You would never know it by watching the TV commercials for the cholesterol drugs but medical reports overwhelmingly recommend lifestyle and dietary changes before the drugs are prescribed. Here is a sample of a few of those articles:

American Journal of Cardiology in 2004, “National guidelines have promulgated therapeutic lifestyle changes as a standard of care in the management of conventional (coronary heart disease) risk factors.”

Journal of the American Medical Association 2003, “Managing diet is the key to treating all common lipid disorders.”

New England Journal of Medicine 2002, “Lifestyle changes and treatment with metformin (a diabetes drug) both reduced the incidence of diabetes in persons at high risk. The lifestyle intervention was more effective than metformin.”

Journal of the American Medical Association 2003, “For most patients, dietary intervention should be the first line of therapy (perhaps for 6 to 12 weeks) before introducing pharmacotherapy for hyperlipidemia.”

Many primary care doctors do not trust their patients to follow recommended dietary or lifestyle changes and will insist that the patient take a cholesterol medicine. It takes significantly more time for the doctor to discuss lifestyle changes than it does to write a prescription. In fact many doctors are unaware of the articles mentioned above and are just as influenced by pharmaceutical promotion, as are their patients.

The low cost treatment of a Mediterranean diet consisting of poultry, fish, minimal red meat, fruits and vegetables, nuts and seeds, beans and legumes has been well documented in the medical literature to be effective for heart disease, high blood pressure, diabetes and arthritis. The components of these foods have effects that no medicine can match for lowering blood pressure and cholesterol, blood sugar and inflammation. Often, if this plan is followed, many medicines can be lowered or even stopped.

These same lifestyle changes are now recommended immediately following a heart attack and are to be prioritized as high as prescription medicines according to the journal Circulation in February of this year.

The low technology approaches documented in the medical journals do not get the exposure of the drug treatments and both doctors and patients continue to be influenced by the advertising especially the tagline, ”when diet and exercise aren’t enough take…” In fact diet and exercise ARE enough in the majority of people if they are given a chance.

Hunter Yost M.D. has a private practice in NW Tucson. www.hunteryostmd.com

Exactly How to lower Cholesterol without Medication?

According to a report by NDC Health which tracks health care trends, statin drugs like Lipitor and Zocor, although highly promoted on TV, have been stopped after four months by two thirds of people for whom they were prescribed. So why are people stopping their statin drugs? Sometimes it’s tiredness and fatigue, or it may be muscle pains and achiness. A common myth promoted by the pharmaceutical companies and some doctors is that “adherence to statins is easy, but adherence to comprehensive lifestyle changes is difficult if not impossible.” This has not been proven to be true. Dr. Dean Ornish who has shown over the past 30 years that diet and lifestyle changes are just as powerful if not more so than medications found in his study that there was a 40% reduction in LDL cholesterol after one year without medication.

For the vast majority of individuals with a mild to moderate cholesterol problem who do not have a familial lipid disease (i.e. about 70% of all Americans) lowering cholesterol without medications starts with a plant based diet consisting of beans and legumes, unsalted nuts and seeds and soy foods. For people who have documented heart disease with blockages of coronary arteries, they should follow a vegetarian diet. For people with just elevated cholesterol without a strong family history of a lipid disorder, a Mediterranean diet with some lean free range chicken and beef and non-farm raised fish along with other plant proteins, fruits and vegetables is a heart healthy diet. If necessary some proven natural supplements can be added if necessary to help the cholesterol numbers.

Once a person sees how diet can lower cholesterol naturally they are encouraged to make that way of eating a way of life. In our lifestyle program we help people make those food and lifestyle changes. The majority of people don’t want to take a statin drug for ever ( or even longer than 4 months). So call us today and let us help you lower your cholesterol naturally.

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.

The natural treatment for type II diabetes

A commonly prescribed drug for type II diabetes is metformin. It is the first-line drug of choice for the treatment of type 2 diabetes, in particular, in overweight and obese people and those with normal kidney function Its use in gestational diabetes has been limited by safety concerns. It is also used in the treatment of polycystic ovary syndrome, and has been investigated for other diseases where insulin resistance may be an important factor. Metformin works by suppressing glucose production by the liver. Metformin is the only anti-diabetic drug that has been conclusively shown to prevent the cardiovascular complications of diabetes. It helps reduce LDL cholesterol and triglyceride levels, and is not associated with weight gain. So knowing all this why would people still be looking for natural treatments for type II diabetes?

Well, in the February 7, 2002 issue of the New England Journal of Medicine. The conclusion of this study found that “Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk. [however] The lifestyle intervention was more effective than metformin.” The lifestyle intervention was a combination of dietary changes and exercise. So this was proof that a natural treatment for type II diabetes was more effective than the prescription. Wow! Why didn’t we hear about this on TV 24/7 like we do about a host of other drugs? Unfortunately there is no profit in selling a natural treatment like lifestyle changes. So since this is a journal for doctors, why haven’t they told everyone of their type II diabetes patients about this natural treatment.

One reason is it takes a lot of time to explain a diet and lifestyle program to a patient–time that most primary care doctors don’t have. At our clinic we specialize in a therapeutic lifestyle program covered through most insurance. We help people with a natural treatment for type II diabetes, cholesterol and weight problems as recommended in the medical literature. See our website for success story video and call us today. We are accepting new patients.

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.

Heart health

In these excerpts from his interview with KQED’s science and environment series QUEST, cardiologist Dean Ornish talks about heart health, diet and his findings on how to reverse heart disease.

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.

Ways to help cholesterol reduction naturally

Two new medical studies show that the “low carb” Atkins diet may be harmful for the heart. A June 2012 study from the British Medical Journal followed a random sample of 43, 396 Swedish women aged 30 to 49 completed an extensive dietary questionnaire and were followed up for an average of 15.7 years. The found an additional four to five cases of cardiovascular disease per 10 000 women per year compared with those who did not regularly eat a low-carbohydrate, high-protein diet. The authors concluded: “Low-carbohydrate/high-protein diets, used on a regular basis and without consideration of the nature of carbohydrates or the source of proteins, are associated with increased risk of cardiovascular disease.” They further stated, “the short-term benefits of low-carbohydrate, high-protein diets for weight loss that have made these diets appealing seem irrelevant in the face of increasing evidence of higher morbidity and mortality from cardiovascular diseases in the long term.” Bottom line: there are much safer ways to help cholesterol reduction naturally than “low carb” diets.

In the September 2010 issue of the Annals of Internal Medicine, the demise of the Atkins diet was sounded. The goal of the study was to determine the association of low-carb diets with mortality during 26 years of follow-up in women and men from 1980 to 2006. Evaluating 85,168 women aged 34 to 59 and 44,548 men aged 40-75 in the Nurses’ Health Study and Health Professionals Follow-up Study, low-carb diets were characterized as animal based or vegetable based depending on whether they emphasized animal or vegetable sources of fat and protein. The Atkins Diet promoted animal protein especially red meat such as beef, pork rinds, bacon and sausage with very limited refined carbohydrates and vegetables.

Analyzing the results for women and men, animal protein and fat based, low-carb diets were strongly associated with higher all cause mortality rates including cardiovascular and cancer deaths. However, vegetable based protein and fat diets were strongly associated to reduced all cause mortality from heart related causes and cancer. This is the first time the Atkins diet was studied for its long term effects.

In addition, a recent study reviewed in The New England Journal of Medicine found that an Atkins-type diet “promotes atherosclerosis (heart disease) through mechanisms that do not modify the classic cardiovascular risk factors” such as HDL. A whole foods plant-based diet that’s also low in refined carbohydrates (i.e. white sugar and white flour) can help with cholesterol reduction naturally and may reverse coronary heart disease.

The treatment for irritable bowel syndrome

In previous blogs I have covered specific foods to avoid in the treatment of Irritable Bowel Syndrome. An overall bad diet of white sugar, white flour and white fat found in many packaged and highly processed foods can disrupt the ecology of the gut by turning non-harmful bacteria into harmful bacteria. We all carry about 3-4 pounds of bacteria in our intestine and colon that contain greater than 100,000 billion bacteria of about 500 different types–many more cells than our whole body. These bacteria can work for us or against us depending upon our diet and usage of antibiotics. The total of these bacteria is called our microbiome which also includes bacteria on our skin surfaces. If there is an overgrowth of the wrong kind of bacteria they can change the molecular structure of the food we eat causing reactions to that food. This is called an acquired food sensitivity i.e. you weren’t born with it. This imbalance can result in diarrhea, constipation, skin problems, headaches, joint and muscle pains, bloating and even heart disease.

So an important treatment for irritable bowel syndrome is to keep your gut bacteria happy and healthy but not through the highly advertised yogurts on TV. I recommend plain yogurt since the flavored kinds have very little of the beneficial bacteria. I may recommend a special stool test not performed by local laboratories to get levels of good and potentially bad bacteria. Then I will know which specific types of good bacteria to recommend. Many times a person will say “I have been taking this kind, is it good?”. When the test will come back and shows very low levels of the good bacteria I will recommend highly researched probiotics available only through health care professionals for them. They will need to take it for six months or longer. People with IBS seldom have just that as a health problem, and tend to have other conditions that are in some way related to disrupted bacteria in their gut. Helping your gut bacteria is essential for treating irritable bowel syndrome.

How to lower high blood pressure naturally

Some quick facts about high blood pressure:

• Hypertension is the third leading cause of death in this country.
• The higher your blood pressure the shorter your life expectancy.
• Up to the age of 60 women are less likely than men to develop high blood pressure but after age 60 women take the lead.
• Vegetarians have lower blood pressure than meat eaters and develop high blood pressure less often.
• Approximately 60% of hypertensive Americans are overweight—but in many cases losing just 10-20 pounds can bring blood pressure to normal levels.
• Being overweight in your 20′s and 30′s significantly increases your risk of developing high blood pressure later in life.
• Aspirin, ibuprofen, Aleve naproxen, decongestants and prednisone can elevate your blood pressure.

It is easier than you might think to lower high blood pressure naturally. Plant based foods such as beans and lentils, nuts and seeds without salt, soy foods as well as fruits and vegetables can significantly lower blood pressure if eaten regularly. The DASH diet (dietary approaches to stop hypertension) was recently rated as the best diet for overall health by a panel of experts for a national magazine. It recommends low salt i.e. 1tsp salt (5.5 grams) about 2100-2300 grams sodium for the entire day or less. The ratio of potassium to sodium is helpful in lowering blood pressure and should be about 5:1. This is easy to do if you avoid all microwave foods, packaged and canned foods and limit restaurant foods. One dinner at a restaurant can have 3-4 days of salt in it. There is a new report almost every week about how dark chocolate can lower blood pressure. It should say at least 70% dark chocolate on the package. But just have a few squares–not the full serving size on the package To make it easy think in terms of a whole foods plant based diet to lower high blood pressure naturally.