Happy New Year to all my readers. With the New Year started most everybody will be trying to develop new healthy habits. One of them is to lose weight. Now new information has been published showing us a great way to help us lose weight.

Years of overeating sweets, fats, and excess calories impair the body’s ability to process blood sugar and utilize insulin. This is called insulin resistance, and is a precursor to diabetes. When one is insulin resistant, excess sugar is stored as fat in the midsection and muscles. This is a vicious cycle. The more laden the muscles become with fat, the more insulin resistant one becomes.

In addition to supporting overall health, most people know that diet and exercise helps lower the risk of diabetes. Now, there is evidence that exercising before breakfast may limit weight gain and lessen insulin resistance—even if one overeats. [1]

Researchers in Belgium studied 28 healthy, active men for six weeks. The men were split into two groups: one was sedentary; the other active. Both groups were fed “supersize-like” diets comprised of 50% fat and 30% more calories than usual.

The active group was also broken into two, and then given identical, taxing, weekly exercise protocols. This involved running and cycling two days for 90 minutes and two days for 60 minutes. The first active group exercised after a carbohydrate-rich breakfast and continued to consume carbs, such as a sports drink, during their workout. The second active group exercised on an empty stomach.

After six weeks, the group who exercised on an empty stomach logged some impressive results, especially when compared to the active group. Here is a summary of the remarkable findings:

•    The sedentary group gained an average of six pounds, developed insulin resistance, and began storing fat within and between their muscle’s cells.
•    The men who had breakfast before exercising gained an average of three pounds, became more insulin resistant, and began storing fat in their muscles.
•    The men who exercised before breakfast gained almost no weight, showed no signs of insulin resistance, and showed increased levels of a muscle protein that encourages the body to burn fat and utilize sugar.

I am not suggesting you overeat! I share this important insight to help you lose weight and lower your risk of obesity related diseases like diabetes. It is hard to make lifestyle changes, even at the beginning of a new year. Knowing this tip, you may get the results you are after.

Note: The number of people with diabetes has skyrocketed to 23.6 million in the U.S., with 1.6 million new cases per year. A staggering 57 million have pre-diabetes. This is largely due to obesity. Unlike type-1 diabetes, which one is born with, type-2 diabetes is most often linked to lifestyle choices. [2]

References:
1. Van Proeyen, K, et al. Training in the fasted state improves glucose tolerance during fat-rich diet, J Physiol, 2010 Nov 1;588(Pt 21):4289-302.
2. American Diabetes Association. http://www.diabetes.org/diabetes-basics/diabetes-statistics/
.

 

Elina Hypponen, M.D., wrote one of the most profound articles showing
the importance of adequate vitamin D in childhood in preventing type
I diabetes. I have extensively written about her article in my book.

Now I am delighted to see that Dr. Hypponen has recently published
another landmark study that looks at vitamin D and heart disease.
Specifically, in this article she was studying how and why people
with deficient vitamin D have over a 200% higher risk of heart attack
compared to those with normal vitamin D levels.

We know that there are vitamin D receptors in many aspects of the
cardiovascular system. This includes the blood vessels on the inside
of the coronary arteries as well as heart muscle cells themselves,
and the inner muscle lining of the coronary arteries.

In this article she specifically looks at some of the underlying
biochemical markers that predispose to heart disease, and their
relationship with vitamin D. In this study she used the information
from the nationwide 1958 British birth group. This consisted of over
6500 now middle-aged people.

Dr. Hypponen looked at the individual's blood levels of five
markers*  that predispose to heart disease. Some of these markers
were associated with inflammation which is known to be related to
heart disease. Other of the markers had to do with stickiness of the
blood, which affects the creation of blood clots that can lead to a
heart attack.

In summary the findings showed that current vitamin D status was
associated with three of the five markers that were evaluated. The
conclusion of the article was that this data suggests that vitamin D
status/intake may be important for maintaining the body's ability to
to prevent blood clots that lead to heart attack.

In this seminal study, I believe we are now beginning to understand
the mechanism of action and biochemistry of how this amazing molecule
we call vitamin D produces its benefit in protecting us from heart
attacks.

If you have people in your family who have heart disease or who have
had a heart attack, do you know if they have had their vitamin D
levels measured? How were their vitamin D levels? Are your loved ones
with heart disease taking vitamin D every day? Let me know your
thoughts.
*The 5 markers that were followed in this study are C-reactive
protein (CRP), fibrinogen, D-dimer, tissue plasminogen activator
(tPA) antigen, and von Willebrand factor (vWF)

Reference

I admire the ingenuity of these researchers in Iran, who looked at the effects of air pollution on vitamin D status in otherwise healthy women.

Dr. F Hosseinpanah and colleagues, took a cross-section of 200 free living housewives with ages between 20 and 55 years old. They looked at the vitamin D levels in the women living in Tehran (a highly polluted area of Iran) and the women living in Ghazvin (a low pollution area of Iran).

The researchers then measured the ground level of UVB by using a Haze meter as a way of measuring air pollution.

The findings confirmed what I have discussed in my book about the importance of pollution blocking the UVB needed for the skin to make vitamin D.

[Read more…]

Fibromyalgia is a common and very complex condition which is characterized by chronic and widespread musculoskeletal pain, fatigue, sleep disturbances, and physical and psychological impairment.

Before about 10 years ago, patients who presented with these symptoms with told that they were depressed and should take a SSRI drug. These patients realized it was not depression, but they were told it was all in their mind. Within the last years the American College of Rheumatology has finally acknowledged this diagnosisand even given it an ICD-9 code.

In my office we see and treat many patients with this fibromyalgia. We usually use an interdisciplinary approach to helping them. We give the patients anti-inflammatory natural supplements as well as change them to  an anti-inflammatory diet. We also give them support for their adrenals and other stress organs, as well as liver support. In addition, the patients will get acupuncture and bodywork. Bodywork is especially important because often these patients have poor posture and "backwards breathing" and need to learn how to stand and walk sit and breathe in a correct way.

Now I am delighted to see a randomized trial of Tai Chi for fibromyalgia being published in the prestigious New England Journal of Medicine. For those of my readers who do not know, Tai Chi is a mind-body practice which began in China as a martial art. It includes meditation along with slow, gentle, graceful movements as well as deep breathing and relaxation. The idea of it is to move the body's life force called "Chi" throughout the body. The beauty of it is that integrates physical psychosocial, emotional, spiritual and behavioral components. It was thought that because of its mind and body attributes that tai chi would be especially well-suited to the treatment of fibromyalgia.
[Read more…]

All of my pregnant patients take a prenatal vitamin based on what would be best for the developing fetus. I have even found a prenatal vitamin that I like so much that I put my own private  label on it.

Now a new study published in the New England Journal of Medicine has  been published showing the importance of vitamin A and its relationship to lung development in the womb.

In this study, that was led by Wiliam Checkley, M.D., over 1600 children in Nepal were evaluated. Some of the mothers were given vitamin A pills during pregnancy and others were given placebo. An additional set of women was given beta-carotene which is a derivative of vitamin A.
[Read more…]

All pregnant women are given a prenatal vitamin by their obstetrician. The implication is that what is in the prenatal is all the extra vitamins that a pregnant mother needs for herself and her fetus.

Recently after an enormous amount of data in the medical literature many prescription prenatal vitamins have start to add an essential fatty acid capsule that is necessary for brain development of the fetus in the uterus.

Integrative medicine doctors have been prescribing this essential fatty acid known as DHA for over 20 years. The information has been in the medical literature but not that literature that is commonly read by obstetricians. More and more studies have shown that DHA during pregnancy and in the first four years of a child's life are necessary to optimize the child's neurological and brain development.

There are other nutrients that the medical literature shows that are essential for pregnancy, and one that has been overlooked by all of the prescription prenatal vitamins that I have seen, is called CHOLINE.

Choline is an essential nutrient and it is usually considered part of the vitamin B complex. It is found in the fat that makes up cell membranes and in certain neurotransmitters. Choline has been found to be essential for the normal functioning of all cells, liver metabolism and the transportation of nutrients throughout the body. Choline can be produced within the body but the amount the body makes is often not sufficient to meet the individuals needs. Therefore choline must be consumed in the diet. Recent research has shown that only 10% or less of older children, men, women, and pregnant women in America are getting sufficient levels of choline on a daily basis.

High amounts of choline is found in foods such as eggs, chicken liver, beef liver, beef steak, cod, broccoli, peanut butter, and milk. I am happy to see that because choline is especially high in egg yokes, the Egg Industry has created a website that talks about choline.

In a pregnant woman choline works with folic acid to help promote brain and memory development in growing fetuses and newborn infants.
Now a new study has been published that shows in mice that a diet low in choline and vitamin B2, during pregnancy influenced the development of the fetus' heart. Specifically the mice that were born to choline deficient mothers had more heart defects, which were specifically ventricular septal defects. The vitamin B2 deficient mothers gave birth to  late embryos and smaller embryos. In addition, vitamin B2 deficiency resulted in decreased thickness of the offsprings' left ventricle in the heart.

The conclusion of the authors of this article were: "Low dietary choline and riboflavin affect embryonic growth and cardiac development in mice. Adequate choline and riboflavin may also play a role in the prevention of these pregnancy complications in women."

Given the increasing preponderance of evidence that choline is essential during pregnancy I have been using a specific prenatal vitamin that is fortified with choline. I believe that choline is the next nutrient that will be found to be essential for all pregnancies. I can only guess how many years it will be until the prescription prenatal vitamins will contain this nutrient. But I am happy to be using one that does contain this nutrient for all my pregnant patients. I like it so much that I have begun to private label it under my name.

Does your prenatal or your family's prenatal's include choline or are you making and sure enough that you are eating enough of the choline containing foods to get enough for the fetus? Let me know if you think I should make my Prenatal vitamin available on my website for the public?

REFERENCE

Other resources and articles:

Egg Nutrition Center

Choline: Critical Role During Fetal Development and Dietary Requirements in Adults

USDA Database for the Choline Content
of Common Foods