A Death that was Completely Preventable

One of my patients, Kathy Mitchell, died from heart disease this past December. Her death left me feeling deeply saddened and somewhat shaken. Kathy passed away at the age of 47 from Cardio Vascular Disease. This was the result of complications caused by Type II Diabetes. She was African American. African Americans are already 20% more at risk then the population as a whole from death caused by a stroke and cardio vascular disease. Kathy first came to see me about 4 months ago. She was on dialysis. Her kidney function was greatly diminished as a result of diabetes. Despite the insulin she was taking for the diabetes and the beta-blocker to lower her blood pressure, she was still in trouble.

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Unfortunately, Kathy’s case is not unique. Cardio Vascular Disease (CVD) and complications from Type II Diabetes are the second cause of death in the US. There are an estimated 8 million people in this country with undiagnosed Type II Diabetes. But what upset me the most is that, the majority of the time, these conditions are completely preventable; Kathy’s death was completely preventable.

The key to lessening your risk for such common illnesses as Diabetes and heart disease is to catch them as early as possible; then make the necessary life-style changes, which can be as simple as changing your diet. Kathy’s life, for example, could have been drastically different with something as simple as restricting intake of processed food and simple carbs at the very onset of her Diabetes. But before I talk about that, let’s look at ways to catch the progression of Diabetes and CVD, before they become irreversible.

Before Kathy ever had Diabetes or CVD, she had Metabolic Syndrome—the root of these more serious illnesses. Metabolic Syndrome refers to a series of conditions that occur simultaneously and drastically increase a person’s risk of developing diabetes, stroke, and heart disease. These conditions include obesity, hypertension, high blood sugar, abnormal blood cholesterol, and high blood triglycerides. When a person has three or more of these disorders, that person is said to have Metabolic Syndrome, or, equivalently, Insulin Resistance. Insulin resistance occurs just in case a body can produce insulin normally, but is unable to use it effectively. It is the precursor of Type 2 Diabetes. Other risk factors of Metabolic Syndrome include obesity, physical inactivity, poor diet, age, sleep apnea, and hormonal imbalance—all of which are also precursors of Diabetes.

According to the Journal of Diabetes36.1% of adult men and 32.4% of women had metabolic syndrome in the US in 2010; this puts an alarmingly large portion of the population at risk of developing a life-threatening condition. But thankfully, Metabolic Syndrome alone is completely reversible. But time is of the essence; once you actually develop Diabetes, contract heart disease, or have a stroke, it becomes almost impossible to reverse the damage. If you have one or more of the five symptoms of Metabolic Syndrome, but don’t see an immediate need for a life-style change, you should know that many people develop Diabetes unknowingly—that is, until the first complications show up (blurred vision, heart problems, etc.). But by that time, treatment is already less promising. In fact, it takes merely a single night of sleep deprivation for a body to start developing insulin resistance, even in completely healthy people.

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The most important takeaway here is that Metabolic Syndrome is reversible—but, when left unaddressed, leads to much more serious illnesses, and can even result in death. Diabetes, in particular, can cause tragedies like heart attacks, strokes, kidney disease, blindness, and even amputations. The number one thing you can do to prevent (or rid yourself of) Metabolic Syndrome and, consequently, Diabetes or Heart Disease, is to maintain a healthy life style at every age, which, as I stated earlier, can be as simple as eating healthy.

This brings me to a second important takeaway: being healthy is not equated with eating fewer calories. It matters where those calories come from; i.e., a calorie is not just a calorie. There is a HUGE difference between eating 2,000 calories of carbs a day versus eating 2,000 calories of fat and protein. Due to growing research in the way carbs and gluten affect our bodies, scientists are starting to see a very negative relationship between brain health and carbohydrates. Dr. David Perlmutter calls this phenomen “Grain Brain” in his New York Times bestseller, also titled Grain Brain. He references studies that specifically link higher levels of blood glucose (a result of eating a lot of carbohydrates) to shrinkage of a critical part of the brain. Several acclaimed journals have come out with reports linking even slight increases in blood glucose to significantly increased risk for developing Dementia. The results of one study in particular showed that people who ate high amounts of Carbohydrates (as compared to those who ate more fat and protein) were 89% more at risk of developing dementia.

It was only recently in the timeline of the human race that we started eating large amounts of carbohydrates. Our bodies evolved in a completely different environment, producing a genome that thrived most when nourished with healthy fats and protein. As a result, we are now seeing many harmful side effects of eating large amounts of refined carbs, including but not limited to, depression, cognitive dysfunction, obesity, and, subsequently, Diabetes. But just as the causes of these conditions can be traced back to diet, so too their cures. One study comparing Diabetes patients on a standard, low-fat “diabetes” diet versus those on the Paleo diet showed that patients on the Paleo diet had greater improvements in weight, blood sugar, triglycerides, blood pressure and waist circumference.

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With this in mind, I would suggest a diet low in simple carbohydrates and grains when it comes to tackling Metabolic syndrome (or any of the other conditions it causes). The Paleo diet is a practice I embrace clinically and personally. I also suggest the Mediterranean diet, which includes olive oil as the main source of fat, plenty of vegetables and fruits, legumes, a moderate-to-high amount of fish and seafood, small quantities of red meat and dairy products, and moderate amounts of wine. The most general advice I can give is to always avoid processed foods, especially any industrial seed oils, like Canola oil or Vegetable oil, which are tremendously processed and often contain harmful chemicals.

Diet change should also be supplemented by moderate exercise for 30-60 minutes a day for the best results. This can be as simple as taking a walk. But if you can’t fit a walk in everyday, try standing at your desk as opposed to sitting; you’ll burn 75% more calories that way.

If Kathy’s doctors had advised her to make any of these changes, she might still be here today. Instead of addressing her Metabolic Syndrome before it progressed, she was given medical attention only after she had already developed diabetes. By that stage, most doctors treat their patients merely by giving them insulin. Because insulin feeds off of glucose, patients then tend to crave even more carbs—the very thing that caused their condition in the first place! Kathy motivated me to write this newsletter precisely because her death was no unnecessary. No one should have to die from a disease that is entirely preventable. Kathy’s life may have been spared if only more doctors were looking for Metabolic Syndrome in its early stages and advocating low-carb diets and exercise, as opposed to prescribing useless pills after it is already too late.

Ultimately, our diets are one of the best tools we have for living a long and healthy life, even when it seems like more and more practitioners are relying on pills and medication. Eating healthy is never something that one does unnecessarily, gratuitously, or overcautiously. It can, however, be something that you do too late.

Please call 734-726-0153 to schedule a free consultation and evaluation. At Digestive Health Ann Arbor we are known for providing professional and compassionate care. We strive to guide people towards a comprehensive and holistic healing strategy. Restoring your body to health will restore the quality of your life.

Part Two: How To Include Carbs Into Your Diet.

First off, I hope everyone had a great thanksgiving. While you all know I endorse a Paleo lifestyle, I will admit that I myself ate my fair share of carbs last Thursday—and lived to tell the tale. Hopefully my last newsletter helped you to understand important role carbohydrates play in both physical and mental health. But an informed decision to include this macronutrient into your balanced diet is only the first step. Now, the questions you're probably asking are: which carbs are the healthiest? How can I incorporate them into my diet with maximum results? And finally, how do I know what exactly what my carb-intake should be? This last question is perhaps the most important, as a lot of people tend to mentally misconstrue how much of a certain food group they are ingesting. Do you know what are the recommended daily allotments of carbohydrates for someone of your age and weight? Have you ever kept track of the grams or percentage of calories you are receiving from carbs? 

As I explained in part-1 of this 2-part series on carbohydrates, something as basic as carb-intake can have an effect on health conditions from depression and lethargy to digestive upset and athletic performance. Keeping a balanced diet is undeniably one of our most valuable roots to good health. So, I have written the following newsletter to expose just which carbohydrate-containing foods offer the most benefits, like increased energy, healthier sleep patterns, etc., and I have included an easy process to help you calculate your own individual, optimum carb-intake based on health conditions, exercise level, age, weight and other factors, so that you can all get the most health benefits out of your diet.

If you’ve been shying away from carbohydrates until now, I’m guessing that’s because you think they make you gain weight. And that’s true—in some cases. If you generally eat very low amounts of carbs but binge on pizza or bread every once in a while, you will probably find that these slip-ups do add on some pounds. Don’t blame carbohydrates as a whole though; blame the refined and processed carbs that constitute America’s favorite junk foods. Carbs must be incorporated into a diet strategically and thoughtfully in order to avoid the harmful side effects that can result from ingesting certain refined carbs, like sugar and white flour. Following are some charts of diet-friendly foods and the amount of carbs (in grams) they contain. If you want to know more about which carb-containing foods to keep and which to toss, take a look at the November newsletter (click here). 

The moral of the story is that, when you’re choosing which carbohydrates to eat, please choose carefully; i.e. go for fruit, not chips. 

Knowing which carbs to eat is only half the work though. The next step is figuring out how much of your daily calories should come from carbohydrates—something that will ultimately be a result of personal factors and preferences. The following information is meant to help you customize your own diet in a way that can have you feeling your best; it just takes a little diligence and patience.

Step 1 is to assess what percentage of carbs will work best with your life-style and weight goals. First, look at any diseases or health conditions you may be suffering from. For example, if you have diabetes or small intestinal bacteria overgrowth, you are going to want to start off in the low-carb category. If you have adrenal fatigue, are breastfeeding, or are a moderate to heavy exerciser, you’ll probably want to start at a moderate carb level. There are many other conditions that can affect how well your body receives carbs, so please be sure to assess your overall health when deciding what amount of carbs might work best for you. If you have multiple conditions that require opposite amounts of carbs, you should consider working personally with a practitioner. 

If you don’t have a condition that places you in a particular spot on the carb-intake spectrum, the best place to start is with a moderate carb diet. I suggest keeping a food diary in order to keep track of any symptom regression/improvement. Ultimately, the best indicator of carb-intake is how you feel, e.g. good, bloated, weak, etc.. Based on this diary, you can experiment by increasing and decreasing your carb percentage until you find a level that benefits you the most.

Step 2 is to figure out how many calories you should be eating each day from carbohydrates. If you know what your daily calorie-intake should be, simply multiply it by your target-percentage of carbohydrates. The following chart details what percentages constitute which carb-levels (low, moderate, high), as well as which populations would benefit most from each level:

 If you are unsure how many calories you should be consuming each day, you may want to search the web for an online calorie calculator. Otherwise, 2000 is a reasonable number to start with. So if you want 20% of your calories to come from carbs, multiply .20 x 2000 = 400. This is the number of calories you should be getting each day from carbohydrates. If you don’t feel like counting calories you can divide this number by 4 to figure out how many grams of carbohydrates you should be eating each day. 400 / 4 = 100g of carbs a day. Based on the first few charts, we see this goal can be met by eating a banana and an apple between meals, ½ a head of romaine lettuce in a salad for lunch, and a sweet potato with dinner, for example. 

If this process sounds a little too mathematical to you, you can also use the basic rule of thirds, which requires your plate to be 1/3 protein, 1/3 starch, and 1/3 low-carb vegetables and tubers. Following this rule will put you somewhere near the moderate-carb level.

I would like to stress that the diet calculation process as a whole is somewhat imprecise and for most, it will take some experimenting. Start in a moderate position unless you have one of the aforementioned health conditions, see how you feel, and adjust your carb-intake from there. My final advice is to please give each stage of your experimenting a fair amount time for your body to acclimate. If you eat only 10%-15% of calories from carbohydrates and you start feeling sluggish, have a harder time shedding that last pound or two of fat, or aren’t sleeping as well, you might need to consider slightly raising your carb-level. If you’re eating 30% or more of calories from carbs and you notice weight gain or digestive upset, you should consider a moderate or low-carb diet.

Remember: patience is key. There’s no miracle diet or one-size-fits-all approach. But, if you do give your diet the time and attention it deserves, the results should be well worth it.

Please call 734-726-0153 to schedule a free consultation and evaluation. At Digestive Health Ann Arbor we are known for providing professional and compassionate care. We strive to guide people towards a comprehensive and holistic healing strategy. Restoring your body to health will restore the quality of your life.

What Fats Do, and Why You Should Eat More!

Fats have a bad name, but why?

Dr. Ancel Keys was an American scientist who studied the impact of diet on health. Dr. Keys’ study, “The Seven Countries Study,” showed a strong statistical relationship between fat consumed and incidence of cardio-vascular disease in the United States and 6 other countries in Europe. The American Heart Association as a result made a public service announcement encouraging the American people to avoid eating fats. It was later discovered that the study originally included 22 countries, not only 7, and that Keys had thrown out the conflicting results. In other words, his hypothesis did not hold water in the remaining 15 countries originally studied. However, the damage was done, and ever since, the American public has been convinced that a diet high in vegetable oils and grains and low in fat was the only way to avoid heart disease. In the following article, we will describe what fats actually do, how they serve our bodies, and how you can develop a healthy relationship with fat that works for your body.

What does fat actually do?

-          Building block for cell membranes.

-          Main composition for our brains, nerves, and reproductive hormones.

-          Key contributor to strong memory.

-          Key source of energy.

-          Stabilizes insulin and glucose metabolism.

-          Prevents us from overeating. It is physically impossible to overeat fat. Sugar and carbs, yes, but not fat.

What happens without fat?

-          Without the right ratios of each type of fat, or without enough fat, there are serious health implications.

What kinds of fats are there?

Saturated, monounsaturated, and polyunsaturated.

What do those names mean?

This is a bit of biochemistry. It is important to understand what makes each type of fat different.  They indicate how many, if any, double bonds exist in a given fat. Chemically, all fats are triglycerides, meaning they contain a glycerol and any of several different kinds of fatty acids. Therefore, the fats are differentiated by the fatty acids which they are made from. Fatty acids are composed of carbon and hydrogen atoms. Long chains of carbon and hydrogen raise the melting point of the fat, and also yield greater energy per molecule when metabolized. Saturated fat means that every carbon in the chain has a hydrogen pair. Unsaturated fats contain double bonds within the carbon chain, meaning the carbons bond to each other, rather than a hydrogen atom. Polyunsaturated fats are triglycerides in which the fatty acid chains contain more than a single carbon-carbon bond.

Saturated fats and unsaturated fats differ in melting point and energy yield. Unsaturated fats provide less energy because they have fewer carbon-hydrogen bonds. Saturated fats can stack themselves neatly because of the carbon-hydrogen pairing, and therefore freeze more easily. This is why at room temperature saturated fats tend to remain solid, while unsaturated fats are liquid.

3 Characteristics of Fat

1.Inert and stable: Solid at room temperature. For example, coconut oil, which is a short-chain saturated fat that rarely becomes rancid, even if exposed to air for years and years.

2. Liquid and easily oxidized: Linseed oil, a polyunsaturated fat, goes bad quickly.

3. The middle of the pack: Monounsaturated fats fall somewhere in the middle between saturated fats and polyunsaturated fats in terms of how quickly they go bad, and how inert they are at room temperature.

What Fats do What?

Saturated Fats

Saturated fats have suffered a pretty terrible reputation the past few years. In fact, they were singled out as the cause of cardio-vascular disease (CVD). Researchers have even linked them to things from cancer to neuro-degeneration to other autoimmune disorders. The truth is that saturated fats are actually quite helpful when consumed within reason. If we make sure to keep our saturated fat and carbohydrate intake within the levels consumed by our ancestors, it is unlikely that you will develop CVD.

-          Lauric Acid. Found in coconut, palm oil, and human breast milk. Boasts antiviral properties including fighting against HIV and chicken pox. It also helps heal the gut.

-          Palmitic Acid. Found in palm oil, beef, eggs, milk, poultry, and seafood, among other animal products. Palmitic Acid helps to optimize cognitive function by helping us to make new memories and store the old. However, among the saturated fats, Palmitic does actually pose the greatest risk for CVD.

-          Stearic Acid. Found in meat, eggs, and chocolate. Stearic Acid helps to decrease systemic inflammation. 

Monounsaturated Fats

Though there are many monounsaturated fats, the only that is important to discuss for the purposes of this paper is oleic acid. Monounsaturated fats were the primary fat in our ancestral diet, so eating plenty of it will help us to enhance physical performance.

-          Oleic Acid. Found in plant sources such as olive oil, avocados, nuts, and even some grass-fed meat. Boosts insulin sensitivity, improves glucagon response, and decreases cholesterol levels. 

Polyunsaturated Fats

These fats could be called “the essential fats,” since we absolutely cannot make them and must get them from our diet. Without them, our bodies suffer. Our current lack of sufficient polyunsaturated fat represents one of the worst consequences of our heavily processed modern diet. We will look at two subfamilies of polyunsaturated fats (PUFAs) called omega-3 (abbreviated as n-3) and omega-6 (abbreviated as n-6). In general, n-3/n-6 are good for us, and found in grass-fed meats and wild-caught fish. However, n-3/n-6’s can be unhealthy when eaten out-of-balance. For example, our ancestors ate 1:1 ratios of n-3 to n-6. Our ratios of consumption today are around 1:10. Why? We eat way too much corn, soy, safflower, and vegetable oils, the source of much of our n-6 fats. This imbalance is the cause of many health-related issues.

1. Omega-3 (n-3)

-          Alpha-linolenic Acid (ALA). Found in flax, hemp, and other plant sources. It supports enhanced performance, health, and longevity, but doesn’t deliver the nutritional punch that other n-3’s do.

-          Eicosapentaenoci Acid (EPA). Found in fish oil and human breast milk. EPA is a strong anti-inflammatory, helps to thin the blood, and blocks the growth of new blood vessels thereby preventing the spread of cancer. EPA is really good for us!

-          Docosahexaenoic Acid (DHA). Found in cold-water oceanic fish, this fat is critical for fetal brain development and cognitive function throughout our lives. Low levels of DHA are detrimental both for the unborn fetus, and the mother. With low DHA levels, women more frequently suffer preeclampsia, gestational diabetes, and postpartum depression. DHA also boasts antitumor and anti-inflammatory capabilities. 

2. Omega-6 (n-6)

-          Linoleic Acid (LA). Found in vegetable oils such as safflower and sunflower. LA can actually cause inflammation and block the inflammatory powers of n-3 fats such as EPA and DHA. It’s not very good for us!

-          Gamma Linolenic Acid. Found in borage, primrose, and hemp oils. GLA can act as an anti-inflammatory agent.

-          Dihomo-Gamma-Linolenic Acid. DGLA is made in the body by the elongation of GLA, and very rarely traces of it are found in animal products. DGLA regulates the production of several molecular messengers that support immune function, increase inflammation, and monitor the body’s experience of pain.

-          Arachidonic Acid (AA). Found predominantly in animal products, AA regulates metabolic functions and is critical for our adaptation to exercise, muscle repair, and general brain function. AA is vital to life, but can lead to excessive inflammation if over-consumed.

Fats that we should never, ever eat.

-          Trans fat. Found in nothing our ancestors ate, ever. In fact, they’ve only existed for about 50 years. Exposing polyunsaturated fats to hydrogen gas creates trans fats, which look and act similar to saturated fats. However, trans fats have some serious flaws. They destroy liver function, ruin blood lipids, and undo our insulin sensitivity. Thankfully, trans fats are being phased out. Now even the FDA is calling for an eventual ban. 

Eat Fat: How Much, What Type, and How You’ll Feel

Now that we’ve described most of the fats we encounter in our lives at great length, we will discuss how to eat it and what the effects on your body will be.

1. How much?

While some medical practitioners have staked their careers on telling people to eat as little of fat as possible, it seems that fat intake actually has little bearing on health, disease, and even weight! The best course of action is to find what works for you through experimentation or discussing with an appropriate health practitioner.

2. What type?

-          Saturated fat is no longer the big bad wolf ready to blow down your house, or blow out your heart. The ancestral diet included 10-15% of calories from saturated fats, unless the population lived in areas near coconut, in which case the population may have eaten up to 40% of its’ calories from saturated fats such as Lauric Acid.

-          Our ancestors also tended to avoid eating much Palmitic Acid, which is a huge indicator in increasing LDL cholesterol.

-          Balanced n-3:n-6 ratios. Since omega-3’s tend to decrease inflammation and omega-6’s increase it, the fact that our ancestors ate about an equal amount of both meant that our bodies remained in balance. Our current diet skews heavily in favor of consuming omega-6’s, leading to increased inflammation throughout the body. To balance this out, eat grass-fed and wild-caught fish, and supplement with fish oil. Try to avoid most seed and grain oils, as well.

-          Coconut Oil improves heart health, boosts metabolism, promote weight loss, supports the immune system and even helps our skin look young when applied topically!

3. How will I feel and look?

Eating good, healthy fats suited to your bodies needs will help you lose fat, gain muscle, and feel amazing.

Please call 734-726-0153 to schedule a free consultation and evaluation. At Digestive Health Ann Arbor we are known for providing professional and compassionate care. We strive to guide people towards a comprehensive and holistic healing strategy. Restoring your body to health will restore the quality of your life.

How much do you know about living a healthy life? What is your Health IQ?

Here are some easy questions to find out.

(the answers are at the end of the questions)

 

1. What is the health significance of skin tag?

2.Which of these disease conditions are caused by Type ll Diabetes?

Glaucoma, cataracts and other eye problems, numbness in the feet, increased skin infections, high blood pressure (Hypertension), depression, inability to deal with natural emotions like sadness and anger, hearing Loss, gum disease, Gastroparesis, Neuropathy (nerve damage), Kidney disease, Peripheral Arterial Disease (PAD) and Stroke

3. What is the main cause of Type ll Diabetes?

4. What is the most common cause of high cholesterol?

5.. What is one of the main causes of high blood pressure?

6. What is one of the main causes of Alzheimer ’s disease?

7. What is the main cause of heart and blood vessel disease?

8.Do you experience any discomforts associated with your menstrual cycle, or resulting from menopause or perimenopause?

9. What is one of the main causes of erectile dysfunction?

10. What food sensitivity is often implicated in all these health conditions?

    Osteoporosis, irritable bowel disease, inflammatory bowel disease, anemia, cancer, fatigue, canker sores, and rheumatoid arthritis, lupus, multiple sclerosis, and almost all other autoimmune diseases. Many psychiatric (vi) and neurological diseases, including anxiety, depression, schizophrenia, dementia, migraines, epilepsy, and neuropathy (nerve damage). It has also been linked to autism.

    11. What is one of the major causes of death in the US and what is its cause?

    12. Percentage of the US population that is overweight or obese?

    13. Percentage of the US population that is prediabetic?

    14. What foods will help you loose weight the quickest?

    15. What is the world ranking of the US in terms of life expectancy?

    16. What part of your body contains 70% of you immune system?

    Answers:

    1. Skin tags are an indication of a potential risk for Type 2 Diabetes.

    2. All of the illness listed are all a direct result of Type 2 Diabetes.

    Questions 3 through 7: A diet high in grains and refined carbohydrates.

    Here is a link to more information about question #7 http://www.diabetes.co.uk/type3-diabetes.html

    8. Often time health issues related to a woman's menstrual cycle or age are homonal in nature, but many time diet has a significant impact on the overal hormonal healht of a woman.

    9. You might think it is low testosterone. It is not! It is a diet high in grains and carbohydrates.

    10. All of the inness listed in question #10 are often a result of consuming gluten which is found in wheat, rye and barley. A review paper in The New England Journal of Medicine listed 55 "diseases" that can be caused by eating gluten.

    11: 35% of all deaths are related to heart and blood vessel disease.

    12. Sixty percent of men and woman over the age of 25 are overweight or obese.

    13. Most people don’t even know that they are prediabetic of have Metabolic Syndrome.

    In 2005–2008, based on fasting glucose or A1C levels, 35 percent of U.S. adults ages 20 years or older had prediabetes—50 percent of those ages 65 years or older. You can guess that these statistic are not going down. http://diabetes.niddk.nih.gov/dm/pubs/statistics/#Pre-diabetesY20

    14. Fats and protein.

    15. The US ranks 26th our of 36 of the most industrialized countries.

    http://www.huffingtonpost.com/2013/11/21/us-life-expectancy-oecd_n_4317367.html

    16. Your digestive tract contain 70% of immune system. I included this question to emphases the relationship of what you eat and your immune system.

    What do all these questions have in common?

    I think you guessed by now, a diet high in grains and simple carbohydrates.

    If health is a choice for most of us, the first step to making that choice is to eat in a way that supports your health. Find out just how healthy you are.

    Digestive Health Ann Arbor now offers a complete Metabolic Health Assessment. It is extremely comprehensive and provides considerably more information about the current state of your health then most doctors will provide. If you are interested in a very detailed assessment of your health, please click here for more information. (All blood work needed for this assessment is covered by your health insurance). For more information, or to schedule a free consultation and evaluation please call Digestive Health Ann Arbor at (734) 222-8210 or visit www.digestivehealth-annarbor.com.

    For more information on the impact of grains and carbohydrates on your health please please read an article just published in the Crazy Wisdom Journal on page 46. http://issuu.com/cwcommunityjournal/docs/issue_56_4_web?e=9760045/6156842

    Please call 734-726-0153 to schedule a free consultation and evaluation. At Digestive Health Ann Arbor we are known for providing professional and compassionate care. We strive to guide people towards a comprehensive and holistic healing strategy. Restoring your body to health will restore the quality of your life.

     

     

     

     

     

     

     

     

     

     

     

       

       

       

       

       

       

       

       

       

       

       

       

      How to Live Well: A Closer Look of the Impact of Food, Nutrition & Health

      How to Live Well: A Closer Look the Impact of Food, Nutrition & Health

       

      Chronic disease is a serious problem. People get sick every year with easily preventable diseases, and spend more and more money to heal. We must learn to use the incredible scientific innovation and resources in our country to better combat these issues as a nation.

       

      According to the CDC: Chronic disease is a public health crisis.

      -          Deadly: Heart disease is the leading cause of death for both men and women

      -          No one is safe: Diabetes affects 25.8 million people (CDC)

      -          Expensive: 75% of our health care dollars goes toward the treatment of chronic illness

      -          Growing Problem: 65% of all men and woman over 25 are overweight or obese.

      For most people health is a choice, but you need the right information to make the best decisions. In the following article we will talk about how poor nutrition leads to chronic disease and what you can do to prevent it.

       

      Section A

       

      The Three Basic Molecules of Nutrition: Proteins, Carbs, and Fats

      No matter what you eat, this is where it ends up. Basic nutrition is all about these three main components. Staying healthy depends on eating the appropriate amount of each. To prevent disease, it’s all about managing insulin and glucose, which all gets back to eating minimal carbs.

       

      1. Proteins:

      Proteins are the source of life itself. They do a lot of cool things, chief among them DNA assembly. Proteins also are used for food and energy, body repair and growth. They are what make up our skin, muscle, hair, and nails, as well as neurotransmitters, enzymes, and hormones. To make proteins useful, our guts break them down into what’s known as amino acids. And just try to eat too much of them- it won’t happen. The body won’t let you. The body has a mechanism for making sure you never, ever overeat them. 

       

      2. Carbohydrates:

      Technically, carbohydrates include everything from wood to grass to apples to bread.  Depending on how you link carbohydrates together, you can have anything from a bowl of pasta to a pine tree. Our body, however, has no use for bark. Unlike the multi-tool protein, sugar is only used for energy production.

       

      It all starts with what are called “monosaccharides.” The two monosaccharides, or sugars, we will follow most closely are glucose (the main sugar used for energy in our bodies) and fructose (a relative of glucose). Everything boils down to glucose. Our bodies need to break down all sugars (whether they be disaccharides or polysaccharides) into glucose, which is the only form of carbohydrate that can pass through the gut wall to be used for energy. This is why if we eat too much of it, it can tax our bodies. It takes a lot of energy to whittle those sugars down into glucose-bites.

       

      Also unlike proteins, our body has no mechanism for controlling our carb consumption. This is why we can just keep eating and eating all that pizza…

       

      3. Fructose

      Fructose is what you really have to look out for. While it is naturally occurring in most fruit, fructose is everywhere in processed foods. And it doesn’t do a whole lot besides make us sick. Fructose actually serves zero purpose- it can’t be used for energy by your body, and as we already know, carbs (sugars) only have that one purpose anyway. Fructose can cause obesity, high cholesterol, and diabetes. It also can feed pathogenic bacteria in the gut, make us forgetful, and damage the liver.

       

      3. Fats:

      Fat has a really bad reputation these days. There are a lot of fad diets out there that tell people the best way to lose weight and get healthy is by cutting out fat. Actually, a good way to lose fat is by cutting out unhealthy fats. But fat itself is really good for us. Our body is designed to run on fat as a source of energy, which it converts into ketones bodies. Scientific research shows that diets rich in monounsaturated and Omega-3 fats actually reduce instances of obesity, cancer, diabetes, heart disease, and cognitive decline.

       

      Just like protein, it’s impossible to overeat fat. Except the fat that you combine with, say, sugar, and chocolate flavoring to make, oh I don’t know, ice cream. It’s possible to overeat ice cream precisely because it has carbs (sugar) in it.

       

      Section B

       

      Hormones: Insulin, Blood Glucose, Glucagon, Leptin, Ghrelin, Adiponectin, Peptide YY, Cortisol and IGF_1

      Besides the three main nutritional building blocks, our body also runs on a series of important hormones. Below are some of the most important hormones for understanding digestive function and health.

       

      1. Insulin

      Critical in regulating blood sugar, body fat, and aging, it’s important to keep insulin levels low by controlling carb intake and maintaining a healthy lifestyle. Too much insulin can be extremely inflammatory. According to Dr. Cordain, 35% of all heart disease and blood vessel disease are related to mismanaged insulin and glucose.

       

      2. Blood Glucose

      Blood Glucose is basically glucose that has left the digestive tract and is now in the blood, traveling around to be utilized by the body. It’s important because red blood cells and certain parts of the brain need it and it alone to run properly. However, we are better off if we can run the body on mostly fat. Our bodies actually have the capability of making glucose from fats and proteins, so this blood glucose could come from carbs or from proteins and fats converted into glucose.

       

      3. Glucagon

      Released from the liver, glucagon allows us to access our body fat for energy which helps normalize blood sugar and energy levels between meals. Insulin and glucagon play complementary roles in the maintenance of energy levels by storing and releasing nutrients at the right time. While insulin facilitates the passage of nutrients into cells, glucagon releases nutrients in cells to be used or energy. Decreased blood glucose levels, among other signifiers, stimulate it. Under normal circumstances, glucagon is stored in the liver and muscle tissues for later use.

       

      4. Leptin

      Leptin tells us when we’re full. It regulates both appetite and metabolism. Produced by white adipose tissue (fat cells) and the cells lining the wall of the stomach, Leptin heads towards the central nervous system where it communicates directly with the brain.

       

      5. Ghrelin

      Ghrelin tells us when we are hungry and low on energy. It is greatly impacted by too little sleep and high levels of stress. It is produced all over the body- in the stomach lining, the pancreas, and other

      tissues.

       

      6. Adiponectin

      Another hormone that tells us we’ve had enough to eat, Adiponectin also protects our arteries from oxidative damage. Though it is secreted by adipose (fat) tissue, it has been found that people with high levels of adiponectin actually have a lower percentage of body fat.

       

      7. Peptide YY (a.k.a. PYY)

      Another satiety hormone. Protein and fat release a lot of PYY, whereas carbohydrates release relatively little. PYY is a gut hormone that plays a synergistic role with leptin in helping us feel satisfied after a fatty (not carb rich) meal.

       

      8. Cortisol

      Cortisol does a lot of things, but in relationship to the topic of this article, w’re only going to talk about what it does with blood sugar. Made in the adrenal glands, cortisol raises blood sugar levels which can lead to fat gain. Spikes in cortisol occur through lack of sleep and stress. In fact, it’s often referred to as “the stress hormone.” It increases blood pressure and lowers the activity of the immune system. It can trigger the breakdown of muscle mass by converting protein into glucose. Too much cortisol can decrease insulin sensitivity, lower the bone formation rate, and diminish skin collagen and connective tissue. However, by and large cortisol is a helpful hormone because it serves as an anti-inflammatory. To avoid developing too much cortisol, avoid: intense or prolonged physical activities, caffeine, sleep deprivation, stress, and certain contraceptives.  

       

      9. Insulin-like Growth Factor-1 (IGF_1)

      Just enough IGF_1 aids in physical recovery, but too much increases our likelihood for cancer and our rate of aging. IGF-1 also helps kids grow, promotes cell maintenance and stress resistance. Exercise, stress and nutrition all affect IGF-1 levels.

       

      Section C

       

      Comparing Healthy and Unhealthy States: The Physiology of Digestion

      Now we have met all the contributing players in the digestion/endocrinology game, we will begin to understand Type 2 diabetes, various types of cancer, Alzheimer’s, Parkinson’s, infertility, cardiovascular disease, and osteoporosis and, of course, our bodies homeostasis: wellness.

      What happens to our bodies when we eat too much, too little, and just enough? In the next section we will use what we have learned to evaluate a “normal” fed state where we eat exactly as much as we need (isocaloric), a “fasted” state (hypocaloric) and an “overfed” state (hypercaloric).

       

      What happens to the body in a “normal” fed state?

      You’ve decided to marinade then roast some salmon. The protein in the salmon is broken down into individual amino acids. The amino acids can now go one of two ways. Either the liver will absorb them and use them for its own functioning, or the amino acids will circulate to the blood where they will help primarily with growth, repair, and energy production.

       

      You’ve also decided to make some pasta with a white wine sauce to go with the salmon. Digestion breaks down the carbs into free glucose, and the glucose makes its way from intestines to liver. Its fate can go one of a few ways, too. Free glucose releases insulin from the pancreas, which activates glucose transport molecules. These glucose transport molecules facilitate blood glucose absorption by the liver, where it is then stored as a form of starch called glucogen.

      What tips the scales in an “overfed” state?

       

      Some people are able to eat everything they want and never gain a pound, while others just look at food and it creeps on their wastes. The secret is not calores-in and calories-out, but rather hormones and food choice.

       

      All the satiety hormones we discussed previously in this essay are complex sensors which let us know when we are “full.” This is why hormones such as leptin are so important. Food choice is also very important. Certain foods affect our sense of satiety and can wreak havoc on various physiological functions.

       

      If instead of eating the amount of salmon our body needs, we instead continue to eat, the protein is still broken down into amino acids. These amino acids will also still be either converted to glucose or burned directly as fuel. While proten can add to overall caloric excess, it is virtually impossible to overeat protein due to the potent satiety signal sent to the brain. Because of our bodies strong response to excess protein, its good to base meals around protein-rich foods, which will tell us to stop eating before we eat too much.

       

      Now, if we start with the pasta before we eat the salmon, we’ve got a different story. If we eat too much pasta, digestion will still break down the carbs into free glucose, and the glucose will make its way from the intestines to the liver. However, we filled up our liver with so much pasta that now excess carbohydrates are converted to fat molecules called VLDL (very low-density lipoprotein) within the liver. The fat is then released from the liver and heads out to the body to be used as fuel or be stored as adipose tissue.

       

      1. VLDLs skyrocket

      VLDL’s are the most inflammatory of the four cholesterol particles (LDL, HDL, IDL, and VLDL). Once released, VLDL’s move all over the body, including the brain. Once inside the brain, VLDL’s can make the hypothalamus (responsible for energy regulation inside the brain) leptin resistant, destroying our normal satiety signal and leading to future over-eating.

      2. Insulin Resistance

       

      This process happens in waves, much like the ocean eroding a sand castle. The liver becomes insulin resistant and blood glucose drives up higher. Insulin sensitivity inour muscle tissue is finally lost when the muscles can physically store no more glycogen. They are literally drowining in glucose. The blood sugar continues to increase, insulin skyrockets, and eventually even the fat cells become resistant to insulin. Insulin resistance is considered the half-way mark to Type 2 diabetes.

       

      3. Cortisol Production

      Once systemic, full-body insulin resistance occurs, the liver is overwhelmed. Blood glucose is turned into fats and VLDLs so quickly that fat cannot escape into circulation, and it builds up within the liver. This is the beginning of what is known as non-alcoholic fatty-liver disease. Even though the liver is literally swimming in glucose at this point, the liver is also insulin resistant so it actually believes that the body has low blood sugar. Your body is worried about the low blood sugar, because if it falls too low you can die. So your body starts producing cortisol, the stress hormone, and it’s like throwing gasoline in a fire.

       

      4. Full System Meltdown

      Cortisol is released to combat the perceived low blood glucose levels, even though your body at this point clearly has way too much.  The body begins to make more glucose by cannibalizing its own tissues. Muscles and organs are “burned” to make more glucose. Remember, the muscles are where the body deals with elevated blood glucose in the first place! So not only is our body producing more glucose, its also doing so by depleting our first line of defense when it comes to lowering glucose levels in the body.

       

      This is why Type 2 diabetes and insulin resistance is effectively a wasting disease of the muscles, while fat cells grow exponentially. Fat is stored in the abdominal region because of the high insulin, blood sugar, and triglycerides. This waistline fat is the telltale sign of insulin resistance. The stage is now set for chronically elevated insulin levels, and all the other complications that brings such as increased cancer rates, accelerated aging, neurodegenerative diseases like Parkinson’s and Alzheimer’s, obesity, and ultimately Type 2 Diabetes which is characterized by insulin resistance and chronically elevated blood glucose levels.

       

      5. AGE’s and Physiological Degeneration

      We’ve seen above how glucose can serve as a toxic substance, even though it is critical for bodily function. Sugars can oxidize and form “advanced glycation end products” (AGEs) which damage proteins, enzymes, DNA, and hormonal receptor sites. AGEs are a major cause of the symptoms we take to be normal aging, and can also cause several degenerative diseases.

       

      6. The link toHigh Cholesterol

      When glucose binds to low-density lipoprotein (LDL cholesterol), it prevents the LDL from binding to receptors that tell the liver to stop manufacturing cholesterol.  As a result, the liver “thinks” there’s a shortage of cholesterol in the body and continues to produce more.  This is one reason why diabetes is almost always associated with high cholesterol levels.

       

      Section D

      How to Live Well: Digestive Health Ann Arbor

      For most of us, health is a choice. Provided the right information and enough support, we can all achieve optimal health and wellness. If you or a loved one suffers from chronic diseases, food allergies, or wants to make sure they are living as healthfully as possible, it is important that they seek professional health. As we have pointed out in this article, following the right nutritional balance is crucial to living well. In order to find the right nutritional balance for you, you need a nutritional path tailored to meet your needs. For more information, please call Digestive Health Ann Arbor at (734) 726-0153

       

      Digestive Health Ann Arbor now offers a complete Metabolic Health Assessment.  It is extremely comprehensive and provides considerably more information about the current state of your health then most doctors will provide.  If you are interested in a very detailed assessment of your health, please click here for more information. (All blood work needed for this assessment is covered by your health insurance).

      Please call 734-726-0153 to schedule a free consultation and evaluation. At Digestive Health Ann Arbor we are known for providing professional and compassionate care. We strive to guide people towards a comprehensive and holistic healing strategy. Restoring your body to health will restore the quality of your life.