Health and Wellness Optimization
Are You Metabolically Healthy? October 2024
Unless you have been in a cave for the past few years, I’m sure you have heard about metabolic syndrome. It is a precursor to many of the chronic inflammatory diseases that plague our country especially cardiovascular diseases and diabetes. So how do you know if you have metabolic syndrome or conversely how do you know if you are metabolically healthy?
First let’s define metabolic syndrome. The National Institutes of Health (https://www.ncbi.nlm.nih.gov/books/NBK459248/) requires the presence of 3 or more metabolic abnormalities:
- A waist circumference of more than 40 inches in men and 35 inches in women
- Serum triglycerides level of 150 mg/dL or greater
- Reduced high-density lipoprotein cholesterol, less than 40 mg/dL in men or less than 50 mg/dL in women
- Elevated fasting glucose of l00 mg/dL or greater
- Blood pressure values of systolic 130 mm Hg or higher or diastolic 85 mm Hg or higher.
These dysfunctions contribute to obesity, insulin resistance, hyperglycemia and hypertension. Having metabolic syndrome predispose your body to excess stress and inflammation over times that leads to increased risk of chronic diseases. The sedentary lifestyle of many Americans and the access to on demand excess calories have led to this becoming an epidemic.
So, if you have none of these metrics, then you are considered metabolically healthy! Does that give you a free pass to eat anything? No, your lifestyle behaviors and your genes have gotten you to this point, keep living those healthy behaviors. By the way, only about 8% of adults are metabolically healthy. Most of us have one or more of the risk factors above. Fort those who have two risk factors if you continue the way you are living you are likely to gain the third soon and thus have metabolic syndrome.
What can you do if you have one or more of these risk factors? There are several lifestyle behavior changes that you can undertake to help improve your metabolic health. What if I told you about one thing that can have an impact on all of the above measures, would you do it? The one behavior that can impact all of these factors and more is exercise! For those who don’t exercise, even starting to exercising can have an impact. The most appropriate type of exercise is not that important (biking, waking, swimming, weightlifting, yoga, etc.). Just the fact that you are exercising consistently on a regular basis is the key point. Ideally you want about 150 minutes a week, or 21 minutes per day of moderate intensity exercise. More details on exercising can be found on this site in other articles.
The other easily modified lifestyle factor is to change the fuel that you put into your system. Avoiding excess sugars, highly processed foods, additives, chemicals and dyes will help to improve your metabolic health. At a high-level focus on a whole food plant based foods and don’t eat too much. More details can be found on this site in other articles.
Lastly, I will leave you with this question – Are your metabolically healthy?
If not, what are you going to start doing differently today to improve your health?
Weight Loss Medications September 2024
Three has been a lot of hype over the past few years about the new weight loss medications such as Ozempic, Mounjaro and others. You have heard about them on TV, on the intranet and in social media. They were originally developed to help type 2 diabetic patients to control their blood sugar fluctuations and their blood sugar level, and they were effective. Ozempic its sister drug Wegovey and similar medications belong to the class of medications called GLP-1 agonists. The first ones came to market in 2005, and they have since been modified and improved. The medications are mostly injections that you receive once a week and require a physician’s prescription. Only recently have they been approved for weight loss in obesity by the FDA, but not all plans may cover this indication.
As their popularity has grown, so have the indications for what they can help with. The medications now are being shown to improve cardiac outcomes and help in kidney disease. Currently there are many people who may benefit from these medications as over 40% of our population is obese, many have cardiac diseases and others have kidney diseases.
The medications however come with some downsides such as cost and side effects. From a cost perspective these medications total cost is about $1,000 or more per month. You may not have to pay this amount depending upon your insurance plan and how much they will subsidize the cost. So, if you are 30 years old and take it for the next 50 years the total cost would be over $600,000 in today’s dollars. These medications are a good part of the rise in overall medical costs the past few years. They have some of the usual side effects like other medications such as headaches, upset stomach, or diarrhea. Other less common side effects are a big loss of appetite, persistent nausea, and increased risk of infections. Less common and rarer are pancreatitis, thyroid cancers, and worsening diabetic retinopathies. As more and more people continue to take the medications, we may find out more side effects over time.
One of the biggest downsides to these medications in my view is that if you want to keep the results you achieve with them, you must remain on them the rest of your life. They do not get to the underlying primary cause of diabetes, obesity or heart disease, but rather mitigate the outcomes. If you stop taking them, you will likely return to the previous physiologic state you were in before.
The challenge in our country is that most of the food we eat is not intended to make us healthier, but rather to make you feel happy and make the companies money. The Western/American diet over time causes chronic inflammation that leads to metabolic dysfunction and ultimately chronic diseases. and some cancers Eating a whole food diet with a slant to plants, as Michael Pollan put it, is your best bet. However, avoiding processed foods, seed oils, added sugars, additives and chemicals in your food is not an easy thing to do at the supermarkets these days. You must view yourself as the salmon swimming upstream to get a healthy food. As a country we also eat too much and too often and do not utilize intermittent fasting to help our bodies optimize their metabolic function.
Mitigating Dementia's Effect August 2024
I have had a few people ask me about dementia, Alzheimer’s, cognitive decline and what can be done about it. A study was recently published in the medical journal The Lancet which indicated that about 50% of the cases of dementia are preventable. They further state that there are about 14 factors that lead to the increase in dementia across the world. This topic hits home for me as I saw my grandmother develop dementia in her late 70s and live to be 100, my aunt in her 80s and lived to her late 90s, and my mother around age 70 and die 5 years later.
As with many other chronic diseases dementia is the result of inflammation, in this case in and around the brain, that gradually builds up over time. The article was an update from the 2020 study and stated that there was more evidence available since then to back these points up and they added two new areas of risk, bringing the total to fourteen. This topic was not as much of a discussion point five years ago with the pandemic taking most of the health headlines. Now that the pandemic is past this is an area that we need to focus on as there are more and more people being diagnosed with dementias and cognitive decline and this is a significant factor in the rise in health care costs in this country.
The fourteen risk for dementia and cognitive decline in no specific order are lower education level, hearing loss, high blood pressure, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol consumption, traumatic brain injury, air pollution, social isolation and the two new ones untreated vision loss and high LDL cholesterol.
Several of these are tied together in common areas such as toxins – alcohol, smoking, and air pollution. The more you can do to reduce toxins in your life, the better off your body will be. Yes, your body can get rid of most toxins, but it is ingesting/inhaling these all the time that overwhelms the body and leads to problems. Being aware of these and reducing or preventing your exposure to them helps improve your overall health.
The second common area is what I call interactions - reduced hearing and reduced vision both of which are risk factors themselves but also can lead to social isolation and depression, which are also risk factors. Being aware of these and purposely working to improve hearing and vision loss, avoiding isolation are risk factors you can monitor and improve upon.
The third grouping is what I call metabolic problems – high blood pressure, diabetes, obesity , elevated LDL cholesterol, and physical inactivity. Being proactive metabolically through lifestyle changes yourself will reduce the incidence of these diseases. The lifestyle changes are covered in other sections but at a high level are eating healthily, exercising regularly, and getting adequate quality sleep.
It is never to late to begin modifying your lifestyle in these areas to reduce the risk of developing cognitive decline and dementia. Every bit of reduction every day is like compounding interest and will add up over time and allow you to have a higher quality of life as well as longer lifespan.
How to improve your High Blood Pressure July 2024
A reader asked how can I improve my blood pressure as it is slowly going up?
This is a great topic as most Americans will be diagnosed with high blood pressure/hypertension at some time in their life. Blood pressure consists of 2 numbers, a systolic and diastolic pressure reading such as 112/65 mmHg. High blood pressure has been redefined in the last several years and is now considered any readings above 130/80. You blood pressure is not a static number but varies during the day with rest, activity and sleep. The current recommendations for a blood pressure reading are to be sitting at rest for at least 5 minutes before having your blood pressure measured. Some people have white collar hypertension which is a high blood pressure reading in the doctor’s office, but regular readings at home or elsewhere. This is not surprising as stress is one of the factors that can drive up blood pressure.
How does high blood pressure occur? Hypertension is a chronic inflammatory condition in which the blood vessels stiffen over time and the heart becomes stiffer, thus more force is required to move blood around your body. Hypertension, if left untreated will lead to congestive heart failure and increased incidence of strokes. Hypertension is difficult to diagnose because you don’t have symptoms until some of your organs begin to fail. This is why it is important to have your blood pressure checked at least every year. So, what causes the stiffening of the cardiovascular system? Chronic inflammation from poor dietary choices, smoking, lack of exercise, and chronic stress are the major contributors to high blood pressure.
I had high blood pressure in my forties (140s / 80s) and my doctor was thinking about starting me on a blood pressure medicine at some time. I didn’t like the idea of taking a medicine every day of my life for the rest of my life as my dad had, so I started to investigate what could be done to reduce blood pressure. Following the behavior changes below I have had normal blood pressure under 120/70 for the past 10 years or so with no need for medication.
Here are the behavior changes that you can work on to reduce your blood pressure. The first recommendation is improve your diet by reducing inflammatory foods in your diet and increasing healthy foods in your diet. The standard American diet will lead to high blood pressure with its emphasis on processed foods, excess sugars, chemicals and additives. There is a lot of literature on the Mediterranean diet and the DASH diet and their ability to reduce blood pressure. Another nutrition behavior is to focus on a whole food plant-based diet, which has also been shown to reduce blood pressure. I personally recommend having some flax seeds daily as that has been shown to reduce blood pressure.
A second behavior change is to exercise on a regular basis. The key is to find which type of exercising you really enjoy and can do 150 minutes per week at moderate to vigorous intensity. I prefer biking and running, but other choices are swimming, brisk walking, yoga, exercise classes, rowing, etc. The key is that you do this at least 5 days a week at a pace that increases your heart rate and breathing rate (zone 2 exercise). This will provide flexibility to your cardiovascular system and improve your overall health, not just you blood pressure. See the section on exercising to learn more about the best ways to exercise.
The last area is to reduce the stress in your life and improve your sleep. Less stress and better recovery during sleep will help you keep your body healthy. Acute or short-term stress sometimes cannot be avoided, and some stress is beneficial. However chronic low stress over years builds up and impairs your body from functioning properly. Some behaviors are self-awareness, practicing grace, meditation. For a full review of how to improve sleep, please see the update on best sleep practice.
By incorporating these behaviors into your lifestyle, you should see reductions in your blood pressure over time.
Options to Improve your Vision June 2024
Many people have basic vision problems at some time in their life. Usually, younger people will become near sighted and have problems seeing objects in the distance. Many ultimately end up wearing glasses or contact lenses. Around the 50s many people will also begin to suffer problems seeing close objects and require reading glasses. I have had the opportunity to experience both, yet as I end my fifth decade, I no longer wear glasses or contact lenses.
During college I began having problems seeing the writings on the blackboards and began wearing prescription glasses. As time passed on, I continued to require stronger and stronger prescriptions each time I went to the eye doctor. The challenge with prescription glasses is that you also require prescription sunglasses and sometimes prescription sports glasses to be able to see. The first option after glasses is contact lenses. Many people turn to contact lenses which have several advantages. You don’t need any prescription glasses and can participate in sports more easily. The downside is that you must put them in every day, they can dry your eyes out and at worst cause infections. Contact lenses have come a long way since they were first developed and are very convenient to most people. I however was not one of them, they irritated my eyes a lot.
I first tried orthokeratology contact lenses. These are hard contact lenses that you put in at bedtime and take them out in the morning. Being hard lenses, they gradually reshape the eyeball, and it take several days to start noticing the difference. By reshaping the eyeball, it helps focus objects on the retina in the back of the eye just like contact lenses. You get the best of both worlds, better sight and not having to wear contact lenses in your eyes during the day. You periodically may need to have these updated and the costs for these are usually covered by vision plans, flexible savings accounts and health savings accounts just like contact lenses.
After a while I ran across an article which focused on exercises that you can perform to help improve your vision, and since I didn’t like contact lenses, I was willing to give it a try. There are six primary exercises to focus on. Looking up to the left, up to the right, down to the left and down to the right. For the last exercise you need an object to focus on like a pencil or pen, and move that from your nose out about a foot and back to your nose, while focusing on the object. These exercises need to be performed two to three times a day. These exercises help strengthen the muscles around the eyeball and provide some reshaping of the eyeball. Since doing these for the past several years I can see pretty good at distance and close up to about 7 inches from my eyes. I have 20/20 vision when visiting the eye doctor the last few years compared to 20/40 when I was wearing glasses.
The last choice and the most drastic is to have laser surgery on your eyes. Laser surgery removes part of the cornea and allows for the eyeball to reshape itself and improve the focus point on the retina, and thus your vision. It is a simple outpatient procedure now but is permanent and has some possible side effects. We would recommend looking into the complication rate and references from others before having this surgery on your eyes.
Osteoarthritis - What Can I do? May 2024
This update is in response to a viewer’s request “What can I do to help my arthritis?”
First let’s talk about arthritis, an inflammation of the joints in your body. There are two basic types of arthritis – rheumatoid arthritis and osteoarthritis. Rheumatoid arthritis is due to an autoimmune process attacks the join lining or synovium and will not be addressed as much in this article.
Osteoarthritis is an inflammatory condition which leads to breaking down of the joint structures in your body and causes pain swelling and/or stiffness. It is more common in the knees, hips, back, neck and certain hand joints and is more common as you get older.
There are a few basic behavior and lifestyle modifications that you can deploy to help reduce the symptoms of joint pain, swelling and soreness. While you may be directed to take anti-inflammatory medications such as Advil, or aspirin and the like, they are masking the symptoms, not treating the cause. They also have adverse effects that can affect you over time.
The first thing to do would be to reduce inflammatory foods, chemicals, and preservatives in your diet. There are many articles and guides on how to determine what inflammatory foods are affecting you. As you work on reducing the inflammatory foods take notice of how your joints feel week to week. This process will not improve symptoms overnight but may take a while to notice symptomatic changes. For me I found that reducing my dairy intake significantly improved my early arthritis in my back. Eliminate chemicals and preservatives in the foods you eat and the liquids you drink as they do not contribute to a healthy body overall and may have some impact on arthritis. Lastly you will want to improve your diet overall focusing on a plant based whole foods diet.
The second factor that should help is improving the strength of the bones in your body. As we age, we gradually loose the strength in our bones and joint structures, and this can impact arthritis. To improve your bone strength, you will want to perform some resistance exercises. However, you don’t want to overload the joints with too much pressure. What these resistance exercises do is to increase the stress that placed on the bones. In response to this stress placed on the joints, your body will increase the strength of your joint structure which can help reduce some of the symptoms of arthritis. You also want to increase your activity level in general without stressing your joints as keeping the joints properly moving through full ranges of motion can reduce pain and stiffness. Lastly improving cardiovascular fitness can improve blood supply to the joints and improve overall heatlh. This can be achieved by biking, swimming, yoga, etc. Some people find that specific physical therapy guided exercises help reduce the symptoms of osteoarthritis and improves joint mechanics and function.
The third factor is losing excess weight. Having more weight to carry around puts excess stress on your joints over time and can lead to instability and poor mechanical function. Losing weight and improving your mechanics of moving will reduce bad stress on your joint structures.
As a last approach when nothing else is working and the pain becomes unbearable is to have your joint replaced. I would only recommend this as a last resort. Orthopedic doctors, or bone doctors, will remove parts of your joints and replace them with synthetic implants. But doing this is not a guarantee that your symptoms will resolve and the implants themselves have some short term and long-term side effects that can’t be reversed without removing the implant. Currently we cannot grow the bone or joints back, but there is some hopeful products that may replace the cartilage int the joints.
Three Step Strategy to Better Health March 2024
A simple three-step strategy to improve your health and life expectancy.
The American lifespan has recently decreased for the first time in several decades. Surprisingly many Americans are susceptible to this in their own life as they are shortening their lifespan and quality of life with the lifestyle they live.
There are three simple steps you can take to dramatically improve your health and life span.
These steps are -
To improve what goes into your body
Move around more,
Get quality sleep.
As simple as it may sound many people do not eat well, ingest toxins regularly, are sedentary and not active, and don't know the basics for good sleep. In this article, I will go into each of these in more detail.
First what goes into your body is very important. There are a lot of toxic substances out there that we may consume regularly. These include pesticides in foods, chemicals/additives in food, microplastics, alcohol, toxins in the air, and chemicals in our water. While many of these alone might not be enough to disrupt our metabolic processes, together over time they can cause chronic inflammation which then induces chronic diseases. So how do you reduce these? Some simple steps are to look at the labels of the foods you eat and make smart choices. For example, compare the following ingredients:
Doritos Nacho Style chips- Corn, Vegetable Oil (Corn, Canola, And/or Sunflower Oil), Maltodextrin (Made From Corn), Salt, Cheddar Cheese (Milk, Cheese Cultures, Salt, Enzymes), Whey, Monosodium Glutamate, Buttermilk, Romano Cheese (Part-skim Cow's Milk, Cheese Cultures, Salt, Enzymes), Whey Protein Concentrate, Onion Powder, Corn Flour, Natural And Artificial Flavor, Dextrose, Tomato Powder, Lactose, Spices, Artificial Color (Yellow 6, Yellow 5, And Red 40), Lactic Acid, Citric Acid, Sugar, Garlic Powder, Skim Milk, Red And Green Bell Pepper Powder, Disodium Inosinate, And Disodium Guanylate.
Boulder Canyon potato chip product – Potatoes, Avocado oil, salt.
Now which is better for you to snack on? You get the idea. Apply this thinking to everything you eat, and you will be well on your way to improving your health. The best nutrition to feed your body is whole foods, with a slant towards mostly plants.
What about what you drink? The same thinking applies. I would recommend that you obtain a local water quality report from your water utility company. There are numerous items in it that the EPA states are at safe levels, but why put these chemicals and pharmaceuticals into your body when you don’t have to? Drink filtered water at some level. Even a simple carbon filter in products such as Brita, Pur, and others with carbon filters will remove some of these toxins. Many personal and home water filter systems can provide increasing levels of water filtration and toxin removal. Also, look at what is in your bottled drinks, and make sure it is what you want and nothing else.
Secondly, let's talk about moving around more. What if I told you about a pill that improves your metabolism, reduces stress, improves sleep, reduces depression, improves immune system function, reduces blood pressure, and improves overall energy? You would want to take it daily every day, right? Well, that magic comes from exercise, not a pill. Most people live a sedentary lifestyle with minimal movement or exertion. What I mean is that they sit most of the day at work and then go home and sit on a chair or couch in the evenings. Our bodies were meant to move, not to remain stationary. For the most part, the more you move or exercise, the better. So how can you change this pattern? Some simple things are getting up from your chair at work and walking around for about 5 minutes for every hour. This little change can have a big impact on your heart health. If you can do walking in place while you work, or chair exercises throughout the day helps also. When you get home don't stay reclined all evening. Going out for a 10–15-minute walk after dinner aids digestion and helps keep your body limber. I prefer to exercise in the mornings before the day can steal that time from me. You want to get your heart rate and breathing up a bit but not too much. If you can find some exercise you enjoy doing regularly and do it for 25-30 minutes every day you are well ahead of the crowd. When you go shopping park away from the entrance, thus making yourself walk more. Who knows, you may enjoy exercising!
Lastly, if you don't sleep well, you are not likely to be healthy. Sleep is the time when the body rejuvenates itself, heals from the stressors of the day, and repairs and improves cells. You have less of this happening when you don't get good quality sleep. Normal sleep patterns are about every 90 minutes going between light and deep sleep. How do you know if you are sleeping well? You have energy during the day, you do not fall asleep easily, you have a clear mind, and can function well. Many apps, watches and other devices can provide a more objective rating of sleep quality. Here are some things to improve your sleep quality. Go to bed and wake up at the same time. Reduce bright/blue or white lights in the evening and instead have warmer and dimmer lights. Have a cool quiet setting for your bedroom, and make it as dark as is reasonable. Don't go dark as you want some sun in the morning to start waking your body up. These tips will help reset your circadian rhythm. Practicing mindfulness and relaxation before sleep can improve the quality of sleep. Don’t drink alcohol or caffeine or eat within 3 hours of going to sleep as they disrupt the sleep cycle.
By implementing these three simple strategies you can make a significant impact on your health and thus your lifespan.