In the past, I have written about junk food that feeds the bad bacteria in your gut – and how this makes you think even more of unhealthy treats: You eat a hamburger, then suddenly you crave a donut (or a bag of donuts), and then you needs some twinkies and a soda to flush them down.
I have likened this process to a computer virus: The bad gut bacteria send messages to your brain, sidetracking your best intentions for healthy eating.
There are a few other players who fiddle with your brain, make you fatter and fatigued, and thus prevent you from reaching your goals in life.
Too little sleep is one of those players. If you haven’t gotten the amount of sleep your body needs – and the individual requirements differ, usually between seven and nine hours. If you get away with five to six hours a night, chances are you are using up your bank account of health.
Too little sleep produces stress hormones the next day, and stress hormones like cortisol make you eat more – ergo, weight gain.
A day is made or broken the night before: Can you find into bed early enough – or are you staying up too late, get unrestful rest, and have a sleep-deprived hangover the next day?
And here are two more players that wreak havoc with your brain: computers and TV. Both keep you busy and interested much longer than they should. Captivated as you are, you don’t heed your body’s little signals that it is time to go to bed. You go on working, watching, playing – and so the next day is spoiled because you have to run on less energy. Once you creep into bed, you have a hard time falling asleep. Or you wake up too early. Because staying up late disrupted your sleep-wake-cycle.
Being tired produces more stress hormones. And those makes you eat more.
The holiday season is a time of high stress and tons of running around because you want to bring joy to your loved ones. This year, try this sneaky little trick: No machines (TV, computer, electronic games) after dinner. Take a book, read, listen to music, ease into slumber time – between eight and ten o’clock. If you wake up in the middle of the night, don’t toss and turn. Take this gifted time for thinking what you want to do with your life, what is important to you. And snuggle back into the pillows.
Next day, observe how you glow and function at your personal best! You regained your brain! Read More
Blog: On Health. On Writing. On Life. On Everything.
How to Measure Diabetes
July 21, 2010
In ancient times, diabetes was diagnosed by licking the urine of the patient. If it tasted sweet, a diagnosis of diabetes mellitus (“honeysweet flow”) was made. As a physician, I am glad we have advanced to better tests...
There are basically four different tests to diagnose diabetes (I am talking here mostly of type II):
• Spot blood sugar. Since sugars rise and fall depending what and when you ate, this is a very unreliable test.
• Fasting blood sugar. Does only take a bit of blood, is cheap and fast – but still can vary with what one ate the day before. However, if your fasting numbers are up consistently, you should pay attention!
• Oral Glucose Tolerance Test: a complicated procedure where one drinks an awfully sweet fluid before blood will be drawn in half-hour intervals to ascertain how fast the sugar load is cleared out. It’s complicated, and very time-consuming for the patient. I object of giving a patient a drink 75 to 100 gm of unpalatably sweet glucose solution – which can’t be healthy if there is a disease caused by sugar. My suspicion is that this test is still be used because doctors can bill the most for this.
• Glycosylated hemoglobin, also called A1c: An easy blood test that gives a rough average of your sugars through the last month. I like this one the best because the usual ups and downs of sugar are not interfering with the test, but going into the overall measuring. With frequent episodes of hypoglycemia (too low blood sugars), the test might come back falsely low or normal. In iron-deficiency, A1c are higher than they really are, suggesting diabetes where there might be none. Every time one eats sugar, it “glycosylates” (adding a sugar to the molecule) a protein on the surface of an erythrocytes (red blood cells), and the chemical process is never reversed as long as the blood cell lives. Red blood cells live about three months; blood we draw is always a mixture of very young cells, newly released into the bloodstream from the bone marrow, and older cells, soon to be discarded. Measuring blood glycosylation therefore represents a fair mirroring of recent sugar intake and over time, those numbers can be compared: A lower A1c means you have done something right lately.
In conventional medicine, A1c is called normal if it is below 6.0. A1c is measured in percent of how much of the blood is “sugared”. Starting at 6.1, you have diabetes. That in it itself is rather absurd: A little step upward from 5.9 to 6.0 does not give you diabetes – you had it coming all along. In Natural Medicine, we think that between 5.0 and 6.0, one has “latent” (developing) diabetes. Why that number of 6.0? Because if one would chose 5.0 as the cut-off point, most Americans would have to be diagnosed with the disease.
The Oral Glucose Tolerance Test is more sensitive to detect cases of diabetes – but only if the cut-off point for diabetes is set at 6.0 A1c.
Arbitrarily putting the number to 6.0 does not make a person healthier. In fact, at the date of diabetes diagnosis, I good proportion of patients have already end-organ failure, namely eye problems, kidney failure, neuropathy – to name a few.
Just looking around tells us that many people are overweight and have some of the telltale signs of diabetes: belly fat, scant hairs on arms and legs, rosy cheeks. One sign alone does not make the diagnosis – but several together gives me an idea. But one can be very overweight and never develop diabetes, because in order to get the disease, you have to have the genes AND an unfortunate lifestyle.
Don’t think that genes are an excuse. Because diabetes type II does not strike, if one lives frugally. For instance, after World War II in Europe, basically nobody had it (but people died in droves of tuberculosis then…). Ten years later, with ballooning economies and waistlines, diabetes was back.
But you don’t have to starve yourself, to heal diabetes. You need a mixture of moderate movement (walking, swimming, biking – or dancing; whatever you like) and a diet without sugars, white starches and bad fats.
In diabetes drug studies, diabetes often is called “controlled” if the blood sugar stays within the limits if 7.0 to 10.0 A1c. We can be sure that at those numbers the damage done by high sugars is continuing in the body. I personally favor an approach that does not “manage” the patient’s diabetes, but gets rid of it. And in many cases it can be done, with exercise, better nutrition – and determination on the patient’s side. Read More
Weighing In
June 21, 2010
How often should you jump on the scale?
For many years, I never recommended to patients to weigh themselves daily (first thing in the morning). The prevailing medical opinion was that weighing oneself triggered anxieties that might end in eating disorders like anorexia and bulimia.
Contrary to what I said to my patients, however, I have weighed myself my whole life (nearly) every morning – and have kept the same weight since age twelve. Except for pregnancies, gaining twenty pounds with my daughter, forty with my son. The difference? In both cases, relentless morning sickness. With my daughter, eating or even thinking of food made me throw up; with my son, eating calmed the sickness. During pregnancy, I did not care what I weighed and how I looked; all I cared was the baby I was expecting. So I followed my body’s whims and cravings. Including the incredible craving for a lobster at a very inconvenient time…
My body feels well only within a very tight margin: Two pounds less, and faintness grips me. Two pounds more, and stuffiness prevents me bending forward.
My personal weight story made me absolutely unacceptable for several overweight patients who stated that I had never been in their shoes and could therefore not advise them. I respect that view. But it would also mean that one can’t be a good doctor for a cancer patient if one didn’t have experience with the dreaded disease. Or could couldn’t treat a heart attack because … you are getting the idea. (On the other hand, the notion that better doctors come from personal experience with serious illness, is worth spinning out. The A+ nerds who populate our medical schools – half of them should be replaced with compassionate, common-sensical young men and women).
A study showed that people who weigh themselves more often also lost more weight. That takes this discussion beyond my personal story – and here it becomes interesting.
French women supposedly don't gain weight as they age. Which means if the scale tells them they have gained a pound or two, they take action. And responsibility. That might be part of the French Paradox - that the French live longer but eat more fat. Might be they eat fat - and then put in a salad day.
A scale is a reality check. If you want to avoid looking the facts in the face – your decision. I like to confront bad situations – weight gain, disease, divorce, death (why do nearly all adverse events start with a "d"?). That led me one time to lie down in a casket and pull the lid shut, just to see how it was. It was surprisingly peaceful. What I found out in the coffin: It was nothing to fear. Read More