Weight loss has become a national obsession in America.
As many as 40% of women and 30% of men in the US are trying to lose weight at any given time through different diets, special dietary supplements, exercise, behavioral modification, and prescription drugs. The World Health Organization estimates that over 300 million adults are obese worldwide and obesity in the United States is increasing at an alarming rate. The prevalence of obesity has increased in the United States over the past few decades.
In a National Health and Nutrition Examination survey, conducted between 2007 and 2008, the prevalence of obesity among adults to 33.8% and the prevalence of overweight or obesity increased to 68%. Among children participating in the survey, from 1999 to 2000, the prevalence of overweight or obesity was 15.4% in children, but this has increased dramatically over the last several years.
It is alarming because excess weight has been linked to a number of health problems
,including high blood pressure, heart disease, stroke, diabetes, gallbladder disease, and respiratory conditions, as well as breast, endometrial, and uterine cancer in women and cancer of the colon and rectum in men. In fact, 85% of type 2 diabetes cases are attributed to obesity, along with 45% of hypertension, 35% of heart disease, and 18% of high cholesterol. Obesity has also been shown to result in decreased lifespan for both men and women and may be a contributing factor in as many as 300,000 deaths per year.
About 65 billion is spent each year on health complications related to obesity. The direct economic cause of dealing with excess body fat in the United States is estimated to be at approximately 100 billion dollars a year.
ARE YOU OVERWEIGHT?
You will probably know if you are overweight. Your clothes seem a little tight or your body just feels bulky or uncomfortable to you. A quick look in the mirror may confirm the extra pounds. I like to use the Body Mass Index, or BMI. Calculating your BMI is another way to determine if you are overweight with a little more precision than the height/weight charts. The BMI is a ratio of your weight to your height and is based on the metric system. The higher your BMI, the greater your health risk.
Physicians generally consider a BMI between 20 and 25 to be acceptable. Those with a BMI of 27 up to 30 are considered overweight and at a higher risk for weight-related disease. Those with a BMI of 30 or higher are considered obese. In addition to this, I like to check the percentage of body fat using a bioelectric impedance device. In this device, a small electric current is passed through the body and, because fat tissue is a poor conductor compared to lean body mass, the percentage of fat in the body can be estimated.
CAUSES OF OBESITY AND WEIGHT GAIN:
Obesity is a complex interaction among culture, environment, exercise, genes, eating styles, and biochemical individuality. Please remember that individual metabolism is inherited and created by lifestyle, diet, and exercise. Living in the consumer culture of the United States, not only are we eating more, but also the kinds of foods we consume. Fast foods, processed, high fat, high sugar offer the least nutrition and the most potential for adding fat to our hips.
FOOD AS INFORMATION, FOOD TALKS TO YOUR GENES
Food contains hidden information, information that is communicated to your genes, giving your metabolism specific instructions on what it should be doing. Some of the instructions food gives are lose weight or gain weight, speed up or slow down the aging process, increase or decrease your cholesterol, and possibly produce molecules that increase or decrease your appetite. The kind of food you eat gives your genes different information, helping you make better decisions, so remember, food talks to your genes. The new science of nutrigenomics teaches what specific foods tell your genes.
We need to eat in harmony with our genes because each of us starts with a different set of DNA. I have begun ordering in the office genomic profiles based on what types of foods to eat. This helps the patient understand his metabolism and dietary traits as well as optimizes effective physical activity and exercise and enhances the nutritional benefit of the diet. No marker does one diet fit all
. The diet is personalized to genetics. The way we eat, how our body processes food, and overall health are impacted by our genes. Studies have shown that consumption of certain foods and nutrients may turn on or off certain genes. Eating behaviors have much effect on our health and some of our behaviors are influenced by our genetics. Certain genes are associated with certain eating behaviors, such as excessive snacking and difficulty feeling full. With this information, I modify the patient’s lifestyle to achieve ultimate wellness.
Food reactions are also important and genes play a role in this. This is associated with caffeine metabolism, bitter and sweet taste sensitivity, as well as lactose intolerance and alcohol flushes. Nutritional needs are also addressed through gene testing. Your genes can also be tested and they can affect how you respond to exercise, your chances of losing weight, improving your cholesterol, and other health benefits.
There are also genetic markers now available to test that show your tendency to regain weight after losing it as well as your predisposition for obesity. Of course, metabolic factors are also checked because these genes may lead to various health conditions including coronary artery disease, stroke, type 2 diabetes, and many others.
I believe there should be a comprehensive approach, with a personal guide and lifestyle change. You should eat according to your genes. Some people do better with low fat, some people do better with low carbohydrates, and some people do better with high protein.
In any event, I believe all calories are not created equal and that food is information for your genes and that this information changes your metabolism and can increase or decrease your weight. In a whole food diet with high fiber, beans, fruits, nuts, and seeds as well as quality protein, such as beans, fish, lean poultry, and healthy fats such as fish oil, extra-virgin olive oil, avocado, olives, coconuts, nuts, and seeds along with puffy carbohydrates such as vegetables and beans should be a lifelong way to eat.
Please be aware that there are good fats and bad fats.
\ There are also ugly fats. The good fats are fats that turn over your genes and increase your metabolism and help you burn fat, the bad fats lower your metabolism, and the ugly fats don’t belong there. The good fats include omega-3 fats such as in wild fish, flaxseed and flax oil, and some types of nuts.
The monounsaturated fats, as used in the Mediterranean diet, include extra-virgin olive oil, probably being the best.
The saturated fat that I do recommend is coconut oil; this is found in raw coconut and coconut milk. There is also Macadamia nut oil. I would avoid foods high in saturated fat from animal protein. The bad fats are refined polyunsaturated vegetable oil such as found in vegetable cooking oils and corn, soy, and safflower; these are unrefined omega-6. Another bad fat is most of the saturated fats found in beef, pork, lamb, and chicken. It is important to note that when you do eat from a cow or a pig I suggest organic, cleaner animals without antibiotics, hormones, or pesticides.
The ugly fat is the hydrogenated or trans fat. This is the most dangerous. It is a new manmade fat seen in margarine or shortening and developed to manufacture fake butter during the butter shortage. They are extremely toxic; they block your metabolism, create weight gain, and increase your risk of diabetes, heart disease, and cancer. They have no place in the diet of any species on the planet.
Carbohydrates are the source of sugar in our diet, our major source of energy. When you eat any type of carbohydrate, whether white flour or wild blueberries or oatmeal, your pancreas produces a master hormone called insulin. Insulin’s job is to help the sugar get into your cells. Once the sugar is in your cells, it can be turned into energy by your mitochondria. Problems occur when there is too much sugar and insulin levels rise. This is measured in all my patients. This insulin resistance has some very serious health implications and a direct impact on your appetite. It is very much like a drug addiction.
When you constantly have high levels of insulin in your blood, you develop a tolerance to it. As a consequence, your body no longer responds normally to it; hence, your pancreas produces more, elevating it more, and there is a vicious cycle.
When you have more insulin in your body than you do sugar, your body tells you to eat some sugar to even out the balance, but every time you eat the sugar you cause your insulin level to go up even more, causing you to want more sugar, and the cycle goes on. In the meantime, you are storing all the extra sugar as fat, slowing down the metabolism, promoting heart disease, dementia, and cancer. This condition is known as prediabetes, also called metabolic syndrome, insulin resistance, or syndrome X.
A key to understanding carbohydrates is the glycemic load or glycemic index
. Foods to avoid are flour, refined grains, white rice, sugar in any form, processed food, junk food, or starchy potatoes, etc. Foods with a low glycemic index include vegetables, beans, nuts, seeds, olive oil, and whole grains. You always want to eat a low glycemic load to keep your insulin levels low. Keep in mind that most good carbs come from whole plain foods.
The key to eating good carbs is eating whole, unprocessed foods.
These foods are loaded with vital nutrients. We should always consume carbs with a low glycemic load and remember that eating foods that quickly turn to sugar also make you eat more and gain more weight because it produces more insulin, which signals your brain to eat more, so choose whole, unprocessed foods with fiber in each meal. Also avoid high fructose corn syrup as well as GMO foods and artificial sweeteners except Stevia. Artificial sweeteners such as aspartame are extremely serious, destructing brain chemistry, and should not be used. Instead, xylitol or Stevia should be used.
CAUSES OF OBESITY:
Weight gain and obesity are multifactorial. The body is a complex web and, without optimal metabolism, vitamins, minerals, and detoxification as well as stress reduction and exercise, our obesity problem in the US will never be improved.
When you are chronically stressed, your hormones get out of balance and there is a serious impact on your health.
When you are introduced to a stressful situation, your body releases a hormone called cortisol. Studies have shown that when cortisol is released in the blood stream you become less sensitive to leptin.
This is a hormone that tells your brain you are full, so when this happens, you tend to eat more and create more sugar. Your weight goes up.
Furthermore, in a study of women with self-reported anxiety, there was a higher level of cortisol and cholesterol as well as lower levels of testosterone and thyroid hormone and more weight around their middle. When you are stressed, your sympathetic nervous system gets turned on and your hunger increases, your metabolism slows, and you gain weight.
This makes you fat. People who are chronically stressed have a burned-out metabolism and eventually are obese. Growth hormone, testosterone, HDL good cholesterol levels drop while insulin, blood sugar, and LDL bad cholesterol as well as blood pressure increase. These all lead to weight gain.
The problem with stress is that there is a loss of the sleep cycle, metabolic burnout, and night eating.
Sleep deprivation is another major source of stress in our modern world. Americans on the average sleep two hours less now than they did forty years ago. How does this affect metabolism? A group of researchers found that depriving healthy men of sleep led to increased grehlin, the hunger hormone, and decreased leptin, the satiety hormone. This increased their hunger and craving for calorie-dense, high-carbohydrate foods.
You need to reduce your stress level by identifying what stresses you out and eliminating it. Practice active relaxation, meditation, deep breathing, take a steam bath or take a sauna.
Another cause of weight gain is inflammation.
Being overweight promotes inflammation and inflammation promotes obesity. It is a terrible vicious cycle. More than half of Americans are inflamed, and most don’t even know it. Getting to the root of inflammation and cooling it off is the key to reducing the obesity epidemic. Inflammation is part of the body’s natural defense system against infections, irritations, toxins, and other harmful molecules. In this state, the immune system shifts into a chronic state of alarm.
With inflammation, there is increased heart disease, Alzheimer’s, dementia, macular degeneration, and many other diseases. Anything that causes inflammation can make you gain weight and any weight gain you have can cause more inflammation.
I perform a test in the office that is called a high sensitivity CRP. CRP is a protein found in the blood and it is an excellent marker of inflammation.
Did you know your own fat cells around your middle are the biggest source of inflammation? The fat cells produce hormones, which increase or decrease our appetite and increase or decrease our cortisol. The bottom line is fat cells promote inflammation, which leads to more fat cells, which promotes more inflammation, and then you are very overweight.
Turning off the inflammation is essential.
By identifying the source of inflammation, the sugar and refined high glycemic load carbs, the saturated and trans fats, we can lower inflammation. Maybe you are allergic to gluten – maybe you have food allergies – maybe you have a mold in a damp basement, or moldy bathrooms, or hidden in a wall – maybe you have fillings in your mouth, which have mercury, which causes inflammation. In the evaluation of inflammation, I not only perform a high sensitivity CRP, but at times I perform food allergy tests as well as gluten intolerance and celiac tests. Every patient’s treatment is individualized, but remember – inflammation and obesity are intimately tied together. You can reverse the process by adjusting your diet and lifestyle.
WE ARE RUSTING ON THE INSIDE: FREE RADICALS
This rust or free radicals leads to weight gain. Free radicals or reactive oxygen species cause a condition called oxidative stress or oxidation. It is commonly seen in the rusting of a car or a sliced apple turning brown. It is also responsible for wrinkles in your face, from too much sunlight over the years, but it is happening on the inside of your body and causing you to age prematurely. When it is out of control, we have fatigue, poor mental function, low resistance to infections, muscle weakness, joint pains, digestive problems, anxiety, depression, headaches, hypoglycemia, irritability, and many other symptoms.
We have to eliminate or reduce the oxidation by avoiding overeating, excessive alcohol, excessive white sugar, excessive toxic foods.
We have to reduce our exposure to toxins and petrochemicals as well as heavy metals, eliminate ionizing radiation, tobacco smoke, and reduce air pollution. Of importance is to treat chronic infections and improve our liver and gut detoxifications. Finally, reduce stress, environmental and internal molds and fungal toxins, as well as improve our breathing and oxygenation.
In my practice, I check all patients for the amount of free radicals and oxidation, because reduced oxidation results in reduced weight. By finding the cause of the oxidative stress or rust, which is primarily caused by empty calories and pollution, if we reduce them, eat plenty of oxidant-rich foods, and take our vitamins and minerals, we can go a long way to protect ourselves from free radicals. We can lose weight and live longer.
Exercise is extremely important because we can turn up our metabolic thermostat. We can burn more calories and lose more weight. With exercise, we can increase our metachondrias and our metabolic power, so you need to get moving, you need to start exercising and eat foods that will turn up your metabolism and avoid foods that will turn it down. I suggest doing interval strength training as well as aerobic training, with supplements that give us a metabolic tuneup, such as D ribose, amino acids such as arginine, NADH, Q10, alpha lipoic acid, acetyl-L-carnitine, and many others.
EATING EARLY IN THE DAY
Foods eat early in the day generally generate more energy and induce more thermogenesis, that is, fat-burning, than foods eaten later in the day. When this happens, the metabolic rate of the body is high early in the day to burn off the calories as energy, whereas the same calories consumed at night can be stored as fat. I advocate eating light after dinner or sometimes not eating after 7:00 PM. Many studies have shown that people who eat breakfast daily are less likely to be obese and are less likely to develop diabetes.
Thin people have a higher metabolic rate and burn calories much faster than do obese people. This basal metabolic rate varies tremendously between individuals and it is the minimal amount of energy needed to maintain normal body function. This is evaluated in all my patients. An insufficient thyroid gland, otherwise known as hypothyroidism, can cause the metabolic rate to be sluggish. Patients experience chronic constipation, fatigue, cold hands, cold feet, brittle nails, dry skin, have thinning hair, and use the lateral aspects of their eyebrows. They also have increased cholesterol, weight gain, body fat, and depression. Since hypothyroidism is a correctable cause of obesity, an extensive thyroid panel is obtained in my patients whom I clinically suspect of having thyroid malfunctioning.
OTHER HORMONE IMBALANCES
HEA, an adrenal hormone, has kept old animals thin and, in humans, many older individuals taking DHEA report anabolic muscle gain and fat loss. It has been shown to boost insulin growth factor, IGF-1 in humans, and this may be responsible for the fat reduction and anabolic effects. There is also a correlation between low thyroid hormone and low DHEA with increasing age. I measure all my patients’ levels and replace as needed.
A consistent finding in the scientific literature is that obese men have low testosterone and high estrogen levels. This central obesity with a pot belly is recognized as a risk factor for heart disease as well as type 2 diabetes. Raising testosterone levels decreases abdominal fat mass, reverses glucose intolerance, and reduces the cholesterol levels. Long-term factors show that individuals with low testosterone levels are at risk for developing visceral obesity. Obese men experience testosterone deficiency caused by production of an excess aromatase enzyme in the fat cells and also from the fat they consume. The resulting hormone imbalance with too much estrogen and not enough free testosterone in obese men may explain why many of them are impotent and experience a wide range of premature diseases.
In correcting hormonal imbalances, I perform testing using blood, saliva, and urine, and each patient has an individualized program according to the levels.
TOXINS AND OBESITY
Toxins from within our body and the environment both contribute to obesity. Getting rid of toxins is essential for long-term weight loss and a healthy metabolism. The toxins, I feel, are contributing to the obesity epidemic. We have unprecedented levels of toxic chemicals and heavy metals in our bodies. Why should we worry about toxins? Because every single person and animal on the planet now has toxic chemicals or metals in their tissues. Since the turn of the twentieth century, we have 80,000 new chemicals and most have never been tested for safety.
Several studies have found that we are all stewing in a toxic soup and that there is little doubt it is playing a major role in the current epidemic of obesity.
Toxins come from two places; one is our environment, which is external, and the other is our own gut, internal. External includes chemical toxins and heavy metals, the heavy metals being lead, mercury, cadmium, arsenic, nickel and aluminum. There are solvents from cleaning materials, formaldehyde, toluene, benzine, glue, drugs, pesticides, herbicides, and food additives. Many prescription drugs, particularly the psychotropic drugs, cause weight gain through various mechanisms.
The internal toxins are from microbial compounds, from bacteria, yeast, or other organisms. Bacteria and yeast in the gut also produce waste products and cellular debris that can interfere with our function. This toxic load increases inflammation and more free radicals. All of these toxins affect your ability to lose weight. Because we store most of the toxins in our bodies, gaining weight itself has kind of a toxic effect. When you burn off fat, the toxins come out and, if they aren’t processed properly, they can cause additional problems.
They can overload our system, impairing our liver and thyroid and damaging our metachondria to where they are no longer making energy.
People with a higher BMI store more toxins because they generally have more fat. Toxins interfere with metabolism, reducing thyroid hormones, and increasing excretion of thyroid by the liver. These toxins also block the thyroid receptors and interfere with transport protein. In other studies, the increase in toxins during weight loss in men inhibited normal metachondrial functioning and reduce its subjects’ ability to burn calories, further reducing weight loss. These toxins also interfere with your appetite and eating behavior. Toxins such as heavy metals block the hormone leptin and, over time, the effects of leptin are resistant and you are hungry all the time.
INCREASE YOUR DETOXIFICATION SYSTEM
You need to minimize your exposure to toxins, take your liver detoxification, your vitamins and minerals. At times, herbal remedies may work. Another way is through a far infrared sauna where you can sweat it off and eat foods that help you detoxify. Of course, avoid foods that make you toxic.
You should minimize your exposure to toxins by eating organic foods, drinking filtered water, using air filters like HEPA, cleaning and monitoring your heating system, keeping household plants, which filter the air, and avoid excess exposure to petrochemicals, such as garden chemicals, dry cleaning fumes, car exhaust, second-hand smoke, deodorants, antacids, and pots and pans with aluminum.
CONSIDER TESTING YOUR DETOXIFICATION SYSTEM
In looking at the toxins, I perform in the office a genetic test of the detoxification pathway, using single nucleotide polymorphisms (SMNP), a special test for the genes that regulate our ability to eliminate toxins. You could also measure your detoxification enzymes as well as looking at heavy metals that are in our bodies. Remember, some people are genetically predisposed to detoxifying more easily than others. The good news is this can now be checked and a personalized program can be made to do something about your detoxification.
THE NEUROTRANSMITTER CONNECTION
I believe that neurotransmitter balance is essential to any weight loss program, specifically, targeted amino acids are used, which are natural products to achieve balance in the brain, so you are in control, not the Haagen-Dazs ice cream.
The obesity epidemic is growing at an alarming rate in this country. As outlined above, obesity is multifactorial, resulting from the interplay of genes and environment. If you wish to learn more about my program and have individualized testing, please call my office. I use an FDA medical food as well as a synergistic blend of amino acids, vitamins, minerals, and herbs. Of course, stress reduction, exercise, and hormonal balance are also implemented to achieve permanent, lifelong weight loss.