The majority of us could stand to lose a little weight. Weight loss can improve our physical health, appearance, and mental/spiritual outlook.
I know that when I loss weight and eat healthier that I feel better and have much more energy. I sleep better and have a better outlook on life.
But does our body and brain agree that weight loss is a good thing?
One of the common concerns I get from patients in regards to diet and weight loss is that they will enter the so-called "starvation mode."
It is true that both our brains and bodies respond to weight loss by trying to conserve energy by reducing the number of calories that we burn. We can also feel hungrier and lethargic.
This normal response of the body is often called "starvation mode."
Whenever we limit our calories our body adapts to try to keep us at a stable weight. This stable weight is different for all of us and may change over time.
It is also key to remember that as we lose weight our calorie expenditure will also decrease just based on the fact that we are lighter. It requires less energy to move a smaller frame. Most people also lose some muscle mass with weight loss which also decreases our basal metabolic rate.
So how can we overcome "starvation mode"?
The more and more I work with patients and learn from my own experience I have come up with a few tricks to limit starvation mode.
1. Lift Weights or High Intensity Exercise: Resistance training has been shown to help limit decreases in muscle mass and our metabolic rate that can come during weight loss. Strength training can also increase our metabolic rate when we are not losing weight.
2. Taking Breaks: Our bodies respond quickly to changes in our environment. If our body senses a consistent caloric restriction then it may respond by decreasing our metabolic rate. One way to possibly combat this is to eat normal calorie amounts for short periods followed by periods of caloric restriction.
3. Fasting: The more and more I have practiced and studied fasting I have come to see it as a powerful tool in the weight loss and/or health arsenal. Some studies have shown that fasting can actually increase our metabolic rate as opposed to decreasing it. This may come as a surprise to some but it actually makes sense. Our bodies know that we cannot decrease our metabolic rate to zero. Our bodies also know that if we are "starving" that we need to have energy to find food. This means that our metabolic rate will increase. There are various types of fasting which can help including intermittent and sustained periods of fasting.
Starvation Mode is Real!
The bottom line is that starvation mode is a real phenomena but the fear of starvation mode should not stop us from trying to live healthier.
Fortunately, there are helpful strategies that can assist us during our weight loss journey. I am happy to help guide you through this process. Before considering any diet or weight loss regimen please consult your personal physician.
We all know that it is important to get exercise. The benefits of exercise are myriad. I personally get not only physical benefits but I also get profound mental and spiritual benefits as well.
But how much do we need to exercise?
The National Institutes of Health (NIH) recommends at least 150 minutes of moderate-intensity exercise a week. This equates to 30 minutes per day if you exercise 5 times a week. The NIH also recommends that you can do 75 minutes of vigorous activity per week in lieu of moderate-intensity exercise.
Despite these recommendations there is more evidence that shorter periods of high-intensity exercise are equivalent to long periods of moderate-intensity exercise. In a prior article I wrote last year I reviewed a study that compared two groups of young men.
These men were not in shape to begin with and they all completed 3 sessions of exercise per week for 12 weeks. One group did 45 minutes of moderate activity exercise on a stationary bike. The other group only did 1 minute of all-out exercise within a 10-minute time commitment.
By the end of the study both groups showed equivalent improvements in peak oxygen activity, insulin sensitivity, and skeletal muscle performance. Both groups had an increase in endurance by about 20 percent.
However, they were not equivalent in terms of total time commitment. The moderate activity group spent 27 hours on the bike whereas the high-intensity group only spent 6 hours with only 36 minutes of that time being strenuous.
So what do I do?
My personal favorite high-intensity activity is sprints. I enjoy doing sprints because it gets me outdoors which I feel is also important. What I do is pretty simple. My neighborhood is one big circle. I simply do 4-5 all out sprints with short walking breaks between the sprints and stop when I get back to my house. It takes me about 10-15 minutes total. I try to do this about 2 times per week. That's it! Of course, you can do all sorts of other activities that mimic this process depending on the health of your joints and ability to do vigorous activity.
For those looking to get healthy this summer feel free to reach out and schedule a consultation. Otherwise, before starting any sort of exercise routine please consult with your physician.
Now that school has ended for our kids and the heat of summer is fast approaching, it is a great time to focus on your health and fitness.
I personally have a love/hate relationship with diet and exercise. At some points in my life I have been very overweight and unhealthy and at other points I have been thin and energetic. This is true for a lot of us.
I have lost 70 lbs twice in my life so I am very familiar with how difficult it is too maintain a healthy body weight. I have purposefully kept my drivers license picture that was taken when I was at my peak weight to serve as a reminder of my weight loss journey.
For a few years I have been proponent and practitioner of the low carb and high fat (LCHF) diet. This type of diet is also called the Ketogenic diet which is not to be confused with Atkins or South Beach diet. These other diets contain a lot more protein especially in the form of meat. A true ketogenic diet only contains a low to moderate amount of protein and the focus is more on eating vegetables and healthy fats and very few carbohydrates. The typical ketogenic is composed of 65-80 % fat calories.
Other things that I have incorporated is both intermittent and long periods of fasting. I have fasted for over a week consuming nothing but water and supplements. I am also a big fan of high intensity training (HIT) and strength training. While not for everyone I enjoy doing sets of all-out sprints. The evidence shows that just 10 minutes of HIT is essentially equivalent to 60 minutes of moderate intensity activity like jogging or cycling.
Recently, I have seen a significant surge of interest from patients that are inquiring about the ketogenic diet or other ways to help with weight loss or to live healthier. In my experience the ketogenic diet can be tricky and it will definitely help to have someone like myself serve as a coach through the process. Since I have personally experimented with many diet and weight loss strategies I can help those that are interested in taking control of their health.
To get you started on your weight loss journey it helps to start simple. One of my favorite meals is composed of 1 avocado, salsa, 1 lime, and a pinch of salt. I start with putting an avocado in a bowel and slice it up as small as possible. I then add the salsa, lime, and salt and mix it up thoroughly. I typically eat about half of it and save the rest for later in the day or the next day. The avocado provides a lot of healthy fats, fiber, and potassium.
In conclusion, before doing the ketogenic diet or any of the strategies I have discussed above please consult with your physician first. If you have any questions or would like to learn more feel free to give me a call or send an email.
One of the common responses that I encounter when I ask my patients about diet is that the ideal diet is essentially a low fat diet. What this means varies to some degree but often people characterize this "ideal diet" as consisting of low-fat yogurt, bread, cereal, fruit, and a lot of chicken.
But is the high sugar, high meat, and low fat diet described above the ideal? Does it actually result in lower levels of fat in the blood?
In my view the answer is clearly no.
When I tell patients that the "ideal" diet they are consuming actually leads to higher levels of fat in their blood even though it is a low fat diet they are puzzled. The reasons for this are complex and beyond the scope of this article. Needless to say, Triglycerides and Serum Fatty Acids (SFA), which represent the majority of the fat that floats in our blood, tend to rise when patients have more insulin resistance and are eating a higher carbohydrate diet.
The serum Triglycercide level is a component of the typical "lipid panel" or cholesterol panel. It is one of the most important numbers you should look at in your cholesterol panel. The higher the level of triglycerides in your blood especially when compared to your HDL ("good" cholesterol) level the higher your risk for heart disease. Ideally, the ratio of your triglycerides to your HDL should be less than 1. See the figure below.
The strength of this correlation is much stronger than the correlation between you total cholesterol or LDL and your risk for cardiovascular disease.
So what dietary intervention helps you lower the TG/HDL ratio, SFA level, Triglycerides, and abdominal fat the best? While this is not a completely settled issue, the vast majority of studies that I have reviewed show something similar to the figure below. The participants in the study below followed either a very low carbohydrate ketogenic diet (Low-carb/High fat diet) compared to a conventional low-fat (High-carb) diet. The results are interesting. The high fat diet dramatically lowered body mass, abdominal pain, triglycercides, TG/HDL, glucose, insulin, and total SFA compared to the conventional low-fat diet. This also means that the "ideal diet" may not be that ideal after all.
I think it is pretty clear that our diet is one of the most crucial elements that we can control to ensure our health. However, I don't think there is an "ideal" diet for everyone. That is because what the "ideal" diet may be for one person may not be appropriate for another. Diet should be individualized and based on objective and subjective measures such as the measures I described above.
If you are looking to improve your health and diet and to get an individualized approach I am happy to help. Your doctor may also be able to help but in many cases my fellow doctors are not always familiar with dietary literature and may not be good guides. If you have health issues please consult with your physician before making any significant changes in your diet.
"Doc, I think I have a sinus infection and need an antibiotic," is a common patient complaint that I hear at this time of year.
With the ups and downs of the weather around Spring time and with the allergy season in full force it is common for me to see patients who have significant sinus and allergy problems. Many patients associate sinus symptoms with sinus infection.
Sinus pressure or inflammation of the sinuses (Sinusitis) can actually be caused by many things. These include viruses, allergies, and bacteria. The most common cause is a viral infection associated with the common cold. Bacterial sinusitis, which is treated with antibiotics, complicates viral sinusitis in only about 0.5 to 2 percent of cases. (1) In theory, this means that the vast majority of patients that present with a "sinus infection" should not be treated with antibiotics.
However, it is not always so clear when someone has a bacterial sinus infection. So what are some criteria that are more suggestive of bacterial sinusitis. The Infectious Disease Society of America suggests the following three criteria (2):
Fortunately, if you do have a sinus infection or sinus symptoms there are some traditional treatments that may help. These include anti-inflammatories, saline irrigation, intranasal steroids like Flonase, antihistamines, mucolytics (guaifenesin), and decongestants. If these treatments are not helping or symptoms are worsening than antibiotics are often necessary. Antibiotics that are commonly used in adults include Augmentin, Doxycycline, Clindamycin, or a Levofloxacin.
Steroids may also help and have been shown to shorten the time to resolution.
Some natural treatments that may help include colloidal silver, essential oils, and natural antihistamines.
If you are experiencing significant sinus or allergy symptoms please feel free to give me a call or see your doctor.
1. Fokkens W, Lund V, Mullol J, European Position Paper on Rhinosinusitis and Nasal Polyps Group. EP3OS 2007: European position paper on rhinosinusitis and nasal polyps 2007. A summary for otorhinolaryngologists. Rhinology 2007; 45:97.
2. Chow AW, Benninger MS, Brook I, et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis 2012; 54:e72.
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