Why Has It Become So Hard To Stay Healthy?

Many patients tell me it is very hard to live a healthy lifestyle. They are absolutely right and a look at our history will explain why.

About two-hundred thousand years ago, modern man (and woman) or Homo Sapiens, is believed to have evolved. This means at that time those early for-bearers had all the phenotypical characteristics that we have today, although they were yet to adopt more evolved social characteristics. That did not happen until an estimated fifty thousand years ago when man began to display modern behavior as he started forming groups and living together.

Yet, there is relatively little human history available beyond ten thousand years ago when the Neolithic Revolution or what some call the first Agricultural Revolution began. This revolution involved the wide-scale transition of many human cultures from a lifestyle of hunting and gathering to one of agriculture and settlement, which supported the growth of large populations. But most sociologists, anthropologists, even humanists would agree that man's heavy lifting and major accomplishments truly began with the Industrial Revolution, which was the transition to new manufacturing processes in the period from about 1760 to some time between 1820 and 1840.

The Digital Revolution, which can be called the newest Industrial Revolution, is the change from analog mechanical and electronic technology to digital technology that has taken place since about 1980 and continues to the present day.

During all these periods, life as we know has undergone profound changes, particularly our relationship with food. From hunting our food and gathering it from nature, we began to grow our own. Take wheat for example.It could be argued that humans' social and cultural roots is closely tied to the development of wheat since before recorded history. In regards to wheat, first we learned how to process it into breads and cakes. Then scientists learned how to genetically manipulate wheat by changing the nature of its protein called gluten so it would grow more robustly.Inventions like refrigeration allowed us to gather in our homes foods, such as meat, dairy, etc. that had been otherwise difficult to access on a regular basis.

Basically, as we advanced our knowledge and the world progressed, men and women changed their relationship with food. We no longer ate to simply sustain ourselves; rather, we began to eat for pleasure.  To paraphrase Benjamin Franklin, "we no longer eat to live,  we now live to eat." Arguably, modern conveniences and those technological advances yet to be discovered have created some significant challenges to our health.

Why do I say that? Consider the following. Today, you can have access to a week's or more supply of food without traversing more than thirty feet to get to your refrigerator or pantry. You can communicate with virtually anyone in the world at any time without moving an inch. You can get to the four corners of the Earth without breaking a sweat. Basically, you can exist by taking weekly or so trips to a local supermarket, stocking up on meats, cheeses, breads, cakes, cookies, crackers, canned foods, frozen foods, etc. You can also have it delivered for free. You can also typically access at least a dozen or more restaurants, fast food or otherwise, within one mile of your home.

Our entire commerce now appears to be built around conveniences, which require little physical exertion and even less social interaction.  Like the lunacy of paying for bottled water, once unthinkable, we now pay countless gyms for the privilege of exercising, which we did for free for nearly two-hundred thousand years, not considering the millions of years before as less evolved hominids. I  often quip to audiences that the Okinawans, Sardinians, and Icarians, who count among them many centenarians for hundreds, if not thousands of years, have never even seen the inside of a gym. They don't need them based on their lifestyle.

Technology has also been disruptive. Countless patients have told me they are either on the computer or watching television in the middle of the night because it's there and they can't sleep. 

Food science may be the worse offender. With the ubiquitous nature of processed foods and consumables that can't in good faith even be called food anymore because they are entirely composed of artificial ingredients and chemicals, we are challenged every passing day to stay healthy.

So what does it still mean to be healthy?  It means to eat healthy foods in reasonable quantities, stay physically fit, enjoy positive social interactions, get adequate sleep, effectively manage unavoidable stresses, and have purpose in life. Our modern society increasingly challenges every single aspect of what it means to be healthy. That's why I say that staying healthy requires extraordinary effort.

To stay healthy you simply have to forgo many modern conveniences and live at least part of your life like your ancestors. You have to walk or run whenever you can, eat primarily real food, which is the produce of the ground best eaten raw when possible with added wild Alaskan salmon, nurture relationships and make an effort to meet friends in person, take steps to get a good night's sleep, develop skills in managing stress.and most of all find new challenges every day to keep you engaged.

I know I'm asking for a lot when it's so simple to do none of these, but if you really want to feel what it means to be human (again), make the effort. I promise you it will be life changing.




    

To Lose Weight, Get Your Head Into the Game

Altogether now. "If your head is not in the game, the game is over before you start."

Last evening, I came across an article about a new analysis of a study called the Look AHEAD (Action For Health in Diabetes) trial that purported to show that lifestyle intervention had no (yes, I meant no) benefit in reducing heart disease for type two diabetics. The study was a randomized study in which one group, the control group, received up to three yearly educational sessions dealing with their diabetes, while the second group, the study group, received regular counseling about reducing their calories and exercising more.

This may surprise you, but I wasn't surprised by the results.

About fifteen years ago, a study was done called the Adverse Childhood Experiences (ACE) study. The  ACE study showed a direct link between adverse child events and unhealthy behaviors. The number of adverse child experiences, which include physical and sexual abuse, the death of a parent, living with an alcoholic parent, etc.correlated almost perfectly with the number of unhealthy behaviors demonstrated during later adult life.  The landmark study showed the absolute relationship between mind and body, psychology and physiology, what's going on in your head, and your overall health.

When I rook a close look at the Look AHEAD study, it was very clear that although a psychologist was suppose to be part of the team at each medical center that participated in the trial that involved over 5,000 patients, psychological counseling and behavioral modification was not an intrinsic part of the study.

Most health conscious people know that simple caloric reduction does not guarantee weight loss, let alone good health because the source of the calories is as important as the number of calories. Case in point. A recent medical case revealed a woman who drank only soda for a number of years and became deathly sick. Another example is the Atkins Diet which proves that calories derived mostly from meat does produce weight loss, but at the cost of heart health.

The lesson here should be clear. Simply telling people to restrict their calories is a failed experiment in the making. Getting them to exercise more without concomitant changes in other aspects of their lifestyle provides marginal benefits at best.

Having now counseled hundreds of patients about their weight and the lifestyle changes they need to make to get healthier and lose weight, I can tell you with almost absolute certainty that simply telling patients what to do does not work.  Virtually every human being has a story unique to him or her. Understanding that story, identifying rationales for the decisions made, exposing motivations to make change, and acknowledging the challenges faced to modify behaviors are equally important to helping a person make changes.

In the Look AHEAD trial, it should have come to no surprise to any of the researchers that many of the participants either regained or were regaining the weight they earlier had lost as the trial progressed. Why? They had followed directions, not made fundamental changes to their mind-body connections. Their relationship to food had not changed. They had simply denied themselves calories for an extended period of time and eventually resumed bad habits. Nothing had really changed and the weight came back. Their hearts were essentially no better off than before the trial began.

Back in March, I wrote a blog titled "The Main Reason You Can't Lose Weight is EXACTLY What You Think!," which can be found at http://mdprevent.blogspot.com/2013/03/the-main-cause-of-weight-gain-is-exacty.html.

I think the Look AHEAD study does an admirable, if clearly not intended, job of proving the point that lifestyle interventions that don't include psychosocial counseling are often doomed to fail.

Discussing the mind-body connection is more than new age mumble-jumble. It is the key to good health and those who ignore the connection do so at their own peril.  If you are one of those people who has tried everything possible to lose weight through the mouth and you just can't seem to get a handle on it, maybe it's time to switch your focus to whats going on in your mind. It may change everything.

Can Dementia Be Prevented?

Let's start with the good news. Among Americans, only one out of eight develop any form of dementia by the age of 65. By 80, four out of seven are still dementia free. Nevertheless, dementia and the related cognitive impairment and short term memory loss, can be devastating to both the person who suffers from it as well as to friends and loved ones.

When I speak of dementia, I mean all types of dementia, including the most common called Alzheimer's and the second most common called vascular or multi-infarct dementia. For a good video review of the the entire topic of dementia and it's prevention based on lifestyle changes, please see my five-part youtube video lecture that starts at http://www.youtube.com/watch?v=nAXJFVDO5-8.

Since giving this lecture back in 2011, the preponderance of evidence I have come across supports the relationship between lifestyle and the development of dementia  However, there were two recent studies worthy of careful consideration. The first, which I wrote about in my blog titled "If You Jump Up and Down After Reading Today's Blog, You May Actually Remember It When You Get Older!,"which can be found at http://mdprevent.blogspot.com/2013/02/if-you-jump-up-and-down-after-reading.html, identifies the correlation between physical fitness and dementia prevention. Exercise is undoubtedly the number one best known strategy to delay or prevent the onset of cognitive impairment. It's better than intellectual stimulation and all the drugs and supplements on the market today. Move!

What about diet? Well, a new study just came out, prompting today's blog that demonstrates the relationship between what you eat and what develops in your cerobro-spinal fluid (CSF), the fluid that encases the brain and spinal canal.  In this study, people fed a low fat, low carb diet were found to have the lowest levels of beta-amyloid, a peptide (smaller than protein) most scientists believe (some believe it's a protein called tau and others think it may be something else entirely) is responsible for the development of Alzheimer's. Although this study was not conducted long enough to offer definitive evidence that a diet that decreases levels of beta-amyloid in the CSF results in lower rates of dementia, I think it still merits close attention because it supports the strengthening assertion that what you eat affects the long term health of not only the rest of your body, but your brain as well.

With the preponderance of evidence showing that what you eat has a profound impact on your chances of living a longer, healthier, pain-free life, or dying prematurely from cancer, heart disease, etc, isn't it seriously worth rethinking the foods you eat?

The short list remains the same. Avoid processed sugar based products, saturated fats, and trans fats, and consume plenty of vegetables, fruits, nuts, beans, seeds, whole grains, and wild Alaskan Salmon.

Are all fish equally healthy?

I would like to preface today's blog by stating that it would take a book to do real justice to this subject.

A few months ago, I wrote a hearty defense of fish as part of a healthy diet.(see http://mdprevent.blogspot.com/2013/03/in-defense-of-fish-consumption.html). Since that time, meaningful studies continue to emerge supporting the value of including fish.  A recent study showed that pesco-vegetarians (vegetarians who also consume fish) do better than any other category of eater, including pure vegans, when it comes to overall mortality. The study, however, did not distinguish among types of fish.

In my practice, I counsel many patients about the importance of consuming fish. Many patients say they already do. On closer scrutiny, it turns out that most are eating tilapia, farm-raised salmon, and canned tuna fish.  When I recommend fish, these are not my first choices. As a choice, they are undoubtedly preferable over hamburgers, hot dogs, and cured meats. They are also superior to other forms of red meat and caged fowl. But when it comes to choosing among fish, they rank low.

My first choice and champion remains wild Alaskan Salmon. One of the great things about wild Alaskan Salmon is that the salmon is often caught after it spawns and closer to the end of it's life cycle. This allows for sustainability of the species and is ecologically friendly.

I make a point about Alaskan salmon because wild Alaskan salmon as opposed to its Oregon and California counterparts, has far less Polychlorinated biphenyl (PCBs) contaminants. In fact, last year, Oregon issued a safety alert about wild Oregon Salmon being highly contaminated. So please take note when selecting wild Salmon, it's source is equally important to it being wild.

Tilapia and other farm raised fish, including salmon, contain far less of the essential Vitamin D and health promoting omega-3s than does wild Alaskan Salmon. In fact, wild Alaskan salmon has four times the Vitamin D as it's farm raised equivalent. Wild salmon tends to be leaner, having less saturated fats, and is an excellent and essential source of Vitamin B12 and protein. It alo contains an generally considered healthy anti-oxidant called astaxanthin. Free of articial dyes, food additives, antibiotics and growth hormones, Wild Alaskan salmon is my ultimate food.

What about other fish?

I like wild sardines and herring. As small, non-predatory fish, they also contain few contaminants and are high in omega-3 fatty acids. Costco and many supermarkets sell wild sardines in a can and wild herring in wine sauce.

What about tilapia, a perennial favorite?

Here's a snippet from Wikipedia discussing the problem with tilapia.

"Typical farm-raised tilapia (the least expensive and most popular source) have low levels of omega-3 fatty acids (the essential nutrient that is an important reason that dieticians recommend eating fish), and a relatively high proportion of omega-6. "Ratios of long-chain omega-6 to long-chain omega-3, AA to EPA, respectively, in tilapia averaged about 11:1, compared to much less than 1:1 (indicating more EPA than AA) in both salmon and trout," reported a study published in July 2008. The report suggests the nutritional value of farm-raised tilapia may be compromised by the amount of corn included in the feed. The corn contains short-chain omega-6 fatty acids that contribute to the buildup of these materials in the fish."

Tuna, wild or otherwise, is a predatory fish and therefore accumulates lots of mercury. As does cod, halibut, sole, lobster, shrimp, etc. Again, given the choice between red meat and these seafood, the fish are better. Of course, that assumes the fish are not soaked in butter or drenched in a fatty mayonnaise.

The evidence against red meat and dairy, by the way, continues to mount. The recent link of L-carnitine, a by product of meat and whey protein degradation, with inflammatory heart disease, combined with the well established dangers of high saturated fat consumption in terms of heart disease, cancer, stroke, dmentia, etc. should give you meat eaters serious pause for reconsideration.

There's nothing fishy about wild Alaskan Salmon. How about some for dinner?

Ginkgo Biloba, Dr. Oz, and Memory

On his Friday May 31, 2013 show, Dr. Oz stated emphatically that there is no conclusive evidence that Ginkgo Biloba in supplement form helps or hurts. He cited recent animal studies that suggest Ginkgo may cause certain types of cancer, but they were only studies in rats and mice. He stated that there are other studies that suggest benefits. His conclusion based on consulting his "experts" was that one is better off not taking it.

Is this news? Not to Steven Novella, MD, an American clinical neurologist and assistant professor at Yale University School of Medicine, who appeared on the April 26, 2011 episode of the Dr. Oz Show and argued this very point. Dr. Novella stated during that episode that the evidence to support the use of Ginkgo Biloba was inconclusive and Dr. Oz pushed back. (See http://www.doctoroz.com/videos/alternative-medicine-controversy-pt-1)

As I wrote in my last blog about other supplements and you may have just seen at the link above, Dr. Oz hasn't always been so neutral about recommending Ginkgo.

Still not convinced?

Check out the following links to see for yourself.

Here's a video I plucked today from his website that shows another previous episode of his show.

http://www.doctoroz.com/videos/does-it-work-ginkgo-biloba

Want more?

Here's a quote from a website called Realage.com in which he has an ownership stake:

"What is Ginkgo Biloba?

RealAge answered:

The ginkgo tree, also known as the maidenhair tree, is one of the oldest living species in the world. This hardy, deciduous tree is cultivated on plantations in many parts of the world, primarily in the United States and China. Ginkgo leaves are picked, dried and extracted to manufacture ginkgo products, which are marketed widely.

Extracts of Ginkgo biloba can be used to treat the following:

• limping due to insufficient peripheral blood flow (disorders of peripheral circulation, or intermittent claudication)
• memory loss due to general mental deterioration (dementia) or physical disorders that cause a decrease in mental function (organic brain syndrome)
• dizziness (vertigo) and ringing in the ears (tinnitus), originating from insufficient blood supply to the inner ear"

Still hungry for proof?

Here's another quote from Sharecare.com, a website he jointly owns and which purchased Realage.com.

"What are the benefits of Ginkgo Biloba?

Dr. Mehmet Oz answered:

Ginkgo biloba improves mood and can help prevent macular degeneration.Watch the video to find out from Dr. Oz about the other benefits of ginkgo biloba."

I can't make this stuff up. Dr. Oz is sowing a great deal of confusion by stating one thing one day and flipping on it the next. The worse part, he doesn't bother to clean upon the web and his own site of the old "wrong" information he previously shared. It's obvious he's not taking anything for memory. He must also think his audience also has a poor memory and can't remember what he previously said.

I wonder if we all wouldn't be better off if Dr. Oz just kept his mouth shut? What do you think?

As for Ginkgo Biloba for memory, forget it.