Tag Archives: insulin resistence

10 Way to Live Longer and Healthier

Two views of local Extension leaders drilling ...

Image by Cornell University Library

Exercise –

Exercising is a key to staying healthy and research shows that people who exercise age more slowly. This is perhaps due to the fact that exercise has been associated with preventing telomere shortening.  Telomeres are strands of DNA at the ends of each chromosome that shorten as we age.

Don’t Smoke –

Smoking causes the skin to wrinkle and wreaks havoc on our brains, heart and lungs.  The inflammation caused by smoking is thought to speed the aging process.

Eat a Healthy Diet –

You are what you eat.  A healthy diet provides antioxidants that gobble up free radicals that speed the aging process.  It also helps maintain a healthy weight which is important in preventing a host of diseases.

Stop Snoring –

Sleep apnea, a condition is which people stop breathing during sleep because tissues in your throat collapse blocking the airway, can cause high blood pressure, memory problems, weight gain, and depression.

Take Resveratrol –

Resveratrol is a powerful antioxidant found most prevalently in the skins of grapes. It provides the health benefits associated with red wine. Just like exercise, it slows telomere shortening. It is available in supplement form.

Manage Your Stress –

Excessive stress leads to the production of hormones in the body that are detrimental to long term health. High stress levels delays healing, increases fat deposition and suppresses the immune system.

Keep Your Insulin Levels In Check –

Insulin is a hormone in the body that is secreted in response to carbohydrate consumption.  An excessive level, due to excessive carbohydrate and sugar intake, is associated with increased cellular aging.  Keep grains and sugar to a low level in your diet.

Get Out in the Sun –

Being in the sun not only improves mood, but it produces vitamin D.  Vitamin D affects up to 10% of your genes and allows them to function optimally.  Vitamin D has also been shown to reduce the rate of many types of cancer.

Get Your Fats –

Eating a diet high in healthy fats, like omega-3, is essential for heart and brain health.  Good sources include fish and nuts.  To get optimal benefit, however, most people will likely have to supplement with fish oil.

Control Your Blood Pressure –

High blood pressure increases the risk of cardiovascular disease, stroke and a host of other diseases.  Controlling it will allow you to live longer.  It is best to control it by losing weight and exercising.


Filed under Public Health

Solving Childhood Obesity – Part I

Recently released this month was an interesting piece on childhood obesity.  It is part of the Let’s Move campaign that is headed by First Lady Michelle Obama.  The report entitled Solving the Problem of Childhood Obesity within a Generation is full of good information (full report available at www.letsmove.gov).  I am usually skeptical of such reports because they seem to just recycle to same old information that has gotten us into the problem in the first place.  This report seems to be different.  Over the next couple of weeks, I am going to try and break down most of the recommendations that were put forth in this new report. Some of the recommendations I find very refreshing.  They are often things chiropractors, naturopaths and nutritionists have been recommending for years.  I’m glad to see traditional medicine catching up.

I have spoken many times on this blog about childhood obesity and what a large problem it is in the US.  The numbers are staggering.

  • One in every three children (31.7%) ages 2-19 is overweight or obese.
  • Obesity is estimated to cause 112,000 deaths per year in the United States, and one third of all children born in the year 2000 are expected to develop diabetes during their lifetime.
  • The current generation may even be on track to have a shorter lifespan than their parents.

Also, this takes a massive toll on our health care system.  As health care costs continue to rise many economists say that they could eventually bankrupt the country.  Each year, obese adults incur an estimated $1,429 more in medical expenses than their normal-weight peers.  Overall from 1998 to 2008 medical costs related directly to obesity in adults increased by almost four fold from $40 billion to over $147 billion.  Childhood obesity now contributes to $3 billion in medical costs.

Unfortunately the trends of obesity are continuing to rise and have risen substantially in the last 30-40 years.  In particular, the levels of obesity have increased significantly since 1980.  Obesity has more than doubled among adults (rising from 15% to 34%), and more than tripled among children and adolescents (rising from 5% to 17%) since 1980.

While most people know that being overweight increases the likelihood of heart disease, there are other problems associated with it as well.  Obesity increases the risk of cancer, diabetes, arthritis, depression and osteoporosis to name a few.  Quality of life is also affected.  Children who are obese report a lower health-related quality of life (a measure of their physical, emotional, educational, and social well-being). One study actually found that children who are obese have similar quality of life as children with cancer!

So the question is how do we solve the problem?  The first part of the solution might surprise you.


Children who are breastfed are at reduced risk of obesity.77 Studies have found that the likelihood of obesity is 22% lower among children who were breastfed. This effect was noted all the way into adolescence suggesting that breastfeeding your child has very long lasting effects.  Other studies have shown that for every month a child is breastfed up to 9 months, a 4% reduction in the risk of being obese is observed.

In my practice I recommend that my patients breastfeed up to 12 months if possible.  Routinely I hear from expectant or new mothers that their doctors ‘recommend’ breast feeding but that they won’t lose out on anything if they choose formula.  This may stem from the years when women were being told that breast milk was no match in terms of nutrients to what could be concocted in a lab.  It is clear now that breastfeeding is an important part of the early life of a child.

Even though the research clearly points out that breastfeeding is critical most children (67%) do not breastfeed after three months.  The protection offered by breast milk is from several factors.   First, synthetic formulas contain twice as much protein as breast milk.  This stimulates insulin to be secreted in amounts that are too high.  This leads to excess fat storage.

Second, the biological response to breast milk differs from that of formula. When feeding a baby, the mother’s milk prompts the baby’s liver to release a protein that helps regulate metabolism.  This is not produced with formula.  Also,  giving formula is associated with unfavorable concentrations of leptin, a hormone that inhibits appetite and controls body fatness.

So why don’t more women breast feed? It is a complicated answer that has physical, social and cultural factors.  However, in this country we don’t make it easy for new mothers.  In the hospital a newborn is often taken from their mother and necessarily given formula.  This makes it difficult for the baby and the mother to learn how to properly breastfeed.  Part of the solution is to designate hospitals as “baby friendly” as determined by an independent group appointed by the government.  A hospital is given this baby friendly designation if they meet certain criteria for breastfeeding.  Currently, only 3% of births occur in baby friendly hospitals.

My advice to patients is always to breastfeed.  Do everything you can to make sure it happens.  If any doctor tells you that formula is ‘just as good’ as breast milk, find another doctor.  If you cannot breastfeed directly, try and pump your breast milk.  The advantages of breast milk over formula are huge.  After all a million years or so of evolution can’t be wrong.  In my next blog we will talk about chemical exposure and screen time and how it relates to childhood obesity.  I hope you’ll continue to read.

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A New Take On Low-Carb…Sort Of

Below is an interview with Dr. Eric Westman, director of the Duke Lifestyle Medicine Clinic in Durham, N.C. about the ‘new’ Atkins diet book he co-authored.

Q: How is the current Atkins diet different from the original?

A: We have emphasized that you have to have five servings of vegetables a day. The book hammers home right away at the myth that you don’t eat vegetables on Atkins. You have to. That’s just sound nutrition. Overall, there has been a large amount of research on low-carb diets, and we incorporated that knowledge into the book.

Q: What does the research, including your work, reveal about the diet?

A: The research shows it’s a healthy lifestyle and many more foods are a part of it. It’s also a therapeutic diet for people with diabetes, obesity, high triglycerides or high blood pressure. People who follow it have improvements.

Q: Does this plan work because it cuts most junk foods?

A: Absolutely, that’s part of it. It is shifting from a junk-food-based diet to an occasional sweet treat, much like most people ate after World War II. All popular diets eliminate junk foods. But it depends on what you call junk foods. A lot of people think of pork rinds as a junk food, but I think of them as a health food. They have no carbs, so in the context of a low-carb diet, they’re fine.

Q: What are the advantages of this plan over others?

A: You get to eat delicious foods: butter, bacon, cream. If you like meat, seafood, avocados, nuts, cheese and brie, it’s fabulous. And hunger suppression is one of the biggest advantages. People aren’t hungry when they eat this way.

Q: The Atkins diet has been criticized for being too high in saturated (animal) fat. It’s about 17% of calories vs. the recommended 7%. Is the saturated fat content unhealthy?

A: Studies have shown that in people following Atkins, the saturated fat is not a problem. People who follow Atkins had improvements in cardio metabolic risk factors such as triglycerides, good cholesterol, blood pressure, blood sugar. The diet fat issue is at the crux of the fear of this diet. But look at the Europeans and French people and all the fat they eat, and they are doing just fine.

Q: Doesn’t the diet drastically cut whole grains, even though research shows they are good for you?

A: In the last two phases (of the diet, known as pre-maintenance and maintenance), most people can eat whole grains, so it’s inaccurate to say that they are totally forbidden, although in the first two phases (induction and ongoing weight loss), you do have to limit them.

Q: Why cut so much fruit?

A: The way Atkins works is it suppresses appetite and hunger, and you can’t do that if you have a lot of sugar in the diet. Fruit is sugar with some fiber. In the induction phase, you eat avocados, olives and tomatoes, which are fruits. And in Phase 2 (ongoing weight loss), you introduce berries and melons.

Via – Digesting the facts on the ‘New Atkins’ low-carb diet

Dr. Court’s Comments

It has long been a myth that the Atkins diet is bad for you.  Dr. Atkins made his first observations that low carbohydrate diets were the best way to maintain health after he managed to lose weight by placing himself on a carbohydrate restricted diet.  This was in the 1960’s.  He published his first book in the early 70’s, which soon became a best seller.  It was many years, however, before this became an accepted way to diet and manage weight.

The principle behind the Atkins diet is the control of insulin.  Insulin is a hormone in the body that is secreted in response to carbohydrate intake and to a much lesser degree protein intake.  Insulin has profound effects on metabolism. It causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle, and stopping use of fat as an energy source. The problem occurs when excess carbohydrate is consumed.  Massive amounts of insulin are released and only so much glycogen can be stored in the muscles and liver.  The rest of that energy is stored at fat. When insulin is produced in low amounts, as is the case with the Atkins diet, the body begins to use fat as an energy source.  It is the burning of this fat that is the very way people are able to lose weight on the Atkins diet.

Consider someone who has insulin dependent diabetes if you want to see the effects of insulin.  If they are insulin dependent that means they do not produce it on their own and require it exogenously.  Many times patients go months before they are aware of this fact and guess what results.  Since they cannot burn the glucose they consume for energy they must burn their body fat to survive.  As a matter of fact one of the hallmark signs of insulin dependent diabetes is uncontrolled weight loss.  This of course is not a healthy person or way to lose weight, but it illustrates very nicely the metabolic effects of insulin (or lack there of).

Many detractors of the low-carb diet say that it is unhealthy, but they clearly do not understand physiology and have not looked at the research.

“There are nearly a dozen randomized controlled trials of obese people trying to lose weight that show those on a low-carb diet do as well or better in the short and long term as people on conventional low-fat, low-calorie diets. And the low-carb diet is associated with favorable improvements in heart disease risk factors.  The research shows that many of the original concerns about the Atkins diet’s impact on LDL (bad) cholesterol and rapid regain were not realized.” Comments by Gary Foster, Director of the Center for Obesity Research and Education at Temple University in Philadelphia.

There is another positive to eating an Atkins type low-carb diet.  It is inherently an anti-inflammatory diet.  The low-carb diets end up being low in grains and  grains are a massive source of inflammation in the American diet.  I routinely check inflammatory markers before placing my patients on a diet program.  I always recommend more emphasis on healthy fats and proteins and less on the carbohydrates.  The markers I like to use are CRP, or c-reactive protein, and homocysteine.  Clinically, the results of placing people on a low-carb diet are always favorable in terms of inflammatory markers.  Their lipid profiles (cholesterol, triglycerides) always improve as well.  If these markers all improve, how can the diet be unhealthy for your heart as some people claim? This is usually a question that goes unanswered by physicians that tout the low fat diet as superior.

The low-carb ‘craze’ is not a craze at all.  It is here to stay and it is the most effective way to reduce weight and maintain heart health.  The studies that have been done are very conclusive, but they fly in the face of many years of conventional ‘wisdom.’  The problem is that the conventional system has failed.  Americans are as fat as they have ever been and diabetes is at epidemic proportions.  Maybe it’s time to re-evaluate our thoughts on diet and look at the hormonal process that is required to store fat.  This process, which requires insulin, can be controlled but not by eating a low fat diet.  It must be controlled by controlling carbohydrate intake.  If this is done, health ensues.

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Filed under Diet