Not All Fat is Created Equal...

Your health is, in many ways, determined by the size of your GUT.  

While fat around the hips (“pear” body shape) is metabolically innocent, but the fat inside the belly (“apple” body type) can be truly dangerous and, potentially, life-threatening. Abdominal obesity or Abdobesity is defined in men as a waist circumference of 40 inches or more and, in women, 35 inches or more and is linked to type 2 diabetes and heart disease.

While a Body Mass Index (BMI) above 30kg/m2 defines obesity, the two conditions (abdobesity and obesity) do not always coexist, as is the case of a “pear” type person or a muscular person that weighs a lot but the above-average weight consists mainly of lean protein (muscle).

The fat confined in our belly is dangerous, in part because it is directly connected to our liver, the main factory of our metabolism. A “highway” called portal vein, allows for constant traffic of belly fat to the liver, turning the liver into a factory of “fat bullets” that bombard our arteries, giving rise to cholesterol plaques. Those plaques mature over the years and became inflamed and unstable, resulting in heart attacks, strokes or even sudden death. As the belly fat affects our entire metabolism, it contributes to diabetes, a serious disease with multiple complications of its own, including heart attacks, strokes, blindness, and kidney failure. Overeating and under exercising can lead to a flabby gut (abdobesity). That spare tire may be more than too much chocolate - it is the prelude of a series of potentially deadly medical conditions.

Sometimes you hear people refer to their “core”.  Your core is more than just your stomach. The core is a complex series of muscle that are essential for core stability and spine protection. It’s important to achieve core stability to protect the spine and surrounding musculature from injury.  The skin fat that surrounds the muscles and the stomach is not medically dangerous, but the deep belly fat, the one inside your belly muscles can cause health trouble. This deep belly fat, beyond contributing to diabetes and heart disease, it also makes it hard to strengthen the core and can lead to chronic low-back pain.

Most individuals with abdobesity were probably much thinner as young children. Some started putting on weight as kids, others as adolescents, and many as adults. Although every person’s metabolism is different (in part due to different rates of food absorption by the gut), healthy people will not become obese without taking in more calories than they burn.

So what can you do to lose that spare tire? There are a few things to kick start the process. Of course a healthy lifestyle (eating healthy and exercise) are the key.

Five ways to help reduce that gut are:

• Don't Eat Sugar and Avoid Sugar-Sweetened Beverages
• Eat the right amount of Lean Protein
• Cut the Bad Carbs From Your Diet
• Eat Foods Rich in Fiber
• Eat Good Fats
• Exercise almost Daily

It is important to add some specifics about the stomach; It produces hydrochloric acid that serves as a first line of defense for the immune system by killing off bacteria and viruses that may enter with the food you eat. Stress can upset your stomach, and not just discomfort. As the central nervous system, through its “subsidiaries”, controls the function of your stomach, stress can often upset these organs, contributing to discomfort, acid reflux, gas, bloating or diarrhea.

So keeping your tummy healthy is important to your overall health. It would be wonderful to have “6 pack abs”, but the health beyond it is important. If your belly is hanging over your belt, take it seriously, as this may be the only obvious sign that other medical problems may be going on in your body. A big belly can be “hiding” prediabetes or diabetes, high cholesterol or high blood pressure, conditions that predispose to serious complications, like heart attacks, stroke and kidney failure. Adopt a healthy lifestyle and ask your doctor about what should be done to help you lose that weight and, even more importantly, to protect your arteries, your liver and your life.

To your health!

Dr. Anthony

If YOU know how your body works then…

“Know thyself “

• An ancient Greek aphorism that appeared in the Temple of Apollo in Delphi and was also inscribed-in Latin- over the Oracle’s door in the 1999 film “Matrix”.
• A maxim that has been attributed to ancient philosophers.
• Benjamin Franklin wrote: "There are three things extremely hard: steel, a diamond, and to know one's self."

Understanding our self, our feelings, our emotions, and what motivates our behavior is or should be an important goal in life. But what does it practically mean in the areas of health, wellness and prevention?

Knowing how our body works helps us understand what is important in keeping it healthy. In order to keep our arteries healthy and avoid heart attacks and stroke, for example, we should care about what we put into our mouth (diet), as this stuff is absorbed by our gut and enters the arteries and heart circulation, with potential salutary (fruits and vegetables filled with antioxidants) or destructive effects (frequent intake of red meat, fast food or cold cuts, filled with unhealthy fats). A healthy metabolism supports healthy arteries and its pillars are a combination of healthy diet and near-daily exercise, including both cardio- and muscle building through light weights. As another example, knowing that one of our immediate family members has type 2 diabetes means that our own pancreas cells that produce insulin are probably not very durable, so we better watch it and avoid becoming obese or eating too many cookies and desserts, or else!

Listen to your body -- once you know it well enough, you can pick up on its cues.

As it is true that no one can know our feelings or emotions better than ourselves, we can also be the best barometers of our physical health. Many times we know when something is “out of whack”, without being able to pinpoint to the exact, precise cause or details. Such knowledge or “gut feeling” may prompt us to make changes in our lifestyle or even visit our doctor.  Speaking about doctors, there must be the right “chemistry” between us and our health care provider.

There are several ways to advocate for yourself.

1. Ask question’s - It is ok to arrive at your doctor’s office with a list of questions.  The better organized you are they better it will be for you and your health care provider.

2. Second opinion - It may be appropriate to get a second opinion. That is why when it comes to YOUR health, you are allowed to talk to several medical professionals about the concerns you have.

3. Be honest - Feel comfortable telling the truth without hiding anything or fearing that will be chastised for doing so.  The old saying Honesty is the best Policy certainly applies here.

4. Not the Right Match - In case we sense that our doctor is not the right match, we should not hesitate to find another provider.

Knowing our body will help us shape and keep our healthiest version of ourselves. Whereas the general principles of a healthy lifestyle may be, more or less, the same for all of us, the details of how to get there are different. This should come as no surprise as no two individuals are the same, not even monozygotic twins.  We have recently spoken to a woman who joined a gym and felt pressured to take a yoga class, as her friends raved about it and she, herself read about its benefits. However, after trying it, she found that yoga was not for her. She did not enjoy it; she felt it was something like a chore she had to attend. As she was not getting the most out of it, she tried something else. She found that a toning class using light weights was more her style. What works for one person does not work for all.

We need not worry if we do not look like the supermodels in the magazines or that bodybuilder at the gym. Actually, this may be a good thing. Some supermodels smoke like a chimney, in order to control their appetite and eat less (smoking is worse than obesity) and many bodybuilders use anabolic steroid drugs that seriously undermine their health. Keep in mind that the weight we carry around our hips is not nearly as bad for our metabolism as our belly weight. In pursuit of a healthy diet, some may be able to follow a strict program and count calories, while others find it easier to just eat healthy. Remember that a diet is good only if we keep it in the long run. And that is okay to be different! If everyone was exactly the same - wouldn’t that make for a boring world?

Listen to your body and watch your body. If you see or notice changes, take action. In today’s busy society it is easy to put everyone else first: kids, spouse, job, even your pet! But YOU have to take care of YOU. Also, do not forget to reward yourself from time to time. Embrace your differences, and work to be the healthiest version of YOU that you can be!

Here’s to your Health!!

Dr. Anthony

AND THE WINNER IS... Balanced Eating vs. Detoxing & Diets

Healthy lifestyle, including healthy diet, is one of the main pillars of wellness and disease prevention and a key to a long- as disease-free as possible- and happy life. For healthy diet and healthy lifestyle to be effective, they must be practiced consistently with only occasional transgressions ( less than 10% of the time).

Given the importance of healthy diet, both the general public and scientists want to know which one is the best. The choice is not easy as so many diets are touted as the absolute best, while the scientific evidence supporting these claims may be lacking. The mere fact that celebrities follow and promote a diet should not be seen as evidence of its true superiority.

On this article we will examine a number of proposed short-term diets that belong to the “Detox” category. These are brief diets, running from as short as three days up to six weeks, and are supposed to “cleanse” our body from toxins and help us get a new, healthy beginning in life. They are also used as a jump-start for weight loss. Some diets work (in terms of losing weight) if you follow them to the letter. Are these diets a true winner or just fads, hype or a new trend? Is it realistic to think you will NEVER eat bread in any form again?

While some people may think that “cleansing” is a new concept, Pharaohs’ doctors in Ancient Egypt used to recommend enemas (colon cleansing or purging) as a way of removing toxins from the body. As an idea, it is appealing, but is it really working or necessary? Consider that our body has very sophisticated mechanisms in place, mostly through our liver, kidneys and immune system  to cleanse itself constantly from toxins and waste products. In 2011, researchers at Georgetown University conducted a comprehensive review of the medical literature and found absolutely no scientific support of the practice of detoxifying the colon.

It is true that several individuals feel better after a detox period but is this a “placebo effect”? Mayo Clinic reports that there is little scientific evidence that a detox diet actually eliminates toxins from your body.

While there is wide variation among detox diets, most of them eliminate highly processed foods. Some suggest fasting and allow only drinking natural juices. Others allow you to eat only raw vegetables and avoid sugar.  Certain diets require you to cut out carbohydrates, but in the same token other “fatty foods” are allowed.  One patient we have spoken to said she was in Las Vegas with a friend and at the breakfast buffet, the friend had bacon piled high on her plate, but you would not catch her dead with a piece of toast. Is that a good way to eat?

Here are some examples of foods prohibited by several detox diets:

• Processed, boxed or canned food
• Table sugar or foods or drinks with added sugar
• Refined vegetable oils
• Artificial sweeteners, preservatives, additives, or coloring
• Flour-based foods
• Grains (rice, oats, quinoa); some diets, though, allow non-gluten grains like rice and quinoa
• Beans and legumes (also allowed by many detox diets)
• Dairy
• Coffee and anything caffeinated
• Alcohol

Examples of recommended foods by several detox diets include:

• Fruits (excluded by some)
• Vegetables
• Non-gluten containing grains (rice, quinoa)
• Beans and legumes
• Nuts and seeds
• Oils (olive oil, hemp oil)
• Probiotic-rich organic yogurt and kefir
• Dairy substitutes
• Green tea
• Water

For “juicing”,  lemonade with spices and plant-based (for example with spinach or kale) drinks are recommended.

Some elements of detox diets are shared by traditional Western Medicine and Nutrient Science, like fruits and vegetables, whole grains, lots of water, avoiding sugary beverages, and opting for foods prepared from scratch with natural elements rather than packaged or processed food.

There are some important differences between Traditional Medicine and detox diets, however. Traditional Medicine and Nutrient Science do not advocate fasting; they recommend low-fat dairy products, accept up to five eggs per week and up to five cups of coffee per day. Healthy fats, as contained in fish, nuts, olive and canola oil, avocado and dark chocolate are also recommended by Traditional Medicine but prohibited by several detox diets.

While many of the detox diets are not dangerous (it is very possible that people who feel better after a detox cleansing period do so because they have avoided sugar and processed food), extreme fasting and drinking only juices for prolonged periods of time may harm your health.

Eating a balanced diet is better for you and easier! Whole grains won’t kill you; and lean meats/protein, whole unprocessed foods, and foods low in salt, fat and sugar are the way to go. Foods full of nutrients, vitamins, minerals, fiber and antioxidants work like medicine, supporting and preserving our health.

Think before diving into that new diet craze or a detox diet and talk to your doctor before embarking upon those diets. Keep in mind that, both for the purpose of weight loss and healthy metabolism, what is more important is consistency in the long run, not just extreme measures over a few days or weeks that allow you to go back to indiscriminate eating.

Eating healthy, exercising, getting restful sleep and making smart choices are the way to a healthy life. Making healthier choices and eating a balanced diet is the real reason for feeling good and healthy!

It is not always easy, but remember -you are in charge of YOUR health.

To your health!

Dr. Anthony

Why HEALTHY employees will SAVE your Business money!

Employees’ health and happiness appear to be a win-win situation for the employees and their employers. Healthy employees and those who are happy at work not only perform better but they also cost less. This is the conclusion of a six-year study conducted by health insurance company Humana and the University of Michigan's Ross School of Business.

It is a fact that more and more organizations work to advance the health and happiness of their employees, anticipating better performance, productivity and personnel retention. Companies are now offering incentives, rewards, reduced fees and more to help their employees reach their healthcare goals and stay healthy and happy.  Employers know, for example, that employees who are obese, have a higher rate to develop diabetes and heart disease, and those who smoke are more likely to develop heart disease, emphysema or cancer. These diseases result in reduced productivity, absenteeism, reduced sense of well-being and increased health care costs for the company, both in the short and the long run.

According to two Harvard School of Public health (HSPH) experts, many employers believed they could reduce their health care costs by influencing employees to adopt healthier lifestyles. One example is the state of Alabama, where state employees were used to paying zero toward their health care premium.  A few years ago that changed when they were made to pay a $50 dollar monthly premium – unless certain incentives were met.  Employees who did not use tobacco got a $25 dollar discount.  $25 dollar wellness premium discounts were offered for employees who met standards for important health markers like blood pressure, cholesterol, glucose, and BMI.  Other employees were able to receive a voucher that covers the co-payment for a doctor’s visit. As of 2011, employees could receive a discount if they have shown that they are within set boundaries, or are taking steps to get healthier.

Other companies offer incentives such as paid gym memberships, free health coaching or points to redeem for rewards or prizes. The point system could work after the employees show their attendance at a gym, enroll in a diet program that helps them choose healthy foods and meals, or “weigh-ins” that show progress at the place of business. Points can be turned in for prizes like gym bags, t-shirts, gift cards, acknowledgement of the employee in the company newsletter and even paid time off.

Some insurance companies are also offering health related programs at discounted rates or free to employees. Things like acupuncture, massage therapy, chiropractic and herbal supplements may be covered according to Jo-Ann Laing, author of The Consumer’s Guide to Health Savings Accounts.  Gohealthinsurance.com reports breast reduction surgery could be covered if causing health problems.

Just how much money is lost to poor health? The Integrated Benefits Institute, which represents major U.S. employers and business coalitions, says the U.S. economy loses  $576 billion dollars a year due to poor health. According to a Forbes story released in 2012,  $227 billion of this money is due to lost productivity from employees being absent from work (absenteeism) or showing up to work ill (“presenteeism”), and therefore not performing at their best. Between absenteeism due to illness and the cost of disability and workers’ compensation, poor health costs the U.S. economy more than half a trillion dollars a year, according to a new study by a nonprofit research organization.

Due to the high economic costs and the potential huge benefits if this cost is curtailed, employee happiness, well-being and health are the focus of very intensive research.

To your health!

- Dr Anthony

Should you integrate Eastern Medicine into your lifestyle?

Traditional Chinese Medicine (TCM), part of Eastern as distinguished from Western Medicine, has been practiced for thousands of years and focuses on HEALTH and WELL BEING through the cultivation of harmony within our lives, according to a University of Minnesota article. Concepts like ying and yang and balance as a condition of healthy living are of central importance to TCM.

While the holistic approach to wellness, health and disease is intuitively appealing, the specific methods of diagnosis and treatment that TCM uses are highly debatable. TCM methods are not subject to as rigorous a data analysis as the ones used in Western Medicine.  Biology is very complex and no statistical method can do perfect justice, whether it is Western or Eastern Medicine.

TCM includes herbs, acupuncture, massage and focusing on the whole body. Listening to one’s body is also regarded highly important. TCM leans toward prevention and wellness, not just diagnosing a problem.  According to Psychology Today, Western Medicine lies in “the newest is the best” camp. Eastern Medicine (like TCM) followers look to their doctor for experience and guidance and consider wellness a lifelong practice.

In the western world, especially in the United States, many doctors are quick to prescribe medicine. More often than not the diagnosis is not 100% determined, but doctors are trying to find a “fix”, something their patients have learned to expect or even demand. Western Medicine emphasizes the use of medications or procedures to stop the pain and suffering. Eastern Medicine practitioners claim that they want to get to the bottom of the issue- and diagnose the problem first - THEN provide a treatment. They believe that sometimes the best treatment is not a man made drug; this attitude is shared by increasingly more practitioners of Western Medicine. Additionally, more and more western physicians are embracing certain eastern practices. Acupuncture has been offered to help stop nausea and vomiting associated with surgery or chemotherapy and for chronic low back pain or even as an adjunct in attempts to quit smoking.  One US hospital has offered a chair massage before imaging examinations at their department of radiology as a way to help calm patients.  

Of course, when it comes to YOUR HEALTH - remember YOU are your own best advocate. You are free to choose a physician who keeps an open mind and is willing to embrace or try eastern medicines, if good evidence supports it. Prevention IS the best medicine, and a holistic approach is the most appropriate one; perhaps these are the principles in Chinese philosophy and TCM that merit further investigation and consideration. As long as professional organizations certify practitioners of eastern medicine using acceptable standards, why not find  a doctor willing to use TCM techniques?

One needs to consider that both Western Medicine drugs and Eastern Medicine herbals can have significant side effects and cause harm. Further scientific research is necessary to help incorporate practices of Eastern and TC Medicine into mainstream Western Medicine.

It is YOUR BODY - YOUR WELLNESS should be priority #1!

To Your health!

Dr. Anthony