My Journey to The Low Carb Cardiologist Podcast

My Journey to The Low Carb Cardiologist Podcast

 

Sometimes change is hard, and sometimes it just feels right.

 

Changing my podcast from The Boundless Health Podcast to The Low Carb Cardiologist Podcast was a little of both.

 

To be fair, this wasn’t exactly the biggest, most impactful decision I have made lately.  The perspective is not lost on me. It’s a podcast name, not heart surgery.

 

But it was meaningful for me personally, and it exemplifies the current atmosphere of health and nutrition, and that is why it is worth exploring with you.

 

I still remember when I started my podcast. I was so afraid that I wouldn’t get any guests, that I was simply happy anyone would agree to come on the show and talk to me! As soon as the interview started, I was so grateful they were there, I just wanted to support them and thank them for their time.

 

But that doesn’t do much for challenging them, or digging deep to determine fact from fiction, or deciphering reasonable recommendations from those that are…..well…..let’s just say not as reasonable. Luckily, my friend HD from HormonesDemystified.com was there to set me straight.

 

HD helped me focus on my relationship with my listeners, and helped me realize that my listeners were my primary responsibility. My job wasn’t to give my guests the best experience. My job was to give my listeners the best experience, and to give them the best information I could.

 

With a clearer mission, I set out to refine my role and my niche.

 

That is where nutritional and health science started to look more like religion to me.

 

When I interviewed a vegan, I got push back from my low carb supporters wondering how I could support his views. When I interviewed a meat proponent, those who appreciated my vegan interview were up in arms about my hypocrisy.  They felt as if I had misled them.

 

What I failed to get across was that my interviews were not about me! These interviews were supposed to tease out the nuances of my guests’ viewpoints, to help determine what is backed by science, what is backed by emotion, and what can we learn from it. Yet many listeners equated my guests’ opinions with my own, and thus were upset at me for supporting both a vegan and a meat advocate. They were left wondering what I stand for.

 

I understand this does not encapsulate everyone. But it does highlight the world in which we live. Far too many people hold so strongly to their nutritional and health beliefs that they cannot bear to listen to the “other side” or even consider an opposing view point. The importance of detail, nuance, and scientific integrity is far too easily lost in the emotion and vigor of belief. And that is a sad reality for the world of reason, debate and scientific “truth.”

 

Which brings me back to the name of my podcast. What do I stand for? Which side of the aisle do I sit?

 

I believe some people can be healthy as vegans. I believe some people can do well restricting their fat intake and focusing on calories.

 

I also believe that the vast majority of people cannot achieve their health goals limiting fat and counting calories.

 

The most generalizable and most effective intervention that I have seen in the past 20 years is without out a doubt the low-carb lifestyle. Thus, the change to The Low Carb Cardiologist Podcast. No confusion there. My guests and my listeners know where I stand.

 

But that doesn’t mean I am going to stop looking at differing views, or trying to find the common ground between healthy vegans, healthy carnivores, and everyone in between. I will continue to tease out the nuances behind endurance athletes, crossfitters, and power walkers.

 

We all need a reminder to look outside our field of view (me included!), to go outside our comfort zone, and to explore the “other side,” even if it is simply to help us feel stronger in our convictions. The exploration is part of the process.  

 

My promise is that I will continue to explore health from any and every angle that I think will help you, my listener, improve your health for a lifetime of Your Best Health Ever!

 

The name has changed, but the mission remains the same.

 

How can I help you on your health journey? Please visit me at www.LowCarbCardiologist.com  and let me know how I can best help you achieve your health goals, or feel free to provide feedback about what you would like to see from The Low Carb cardiologist in the future.

 

Thanks for reading!

 

Bret Scher, MD FACC

Founder, Boundless Health

www.LowCarbCardiologist.com

 

Do Low Carb Ketogenic Diets Increase Your Risk of Dying?

Do Low Carb Ketogenic Diets Increase Your Risk of Dying?

 

Some people certainly want us to think so.

 

But as is often the case, the evidence doesn’t reliably support the dramatic claim.

 

Let’s face it. We all have biases. We all believe things strongly, and we look for evidence to support our position.  I have been guilty of that.

 

That is why those who state that ketogenic diets kill us may still be well meaning, even if they completely miss the point.

 

One frequently cited article to “prove” ketogenic diets kill us was published in the Annals of Internal Medicine in 2010

 

If we just read the abstract, the conclusion is clear. In a study of 129,000 subjects, those who scored the highest for an animal based low-carb diet had a 23% relative increased risk of all-cause mortality.

 

A plant based low-carb diet, on the other hand, seemed to be protective with a 20% decreased risk.

 

For many, an abstract is good enough evidence to sing from the rafters as if it were fact.

 

But that is not how science works. The details matter. They matter a lot. So, let’s look at the details before we condemn a ketogenic diet as a serial killer.

 

The analysis was based on a retrospective look at the Health Professional’s Study and the Nurse’s Health Study. Subjects filled out food questionnaires to estimate their nutrition intake over the past year, estimating their frequency of eating certain foods. Based on that frequency, they were given an animal low-carb diet “score,” and a vegetable low-carb diet “score”.

 

Let’s set aside the how horrible food questionnaires are for scientific validity. That’s the least of the study’s problems.

 

Looking at the baseline characteristics, we see all we need to know. Those who scored highest for animal low-carb diets also had the highest percentage of smokers, 30% vs 27% for women and 14% vs 9% for men (anyone else surprised there were more women smokers than men? I was). Is a 3-5% difference in smoking significant? You better believe it. Smoking is the single most dangerous thing we can do for our health. Considering the mortality difference was so small between the groups, a 5% smoking difference could absolutely account for it.

 

But it doesn’t stop there. The animal consuming men were less physically active and ate more trans-fats.  

 

This is a prime example of the “healthy user bias.” When the whole world says eating meat is bad for you (as they did in the 1980s), who do you think eats meat? You got it. Those who don’t care all that much about their health. Thus, the increase in smokers, increased unhealthy trans fats, and less physical activity.

 

And that is likely just the tip of the iceberg. What other unhealthy practices do they do more often that weren’t measured? We can’t analyze the data from what we didn’t measure.

 

Oh, and let’s not forget that the diets were nowhere close to being low carb ketogenic diets. The animal based low carb eaters consumed 163 grams of carbohydrates per day. 163 grams! I am not sure in what universe that is considered “low carb,” but I can assure you it isn’t in the actual low-carb community. For that, we need to eat at most 50 grams of carbs per day, and even less if we are already insulin resistant.

 

The paper then goes on to show the risk for all-cause mortality, cardiovascular mortality, and cancer mortality. But does it matter? When the data is as poor as this study’s, what can we really conclude?

 

We can conclude this: People who are unhealthy, who smoke, who follow a mixed diet of animal fat and moderate in carbohydrates, and who ignore society’s recommendations about their health have a worse outcome than those who are healthier and follow society’s health advice. Yawn. I think we have seen this movie before

 

So, before we condemn a ketogenic diet as being a silent killer, let’s make sure we are actually studying a ketogenic diet, and let’s make sure it is a level playing ground.

 

Does this mean ketogenic diets have been proven to be safe long term? No. Those studies have not been done. But……

 

Is losing weight, reducing inflammation, reversing diabetes and normalizing blood pressure, all while getting rid of medications likely to improve people’s long-term health? You better believe it.

 

Say hello to a real ketogenic diet.

 

Thanks for reading

 

Bret Scher, MD FACC

LowCarbCardiologist.com

Low-Carb No Better Than Low-Fat….Or is it?

The quest for the one study to finally answer all our nutritional questions continues. And likely will continue forever.

 

If you believe the hype, the recent JAMA study comparing a “healthy low fat” and “healthy low carb” diet on the effect of weight loss was the definitive answer we sought.  The only problem is that it wasn’t.

 

Their conclusion? Everyone lost the same amount of weight regardless of the diet, and genetics of insulin resistance didn’t matter. So, in the end, we can all stop worrying about low fat or low carb or insulin resistance and just eat well. Right?

 

I’m all for simple advice, and that is as simple as it gets. And it will work for many people. But from a scientific perspective, this study did not adequately address the questions it sought to answer. Let’s look under the hood…..

 

600 people without diabetes or heart disease and not on hypertension or lipid medicines were randomized to a “healthy low fat” or “healthy low carb” diet for 12 months.

 

Neither group was told to restrict calories (although both groups ended up eating 500 calories less per day on their own). They had extensive counseling and support with over 20 support sessions throughout the 12 months. These sessions included specifics about the diet and support for maintaining behavioral changes. (That’s a great goal for us all, but the reality of behavior change support looks far different. “Eat better, lose weight and come back in a year” is an all-to-familiar refrain).

 

Here is the kicker. Both diet groups were advised to maximize the veggies, minimize sugar and processed flour, minimize trans fats, and focus on nutrient dense whole foods prepared mostly at home.

 

I don’t care what the macros of the diet are. If we get people to do that, Bravo! That would be a vast improvement for the majority of this country. As a result, the “low fat” group reduced their carb intake from 241 grams per day at baseline down to 205-212 grams per day during the study, and undoubtedly improved the quality of their carbs. They were the low-fat group, and they reduced their carbs! Red flag #1.

 

On the other side, the low-carb group also started in the 240s per day, and reduced their carb intake to 96-132 grams per day during the trial. Red flag #2. This is not a true low carb diet. Low carb diets tend to have less than 50 grams of carbs (100 at the absolute most!), and ketogenic diets tend to have carbs <30grams per day.

 

So, let’s be clear about what was tested. The diet was a “lower than average but still not all that low” intake of carbohydrates, compared to a “lower than average but more moderate carb intake” diet.  

 

This is hardly the definitive once and for all answer about low fat vs low carb diets for which we had all hoped.

 

That doesn’t mean we have to throw out the results, however. We can still learn valuable information from the trial.

 

  1. Reduce junk, and focus on real foods and you will lose weight and improve your health. AMEN! Not a shocker, but always nice to be reminded of the simple things that work.
  2. Engage in a strong support system and you have a good shot of staying with a nutritional change for 12 months.
  3. The more you reduce your carbs, the more likely you are to raise your HDL and lower your TG.
  4. The more you lower your fat, the more likely you are to lower your LDL
  5. Following a mildly reduced carbohydrate intake may not significantly improve insulin resistance blood tests.
  6. There was still a huge variability within each group with some people losing a great deal of weight, and some not losing any. Looking at the averages does not help us decide what specific characteristics predicted success. But in this trial, it did not seem to be genetics.

 

And the other take home? Testing moderate changes in diet are unlikely to show dramatic differences when both tested diets focus on real, nutrient dense, whole foods, limiting added sugar and processed flour.

 

If we want to test for a REAL difference, we need to go more “extreme.”

 

Doing this same study with a ketogenic diet would be very interesting.

 

Including people with diabetes and hypertension (more metabolically unhealthy, like so many in this country) would be very interesting.

 

Would that give us the once and for all answer which we crave?

 

Once again, probably not. But it may help us understand when to use the different tools we have in our nutritional tool box.

 

As was so nicely stated by The Diet Doctor, we now have an equal number of studies showing no difference between low fat and low carb diets as we do showing that low carb is better. We are still waiting for one to show low fat is better…….

 

The main takeaway, however, is that we don’t have to believe there is one diet for everyone. That is why we need an open mind, we need to be open to experimentation, and we need to treat individuals as…….individuals.

 

We can reverse type II diabetes with a ketogenic diet. Virta Health has shown us that.

 

Real food, relatively low-fat diets, when combined with healthy lifestyle practices can be associated with good healthspan. The Blue Zones observations have shown us that.

 

Our definitive trial may never come. But we don’t need it as long as we are willing to work with the n=1 experiment with each and every person we encounter. The starting point is easy. Just eat real food. Then be open to different avenues of specifics and see where the road goes.

 

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

The War Against Wheat- Will Our Health Win?

The War Against Wheat

 

What’s at the base of your food pyramid? Is it whole grains? Have you ever stopped to ask why?

 

As we know, whole grains are the base of just about every “healthy” food pyramid. The American Heart Association recommends at least 3-5 servings of whole grains per day for optimal healthy nutrition. It’s simply accepted that whole grains are good for us.

 

So why are so many waging a war against whole grains?

 

Just look at the bestsellers on Amazon and you will find Wheat Belly, by Dr. William Davis, Grain Brain by Dr. David Perlmutter, plus a slew of books promoting low carb nutrition. Do they know something the AHA doesn’t?

 

It turns out, they just might.

 

It is time to start asking the questions, how do we know whole grains are healthy? What’s the evidence?

 

First, people living in Blue Zone communities (those where people routinely live the longest) eat vegetables fruits, nuts, seeds, legumes and whole grains. Since they routinely have better health than most other populations, that must mean whole grains are healthy, right?

 

Not so fast. People living in the Blue Zones also sleep 8 hours per night, they get regular physical activity, they have close social connections, they enjoy life and have a purpose for waking up every day, and they do not eat many sugars or processed junk food.  Plus, they eat vegetables, fruits, nuts, seeds and legumes.

 

How could we possibly say the whole grains themselves are what keeps them healthy? Are they healthy because of the whole grains? Or does the rest of their healthy activities outweigh the unhealthy effects of the whole grains?

 

Luckily, we have studies that tried to answer that question.

 

Studies looking at replacing white flour with whole grains consistently showed health improvements in those easting whole grains. Easy answer. Whole grains must be healthy.

 

Again, not so fast. That only tells us that whole grains are healthier than processed white flour. That should not be a surprise. Said another way, they are less bad than white flour.

 

But are they healthy? Or are they necessary?

 

It turns out, grains are not necessary at all for health or for survival. You heard that right. Fats and proteins are considered essential nutrients. Our bodies cannot make all the fats and proteins we need, so we must eat them. That Is not the case for grains and carbs. Our bodies get all the fuel they need from converting fats and proteins to glucose or other fuel sources such as ketones.

 

OK. We have established that grains are not necessary. But do they add anything to a diet consisting only of fats and proteins?

 

Fiber. The whole grains that show the greatest health benefits, compared to white flour, are those with the highest fiber-to-carbohydrate ratio. That makes sense. Fiber is a key component to healthy eating, and whole grains can be a good source of fiber.

 

Lucky for us, we have a bounty of choices from where we can get our fiber. Vegetables, fruit, nuts, seeds and legumes are fantastic sources of fiber. If fiber is our goal, we once again see that grains are not necessary.

 

But are they harmful? Listening to William Davis, and reading his book Wheat Belly, will certainly convince you that they are.

 

For some, the answer is clear. If someone has celiac disease, or gluten sensitive enteropathy, the proteins in wheat cause an autoimmune reaction that attacks their intestinal lining. There is no question that they need to avoid wheat and grains.  

 

What if someone does not have celiac disease? Some are still sensitive to gluten or other elements of grains (some studies show it may be other components of grains called the FODMAPs instead of the gluten). Although there is no clear diagnostic test for this, we can subjectively test it very simply. Go for 30 days without wheat and grains and see if you feel better. Do you have more energy? Do you feel less bloated? Less achy? Do you sleep better? Do you think more clearly? If the answer is yes, then you too should avoid wheat and grains.

 

So far, this should be pretty intuitive.

 

But what if you do not feel any better off grains? Is there still a reason to avoid them?

 

At this point we need to better define our enemy. Is gluten inherently evil for everyone?

 

No.

 

Well then, are FODMAPS inherently evil for all?

 

No.

 

Is there something that is evil for all?

 

Maybe.

 

It’s true that we do not all need to avoid gluten. In fact, gluten-free foods may be far worse for our health than gluten containing whole grains. A recent study suggested that low fiber, gluten free foods increased heart disease risk compared to higher fiber whole grains. Again, this proves whole grains are less bad than something really bad. That makes sense.

 

But wheat, grains and flour are not comprised of only gluten. They are a mix of carbohydrates and other grain proteins.  And what do those carbohydrates do? Raise your blood glucose and insulin levels. “Healthy” whole grains have a glycemic index on par with a snickers bar!

 

Admittedly, glycemic index is not a perfect measure, but it is an accurate assessment of how quickly and strongly a food induces a glucose (and subsequently, an insulin) spike in your blood. For reference, white bread has a GI of 73, 100% Whole Grain Bread 51, Coca Cola 63, Snicker’s 51, oatmeal 55, cashews 22, broccoli 10, and cauliflower 10. Also for reference, spinach, salmon, beef, chicken and eggs have a GI of zero.

 

Do you see a pattern? Food that comes from wheat and grains, no matter how “Whole,” significantly raise our blood sugar and insulin. Real food, vegetables, meats, etc. do not.

 

Our bodies were never meant to eat grains or wheat. The agricultural revolution and production of wheat and grains has only existed for less than 0.1% of our evolution.

 

Some would argue that is enough for us to avoid them.

 

That’s not supported by evidence. But it does make sense (remember, this is an article on health, not about the economics of agricultural wheat production, government subsidies, worldwide famine or other issues outside larger than I care to tackle).

 

Again, the question comes back to, why are we eating them? Not because of physiological need. Not for health (as long as we can get fiber elsewhere).

 

We eat grains and wheat for taste, for convenience (since our society has evolved into a grain-centric society), and possibly for addiction (or at least a stimulated craving).

 

Health does not factor into the “Why.” If we believe Hippocrates who said, “Let food be thy medicine and medicine be thy food,” then our perspective of why we eat has to change. Everything we eat either helps our health, or hurts it. For that reason alone, I would argue that we should avoid wheat and most grains. I can’t defend it with solid research, but I can defend it with the often dangerous, “It makes sense.”

 

That’s enough for me. Is it for you?

Simple Salad Recipes

You don’t have to be a chef extraordinaire to put together a tasty and filling salad! You might need an easy go to lunch or something to complement your dinner but you’re overwhelmed by all the complicated recipes online. These simple salads are made up of only 5-6 ingredients and feature healthy options for salad dressings that you can make from your own kitchen. If you’ve got a busy schedule this week, try mixing together a larger batch of each salad, double the dressing recipe and set aside the dressing and salad mix in Tupperware to take with you on the go! 

Greek Salad 

Ingredients:

2 chopped heads of romaine lettuce
1/2 sliced purple onion
2 sliced roma tomatoes
1 sliced cucumber
1 cup sliced Kalamata olives
2 tbsp feta 

Greek Salad Dressing:

1/2 cup olive oil 
1/4 cup red wine vinegar
1/2 teaspoon Dijon mustard
1 minced garlic clove 
1 teaspoon dried oregano
1/2 teaspoon salt 
1/2 teaspoon pepper

Walnut & Strawberry Spinach Salad 

Ingredients:

2 handfuls of fresh spinach
1 cup sliced strawberries 
1/2 cup chopped walnuts 
1/4 cup crumbled goat cheese

Balsamic Vinaigrette Dressing:

1/2 cup olive oil
1/4 cup balsamic vinegar
1 tablespoon Dijon mustard
1/2 teaspoon salt
1/2 teaspoon pepper

Italian Mixed Greens Salad 

Ingredients:

2 handfuls of mixed greens 
1 cup halved cherry tomatoes 
1/2 cup sliced black olives 
1 cup garbanzo beans 
1/2 chopped purple onion

Italian Salad Dressing:

1/3 cup olive oil
1/3 cup white wine vinegar
1 teaspoon lemon juice
1 teaspoon honey
1 teaspoon dried oregano 
1 teaspoon dried parsley
1 teaspoon dried basil
1/2 teaspoon pepper

Also,  try adding your favorite protein to any of these salads and make sure to let us know which is your favorite! 

Photo Cred: Food Network, Cookie+Kate, WeightWatchers

Carbs Kill? Fat Heals? What does PURE Really Say?

Are you still confused about all the contradictory advice on fat and carbs? We have been told for decades that low-fat is best when it comes to our health.  Turns out, that was pretty bad advice.

 

We now have even more evidence showing that fat certainly isn’t “bad,” and it is probably beneficial for our health. Carbohydrates, on the other hand, are trending toward the “bad” side and may need to be reduced.

 

Confused? I don’t blame you. Read on for more info.

 

First my usual disclaimer.

 

We do not eat fats and carbs. We eat food. A wonderful combination of macro- and micronutrients, including fat and carbs. Whole grain bread, farro, quinoa can all be labeled as carbs. So too, can bleached white bread, French fries, Cheetos, and cookies. They are all carbs, but I guarantee you they are not all the same for your health.

 

Grass-fed steak, wild salmon, and avocado can all be labeled as fat and protein. So too, can deep fried chicken, processed lunch meats and others.  Do you see where I am going with this?

 

The Study

 

With that disclaimer in place, let’s talk about the new study released in the Lancet and presented at the European Society of cardiology Conference earlier this week. You may have already seen the headlines, “Low-fat Diet May Kill You!” “The Low-Fat, Low-Carb Question Has a New Answer.” And others. As usual, the truth is never as exciting as the headlines, but it is still worth exploring.


This trial followed over 135,000 subjects from 18 countries for over 7 years. Researchers recorded nutritional intake through standard questionnaires (which are subject to errors as I’ve mentioned before), and investigators followed the subjects, noting who died, who had heart attacks, strokes or heart failure.

 

The short answer is that the group with the highest intake of carbohydrates (77% of daily calories) had an increase in their risk of dying when compared to the group with the lowest intake of carbs (46%). Interestingly, their risk of dying from heart disease was not increased, but their overall risk of dying was increased.  This was mostly driven by cancer, respiratory diseases and dementia.

 

Intake of fat, on the other hand, was associated with a lower risk of dying. This held true for saturated fat, monounsaturated fat and poly unsaturated fat.  There was no significant change in the risk of cardiovascular disease, but again, total mortality was significantly improved.

 

What can we make of all this?

 

It is important to remember that this was an observational trial. It doesn’t prove anything. It shows a very interesting association, but there is no way to control for all the variables that could influence the outcome (as an aside, the same caveat applies to all the prior observational trials condemning saturated fat).

 

The subjects filled out a food intake questionnaire at the beginning of the study, but they were not followed over the seven years to see if their food intake changed. That can certainly introduce inconsistencies in the data.

 

Also, the study lacked many nutritional specifics. What kind of carbs were the subjects eating? Something tells me in the high carbohydrate group, it probably wasn’t sweet potatoes, buckwheat, quinoa, and amaranth. The higher the overall intake of carbs, the more likely their diet included poor quality carbs. Food quality matters.

 

Nonetheless, increasing carb intake seemed to go along with increasing risk of death. That association was clear. Conclusion #1, therefore, is to reduce our carb intake. My editorial is to reduce your low-quality carb intake, although that was not specifically studied.

 

Increasing fat intake, on the other hand, was associated with a reduced risk of death.  The group eating 35% fat had a better survival than the group eating 10% or 18%. Importantly, increasing fat intake was not associated with a lower risk of cardiovascular disease. But it wasn’t associated with a higher risk of cardiovascular disease either. It was neutral to heart disease, and beneficial to overall mortality.

 

Picture your doctor telling you a pill won’t change your risk of heart disease, but will reduce your risk of dying. And it’s only side effects are enjoying it as you ingest it, it gives you energy and nutrients, and helps you feel full. Sounds like a pretty good pill to me! Sign me up. Only in this case, it wasn’t a pill. It was dietary fat.

 

Conclusion #2, therefore, is to not fear the fat. Adding fat can be a benefit, especially if (again, my editorial) it is high quality and helps you reduce your carb and overall caloric intake.

 

There is Another

 

Based on most social media headlines, one may think that this was the only PURE study. It turns out, there was another one.

 

The other PURE study involved the same group of individuals, but it investigated overall fruit, vegetable and legume intake. The researchers found that three-to-four servings per day of fruit, vegetables and legumes was associated with the greatest decreased risk of death.

 

Interestingly, adding more was of no further benefit, but eating less was a lower benefit. This likely did not get the same media attention as the low fat study since the benefits of eating fruit, vegetables and legumes is much less controversial, and not surprising at all.

 

Should anything change from these studies?

 

Yes and no.

 

Real-foods like veggies, fruits, beans, legumes, nuts and seeds are a great place to start for most people. Hopefully we already knew that.

 

Fear of fat should get squashed. Fat is not inherently dangerous. Hopefully we already knew that as well.

 

Concern for too many carbs should be a hot button issue. Hopefully we already knew that also!

 

What may change for some people is further increasing the fat (up to 40+% of daily calories) and animal sources in your diet, and further limiting the carbohydrate sources (down to 40% of calories). Go ahead and add fish, meat, chicken, eggs, milk, olives, olive oil, avocados and avocado oil to your diet. Especially if your diet is based on veggies, fruits, beans, legumes, nuts and seeds. The evidence supports it.

 

Be careful of over-generalizing these results. Many details are missing, and observational trials cannot control for all the important variables. But since this is the best evidence we have, we still should take note.

 

Will this be enough to change national nutritional guidelines? That seems unlikely. Bureaucracy is much slower to move than individual recommendations. On an individual basis, not many people follow national guidelines anyway. But guidelines do impact governmental programs (i.e. school lunches, etc.), so my hope is that they will take note and start to change with the tide.

 

My advice?

 

Eat foods that make you happy. Eat foods that fit with your traditions. Just make sure you follow the concept of eating simply prepared, high-quality, real foods. Don’t over-do the carbs, and don’t underdo the fats. Start there and you are well on your way.

 

Interested in more information? Listen to my podcast, The Boundless Health Podcast here, read more of my blog here, learn about my book, Your Best Health Ever,  here, or The Boundless Health Membership Program here. My goal is to provide helpful information through multiple avenues to make sure you get what you need to live Your Best Health Ever!

 

Thanks for reading

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

 

 

 

 

How to Incorporate More Superfoods Into Your Nutrition

Achieving your best health ever a lot easier when you incorporate superfoods into your nutrition. But what are superfoods? Superfoods are considered nutritional powerhouses because they are low-calorie whole foods that pack loads of nutrients into every bite.

Ready to expand your palate? Not all superfoods are as exotic or hard to find as you think! Here are 6 everyday superfoods you should try, plus easy ways you can fit them into your healthy eating plan.

Almonds

Why it’s super: When it comes to weight loss, almonds and other nuts often get a bad rap for their high fat and calorie content. But almonds are a rich source of heart-healthy, unsaturated fats—just be sure to eat them in moderation. Not only are they nutritionally dense, almonds are a good source of fiber and protein, plus minerals, like iron, magnesium, and calcium.

How to enjoy it: Grab a small handful (about 100 calories) and pair them with a serving of dark chocolate for a delicious afternoon snack. Or try sprinkling slivered almonds over your salad for a crunchy alternative to croutons.

 

 


Kale

Why it’s super: Kale is a cruciferous vegetable that’s bursting with nutrients. In fact, kale is more nutrient-dense than nearly any of other whole food. It’s packed with antioxidants like carotenoids, flavonoids, and isothiocyanates, which may lessen the risk of certain cancers. It’s also a fantastic source of vitamin A for eye health, fiber for a healthy gut, and omega-3 fatty acids for blocking inflammation in the body.

How to enjoy it: Serve sautéed kale with caramelized onions as a side dish for dinner. Or liven up lunch by tossing raw kale into your salad. 

 

 

Apples

Why it’s super: Crunchy, delicious, and easy to munch on when you’re on the go. What’s not to love about apples? They’re chock-full of antioxidants and other health-promoting nutrients that help the body to fight inflammation and many chronic diseases. Eating the fruit whole, rather than juiced, can aid in blood sugar control and may lower the risk of developing type 2 diabetes. Plus, they contain soluble fiber, which promotes weight loss because the stomach will feel fuller for longer.

How to enjoy it: Eat whole as a hand fruit or add apple chunks to your fruit cup for a savory snack. You can also pair apples and cheese as healthy party appetizers.

 

 

 


 

Garlic Cloves

Why it’s super: Garlic is often used to make prepared foods taste better, but it has also been used as a plant-based medicine for thousands of years. Garlic contains bioactive sulfur compounds that have the potential to fight certain cancers, such as those in the breast, stomach, or colon. It can also be used to treat metabolic diseases like diabetes and cardiovascular diseases like arteriosclerosis and hypertension.

How to enjoy it: Purée fresh or roasted garlic cloves and add them to homemade hummus dips, sauces, and soups!

 

 

Avocados

Why it’s super: Not only are avocados teeming with vitamins and minerals, they may help to boost the absorption of nutrients from other whole foods as well—meaning you get double the health benefits. Avocados are a good source of healthy fats that promote weight loss. And because avocados are a high-fiber fruit, they naturally increase good cholesterol levels (HDL) and lower bad cholesterol levels (LDL).

How to enjoy it: No matter how you take your eggs, add a few slices of avocado to your plate for a powerhouse breakfast. Or try substituting mayo on your sandwich for slices of creamy and buttery avocado. 

 

Dark Chocolate

Why it’s super: A nibble of dark chocolate a day may play an important role in helping the mind age well. That’s because dark chocolate is powered by cocoa flavanols, which promote healthy blood flow and the delivery of oxygen and nutrients to the brain. Better circulation also leads to improved cognitive function and can enhance learning, memory, and focus. And good circulation may lower the risk of stroke by encouraging the heart to maintain a healthy blood pressure.

How to enjoy it: As an occasional treat, a square or two of dark chocolate can be a tasty way to indulge a craving without the guilt. You can also mix dark chocolate cocoa powder with Greek yogurt for a high-protein snack that will fuel your body after a workout. 

 

 

 

Superfoods may be good for you, but the magic happens when you make them part of a well-balanced diet. Be sure to eat a variety of fruits, vegetables, whole grains, fats and proteins, and other foods to get all of the nutrients your body needs. How will you work more superfoods into your meals and snacks? Let the community know in the comments below!

 

 

Cauliflower Mac & Cheese by Nourished Balance

When you're first implementing healthier alternatives to your diet and nutrition, you can start to have some serious cravings for those go-to meals you used to make on a regular basis. This is especially true for those comfort foods we crave after a long day, like a big bowl of mac & cheese. This is why we love this recipe here at Boundless Health, it's the perfect healthy alternative to your classic mac & cheese that still satisfies your appetite for something cheesy and delicious. Thank you to Nourished Balance for our favorite "mac & cheese" recipe! 

Cauliflower Mac & Cheese 

Ingredients

  1. 5 cups cauliflower florets, cut into bite size pieces
  2. Sea salt and pepper to taste
  3. 1 cup coconut milk
  4. 1/2 cup chicken stock (or homemade broth)
  5. 2 Tbsp coconut flour
  6. 1 organic egg, beaten
  7. 2 Tbsps Nutritional yeast
  8. 2 cups organic mozzarella cheese

Instructions

  1. Preheat oven to 350. Grease a baking dish with unsalted butter
  2. Place cauliflower pieces in steamer basket, add a pinch of salt. Steam until al dente (not too soft, not too hard)
  3. Spread cauliflower pieces evenly at the bottom of the baking dish
  4. In a saute pan over medium heat, heat up the coconut milk- add a pinch of salt and pepper
  5. Add the broth and keep stirring- then add the coconut flour heat until simmering
  6. Take pan off the heat, add the egg and nutritional yeast to the sauce and stir with a fork until well incorporated
  7. The sauce will thicken- pour over the cauliflower. Add the cheese evenly and bake for 35-40 minutes.
  8. Turn the oven onto broil for 3-5 minutes to get a nice brown coloring on top.

And don't forget to eat mindfully so you truly enjoy each bite of this savory meal! 

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.

 

858-799-0980Dr Bret Scher