The Metabolic Syndrome

The medical journal Diabetes Care in 2004 stated, “Individuals in the upper normal-weight and slightly overweight BMI range (i.e. BMI of 24-27) have a relatively high prevalence and are at increased risk of having the metabolic syndrome. Therefore, screening in individuals with normal or slightly elevated BMI is important in the prevention of diabetes and cardiovascular disease.” Normal BMI (body mass index) is 20-24, overweight 25-29 and obese is greater than 30. The article refers to what is called “metabolically obese normal weight individuals”. Metabolically obese means the following criteria:

• elevated blood sugar greater than 100 mg/dl),
• blood pressure >130/85),
• triglycerides >150 mg/dl),
• waist circumference over 40 inches for men and 35 inches for women measured at the level of the belly button
• low LDL below 40 mg/dl for men and <50 mg/dl for women.

So why is this important? Metabolic Syndrome confers:

ü A 2-fold increase in relative risk for heart disease.

ü A 5-fold increase in risk for developing type II diabetes in individuals without established diabetes.

So doctors should be telling their “normal weight” patients who meet the above criteria that they are “metabolically obese” and on the road to heart disease and diabetes. The pot belly, beer belly, baby belly (when there is no baby) and “love handles” are signs of possible metabolic obesity. Metabolic Syndrome is a lifestyle disease and the treatment should not require medications. “All patients diagnosed with metabolic syndrome should be encouraged to change their diet and exercise habits as primary therapy” according to the journal American Family Physician in 2004.

Our therapeutic lifestyle program called FirstLine Therapy is specifically designed to diagnose and treat the Metabolic Syndrome through dietary and lifestyle changes. Watch our success story video and call us today even if you are of “normal weight”. Reverse the Metabolic Syndrome naturally to live a long and healthy life.

Lifestyle Treatment for Metabolic Syndrome

The Metabolic Syndrome consists of having any 3 out of these 5 criteria:

• elevated blood sugar greater than 100 mg/dl),
• blood pressure >130/85),
• triglycerides >150 mg/dl),
• waist circumference over 40 inches for men and 35 inches for women measured at the level of the belly button
• low LDL below 40 mg/dl for men and <50 mg/dl for women.

It affects almost 50 million adults in the U.S. or about one in four individuals. Having Metabolic Syndrome is a significant risk factor for heart disease, diabetes, stroke, Alzheimer’s and more. Studies have shown that the Mediterranean diet is perhaps the best single treatment. However a new study in the journal Nutrition conducted by the Functional Medicine Research Center in Gig Harbor Washington in conjunction with the Metagenics company, found that a specialized soy based medical food containing plant sterols with a hops derived anti-inflammatory nutrient along with the Mediterranean diet was better than the American Heart Association Diet in reducing 14 cardiovascular risk factors and it worked faster than diet alone.

The conventional medical treatment for the Metabolic Syndrome would be to prescribe a separate medicine for elevated blood sugar, blood pressure, triglycerides and cholesterol. According to the journal American Family Physician in 2004, “Soon metabolic syndrome will overtake cigarette smoking as the number one risk factor for heart disease among the U.S. population. The National

Cholesterol Education Program Adult Treatment Panel III has identified Metabolic Syndrome as an indication for vigorous lifestyle intervention.” So medical journals actually do not recommend prescriptions as the first line of treatment for Metabolic Syndrome.

The studies mentioned above show the power of simple, easy to adhere to dietary changes that can work even faster with a specialized medical food. We implement these lifestyle treatments for Metabolic Syndrome in our therapeutic lifestyle program. Call us today.

The FDA has just approved the first new weight loss drug in 13 years called Belviq (lorcaserin). This is essentially a “new and improved” version of Fen-Phen pulled by the FDA in 1997 due to heart valve problems. On the same day this week of the new drug’s approval, a recommendation against using diet drugs was published online in the Annals of Internal Medicine. Referring to currently marketed diet drugs, the U.S. Preventive Services Task Force concluded that because of safety problems and a lack of data showing that people can keep weight off after discontinuing diet medications , the task force could not recommend that anyone use diet drugs.

Although an FDA advisory committee that reviewed lorcaserin for medical weight loss voted to approve it, it did so reluctantly, particularly because of widely shared concerns about evidence of heart valve damage in people using the drug in clinical trials. When these last heart valve-damaging diet drugs were banned in 1997, the knowledge of this life-threatening adverse effect was known only after approval. But in this case, the FDA has known before today’s approval of lorcaserin that it could damage heart valves. The agency’s own advisory committee concluded that “[t]here’s probably not sufficient data at this time to rule out a clinically meaningful increase in the risk for valvular heart disease.”

This is hardly an overwhelming endorsement for a new drug for medical weight loss by the FDA. A major medical journal and a government task force advocates against “diet pills” because of serious side effects and no one really keeps the weight off long term when using them. In complicated conditions like overweight and obesity the old mentality of “a pill for an ill” is too simple minded. Doctors and the general public know that the only long term solution is changes lifestyle in food choices that do not cause serious health issues like heart valve problems.

We help many people in our clinic with weight related medical problems like high cholesterol and triglycerides, blood sugar, blood pressure and body pains related to excess weight. Please see our success story video and the tab for FirstLine Therapy lifestyle program and see how safe medical weight loss can help you.

Does your weight loss plan prevent you from loosing muscle as you lose weight? Did you know that muscle loss begins around age 40? After age 50, there is an average half-pound muscle loss and a 1-lb. fat gain per year. This means that for the average person by age 70, they will have lost 10 pounds of muscle and gained 20 pounds of fat. (this is a major reason why elderly people fall down and break their hips). According to the Journal of Nutrition in 1997, “no decline with age is as dramatic or potentially more significant than the decline in lean body mass.”

If your weight loss plan talks only about weight loss then you are probably losing muscle in the process and you will be more likely to gain weight back. Why is muscle important? “Muscle is the major source of protein for functions such as antibody production, wound healing, and white blood cell production during illness. If the body’s protein reserves are already depleted by sarcopenia, there is less to mobilize for illness,” according to the Journal of the American Medical Association. Sarcopenia is the loss of muscle mass that occurs as people age. When you see frail elderly people i.e. “little old ladies” (and men) they have sarcopenia.

So what are the benefits of healthy weight loss (fat loss) in your weight loss plan?

• Decreased cardiovascular risk
• Decreased blood sugar and insulin levels
• Decreased blood pressure
• Decreased LDL cholesterol and triglycerides
• Increased HDL cholesterol
• Decreased severity of sleep apnea
• Reduced symptoms of arthritis
• Improved gynecological conditions

So how do you build muscle but lose the fat? You must have adequate protein, approximately .8-1.2 grams per kg depending upon physical activity level. So for a 160 pound woman (160/2.2kg=73kg), this would be 58-88 grams of protein per day. Most people get less than half the amount of daily protein they need and as a result they will gradually lose muscle mass starting at age 40. Your weight loss plan also needs to incorporate some type of resistance exercise to give muscles something to do. (Hint to women: now days some degree of muscle definition is considered to be attractive).

Could weight loss problems be in the gut? Not fat cells, but excess amounts of the wrong kind of intestinal bacteria. Compelling medical research indicates that with changes in the surface structure of intestinal cells, the normally harmless gut bacteria tend to over flourish and expand in number. This causes inflammation in the gut which leads to insulin resistance so cells do not take up glucose. Elevated levels of insulin increase apatite, LDL cholesterol, triglycerides and blood pressure. Many people are frustrated and think they need to exercise more and eat less and still don’t see results. If you have a history of antibiotic usage starting in childhood or in adulthood, if is very possible you may have disruptions of the good and bad bacteria in your gut that is sending the wrong messages to the rest of your body. If you have had a poor diet or stomach flu, intestinal infections or food poisoning you may also have an unhealthy bacteria balance in your intestines and colon.

So ways to lose weight would be finding out if there are ways you can avoid antibiotic usage in the future and begin to restore good bacteria in your gut with strong probiotics. If you have to take an antibiotic for a serious infection, you can take the probiotic several hours away from the antibiotic i.e. just not at the same time. Restoring the good bacteria takes much longer than the 5-10 day course of your last antibiotic, it can take as long as 6-12 months. This is a hidden cause of weight loss problems that we address in our therapeutic lifestyle program. Since there are so many types of probiotics sold we recommend pharmaceutical grade probiotics from a trusted company. A fresh whole food diet, organic if possible, can be very helpful in growing the right kind of bacteria. Ways to lose weight really do start in the gut.

Interested in medical weight loss without surgery? The functional medicine approach to weight loss looks at the hidden causes that make it difficult to lose weight such as inflammation in the body, toxins stored in the body, disruptions of beneficial bacteria in the gut, sleeping less than six hours a night, elevated insulin preceding diabetes, elevations of cortisol the stress hormone and unsuspected food sensitivities. These causes can be evaluated through lab tests and lifestyle and nutritional changes can treat them. Without addressing them a person can diet and exercise endlessly and end up frustrated with minimal results. Most doctors and dietitians have learned that weight loss is simply calories in and calories out. This simplistic understanding ignores underlying biochemical processes that affect weight loss. Doctors trained in Functional Medicine understand these basic biochemical processes.

Medical weight loss through a functional medicine approach does not use diet pills, hormones or surgery. It is about getting the body in balance through lifestyle and dietary changes and possibly using specific nutritional substances backed through research. This helps a person’s body to work with them rather than against them. This approach does not promise rapid weight loss. A pound a week for women and 1-2 pounds per week for men is considered to be a safe rate of weight loss. Our therapeutic lifestyle program called FirstLine Therapy will assess your body composition through a non-invasive bioimpedance analysis to determine percentage muscle mass, fat mass, water distribution and your basal metabolic rate. Then a trained Lifestyle Educator will design a Mediterranean diet with you based on your metabolic rate. We will measure your body composition at each visit every few weeks to make sure you are retaining your muscle mass while losing fat. We will check relevant blood tests every few months. So if you are interested in medical weight loss see our success story video and give us a call.

Evolving research suggests that the cause of many health problems may be associated with prolonged exposure to various toxic agents in our environment. Some of my patients health issues may be related to impairments or imbalances in the body’s ability to properly detoxify and remove these toxic compounds. The body’s capacity to carry our this complex process of detoxification has a lot to do with nutrition. Certain foods (fast foods) can impair the detox chemistry especially in the liver while some foods and nutrients can improve this process (cruciferous vegetables). Specific vitamins, minerals, and phytonutrients may be extremely important in helping to detox your body. Some of the detox process is genetically determined and some of it is significantly influenced by our environmental exposures and what we eat.

Many cultures around the world have long believed that toxins accumulate in the body and can be an underlying cause of a variety of health problems. For hundreds of years different therapies have been used to “cleanse” or detoxify, from simple water fasts to elaborate regimes of bowel cleansing and sweating. Western medicine has ignored or criticized these traditions for years but is slowly beginning to recognize detoxification as vital to good health. In our industrialized world we produce more and more potentially toxic compounds that enter the air we breathe, the water we drink and the food we eat. The body must rid itself of these dangerous substances by transforming them to be more water soluble, then excrete them through the lungs, skin, kidneys and bowels. Unfortunately, not all of them get excreted efficiently. Some are circulated back into the bloodstream while many others are stored in various body tissues such as fat and bone. Over the years toxins build up in our fat, joints, brain and liver and lead to a variety of chronic health problems. See our video on metabolic detoxification and learn more about how to safely detox your body.

Metagenics UltraClear

UltraClear RENEW by Metagenics is a clinically tested medical food that is mixed in water and formulated to provide specialized nutritional support to address altered pain signaling and neuromuscular function in patients with fibromyalgia. UltraClear RENEW is designed for individuals who may benefit from additional support for liver function, and features an array of nutrients in a low-allergen-potential macronutrient base to support Phase II liver detoxification. In preliminary research with fibromyalgia patients exposed to common heavy metal toxins, administration of UltraClear RENEW was associated with significant decrease in FibroQuest scores including pain and stiffness.

I recommend UltraClear Renew for my patients who describe the muscle pain of fibromyalgia and have the characteristic tender points. They report decrease pains, more energy , clearer thinking and overall “just feeling better”. They much prefer drinking a medical food than taking prescription medications which may have side effects of tiredness and weight gain. We usually start with a 10 day metabolic detox program using the UltraClear Renew and a clean diet of mostly whole foods plant based diet with detoxifying greens. It is not a fast. It is a cleansing process to help reset your metabolism and eliminate toxins. If necessary we may do a 24 day version. My patients say that they would prefer to spend their recourses on UltraClear Renew than on multiple co-pays for medications.

Very few side effects are reported and mostly involve some GI discomfort which may partially be due to the clean diet which is an essential part of the treatment with UltraClear Renew for fibromyalgia. Fibromyalgia is a multi-systemic condition and it is highly unlikely there will ever be a single medication to address this complexity. The advantage of UltraClear Renew by Metagenics is that it is designed to address the causes of multi-systemic processes in the body rather than target one or two pain receptors like a medication. Call us today and begin to feel better.

Body Cleanse

Many of my patients ask about a “body cleanse“. Other similar terms are detox or detoxification which are usually used in a medical context. I have also heard the term “flush”. What this means is the body, specifically fatty tissues, store toxins from the environment. Since 2001 more than 6 billion pounds of chemical pollutants have been released in to the environment. These chemicals enter our bodies through food, water, air and our skin. Fast food diets also “pollute” the body. Toxins come from pesticides, lead, mercury, arsenic in water or air, cigarette smoke, alcohol and food additives. This affects multiple organs of the body especially the liver which can’t keep up its cleansing process. This can lead to migraine headaches, muscle pains and fibromyalgia, joint pains, chemical sensitivity, and chronic fatigue.

Detoxification is the body’s way of cleansing itself from these toxins. Because the detoxification process requires a lot of energy, fasting with water or juice can be ineffective and dangerous for some people and they end up feeling worse. Prolonged fasting may lead to weaker muscles and put stress on internal organs. Therefore it is necessary to support the body with both clean organic foods especially greens and fruits and multiple specific nutrients to help the liver through its cleansing process.

We offer 10 and 28 day cleanse (detox) programs. We give booklets with the complete food and nutrient protocols. People usually say their energy is better and mind is clearer. These programs can also to help “reboot” the body metabolism for weight loss. They are great for widespread muscle and joint pains. Please see the video Metabolic Detox on our website. If you would like to have a body cleanse for every organ in your body call us today to start your medically supervised detox program.

Help Me Lose Weight

In parts I and II I covered two hidden causes of weight loss frustration, lack of adequate sleep and disruptions of bacteria in the intestinal tract. The next hidden cause of weight loss frustration is toxic chemicals stored in our fatty tissues. These are called Obesogens. Some of the most common obesogens are pesticides and other chemicals called POP’s or persistent organic pollutants such as PCBs (dry cleaning fluid), DDE (a break down product o DDT), hexachlorocyclohexane (pesticide), Pthalates and Bisphenol A (both in some plastic bottles and packaged foods). These chemicals disrupt normal weight loss signals in the body. In your quest to “Help me lose weight” we have to consider these toxins.

In an article entitled: “Chemical toxins: a hypothesis to explain the global obesity epidemic” in the Journal of Alternative and Complementary Medicine in 2002 the authors state, “Because the obesity epidemic occurred relatively quickly, it has been suggested that environmental causes instead of genetic factors may be largely responsible. What has, up to now, been overlooked is that the earth’s environment has changed significantly during the last few decades because of the exponential production and usage of synthetic organic and inorganic chemicals. Many of these chemicals are better known for causing weight loss at high levels of exposure but much lower concentrations of these same chemicals have powerful weight-promoting actions. This property has already been widely exploited commercially to produce growth hormones that fatten livestock and pharmaceuticals that induce weight gain in grossly underweight patients. This paper presents a hypothesis that the current level of human exposure to these chemicals may have damaged many of the body’s natural weight-control mechanisms. Furthermore, it is posited here that these effects, together with a wide range of additional, possibly synergistic, factors may play a significant role in the worldwide obesity epidemic.”

A strong correlation was seen between increased levels of specific POPs and insulin resistance and Body Mass Index reported in the journal Obesity in 2010. Research from Diabetes Care 2007 suggest that persistent organic pollutants (POPs) may be associated with type 2 diabetes risk by increasing insulin resistance in obese individuals.

See our video about our 10 day metabolic detoxification program and ask us to “Help me lose weight“.