Meat and Homocysteine- Irrelevant or Dangerous?

Do we have to avoid meat if we have high homocysteine levels? Not really.

 

What our body does with homocysteine is more important than our food intake. I thought this was easier to explain in video form, so you can see my 4 minute explanation here:

The bottom line is we need to know our methylation status, make sure we have adequate levels of folate, B12 and B6, and make sure we have adequate choline (found in egg yolks).  If all those are perfect, and we still have elevated homocysteine, then we may want to experiment with a diet low in methionine to see if it makes a difference.

 

As always, however, we have to evaluate our overall health picture and not get too hung up on one blood marker. The more important questions to ask are how does homocysteine affect my overall health, and how will altering my supplements or diet change the big picture?

 

Hopefully this helps! Let me know if you have any comments or questions.

 

Thanks for reading (and watching!)

Bret Scher MD FACC

Low Carb Health and Fixing Our Broken Healthcare Experience Webinar

We had an incredible turnout for our Webinar, aimed to help you transform your health in 2019. As a result, we decided to create a blog post that includes the full webinar recording, as well as an overview of the learnings for those that were unable to attend.

Webinar Recording

Webinar Overview

Cardiovascular Disease Is the #1 Killer for Men and Women

  • 1/3 of all Americans die from Cardiovascular disease
  • Around 92 million Americans are living with CVD
  • Every 34 seconds someone suffers a heart attack
  • Annual health expenditure and lost productivity from CVD ~$330 billion

It’s been estimated that 50-80% of these are preventable! Unfortunately, our healthcare system and associated lifestyle guidelines have failed to prevent disease. We could say at best they have failed to prevent heart disease, obesity and diabetes. At worst they have been implicit in its prevalence. While this graph doesn’t show causation, it certainly shows the association of instituting national nutritional guidelines and the rise in diabetes.

Drugs Don’t Fix the Problem

  • 60% of Americans take at least 1 prescription drug
  • 15% take more than 5 drugs
  • Despite this, our overall health and life expectancy continue to decline

HEALTH IS NOT THE ABSENCE OF DISEASE!

In this webinar, we will discuss how to be your own best advocate, why low carb, high fat nutrition should be an option for everyone, and how lifestyle really is the best medicine.

3 Interventions to Improve your Healthcare Experience and Be Your Best Advocate

  1. Make sure your doc is working with accurate information! Lipids and blood pressure are two prime examples of when doctors make decisions based on limited and faulty information.
  2. Get your questions answered by writing them down ahead of time so you don’t forget anything and tell your doctor at the beginning of the appointment that you have some questions you’d like to ask at the end.
  3. Make sure you understand the purpose and benefit of each and every medication. Not some vague answer like “It will improve your cholesterol,” or “It will lower your blood pressure.” Rather, “what impact will it have on my longevity and quality of life?” Will I live longer? Will I feel better? What are the chances the drug will actually benefit me? These are the questions we need answered.

Why Low Carb, High Fat Nutrition Should be an Option for Everyone!

LCHF vs Low Fat Diets

LCHF Benefits

  • Decreased hunger, increased energy, mental clarity
  • Treats metabolic syndrome/insulin resistance
  • Better weight loss
  • Improves overall cardiovascular risk for most people

LCHF may not be the best for everyone, but it certainly should be an option for everyone. If you want tips that do work for everyone, follow these bonus tips for weight loss and overall health!

  • Don’t drink your calories – even “natural” drinks are full of unnecessary calories. Think about it this way, you would drink a glass of orange juice, but would you really sit down eat the 5 or so oranges it takes to make it? If not, why drink that same amount?
  • Get rid of “Food Delivery Systems” – Think about the big sandwiches or burritos we see everywhere in our culture. What is the food? The stuff in the middle! The meat, the cheese, the veggies. What is the unnecessary food delivery system? The bread, the tortilla, the outer layer that has a fraction of the nutrients and a multitude of the carbs!

Lifestyle Really is the Best Medicine!

Science says lifestyle, not drugs, reverse disease:

  • NEJM study reported findings on patients at highest genetic risk for heart attack, over 90% more likely to suffer heart attack. Those with healthy lifestyles had a 50% reduced risk with no drugs and no surgeries!
  • JACC study found 85% of all heart attacks could be prevented with greater attention to lifestyle.
  • A 2018 British Journal of Sports Medicine study found that increasing walking pace to “brisk” for those over 50 reduced all-cause mortality and cardiovascular mortality by 20-24%.

Why is it so hard?

We have all been told that in order to be healthy, we need to eat less, move more, and reduce fat in our diets. But if that is the case, why is it that only 12% of Americans are metabolically healthy, and only 3% of Americans follow a healthy lifestyle?

Because the simple Eat Less, Move More, Reduce Fat approach DOESN’T WORK!!!

I want to assure you that it’s not your fault, you’ve been given the wrong information.

“I was always told I simply didn’t have enough willpower to stick to a diet. I couldn’t understand why I was always hungry and craving foods. I figured it was all genetics. But working with Dr. Scher showed me there is a better lifestyle that I can stick with and still feel great and enjoy my life! Thanks Dr. Scher!”

  • E

Keys to Making Lifestyle Change Stick

  • Beware of one-size-fits-all nutrition and lifestyle claims
  • Individually tailored and flexible nutrition is the key.
  • When you eat is just as important as what you eat
  • Move your body more
  • Get Serious about your sleep
  • Don’t be afraid to test and adjust

A Word of Caution

Don’t try to Change Everything at one time.

Choose YOUR most important first step (nutrition, stress, fitness, etc.) and work on that until a new habit is created!

And remember, you don’t have to do it alone! Working with an expert who can help you on your health journey will increase your likelihood for long term success.

As you can see, this was a quick tour to highlight the main points in the webinar. To get the full benefit, I recommend watching the full recording to get all of the context and be able to see the Q&A session at the end.

If you want to get the full experience, here is that recording again:

If you’d like to see the date and content of our next webinar, or be notified when our next webinar will be, please visit our Webinar Page.

I hope you enjoyed this recording, and that we will see you at the next live webinar!

 

Thanks for reading,

Bret Scher MD FACC

The Great Misunderstood High-Density Lipoprotein

What do I mean by “misunderstood?” Look no further than the common misnomer of “good” or “bad” cholesterol.

Good and Bad Cholesterol

While it may be true that High-Density Lipoprotein (HDL) has potentially beneficial functions (reverse cholesterol transport), we have to remember there is no such thing as good and bad cholesterol. The cholesterol carried by HDL is the same as that carried by LDL. The only thing that makes it good or bad is if it ends up synthesizing our hormones or bile acids (good), or if it ends up in our vessel walls (bad).

If it’s true there is no such thing as good and bad cholesterol, why do we care about our HDL levels?

First, let’s start with the basics.

HDL is the smallest and most densely packed lipoprotein and has one or more ApoA protein on its surface. HDL can help lipids move around in circulation by accepting triglycerides or cholesterol from other particles, thus helping a VLDL turn into an LDL, or helping an LDL contain less cholesterol (turning a small dense LDL into a less densely packed LDL).

Like LDL, HDL transports cholesterol to the liver for recycling or excretion, or to the hormone producing cells like in the adrenals. Unlike LDL, HDL does not have the potential to get retained in the vascular wall and does not, therefore, contribute to plaque formation. In fact, functioning HDL can remove cholesterol from the vessel wall, thus putting it back into circulation and possibly removing it from the body.

Back to the question at hand.

 

Why should we care about HDL levels?

Early epidemiological trials showed that lower HDL levels were associated with a higher risk of cardiovascular disease and even death.  With such a strong association, the medical profession promoted elevated HDL levels as protective and low levels as something we need to avoid.

Since these were observational epidemiological studies, they do not prove that the low HDL caused the problems, only that HDL was associated with it. For instance, HDL is also known to be low in diabetes, metabolic syndrome and insulin resistance. It may, therefore, simply be a marker of underlying metabolic dysfunction that contributes to increased risk.  Yet, HDL’s function in reverse cholesterol transport, and its ability to remove cholesterol from vessel walls suggests a more direct impact on cardiovascular health.

It is also important to note that the Framingham data suggested that increased cardiovascular risk with elevated total cholesterol and LDL-C was lost in the presence of high HDL. In fact, very low levels of LDL combined with very low HDL levels had a much higher risk than markedly elevated LDL levels when combined with elevated HDL.

Thus, HDL proves to be a useful marker to help predict cardiovascular risk. For instance, one large meta-analysis showed that total cholesterol/HDL ratio was a much stronger predictor of cardiac mortality than total cholesterol alone.

In addition, the PURE study, an observational trial in over 135,000 subjects, showed that when considering lipid changes brought about by nutritional changes, ApoB/ApoA1 (essentially LDL-P/HDL-P ratio) is the best predictor of clinical outcomes.

Thus, HDL level is important in assessing cardiovascular risk.

 

Drugs Muddy the Picture

While HDL may be a good predictor of risk, raising it with drugs does not seem to confer added benefit.

For instance, cholesterol ester transferase protein inhibitors (CETP inhibitors) significantly reduced LDL by 20-30% and increased HDL 100-fold, yet showed either no clinical benefit or even worse, an increased risk of death.

This was a shock to many in the lipid world as the notion of “good” and “bad” cholesterol would clearly predict lowering LDL and raising HDL would confer dramatic health benefits. So much so, that multiple pharmaceutical companies invested hundreds of millions of dollars developing these drugs only to abandon them when the trials showed no benefit.

Part of the issue is that not all HDL lipoproteins function the same. There are subsets of people with genetically determined markedly elevated HDL levels who have an increased risk of CVD. They may have plenty of cholesterol circulating in HDL particles, but the HDL particles are dysfunctional and therefore  do not effectively remove cholesterol from vessel walls or LDL and do not effectively transport it to the liver. Conversely, there are those with a specific genetic mutation called ApoA1 Milano who have very low HDL-C and lower cardiovascular risk.

Simply measuring the HDL cholesterol content, therefore, may not accurately reflect its function. While we do not have easily available tests to measure HDL function, we can potentially use HDL particle assessment as well as the company it keeps (i.e. low triglycerides, larger less dense LDL particles) to better assess the potential benefits of HDL. Thus, if there is any concern about potentially dysfunctional HDL, I usually recommend advanced lipid testing to see the specific subtypes of HDL.

What can we conclude from all the HDL confusion?

Raising HDL with drugs does not reduce cardiovascular events, yet having a naturally low HDL is associated with increased risk.

The best answer, therefore, is to live a lifestyle that helps you have a “not low” HDL level. This means first and foremost avoiding the medical conditions associated with low HDL (i.e. insulin resistance, diabetes, and metabolic syndrome).

Textbooks predictably state the interventions to naturally raise HDL include exercise and moderate alcohol intake. Unfortunately, these have minimal effects. In fact, they pale in comparison to a low carb high fat lifestyle. In my 20+ years in the medical field, I have never seen an intervention as effective as LCHF in raising HDL, and the studies agree.

This brings us back to our question once again.

Why are HDL levels important?

HDL levels are important because it is a reflection of our underlying metabolic health and our lifestyle. A properly constructed LCHF lifestyle lowers triglycerides, raises HDL, and reduces the small dense LDL, among other benefits. Such a lifestyle likely reduces overall cardiovascular risk and will likely be shown to improve longevity and health span. While HDL may not be the main reason for this, we can’t ignore its role simply because it is more nuanced than “good” and “bad” cholesterol.

My advice, therefore, is to see the whole picture. Embrace the nuance. And make sure you get a thorough and proper evaluation of your cardiovascular risk.

If you are hungry for more, I created my Truth About Lipids program, a program focused on Cholesterol, to help break through the confusion and provide you with everything you need to thoroughly understand cholesterol and its impact on your health.

Learn more: Truth About Lipids Program

 

If you still have questions, you may want to consider a one-on-one health coaching consultation so you can get the individual attention you deserve  with a thorough assessment of your lifestyle and its impact on you as an individual.

Please comment below if you have any questions or comments that may help further the discussion.

Thanks for reading.

Bret Scher MD FACC

Is a Low Carb High Fat Diet Heart Healthy?

We hear the words Heart Healthy a lot, especially when it comes to our nutrition.

 

By now, you’re likely used to seeing cereals with the “heart healthy” moniker. Is it really heart healthy? We all too frequently refer to foods as “heart healthy”, or we say that our doctor gave our hearts a “healthy” checkup.  

 

It all sounds nice. But what does it mean? How do we define heart health?

 

How does LDL Cholesterol affect Heart Health?

 

Unfortunately, most of our current definitions center around LDL cholesterol concentration.  While LDL cholesterol plays a role in heart health, it by no means defines heart health in totality.

 

In fact, in many cases it is the least important factor.

 

Our healthcare system has simplified things too much, so as a result we focus on one bad guy, one demon to fight. In reality heart disease is caused, and made more likely to occur, by a constellation of contributing issues.

 

Elevated blood sugar, elevated insulin levels, inflammation, high blood pressure, poor nutrition, and yes, lipids all contribute to heart health.  It does us all an injustice to over simplify it to one single cause.

 

What food is heart healthy?

 

Our superficial definition of cardiac risk is how industrial seed oils containing polyunsaturated fatty acids (PUFAs) became known as “heart healthy.”

 

Studies show that they can lower LDL. But they can also increase inflammation and have no clinical benefit and even increase risk of dying. According to our simplified definitions, that doesn’t stop them from being defined as “heart healthy.”

 

 That’s right! Something that increases our risk of dying is still termed “heart healthy.”  How’s that for a backwards medical system?!

 

Same for blood sugar. If you have a diagnosis of Type 2 Diabetes (DM2) that is a risk for cardiovascular disease. If you don’t have the diagnosis, you are fine. That ignores the disease of insulin resistance that can predate diabetes for decades and increases the risk of heart disease and possibly even cancer and dementia.

 

Cereal can also be called “heart healthy” as they may minimally lower LDL. But is that a good thing if they contain grains that also worsen your insulin resistance and metabolic syndrome? I say definitely not.

 

Time has come to stop this basic, simplified evaluation and start looking at the whole picture.

 

How Low Carb High Fat Diets Improve Heart Health

 

Low carb high fat diets have been vilified as they can increase LDL. But the fact of the matter is that it does so only in a minority of people. The truth is that they can improve everything else!

 

These diets reduce blood pressure, reduce inflammation, improve HDL and triglycerides, and reverse diabetes and metabolic syndrome! Shouldn’t that be the definition of “heart healthy” we seek? Instead of focusing on one isolated marker, shouldn’t we define heart health by looking at the whole patient?

 

Only by opening our eyes and seeing the whole picture of heart healthy lifestyles can we truly make an impact on our cardiovascular risk and achieve the health we deserve.

 

Join me in demanding more. Demand better.

 

Thanks for reading,

Bret Scher, MD FACC

Blood pressure medications — friend or foe?

The medical world experienced yet another guideline update in 2018 telling doctors more medication is better. This guideline for treating hypertension was put out by the American College of Cardiology and the American Heart Association, and effectively lowered the definition of hypertension from 140/90 down to 130/80. The organizations also recommended drug treatment for all individuals with blood pressure greater than 140/90, regardless of underlying risk.

Unfortunately, this seems like a common scenario — medical guidelines recommend more aggressive medication use for minimal potential benefit despite potential harm. A new study published in the Journal of the American Medical Association (JAMA), suggests the blood pressure guidelines go too far for low risk individuals, and the risk of harm outweighs the potential benefits.

JAMA: Benefits and harms of antihypertensive treatment in low-risk patients with mild hypertension

The JAMA study was an extensive chart review of over 38,000 patients at low risk for heart disease who had stage two hypertension (blood pressure between 149/90 and 159/99) and were treated with blood pressure medications. Over an average follow-up time of almost six years, they found no reduction in the risk of cardiovascular disease events or risk of death with medication use. They did, however, find an increased risk for low blood pressure, fainting, and acute kidney injury among those treated with medications.

Based on these results, treating stage two hypertension in low risk patients tends to cause more harm than good.

What makes this study valuable is that it documents real world experience. Guidelines are frequently made from trials conducted with more aggressive follow-up and monitoring than is typical in usual care. That fuels the medical community’s perspective that drug interventions are the best course of care, which is why we need more studies like this one from Dr. Sheppard et. al. showing us how low risk patients probably do not benefit from drug therapy in real world scenarios.

Instead of reaching for drugs, we should continue to find the most effective lifestyle interventions to help lower blood pressure and reduce cardiovascular risk without a laundry list of side effects. Unless, of course, you consider losing weight, having more energy, and feeling great as side effects — those are the type of side effects (from low-carb eating) that we all can embrace!

Thanks for reading,
Bret Scher, MD FACC

 

Originally Posted on the Diet Doctor Blog 

High LDL cholesterol may protect against dementia – don’t tell the statin pushers!

Don’t tell the statin brigade, but elevated LDL cholesterol may actually help us as we age!

new study from China suggests that those with higher levels of LDL-C have a lower incidence of dementia. They evaluated 3,800 subjects with a mean age of 69 years, performing extensive neuropsychological and cognitive ability testing. They found that the diagnosis of dementia and cognitive impairment correlated with increasing age, decreasing education level, diagnosis of type 2 diabetes, and being an ApoE4 carrier. After controlling for all these factors, they also found that those in the highest tertile of LDL-C (>142 mg/dL or 3.7 mmol/L) had a 50% lower incidence of dementia than those in the lowest tertile (<110 mg/dL or 2.9 mmol/L).

Frontiers in Neurology: High low-density lipoprotein cholesterol inversely relates to dementia in community-dwelling older adults: The Shanghai aging study

These findings are consistent with a prior study (also observational) examining the Framingham Heart Study data that found lower risk of dementia in those over 85 years old with higher cholesterol levels.

In fairness, these studies were observational studies, so they do not prove higher LDL-C directly protected against dementia. We can hypothesize why higher levels of LDL-C are associated with lower incidence of dementia. It could be a marker of overall health or nutritional status, it could be that LDL-C directly improves the health of neurons and prevents brain atrophy, or it could be more related to lack of diabetes or ApoE4 status for which a study may not always completely control.

Even without proving causation, these studies are wonderful reminders that we can easily get caught up in one specific disease processes (i.e. cardiovascular disease) and forget about the rest of the patient. The old joke is that when the surgeon talks to the family after a complicated and risky coronary bypass surgery, he says, “The surgery was a great success. The grafts were perfect, and the anastomosis were flawless, some of the best I have ever done. I’m sorry the patient died, but the surgery was wonderful.”

This is a fictional over-exaggeration, but it makes my point.

Cholesterol’s effects on our health are far too intricate to simply label LDL-C as “bad” and leave it at that. Such oversimplifications harm our overall understanding and eventually harms our health.

Instead, we need to focus on the whole patient, not one specific outcome. Trials should focus on all-cause mortality and overall morbidity rather than one or two specific outcomes. It doesn’t do us much good to lower heart attack risk by 0.5% over five years if we are also increasing the risk of dementia, cancer or other complications.

Thanks for reading,
Bret Scher MD FACC

 

Originally Posted on the Diet Doctor Blog 

Forget Weight loss – Focus on Your Health First!

Each month, there are an estimated 4 million google searches about weight loss. 4 million!

 

On the one hand, that is an astounding number. On the other hand, considering more than one-third of U.S. Adults are obese with two-thirds overweight, along with alarming rates of growing obesity within our youth, suddenly 4 million searches seem just about right.

 

Of even greater concern, this growing obesity epidemic has coincided with increasing occurrences of heart disease, strokes, type 2 diabetes, and other chronic diseases.

 

It appears as if Google has yet to solve our obesity crisis. Why not?

 

One study suggests that Less than 3% of Americans are living a generally healthy lifestyle. Less than 3%! That means less then 3% of Americans are:

  • Performing moderate exercise for at least 150 minutes a week
  • Following a healthy diet as defined by the healthy eating index
  • Maintaining a body fat percentage of under 20 percent for men or 30 percent for women
  • Not smoking

 

It’s not lack of information that is most likely the issue. It’s the lack of attention to our behaviors and habits and our mindset regarding a healthy lifestyle.

 

We live in an impatient world that is addicted to convenience. We expect everything, from our food to our information, to be packed in a neat and convenient package for immediate consumption.

 

It is this attitude that has led many who are suffering from obesity to resort to weight loss drugs or dramatic interventions popularized by T.V. shows such as The Biggest Loser.

 

Unfortunately, neither of these options are making our society healthier.

 

Why?

 

Because weight loss by itself does not equate to better health. And because our health can’t be solved with convenience.

 

Weight loss drugs: Wrong Goal- Wrong Approach

 

Over the course of the last few years, weight loss drugs such as Qnexa, Contrave, & Lorcaserin have hit the market and have seemingly become the solution for many people’s weight loss problem.

 

But, if you dig deeper, these drugs are anything but a solution. Significant side effects, not to mention exorbitant costs, limit their efficacy.

 

Contrave (ranging from $55 to $200 depending on the plan) demonstrated 9% weight loss after 56-weeks with the most common side effect being nausea (did it work by making people feel sick so they ate less? One has to wonder).

 

Lorcaserin, also known as Belviq (starting at $213), also showed modest results. In its main study, only half of the subjects taking the drug lost more than 5% of their body weight. Once the drug was stopped, most regained the weight. The main side effect again was nausea, along with headache and dizziness. Are you seeing a pattern?

 

Lastly, a panel of FDA advisors recently voted against the approval of Qnexa. It showed a modest 5% weight loss and showed increased depression, trouble concentrating and suicidal thoughts. Hardly a path to health.

 

One of the biggest problems is that these drugs aren’t changing anyone’s behavior toward food. They aren’t changing habits or mindsets. Instead, they’re applying a band aid to the problem, creating a reliance on the drug, and ultimately helping the drug company shareholders more than your health.

 

What else can we do if drugs aren’t the answer? Unfortunately, some have taken it even further to create a surgical form of bulimia. The AspireAssist is a pump that is surgically implanted into the stomach so that you can drain out what you just ate. The studies show that it can help you lose weight. No question about it. But what about your nutrition, vitamins, energy, and quality of life? Apparently, those are less important for some.

 

These weight loss drugs and surgeries are a direct contradiction to the development of healthy habits. Habits that create and maintain our health. It may not be easy to adopt these habits, but easy rarely leads to the best results.

 

Where can America learn the healthy habits that will produce results?

 

The biggest loser? It’s society that loses

 

The T.V. show The Biggest Loser has caught the attention and hearts of the American public for years. Watching men and women shed pounds along with witnessing the emotional hurdles they overcome is a powerful representation of overcoming health struggles.

 

But there’s a lot of the story that isn’t displayed on the television screen.

 

Contestants are losing weight and following strategies that aren’t kind to their metabolism and aren’t likely to succeed in the future. Astudy done on contestants from season 8 of the biggest loser found the majority regained most or all of the weight, and they showed a significant slowing of their resting metabolism. A slower metabolism makes it that much harder to keep the weight off. In essence, their own bodies were fighting against their efforts to lose weight.

 

Here’s a more sustainable alternative

 

If weight loss drugs and rapid weight loss programs aren’t the answer, then what is?

 

  1. Focus on your entire lifestyle, not just one part

 

We frequently hear about nutrition and exercise, but paying attention to factors such as sleep and stress levels will pay huge dividends with your health and weight loss as well.

 

When your body does not respond well to stress, the increased cortisol and adrenaline hormones sabotage your weight loss efforts, and negatively impact your overall health.

 

A regular mindfulness or meditation practice is the first step in correcting your body’s reaction to stress. Over time, your stress hormone response will diminish and your body will more efficiently lose weight and restore health.

 

The same applies to sleep. A poor night’s sleep is one of the best ways to sabotage our health or weight loss goals. It creates an imbalance in our leptin (I’m full hormone) and our Ghrelin (I’m hungry hormone), thus tricking our body into feeling hungry. That usually results in snacking on nutrient-poor, processed, high-carb foods. In short, a recipe for disaster.

 

  1. Commit to consistent activity

 

This doesn’t mean exhaustive boot camps or rigorous workouts for hours each day. Don’t get me wrong, those are great too. But they are not the only goal. Instead, focus on being active in your daily life.

 

In his book, Blue Zones, Dan Buettner identified the most common habits in societies where people live the longest. Guess what? They didn’t do triathlons or run marathons. Instead, they made regular physical activity a consistent part of their lifestyle.

 

If you can do that and still get your boot camp workouts done, fantastic! If not, don’t let perfect be the enemy of good. Develop the habits that will keep you moving. Start gardening, walk to do your errands, take the stairs. You have heard these before, now you just need to start doing them.

 

  1. Be okay with losing weight slowly

 

Slow and steady truly does win the race. Rapid, extreme weight loss disrupts our hormones and can create long-lasting metabolic changes that counteract our intentions in the future.

 

Focusing on healthy habits instead of weight loss ensures that your body does not react in a counterproductive way. Slow and steady is less likely to trigger deleterious hormonal and metabolic shifts within your body. And most importantly, slow and steady is more sustainable for the long term.

 

  1. Reframe your goal

 

If you want to lose 20, 50 or 100 pounds, this can be an overwhelming task.

 

To lessen the psychological toll of such a task, it’s better to break it up into mini goals and get small wins along the way.

 

Small victories can still have health benefits.  For example, 5% weight loss in obese individuals results in improved insulin sensitivity, an important factor for diabetes, heart disease, and dementia.

 

The small wins can add up to big wins, and the ultimate goal becomes less onerous and stressful.

 

Conclusion

 

If weight loss is your goal, stop and ask yourself why. Especially if you have considered weight loss drugs or intensive rapid weight loss programs. Take a moment to think about the difference between weight loss and health.

 

Being skinny but also stressed out and with a disturbed metabolism doesn’t sound like much of a victory.

 

Commit to healthy lifestyle habits, embrace them as part of who you are, and watch the weight steadily fall away. Slow and steady wins the race to your health.

Understanding Health Fads: Juice Cleanses

It’s hard to say when the juice cleanse craze began, but it’s definitely still here and probably not going anywhere soon. Whether it was the early 90s, or in the 2000’s when the internet started pouring out endless health tips, juice cleanses were deemed as the best way to “detox” and “lose weight fast”. Celebrities churn out endorsements for different juicing brands and you can even purchase pre-made juice cleanses sent right to your door step. The question is, are juice cleanses really a benefit to our health?

Let’s break down the two health claims that come from juicing and why they might not be so accurate…

Juice cleanses claim to act as a detox, a method to rid your body of toxins and reset itself to a healthier state. But what your body is actually detoxing from during a juice cleanse might be many of the essential nutrients we need for our body to properly function.

By only consuming fruit and vegetable juice we’re actually stripping out vital vitamins and minerals we need such as Vitamin D, E and B-12 that help power our metabolic functions, such as converting our food into glucose and energy.

And even though fruit and vegetable juices do contain many healthy vitamins such as Vitamin C, A & B, these vitamins need to work in conjunction with other foods to be best absorbed. Removing good fats from your diet prevents your body from processing those potentially healthy vitamins. In the end, you’re wasting your body's chance to absorb these great vitamins by restricting yourself to just vegetables and fruits and eliminating other valuable elements in your diet such as nuts, seeds and, yes even coconut oil (yes coconut oil can be part of a healthy eating pattern!)

Also, it’s important to note our body has its own detoxifying functions to keep you healthy and rid your system of anything it doesn't need. This is what your kidneys, liver and GI tract function as, organs that help rid our bodies of harmful substances. Keep those organs happy and healthy with a well-balanced eating pattern full of real foods and you should be fine functioning with just your own internal detox system!

The second biggest promise a juice cleanse offers is the opportunity to lose weight – fast. In a sense, this claim might actually be true because you are in fact reducing your daily calorie intake, sometimes to as low as just 1000 calories a day. However, if you're looking for a long-term weight loss solution, a juice cleanse will do anything but that for you.

The quick weight loss from a juice cleanse comes predominately from the loss of water weight because as your body is starved for calories it will turn to its stores of glycogen for energy and as your glycogen is depleted so is the water attached to it. So rather than any true fat loss being accomplished, your body is only losing the grams of water in the glycogen that it is burning to keep you functioning on the few calories you’re ingesting. Once you end the juice cleanse and return to your regular diet, your glycogen stores will quickly be replenished, along with the water attached to them, returning you to your initial weight.

If you really want to lose weight fast, you are better off with a fasting mimicking diet full of healthy fats and low carbohydrates. This helps you metabolize your own fat stores rather than burning through your stored glycogen. But even then, short term weight loss is not synonymous with health! In fact, it is usually quite the opposite.

In the end, a juice cleanse won’t deliver on either of its promises, and it will also lead to unpleasant side effects such as headaches, nausea and mood swings on top of faltering energy levels (usually from the lack of fiber and protein in your diet). As you can imagine, these side effects will only slow you down on your path to better health.

It might be appealing to consider a diet that promises to change your life in just 3-5 days, but with a juice cleanse not only is the change short lived, it’s not of considerable benefit to your overall health. To really make a lasting impact on your health, there are no short cuts. So don’t believe it when someone tries to sell you one.

Instead, make a long-term commitment to your health. Implement daily lifestyles that will help you feel better and be better. That involves smarter decisions around nutrition, exercise, mindfulness and more. To learn more and get practical tips on how to accomplish this, consider taking the first step to achieving your best health ever with the Boundless Health Program.

 

8 Ways to Instantly Improve Your Mood

Are you struggling to snap out of a funk? Whether you’re a little grumpy or you’re in an all around bad mood, you don’t have to spend the rest of your day wallowing. Need a few ideas for turning that frown upside down? Here are 8 ways you can instantly improve your mood.

1. Tidy Up Your Spaces

When your spaces are too cluttered, it can have an effect on your mental state. Juggling hectic schedules and constant deadlines means something else has to give, like organization. It’s easier to let things pile up around you when keeping a clutter free zone isn’t your priority. So start with just one thing you would like to tidy up, such as your office cubicle, the laundry room, or the trunk of your car. Set the kitchen timer for 30 minutes and focus on cleaning whatever you can for that amount of time. If you’ve got more time, rummage through your closets and then donate any clothes your family doesn’t wear. Or go through the pantry and donate any food that is no longer part of your healthy lifestyle!

2. Take a Nap

Maybe you just woke up on the wrong side of the bed. Or maybe you didn’t get enough deep, restful sleep (which is the more likely culprit of your bad mood). Feeling tired can make it that much harder to meet deadlines, be creative, or enjoy time with your family. Kick back for a 20-minute power nap to feel more refreshed and able to take on the rest of your day. Just keep in mind that naps are not a substitute for getting good quality sleep every night.

3. Write It Out

Is your mind’s playlist loaded with worries and stuck on repeat? A quick way to fix that broken record is to get all of those thoughts out of your head. Grab a notepad and organize a master to-do list, then break it down into smaller, more manageable lists. Kick start a project by doing 15 – 20 minutes of research, which can also get the creative ideas flowing. Or try journaling to put any worries or anxieties onto paper. Sometimes seeing them in writing can take a weight off your shoulders and leave you with more energy to take on the rest of the day.

4. Play a Word Game

If you love Scrabble, give Words with Friends a try. It’s a free virtual word game you can download to your smartphone and play to test your skills. Plus, feeling that Triple Word Score victory will definitely have you grinning ear to ear! You can work also in a little brain fitness. Just like your body, your mind needs a regular workout, too. Playing strategy games is an effective way to challenge your brain and keep it smart as you age.

5. Spend Time with Others

Are you communicating more and more by text, instant message, and email? Having real conversations can be a real mood booster. Meet a friend for coffee, or if you just can’t get away from your desk, call each other on Skype and switch on your web cameras for a virtual coffee chat. Go on a hike with your family and talk about what’s happening in each other’s lives. Or walk to a co-workers desk next time you have a question that can be answered with a quick chat.

6. Pump Up The Jams

Turn up the tunes you loved as a teenager (hello, Duran Duran!) and dance like it’s 1985. Not only is it fun, but also moving freely to high-energy music can liberate you from your bad mood. That’s because like running, dancing releases feel-good endorphins that can curb stress and anxiety. Don’t want to dance alone? Join a social fitness class like Zumba or Jazzercise and follow along to the beat.

7. Doing Something Nice for Someone Else

Performing a random act of kindness can go a long way for making your day—and someone else’s. Next time you’re in line at the coffee shop, you could show a “pay it forward” act of kindness by buying the drink of the person behind you. Who doesn’t love a surprise freebie? You could also leave sticky notes on your kids’ bathroom mirror and start their day with an inspirational message. Or you could offer a simple gesture, like giving someone a smile as you pass by. Chances are, they’ll smile back! It’s win-win.

8. Move Your Body

Being physically active is a great way to reduce stress and anxiety. But you don’t have to squeeze in a midday workout to reap the mood-boosting benefits of exercise. Just going for a 10-minute stroll by yourself or with a walking partner can get you on the path to feeling happier—and help you work toward your daily goal of 10,000 steps. Is your day packed with meetings? See if there are any you don’t need to be physically present for; you may be able to call into the meeting during your walk and get some stimulating fresh air and vitamin D to boot.

Next time you’re in need of an instant mood boost, give one of these simple techniques a try. You might be surprised just how well it works!

 

 

Fly Fishing as a Guide to Our Health

I just had one of my best vacations in recent memory. Biking, hiking, and fly fishing my way through Bend, Oregon. The mountains, the rivers, the trails. It doesn’t get much better.

 

But I realized I can’t “turn off” completely and get away from my desire to help people improve their health and their lives. Nor do I want to.

 

My fishing guide and I had a 45-minute drive to the Crooked River northeast of Bend near Prineville, Oregon.  He is a great guy (and a phenomenal guide), and we immediately struck up a lively conversation. He is full of stories and tall tales of life as a fly fishing guide.

 

His tune changed, however, when I told him what I do. His response? “You can probably tell, I am not the healthiest guy around. I drink a little too much beer. Well, OK. A lot too much beer. I don't eat right. I'm active on the job but I’m not into exercise. I know I should be healthier. Do you have any advice to help me?” 

 

Where do I begin? I was at a loss at first where to start. I wanted to hear more stories about rainbow trout, nymphs, flies, and the “one that got away.” But since the conversation turned to health and I saw a chance to help, I knew this deserved a long discussion.

 

I could have told him to eat more veggies, get regular exercise, consume fewer empty calories, prioritize sleep more, and of course, Drink Less Beer.

 

Unfortunately, that wouldn’t have helped him at all. He knew all that. His problem was not one of poor advice or poor understanding of the unhealthy aspects of his lifestyle.

 

He didn’t need me to tell him what to do. Instead, he needed to understand why he does the things he currently does.

 

We all develop patterns and routines in our lives. Some become more entrenched than others. The key is making sure those routines are as healthy as possible.

 

For instance, we tend to have patterns of usual restaurants we go back to again and again. Whether it is a night with friends or loved ones, or a dinner business meeting, we likely have a handful of choices from which we choose.

 

Our job is to make sure those choices look more like True Food KitchenFlower Child, or Tender Greens and less like Olive Garden, the Chop House or other over-sauced, “under-vegetablized” establishments.

 

What about our post-dinner routine at home? Sitting on the couch, raiding the fridge for food our body does not need, and drinking one too many beers is an easy pattern to fall into.

 

Why not take a walk instead? Read a book in a room away from the kitchen. Meet friends for games that involve no or at most one beer.

 

The first step is understanding why our patterns exist.

 

My fishing guide drinks too much beer. He likes the taste. Ok, I say, but you can get the taste from one beer and savor it. That wasn’t it.

 

He likes the way it makes him feel, he likes the buzz. The buzz takes volume to get. One beer won’t cut it. We had to question, what else can give him similar joy? Did he need the buzz, or did he just need to feel good about something? 

 

It turns out, outside of fishing, his life was not very full. He had no nearby family, no real hobbies outside of fishing. He had plenty of friends, but they were all big drinkers and thus it was all too easy to drink on a regular basis.

 

I wasn’t going to help him by citing studies showing the dangers of being overweight, or the dangers of excessive alcohol consumption.

 

He needed to escape his routines and the company he keeps.

 

It’s remarkably difficult to tell someone you just met that they need to find their purpose in life. They need to like themselves more. And they need new friends, or at least to see current friends less. 

 

Thankfully before I overstepped my bounds, we reached the river and were well on our way of creating our own tall tales of rainbow trout, nymphs, flies, and the one that got away.

 

In the end, however, I was able to lay the groundwork for what will hopefully be a change in perspective regarding his life. It won’t happen overnight. It will take time, and it will take work. And it all starts with understanding why we do what we do.

 

Ask yourself that question. Question your assumptions and your routines. Find ways to alter them a little more towards health. We don’t have to be perfect. We just need to be better.

 

And we all need to get to the Crooked River to catch some fish. It’s simply beautiful.

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

Action Item: Find one routine per day and question it. Even something as simple as where you park your car. Or where you sit after dinner. Question one routine per day. Understand why you do what you do. Then see if you can reframe it in a healthier way. You don't have to be perfect. Just be a little better every day.

 

Bret Scher, MD FACC

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