When it is “stuck” to the end of a protein it forms a “glycoprotein.” This deformed protein is responsible for creating biochemical havoc and accelerating unhealthy aging. Once formed, these proteins are difficult to remove. Avoiding their formation is the only reliable way to maintain healthy cell structure and function. Inflammation The immediate response to sugar includes a spike in insulin levels. This triggers multiple negative responses in the immune system. Reduced resistance to infection, increased production of inflammatory chemicals and massive oxidative stress are some of the consequences. Simple sugars are absorbed rapidly from the gastrointestinal tract and are uninhibited by fiber found in whole foods. A rapid increase in insulin levels is followed quickly by a drop in blood glucose as sugar is forced into the cell. This requires glucagon secretion from the pancreas, further depleting stress reserves. Using “Good Fats” can dramatically alter the expression of insulin-induced immune dysfunction. Using a 2:1 ratio of Omega 3:Omega 6 fats has been shown to reduce this inflammatory activation. Fat Storage Insulin levels cue the receptors on the fat cell to store or release fat. Sustained high levels of insulin in response to simple sugar intake have been shown to maintain fat in the cell. Fat cells also become insulin resistant and become biochemically possessive of their previously stored calories. Through proper food selection and exercise receptors on the fat cell can be brought back to life and respond to normal insulin cueing. Human Growth Hormone Human growth hormone (HGH) is rapidly converted to insulin-like growth factor (IGF-1) and has clear implications in the development of healthy lean muscle tissue. Sugar intake spikes insulin levels and subsequently IGF-1 is less readily used to improve metabolic activity in favor of muscle gain. Fat deposition is enhanced in the presence of excess insulin. Large muscle exercise will enhance the natural output of HGH and reduce the impact of insulin resistance. HGH releasers can increase these levels even further and can be helpful as part of an overall strategy. Complex Carbohydrates Small amounts of complex carbohydrates (1-2 ounces) can significantly reduce sugar cravings. High fiber carbohydrates are more effective in the improvement of insulin levels. Fresh whole foods usually contain ideal amounts of fiber. Those foods that may have lower than ideal levels can be improved by taking fiber supplements with them to slow the release of sugar into the circulation. A 12 - 16 ounce glass of high quality water should always accompany fiber supplementation. Thyroid This is my favorite. Dieting by the many methods of lowering calories has a tendency to depress thyroid function. Stress associated with dieting also tends to block production of active thyroid hormone. A low body temperature, feeling “chilly” all the time and many other symptoms suggest low thyroid function. By taking your morning temperature according to the basal body method you’ll be able to identify most diminished metabolic activity. I can’t pin this one on sugar except for the stress on the system that sugar invariably creates. Most of the negative impact on the thyroid gland comes from environmental toxicity, hormones in foods and social and job stress. Adrenal Your stress response is dependent on a functioning adrenal gland. Sugar consumption exhausts the reserves of the gland by constantly requiring adrenaline and steroid output. These demands leave the victim feeling drained and incapable of high-intensity output (emotionally and physically). Without proper adrenal output the thyroid cannot adequately do its job. The result is catastrophic reduction in energy output and chronic fatigue. Adrenal supplementation can restore normal sleep patterns, decrease cravings and enhance energy production. The Appestat The appestat is the regulator of hunger and satiety (satisfaction with food). The normal sensation of hunger comes from the body’s need for fuel. The stomach is empty, the insulin level has been baseline for some time and the system is beginning to dip into fat reserves for fuel. The feeling of satisfaction or fulfillment comes from the brain’s satiety center. This has less to do with hormones and chemistry than it does with the perception and appreciation of food. This is the reason that the most desirable foods MUST be eaten. Without this simple requirement being met you will stay hungry most of the time no matter what other things you do. The hormonal system works to provide a precise signal when the body needs more fuel. Most of us have damaged the sensitivity of our hunger system to the point that it needs rehabilitation. This occurs through several mechanisms. By reducing the stress associated with sugar consumption the remainder of steps seem easy by comparison. Tediously slow chewing reprograms the neurological system of the temperomandibular joint (TMJ). Resting to evaluate stomach fullness resets the neurological systems of stomach feedback. Highest choice food selection reprograms the vital satiety center so that satisfaction is reached early in the feeding process. You have been programmed to eat more because “it’s late” and to drink milk because “it does a body good.” I invite you to step up to the controls and do some programming of your own. Eat food you love because you love it. Chew slowly to savor every delicious morsel of your favorite foods. Stop eating when you are comfortable. Enjoy the freedom of eating what you really want while working towards true satisfaction and freedom. Red/Yellow/Green To simplify the biochemistry and give a clear picture of how the levels of hunger work we’ve decided to give a traffic-light analogy. When insulin levels are high and the blood sugar level is still receding emotion drives the decision to eat. This is the red-light level. Fueling at this point provides nothing that won’t be a problem again in 10-15 minutes when the blood sugar begins to ramp down again. Yellow light level is part-way there and associated with more solid cues like “lunchtime.” The programmed responses to these types of cues should be checked against a more reliable indicator like a sense of stomach emptiness or tightness. Eating at this point will reduce the body’s attempts to restore insulin sensitivity to the fat cell and reduce energy consumption from fat storage. Green light level eating will improve your physiology. Your favorite food choice will meet your emotional/satiety center needs and the influx of fuel will leave your body prepared to function at its peak. You’ll be able to bridge this level with suggested snacks if your hunger peaks to a green level before it is convenient to undertake a normal meal. The “Furies” (Green and ½) exist beyond the traffic lights. This is outlaw territory. At this point it is hard to take a slow pace and reset your appestat. Wolfing food down and breaking down new programming are frequently the consequence of such action. Don’t wait to eat when you are literally starving. Be prepared with appropriate snacks! The single greatest decision to improve health and increase your energy level is easily within your reach. In fact it is only as far away as the sugar bowl. Eliminating processed foods is difficult with so many available in every part of our lives. Eliminating sugar is the key to getting the process started. The benefits are nearly universal and within a week of quitting sugar the withdrawal symptoms fade away and become less and less bothersome. The Great American Diet History Barnes and Noble love the diet industry. Every major publisher has a warm and fuzzy feeling when they see the words weight and loss in the same sentence. The books and articles abound. The lasting results apparently do not or there would be no need for this year’s greatest diet trend. As a nation we have become 20-30% more obese since the 1970’s. The low-fat craze was beginning to swing into high gear about that time. The conditions were ripe for a “revolutionary” new plan that was hip and “earth-friendly.” Thus, the low-fat diet boom was launched. The number of books on diet increases annually. The number of fat people increases annually. I conclude that diets cause people to be fat. Some of the myths of low-fat dieting include “eating all you want without gaining weight.” The problem is that most people never get enough of low-fat foods to ever feel satisfied. So they continue to pile on the carbs in a vain attempt to be sated. Insulin levels increase in normal individuals until the only possible outcome is obesity. The Journal of the American Medical Association in its January 16th 2002 issue claimed that “Metabolic Syndrome” needed to be addressed before we have a public health crisis on our hands. The first step in their recommendation was to increase reimbursement for education. I suggest we should increase doctor’s awareness of the causes of the “Syndrome” and then educate the public. Unfortunately, the medical establishment holds to the belief that low-fat dieting is the best solution to the problem. Despite the mounting evidence to the contrary the reduced-carb approach has not held sway in any recent discussion in any peer-reviewed journal. I do have good news. You can make your own choices about how you want to look and feel. The following diet resources can be found in any good bookstore. In addition to these resources we will try to provide an adequate basis for you to make some decisions about which foods would be the best for you and your family. Fats, Carbohydrates and Protein (Macronutrients) Our food is primarily composed of living matter that derives energy through photosynthesis. Every creature that doesn’t actively photosynthesize is a beneficiary of the process. All living organisms that have a cell wall must contain the three macronutrients. Any “living food” will have a ratio of these three that will determine caloric and nutritional values. All of the macronutrients should be included in an eating plan that can be maintained as it is “tuned up” to meet individual needs. A brief discussion of the macronutrients will help to demonstrate their usefulness in managing the flow of energy through eating. The “Paleolithic” or “Stone-Age” diet is highly restrictive and revolves around the theory that you were designed to eat foods that would have been eaten by our ancestors 40,000 years ago. Ray Audette has written a book called “Neanderthin: Eat Like a Cave Man to Achieve a Lean, Strong, Healthy Body. This book sums up the whole process. I know some very disciplined folks who have done well for a short while on this diet. The Atkin’s Diet is well known to any having plied the waters of weight-loss wonderment. He has a very potent method for rapid weight loss and has popularized the low-carb approach more than any of his peers. His diet is based on the theory that ketosis (shifting to fat-burning metabolism) causes the body to conserve muscle and lose excess adipose tissue. This is true for some and probably not attainable for others. I have known many dieters who have been unable to reach the point of ketosis despite their best efforts to limit their carbohydrates. His disregard for food toxicity is my major “beef” woth his program. The goal of weight loss should not come at the reduction in overall health. Protein Power, by MD’s Michael and Mary Dan Eades, is a more rational approach to the same kind of carbohydrate lowering. Ketosis is not a goal and the biochemical benefits are clearly explained in their well-written book. They have excellent case studies to document the cholesterol lowering benefits and overall health increases in their subjects. Sugar Busters is a great simple book by some doctors out of New Orleans that know both food and the benefits of low-carbohydrate eating. The GO-Diet is a variation on Protein Power and has some great points about monounsaturated fats, live-culture milk products and fiber. A clinical biochemist and intensivist developed the program and tested it in a Chicago community hospital with patients losing 20 pounds in about 12 weeks. You can download your own copy at go-diet.com for free! When you feel inspired to look into the hundreds of other diets I recommend Ornish and Pritikin as the Pioneers of low-fat. They are the best in their field. Some "General Guidelines"
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