Prevention of Pre-Diabetes
It’s always nice to see people in the medical community backing your beliefs. I found this quote recently by Dr. Michael Valentine, the President of American College of Cardiology (2018-2019) that said “While we are constantly finding innovative ways to treat existing heart disease, we must continue to focus our efforts on preventing heart disease. It will require efforts from more than just the medical community, but from communities and government as well.”
In this blog, we’ll be covering pre-diabetes, obesity and how to prevent both of these things from occurring in the first place. Many people have heard about diabetes, but what most people don’t know is how the sequence happens from pre-diabetes to full-on diabetes and the process that the body goes through during this time.
High blood pressure, diabetes, and obesity all go hand-in-hand.
When you have a meal that is rich in carbs, where do those carbs go? They are absorbed into the bloodstream and go knocking on the door of our working cells in our liver, muscles, and other arteries to tell them that blood sugar is available. The cells listen and use this to go about their routine and create the energy that we use daily. However, as blood sugar continues you to come around and tell us that blood sugar is available, not all doors open. Now, the pancreas already secretes insulin into our bodies, and when that blood sugar comes knocking, they say - “Knock louder, I can’t hear you.” The blood sugar or insulin must be louder and work harder to get through those doors, hence the creation of insulin becomes higher. Insulin continues to come back with more and more insulin in order to open those doors, but after it accumulates such high levels over and over, it eventually says, “What do you expect of me? I can’t keep up with these levels anymore” Hence insulin resistance starts its journey.
The main reason this occurs is when our bodies are not getting the proper treatment tactics - a healthy diet, exercise, and of course, too many carbohydrates. As we know, everything is okay in moderation, but when your body starts to become unresponsive, it’s because of unwanted belly fat and lack of care for our bodies. Our bodies try to help us maintain healthy weights, even from the inside, hence the resistance to insulin production trying to help keep us healthy and fit. For people that have diabetes and other health-related issues, this fight can be challenging. Your blood test will be where you see the difference in your body.
Your number should look something like this:
Pre-Diabetes: between 100-126
Diabetes: 126 or higher
1 out of 3 people in the United States test positive for pre-diabetes, and had no idea that they were even in a categorical place for pre-diabetes or diabetes in general. This is where we wrap everything back to our previous lessons: stay on top of your health and make your primary care physician your best friend. Get your checkups, monitor your own health at home, and do the things that you know are good for your bodies in the long run. Your physicians will tell you how to take care of your bodies before diabetes can kick in, or how to prevent your body from getting to a diabetic level.
To your health,
Dr. Anthony
New Year, New Diet? - Mediterranean (Part 3 of 3)
In my years of practicing medicine and prevention of cardiometabolic diseases, our diets and the way we eat make a very profound difference on our health. In my previous two blogs about the Paleo and Keto diets, I shared my professional opinion on their structure. But there is one more diet that I explain in my book which is a very healthy way of eating — the Mediterranean Diet.
The Mediterranean Diet is rich in whole, natural foods, including fresh vegetables, lean proteins and fish, and olive oil.
The Mediterranean Diet gained popularity - as you can guess - near the Mediterranean Sea and has since expanded from its creation in the 1960s and 70s. It is a diet rich in fruits, vegetables, nuts (unsalted), fish, eggs, lean meat (mostly white meat), whole grains and olive oil — but red meat is rarely eaten. As with all healthy habits, processed foods, deep fried foods, and sugary beverages have no place in Mediterranean diet.
Key items to success with the Mediterranean diet (similar to Paleo) is that you consume healthy, whole foods made from scratch from fresh ingredients and that processed foods are thrown out of the window. It’s also important to note the lifestyle that goes along with this diet. The people who ate the Mediterranean diet would typically work out in the fields for 6-8 hours a day six days a week, which helped them keep up with their muscular physiques and flat bellies.
When comparing the Paleo and the Mediterranean diets, you can see many similarities with the biggest differences coming down to legumes, whole grains and dairy products (these are part of the Mediterranean Diet, but not the Paleo Diet) and the red meat and butter that are liberally allowed in the Paleo diet. The overall lifestyles that match these diets are similar to those who have daily physical work for several hours. There is good scientific evidence that people who eat the Mediterranean diet are prone to living longer, having less chance of contracting diabetes, and that the diet can protect against Alzheimer's and dementia.
Following a diet to live healthier should never be a “fad'“. Focusing on whole foods, while getting rid of sugars, processed and deep fried foods are probably the most important take home messages from both the Paleo and Mediterranean diets. Red meat (when eaten in moderate quantities, and provided that you check your cholesterol with your doctor) or “antinutrients” in legumes are not going to ruin your health. Always complement your diet with an active lifestyle and, of course, do not smoke.
To your health,
Dr. Anthony
New Year, New Diet? - Paleo (Part 2 of 3)
It’s hard to believe we’re almost through the month of January! Have you taken steps towards a healthier life?
In my last blog, I shared some information about the Keto Diet — and this time, I want to share one of the two diets that I have studied for many years and encourage my own patients to follow.
Let’s start with the Paleo Diet!
The Paleo Diet comes from the term “paleolithic”: meaning the era of early stone age and cavemen. Cavemen had no choice but to eat what they had access to, which for many, was heavy in protein — whereas, for others, it was predominantly plant-based. So, in the Paleo diet meat is in big time, including red meat.
What all is “ok’d” in the Paleo Diet? Grass-fed meat, poultry, fish, shellfish, eggs, vegetables, fruits, nuts, seeds and healthy oils are the favored foods.
Processed foods, sugars (including sugary beverages), dairy, legumes and grains are off the table.
Grass-fed meats and vegetables are always a win on the Paleo Diet.
A strong argument of the proponents of Paleo diet is that the human body was created for the challenges of the cavemen, so why shouldn’t we eat today what they ate then? A positive point of this diet is that, once you exclude sugars from your diet, you avoid insulin spikes and can lose weight without feeling hungry. I believe that cutting out legumes, whole grains and dairy is a rather weak point of Paleo diet as these foods contain fiber (legumes and whole grains), protein (legumes and milk), and antioxidants (all three). The concern that legumes contain anti-nutrients that block the absorption of other essential nutrients is more theoretical than real; one would have to eat extremely large quantities of the same legume to have a negative impact on their nutritional status.
Finally, a better way to approach Paleo diet is to consider it as a part of a “Paleo lifestyle”: cavemen used to walk for 2-4 hours a day and seven days a week, jump, lift weights and climb trees. This diet makes it ideal for those who are extremely active.
Overall, eating whole foods, cutting out the sugars and eliminating processed foods are strong, positive points of the Paleo diet — while cutting off legumes, dairy and whole grains is controversial.
Do you eat Paleo? Would this be a way of eating that you would consider trying?
To your health,
Dr. Anthony
Do you stint on your sleep?
So you’ve been making changes to your diet and lifestyle to become a happier and healthier individual… that’s great! But have you been catching enough zzz’s?
Today, I want to talk to you about sleep and how essential it is to our health. As we try to define what a healthy lifestyle is, we need to understand that, while exercise and a healthy diet are the pillars of getting on track with a healthy lifestyle, we must also factor in sleep, stress management, and other key factors that people too often push under the rug.
Scientific studies have concluded that we need 7-9 hours of sleep a night in order to function properly and let the body do its intended job of healing. Our ability to make decisions, to operate machinery, and other issues may be impaired when we are sleep deprived. Not only can sleep deprivation affect our day in terms of safety and productivity, but it affects our body internally as well. Some of the effects that sleep deprivation can have on the body are:
Appetite increases, which can lead to weight gain
Blood pressure rises, eventually causing high blood pressure
Blood sugar metabolism worsens which, in the long run can contribute to T. 2 diabetes.
If we sleep less than 7 hours a night, that can damage our body over the years. We are all pressured to work longer hours, stay up late, and not get to bed at a decent hour - which causes us to stint on sleep. The price we pay now and in the future regarding our health, can be detrimental. Do you have a job that forces you to stay up until midnight and wake up feeling fatigued, fuzzy, and irritable? If the answer is yes, take a second to assess how much sleep you are truly getting each night and if your health is paying the price. YOU are the only one that can make that choice for yourself. Choose health and try to schedule in 7-9 hours a night.
For extra advice visit the Sleep Foundation and read about how to get into a better routine and get your health, mind, and body back on track. A few of the tips and tricks that they provide are:
Avoid eating heavy meals or drinking caffeine and alcohol several hours before your set bedtime.
Make your room a pleasant and peaceful place that promotes sleep.
Avoid screen-time and harsh lighting a few hours before bed- try reading a book instead!
Healthy living requires high quality sleep. Get your sleep on track and your body will follow.
To your health!
Dr Anthony
The Tip of the Iceberg
Last week I was honored to present on the obesity-diabetes-and artery disease epidemic to a group of Delta employees in Atlanta. The venue was warm and inviting and very well organized. The participants were engaged and asked a large number of insightful questions. After my talk was over, I was invited to one of the working areas and I was happy to see that there were so many standing desks and a lot of opportunities for the employees to be physically active. A great workplace!
I used several PowerPoint slides for my presentation. One of those showed a picture of a gigantic iceberg where both the above-the-surface and below-the-surface parts of the iceberg were visible. The caption read: “Why am I showing you this picture?” After I let the question sink in the minds of the audience for a few seconds, I presented the next slide. There was the picture of a huge belly of a man. The face or the rest of the body were not shown; the focus was on the belly. The caption read: “Because it is so easy to see this…”. The next slide followed in quick succession and its caption picked up where the previous one left: “...but you can’t see that!”
Just like the iceberg that sunk the Titanic, what is hiding below the surface is the most dangerous. Our artery health can’t be seen from the outside, but inside, the story is much different.
You can clearly see the “deeper issue” in this up-close photo of an adult artery.
The “that” was the inside of an artery of a person with a huge belly like the one on the slide. The artery looked ugly, like a war zone. Instead of appearing like a smooth glistening tube, the inside of the artery was uneven, filled with dirty-looking red and yellow growths, like tumors. These tumors were not cancers; they were advanced-stage cholesterol plaques with bleeding and clots on their surface. Such an artery can become the cause of a heart attack, stroke or sudden death without further notice. The slide that followed showed exactly how such a thing can happen. Most of us (especially men) start developing thin fatty lines in the wall of our arteries when we are teenagers. These early fat accumulations are called “fatty streaks” and represent the only form of cholesterol accumulation in our arteries that is reversible. As the cholesterol plaques continue to develop, it usually takes them a minimum of 20 plus years to mature and, usually, cause zero symptoms during that phase. Once mature, they can, all of a sudden and without any further warning, become unstable, and within a minute they can be causing serious symptoms like chest pain, heart attack, stroke or even sudden death.
Unfortunately, in western countries like ours, by the time we are 45 years of age most of us (especially men) do have some cholesterol plaque in the walls of our arteries. As long as these plaques stay stable, they are not a health problem and usually cause no symptoms. Once unstable, the result is catastrophic. So, what do we need to do to keep any plaques stable:
No smoking (not even one or two cigarettes a day)
Keeping our blood pressure and LDL cholesterol low (our health care provider will advise us whether or not we need medications to achieve this)
Staying physically and socially active
Eating a healthy diet with an emphasis on avoiding abdominal obesity by excluding fast carbs
Avoiding alcohol abuse
Sleeping at least 7 hours per night
Avoiding excessive stress
So, take good care of your arteries in order to keep any possible cholesterol plaques at bay and enjoy a long life without heart attacks, strokes or the need for heart surgery or other heart procedures.
To your health,
Dr. Anthony