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About Gymnema Sylvestre

About Gymnema Sylvestre

Gymnema sylvestre is a woody climbing shrub that’s native to the tropical forests of India, Africa and Australia.

Its leaves have been used in the ancient Indian medicinal practice Ayurveda for thousands of years.

It has been a traditional remedy for various ailments, including diabetes, malaria and snakebites.

This herb is thought to inhibit sugar absorption and thus has become a popular study subject in Western medicine.

Here are 6 impressive health benefits of Gymnema sylvestre.

1. Reduces Sugar Cravings by Making Sweet Foods Taste Less Appealing

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Gymnema sylvestre can help reduce sugar cravings.

One of the primary active components in this plant is gymnemic acid, which helps suppress sweetness.

When consumed prior to a sugary food or beverage, gymnemic acid blocks the sugar receptors on your taste buds.

Research shows that Gymnema sylvestre extracts can reduce the ability to taste sweetness and thus make sweet foods less appealing.

In a study in fasted individuals, half were given Gymnema extract. Those who received the supplement had less appetite for sweet foods at a subsequent meal and were more likely to limit their food intake, compared to those not taking the extract.

Summary Gymnemic acids in Gymnema sylvestre can block the sugar receptors on your tongue, decreasing your ability to taste sweetness. This can lead to reduced sugar cravings.

2. Helps Lower Blood Sugar Levels

According to the World Health Organization, more than 420 million people worldwide have diabetes, and this number is expected to increase.

Diabetes is a metabolic disease characterized by high blood sugar levels. It’s caused by the inability of your body to produce or use insulin effectively.

Gymnema sylvestre is considered to have anti-diabetic properties.

As a supplement, it has been used in combination with other diabetes medications to lower blood sugar. It’s also called gurmar, which is Hindi for “destroyer of sugar”.

Similar to its effects on your taste buds, Gymnema sylvestre can also block receptors in your intestines and thus sugar absorption, lowering your post-meal blood sugar levels.

Scientific proof of gymnema’s ability to lower blood sugar is insufficient to recommend it as a stand-alone diabetes medication. However, research shows strong potential.

Studies suggest that consuming 200–400 mg of gymnemic acid reduces the intestinal absorption of the sugar glucose.

In one study, Gymnema appeared to improve blood sugar control in people with type 2 diabetes by lowering blood sugar levels (5).

The study concluded that reducing blood sugar after a meal resulted in a decrease in average blood sugar levels over time. This could help decrease long-term complications of diabetes.

For people with high blood sugar or a high HbA1c, Gymnema sylvestre can help reduce fasting, post-meal and long-term blood sugar levels. However, if you’re taking blood-sugar-lowering medications, consult with your doctor first.

Summary Gymnema sylvestre has anti-diabetic properties and may lower your blood sugar levels after a meal.

3. May Contribute to Favorable Insulin Levels by Increasing Insulin Production

Gymnema’s role in insulin secretion and cell regeneration may also contribute to its blood-sugar-lowering capabilities.

Higher insulin levels mean that sugar is cleared from your blood at a faster rate.

If you have prediabetes or type 2 diabetes, your body tends to not make enough insulin, or your cells become less sensitive to it over time. This results in consistently high blood sugar levels.

Gymnema sylvestre may stimulate insulin production in your pancreas, promoting the regeneration of insulin-producing islet cells. This can help lower your blood sugar levels.

Many traditional drugs help increase insulin secretion and sensitivity. However, herbal therapies are gaining momentum in drug development.

Interestingly, metformin, the first anti-diabetic drug, was an herbal formulation isolated from Galega officinalis.

Summary Gymnema sylvestre appears to contribute to favorable insulin levels by increasing insulin production and regenerating insulin-secreting islet cells. Both can help lower blood sugar levels.

4. Improves Cholesterol and Triglyceride Levels, Reducing Heart Disease Risk

Gymnema sylvestre may help lower “bad” LDL cholesterol levels and triglycerides.

While Gymnema gets its fame from lowering blood sugar levels and reducing sugar cravings, research shows that it may also influence fat absorption and lipid levels.

In one study in rats on a high-fat diet, Gymnema extract aided weight maintenance and suppressed the accumulation of liver fats. Also, animals fed the extract and a normal-fat diet experienced lower triglyceride levels.

Another study found that Gymnema extract had an anti-obesity effect on animals fed a high-fat diet. It also decreased blood fat and “bad” LDL cholesterol levels.

In addition, a study in moderately-obese people showed that Gymnema extract decreased triglycerides and bad “LDL” cholesterol by 20.2% and 19%, respectively. What’s more, it increased “good” HDL cholesterol levels by 22%.

High levels of “bad” LDL cholesterol and triglycerides are risk factors for heart disease.

Therefore, the positive effects of Gymnema sylvestre on LDL and triglycerides levels may contribute to a lower risk of heart conditions.

Summary Research supports that Gymnema can play a role in lowering “bad” LDL cholesterol and triglyceride levels, which can decrease your risk of heart disease.

5. May Aid Weight Loss

Gymnema sylvestre extracts have been shown to aid weight loss in animals and humans.

One three-week study showed reduced body weight in rats given a water extract of Gymnema sylvestre. In another study, rats on a high-fat diet that were fed a Gymnema extract gained less weight.

What’s more, a study in 60 moderately-obese people taking a Gymnema extract found a 5–6% decrease in body weight, as well as reduced food intake.

By blocking sweet receptors on your taste buds, Gymnema sylvestre may cause you to eat fewer sweet foods and consume fewer calories.

A consistent calorie deficit can result in weight loss.

Summary Gymnema sylvestre may play a role in weight loss and prevent weight gain. It may promote reduced calorie intake.

6. Helps Reduce Inflammation Due to Its Tannin and Saponin Content

Inflammation plays an important role in your body’s healing process.

Some inflammation is good, such as when it helps protect your body from harmful organisms in cases of injury or infection.

Other times, inflammation may be caused by the environment or the foods you eat.

However, chronic low-grade inflammation can contribute to various health issues.

Studies have confirmed the link between excessive sugar intake and increased inflammatory markers in animals and humans.

The ability of Gymnema sylvestre to reduce sugar absorption in your intestines may also allow it to decrease inflammation caused by excess sugar intake.

What’s more, Gymnema appears to have anti-inflammatory properties of its own. This is thought to be due to its content of tannins and saponins, which are beneficial plant compounds.

Gymnema sylvestre leaves are considered immunostimulatory, meaning they can regulate the immune system, reducing inflammation.

People with diabetes not only suffer from high blood sugar and insulin resistance but may also have decreased antioxidant levels, which can contribute to inflammation.

Due to its anti-inflammatory properties, Gymnema sylvestre can help those with diabetes and high blood sugar in a variety of ways, including by fighting inflammation.

Summary The tannins and saponins in Gymnema have anti-inflammatory properties that help fight inflammation.

Dosage, Safety and Side Effects

Gymnema sylvestre is traditionally consumed as a tea or by chewing its leaves.

In Western medicine, it’s typically taken in pill or tablet form, making it easier to control and monitor dosage. It can also be ingested in extract or leaf powder form.

Dosage

The recommended dosage for Gymnema sylvestre depends on the form in which you consume it.

  • Tea: Boil leaves for 5 minutes, then let steep for 10–15 minutes before drinking.
  • Powder: Start with 2 grams, increasing to 4 grams if no side effects occur.
  • Capsule: 100 mg, 3–4 times daily.

If you’re looking to use Gymnema sylvestre to block the sugar receptors on your tongue, take a supplement with water 5–10 minutes before a high-sugar meal or snack.

Safety Information

Gymnema sylvestre is considered safe for most people, but it should not be taken by children or women who are pregnant, breastfeeding or planning to get pregnant.

Moreover, though it appears to improve blood sugar and insulin levels, it’s not a substitute for diabetes medication. Only take Gymnema with other blood-sugar-lowering medications under your doctor’s supervision.

Possible Side Effects

While its effects on blood sugar are rather positive, combining Gymnema sylvestre with other blood-sugar-lowering medications can cause an unsafe drop in your blood sugar levels.

This can cause side effects, such as headache, nausea, lightheadedness, shakiness and dizziness.

Gymnema sylvestre supplements should not be taken at the same time as blood-sugar-lowering medications, including insulin injections. Be sure to talk to your doctor about the best timing for taking this supplement.

Additionally, the supplement should not be taken with aspirin or the herb St. John’s Wort, as this may increase gymnema’s blood-sugar-lowering effects.

Lastly, those with milkweed allergies may also experience unpleasant side effects.

Always talk to your doctor before taking any herbal supplements.

Summary Gymnema is considered safe for most, but children or women who are pregnant, breastfeeding or planning to get pregnant should not take it. People on blood-sugar-lowering medications should consult with a doctor first.

The Bottom Line

Gymnema sylvestre may help you fight sugar cravings and lower high blood sugar levels.

The plant may also play a beneficial role in diabetes treatment, as it may help stimulate insulin secretion and the regeneration of pancreas islet cells — both of which can help lower blood sugar.

In addition, Gymnema may fight inflammation, aid weight loss and lower “bad” LDL cholesterol and triglyceride levels.

Though it’s safe for most, talk to your doctor first, particularly if you intend to take the supplement in combination with other medications.

All in all, if sugar is one of your vices, you could try a cup of Gymnema sylvestre tea to help you reduce your intake.

Refer to the original article in Healthline for publication references

https://www.healthline.com/nutrition/gymnema-sylvestre-benefits

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About Berberine

About Berberine

A compound called berberine is one of the most effective natural ingredients available.  It has very impressive health benefits and affects your body at the molecular level.  Berberine has been shown to lower blood sugar, cause weight loss and improve heart health, to name a few.  It is one of the few supplements shown to be as effective as a pharmaceutical drug.  This is a detailed review of berberine and its health effects.

What Is Berberine?

Berberine is a bioactive compound that can be extracted from several different plants, including a group of shrubs called Berberis.  Technically, it belongs to a class of compounds called alkaloids. It has a yellow color and has often been used as a dye.  Berberine has a long history of use in traditional Chinese medicine, where it was used to treat various ailments.  Now, modern science has confirmed that it has impressive benefits for several different health problems.

BOTTOM LINE: Berberine is a compound that can be extracted from several different plants. It has a long history of use in traditional Chinese medicine.

How Does It Work?

Berberine has now been tested in hundreds of different studies.  It has been shown to have powerful effects on many different biological systems.  After you ingest berberine, it gets taken in by the body and transported into the bloodstream. Then it travels into the body’s cells.  Inside the cells, it binds to several different “molecular targets” and changes their function. This is similar to how pharmaceutical drugs work.  I am not going to get into much detail here, because the biological mechanisms are complicated and diverse.  However, one of the main actions of berberine is to activate an enzyme inside cells called AMP-activated protein kinase (AMPK).  This enzyme is sometimes referred to as a “metabolic master switch”.  It is found in the cells of various organs, including the brain, muscle, kidney, heart and liver. This enzyme plays a major role in regulating metabolism.  Berberine also affects various other molecules inside cells and may even affect which genes are turned on or off.

BOTTOM LINE: Berberine affects the body at the molecular level and has a variety of functions inside cells. One of the main functions is activating an important enzyme called AMPK, which regulates metabolism.

It Causes a Major Reduction in Blood Sugar Levels

Type 2 diabetes is a serious disease that has become incredibly common in recent decades, causing millions of deaths every year.  It is characterized by elevated blood sugar (glucose) levels, either caused by insulin resistance or lack of insulin.  Over time, high blood sugar levels can damage the body’s tissues and organs, leading to various health problems and a shortened lifespan.  Many studies show that berberine can significantly reduce blood sugar levels in individuals with type 2 diabetes.  In fact, its effectiveness is comparable to the popular diabetes drug metformin (Glucophage).

It seems to work via multiple different mechanisms:

  • Decreases insulin resistance, making the blood sugar lowering hormone insulin more effective.
  • Increases glycolysis, helping the body break down sugars inside cells.
  • Decrease sugar production in the liver.
  • Slows the breakdown of carbohydrates in the gut.
  • Increases the number of beneficial bacteria in the gut.

In one study of 116 diabetic patients, 1 gram of berberine per day lowered fasting blood sugar by 20%, from 7.0 to 5.6 mmol/L (126 to 101 mg/dL), or from diabetic to normal levels.  It also lowered hemoglobin A1c by 12% (a marker for long-term blood sugar levels), and also improved blood lipids like cholesterol and triglycerides.  According to a big review of 14 studies, berberine is as effective as oral diabetes drugs, including metformin, glipizide and rosiglitazone.  It works very well with lifestyle modifications, and also has additive effects when administered with other blood sugar lowering drugs.  If you look at discussions online, you often see people with sky-high blood sugars literally normalizing them just by taking this supplement.  This stuff really works, in both the studies and the real world.

BOTTOM LINE: Berberine is very effective at lowering blood sugar and HbA1c, which are elevated in people with diabetes. It works as well as some pharmaceutical drugs.

Berberine May Help You Lose Weight

Berberine may also be effective as a weight loss supplement.  So far, two studies have examined the effects on body weight.  In a 12-week study in obese individuals, 500 mg taken three times per day caused about 5 pounds of weight loss, on average. The participants also lost 3.6% of their body fat.  Another more impressive study was conducted in 37 men and women with metabolic syndrome. This study went on for 3 months, and the participants took 300 mg, 3 times per day.  The participants dropped their body mass index (BMI) levels from 31.5 to 27.4, or from obese to overweight in only 3 months. They also lost belly fat and improved many health markers.  The researchers believe that the weight loss is caused by improved function of fat-regulating hormones, such as insulin, adiponectin and leptin.  Berberine also appears to inhibit the growth of fat cells at the molecular level.  However, more research is needed on the weight loss effects of berberine.

BOTTOM LINE: Two studies have shown that berberine can cause significant weight loss, while improving all sorts of other health markers at the same time.

It Lowers Cholesterol and May Reduce Your Risk of Heart Disease

Heart disease is currently the world’s most common cause of premature death.  Many factors that can be measured in the blood are associated with an increased risk of heart disease.  As it turns out, berberine has been shown to improve many of these factors.  According to a review of 11 studies, it can:

  • Lower total cholesterol by 0.61 mmol/L (24 mg/dL).
  • Lower LDL cholesterol by 0.65 mmol/L (25 mg/dL).
  • Lower blood triglycerides by 0.50 mmol/L (44 mg/dL).
  • Raise HDL cholesterol by 0.05 mmol/L (2 mg/dL).

It has also been shown to lower apolipoprotein B by 13-15%, which is a very important risk factor.  According to some studies, berberine works by inhibiting an enzyme called PCSK9. This leads to more LDL being removed from the bloodstream.  Keep in mind that diabetes, high blood sugar levels and obesity are also major risk factors for heart disease, all of which seem to be improved with this supplement.  Given the beneficial effects on all these risk factors, it seems likely that berberine could drastically reduce the risk of heart disease.

BOTTOM LINE: Studies show that berberine reduces cholesterol and triglyceride levels, while raising HDL (the “good”) cholesterol. It may lower the risk of heart disease in the long-term.

Other Health Benefits

Berberine may also have numerous other health benefits:

  • Depression: Rat studies show that it may help fight depression.
  • Cancer: Test tube and animal studies have shown that it can reduce the growth and spread of various different types of cancer.
  • Antioxidant and anti-inflammatory: It has been shown to have potent antioxidant and anti-inflammatory effects in some studies.
  • Infections: It has been shown to fight harmful microorganisms, including bacteria, viruses, fungi and parasites.
  • Fatty liver: It can reduce fat build-up in the liver, which should help protect against non-alcoholic fatty liver disease (NAFLD).
  • Heart failure: One study showed that it drastically improved symptoms and reduced risk of death in heart failure patients.

Many of these benefits need more research before firm recommendations can be made, but the current evidence is very promising.

BOTTOM LINE: Preliminary studies show that berberine may have benefits against depression, cancer, infections, fatty liver and heart failure. It also has potent antioxidant and anti-inflammatory effects.

Dosage and Side Effects

Many of the studies cited in the article used dosages in the range of 900 to 1500 mg per day.  It is common to take 500 mg, 3 times per day, before meals (a total of 1500 mg per day).  Berberine has a half-life of several hours, so it is necessary to spread your dosage to several times per day to achieve stable blood levels.  If you have a medical condition or are on any medications, then it is recommended that you speak to your doctor before taking it.  This is especially important if you are currently taking blood sugar lowering medications.  Overall, berberine has an outstanding safety profile. The main side effects are related to digestion, and there are some reports of cramping, diarrhea, flatulence, constipation and stomach pain.

BOTTOM LINE: A common dosage recommendation is 500 mg, 3 times per day, half an hour before meals. Berberine may cause digestive side effects in some people.

Take Home Message

Berberine is one of very few supplements that are as effective as a drug.  It has powerful effects on various aspects of health, especially blood sugar control.  The people who stand to benefit the most are individuals with type 2 diabetes and metabolic syndrome.  However, it may also be useful as a general protection against chronic disease, as well as an anti-aging supplement. 

Refer to the original article in Healthline for publication references

https://www.healthline.com/nutrition/berberine-powerful-supplement

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The Science of Gut Sensory Modulation (GSM)

The Science of Gut Sensory Modulation (GSM)

GSM is an emerging science, discovered by scientists who observed and studied hormonal changes that occur following gastric bypass surgery, specifically, higher levels of the hormones GLP-1 and PYY. These hormones, released by intestinal L-cells, act as satiety signals to the brain. GSM targets L-cells in the lower gut with natural ingredients to produce a wide range of beneficial effects.

Bariatric surgery which results in satiety, weight loss, and amelioration of type 2 diabetes, also dramatically enhances gut hormone secretion. This hormone enhancement is a result of delivering nutrients to the lower bowel a region of the gut where hormone secreting L-cells are most abundant. Gut hormones are known to mediate many of the beneficial effects of gastric bypass surgery.

Additionally, new evidence suggests that nutrient-driven gut hormone secretion can be augmented by non-nutritive agonists to nutrient chemosensory (taste) receptors located in the intestine. Taste receptors are chemosensory receptors that transmit and convey the perception of taste for bitter, sweet, umami, salt and sour. The same taste receptors located on the tongue also exist in other organs including the lung and gut epithelium. Targeting intestinal taste receptors on L cells with non-nutritive agonists to augment meal-driven gut hormone secretion is a novel approach to manage bodyweight. Taste receptor agonists can exert biological and pharmacologic actions without being absorbed into the bloodstream, thus reducing the potential for off-target side-effects. This more natural approach to the management of healthy bodyweight represents an attractive opportunity for continuing research.

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Gastrointestinal Transit: How Long Does It Take?

Gastrointestinal Transit: How Long Does It Take?

How long does food stay in my stomach? How long is it before a meal reaches the large intestine? The answer to such commonly-asked questions is not necessarily simple.

First, there is considerable normal variability among healthy people and animals in transit times through different sections of the gastrointestinal tract. Second, the time required for material to move through the digestive tube is significantly affected by the composition of the meal. Finally, transit time is influenced by such factors as psychological stress and even gender and reproductive status.

Several techniques have been used to measure transit times in humans and animals. Not surprisingly, differing estimates have been reported depending on the technique used and the population of subjects being evaluated. Some of the techniques used include:

  • Radiography following a barium-labelled meal. Sequential radiographs can be used to determine when the front of the barium label reaches different regions of the digestive tube. Such meals are not very physiologic and the technique exposes the patient to repeated exposure to radiation.
  • Breath hydrogen analysis. A number of carbohydrates are very poorly digested or absorbed in the small intestine, but readily fermented by bacteria when they reach the large intestine. Fermentation liberates hydrogen gas, which diffuses into blood and is exhaled in breath, where it can be readily measured. Thus, after consumption of a meal containing a non-absorbable carbohydrate (lactulose or, more commonly, baked beans), there is a large increase in exhaled hydrogen when the carbohydrate reaches the large intestine. This provides an estimate of pre-colonic (stomach plus small intestine) transit time.
  • Scintigraphic analyses. Meals containing pellets or colloids labelled with a small amount of radionuclide (99mTechnetium, 113mIndium, etc.) are consumed, and the position of the radioactive label is sequentially monitored using a gamma camera.

Studies of gastrointestinal transit have clearly demonstrated two related phenomena important to understanding this process:

  1. Substances do not move uniformly through the digestive system.
  2. Materials do not leave segments of the digestive tube in the same order as they arrive.

In other words, a meal is typically a mixture of chemically and physically diverse materials and some substances in this mixture show accelerated transit while others are retarded in their flow downstream.

An example of how ingested substances spread out in the digestive tube rather than travel synchronously is shown in the figure below. These data were obtained from a human volunteer that ingested a meal containing 111Indium-labeled pellets, then measuring the location of the radioactive signal over time by scintigraphy. It is clear that parts of the meal are entering the colon at the same time that other parts are still in the stomach.

The discussion above should help to explain why it is difficult to state with any precision how long ingesta remains in the stomach, small intestine and large intestine. Nonetheless, there have been many studies on GI transit, and the table below presents rough estimates for transit times in healthy humans following ingestion of a standard meal (i.e. solid, mixed foods).

50% of stomach contents emptied

2.5 to 3 hours

Total emptying of the stomach

4 to 5 hours

50% emptying of the small intestine

2.5 to 3 hours

Transit through the colon

30 to 40 hours

Remember that these are estimates of average transit times, and there is a great deal of variability among individuals and within the same person at different times and after different meals.

 

References

  • Camilleri M, Colemont LJ, Phillips SF, etc. Human gastric emptying and colonic filling of solids characterized by a new method. Am J Physiol Gastrointest Liver Physiol. 257:284, 1989.
  • Charles F, Camilleri M, Phillips SF, etc. Scintigraphy of the whole gut: clinical evaluation of transit disorders. Mayo Clin Proc 70:113, 1995.
  • Degen LP and Phillips SF. Variability of gastrointestinal transit in healthy women and men. Gut 39:299, 1996.
  • Iwanaga Y, Wen J, Thollander MS, etc. Scintigraphic measurement of regional gastrointestinal transit in the dog. Am J Physiol Gastrointest Liver Physiol 275:904, 1998.
  • Metcalf AM, Phillips SF, Zinsmeister AR, etc. Simplified assessment of segmental colonic transit. Gastroenterology 92:40, 1987.
  • Proano M, Camilleri M, Phillips SF, etc. Transit of solids through the human colon: regional quantification in the unprepared bowel. Am J Physiol Gastrointest Liver Physiol 258:856, 1990.
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Beach Season and Covid-19

Beach Season and COVID-19

(Contributed by Linda Anegawa, MD, FACP anegawa-md.com )

Summer is in full swing, and for many of us, a beach trip is a family tradition. But how should we proceed in these uncertain times?

1. Is it safe to go to the beach at all?

Currently, the word “safe” must be used as a relative term. We are dealing with a novel Coronavirus and limited testing – so other than staying home 100% of the time and having no contact with outsiders, there isn’t any way to determine if any activity is truly “safe.” Having said that, by taking precautions, any activity can be made “safer” when it comes to the risk of contracting viral infection. You are also probably safer from the virus when outdoors in the sunlight (where it is thought that the virus may die quickly) vs. in a closed environment such as a restaurant or theatre.

2. What are the risks?

The risks of going to the beach include the presence of large crowds which impact your ability to social distance, people shouting or yelling which can theoretically spread more virus particles in the air than vs. normal talking, having to use public restrooms with lots of high-touch surfaces which can harbor the virus, or lying in sand where someone may have sneezed or coughed.

3. How can I prepare, should I decide to go?

• Read up on your local area’s cautions and restrictions before you go. Some counties have strict rules on the number of people who are allowed on the beach, what you can bring, and there could be time restrictions, too.

• Keep your beach visit activity-focused… go for a walk, swim, or a paddle. When you are moving and far from others, your risk of catching the virus is lower. Plus, you’ll get in some exercise which is critical for mood, stress, and sleep, and can help lower inflammation.

• Social distancing remains the mainstay of preparation. Your likelihood of viral infection is dependent on the amount of virus in the air or on surfaces + duration of contact, so this is key. Try to find the least crowded area that you can. Avoid areas where it looks like there are large parties or other gatherings.

• It’s ideal to continue wearing a mask at all times unless in the water.

• Avoid public chairs or benches. Bring your own beach chairs and equipment. Bring plenty of hand sanitizer or wipes in case you need to use a public rest room.

• Avoid setting food and beverages directly in the sand. Bring a folding table with you or a large blanket. And of course, to maximize your metabolic health, be sure to bring healthy low-carb snacks to fuel your body such as small packets of nuts and dried seeds, hard boiled eggs and cut veggies.

• When you get home, wash everything in hot water with detergent and dry in the dryer.

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BMI (Body Mass Index)

BMI (Body Mass Index)

(Contributed by Linda Anegawa, MD, FACP anegawa-md.com )

The BMI, or Body Mass Index, is one of the most commonly used measures to identify people whose health is at risk from excess weight.

But despite its near-universal use by medical practices and hospitals, BMI can be one of the most misleading measurements when it comes to health risks. How is this possible?

First, let’s define what the BMI is. BMI is simply equal to your weight in kilograms divided by your height in meters squared. Typically, a BMI of 19-25 is considered normal. Those with a BMI of 26-29 are considered to be overweight, and those with a BMI 30 or above are considered to be suffering from obesity.

At first glance these categories may seem helpful to us. You might assume that the higher the BMI, the less healthy the person is, and sometimes that is in fact the case. However, as it turns out there are serious flaws with relying only on BMI.

As an illustration: let’s take the case of two individual men:
(1) A 22 year old, 6 feet 4 inch tall professional linebacker with the NFL who weighs 300 pounds.
(2) A 65 year old, 5 feet 1 inch tall secretary who weighs 190 pounds.

You might guess that these two men sound like they’d have very different bodies which is clearly the case. However, despite their vastly different physiques, these two men in fact have the exact same BMI – 36! They’d appear to be identical using a health scale that relies on BMI as a measure.

In addition, both the football player’s and the secretary’s BMIs of 36 would place them in the range of morbid obesity per standard guidelines. But as I mentioned, the BMI doesn’t tell us whether most of their weight is made up of fat, muscle, bone, or water weight, otherwise known as body composition. For example, the typical pro athlete has a body fat percentage under 10% making them extremely lean, regardless of BMI. As we get older, more of our body composition shifts towards fat, and we lose lean mass. BMI alone is unable to account for this.

Also, as it turns out, even if these two people had the same body fat percentage, where the fat is located on the body makes a very big difference in predicting health risk. For example, fat located around the middle of the body, known as ‘visceral fat,’ puts one at higher risk of cardiovascular-related death, even with a normal BMI [1]. So just because one has a BMI under 25 does not necessarily mean one is safe from metabolic disease.

One final thing that BMI doesn’t account for is whether each person’s weight causes health problems. One could have a higher BMI and yet be free of health conditions. On the other hand, some individuals with lower BMIs have very significant weight-related diseases such as prediabetes and type II diabetes, hypertension, or abnormal cholesterol. We don’t know exactly why that is, but it’s likely that genetics, ethnicity, activity levels, and even environmental factors all play a role.

Using BMI therefore can make it extremely difficult to tell who is at risk from their weight, and who is healthy. Doctors especially Obesity Medicine specialists, have recognized this, and are turning to other measures to help. Here are some examples of other methods which are growing in use:


(1) Waist -to-Hip Ratio: this simple, inexpensive measure is easy to do at home or in your doctor’s office. To obtain it, you simply measure your waist at the level of your navel, and your hip at the widest portion, then divide. A ratio of 0.9 or less is best for men, and 0.85 or less is healthiest for women.

(2) Body Composition Analysis, or BCA: BCA readings are able to determine how much of a person’s makeup is fat, versus muscle, bone, and water. Healthy body fat percentages for men are anywhere from 10-20% and for women, 22-33%. Segmental BCA machines are also able to estimate the degree of visceral (belly) fat one has, which as we know raises health risks.

(3) Edmonton Obesity Staging System: not a measurement, but the Edmonton system allows doctors to estimate risk based on whether weight-associated medical problems are present and the severity. For example, a smaller person with a higher Edmonton Stage is at much higher risk of problems than a larger person with a lower Edmonton Stage. [2]

The BMI simply doesn’t tell the whole story. Fortunately, Obesity Specialists have taken the lead in advancing newer ways to assess weight-related health risks in order to provide critical attention to those who need it the most.

References
(1) Ann Intern Med. 2015 Dec 1;163(11):827-35. doi: 10.7326/M14-2525. Epub 2015 Nov 10.
(2) CMAJ. 2011 Oct 4; 183(14): e1059–e1066.
doi: 10.1503/cmaj.110387

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Intermittent Fasting 101 — The Ultimate Beginner’s Guide

Intermittent Fasting 101 — The Ultimate Beginner’s Guide

By Kris Gunnars, BSc

Intermittent fasting (IF) is currently one of the world’s most popular health and fitness trends.

People are using it to lose weight, improve their health and simplify their lifestyles.

Many studies show that it can have powerful effects on your body and brain and may even help you live longer.

This is the ultimate beginner’s guide to intermittent fasting.

What Is Intermittent Fasting (IF)?

Intermittent Fasting (IF) is an eating pattern that cycles between periods of fasting and eating.

It doesn’t specify which foods you should eat but rather when you should eat them.

In this respect, it’s not a diet in the conventional sense but more accurately described as an eating pattern.

Common intermittent fasting methods involve daily 16-hour fasts or fasting for 24 hours, twice per week.

Fasting has been a practice throughout human evolution. Ancient hunter-gatherers didn’t have supermarkets, refrigerators or food available year-round. Sometimes they couldn’t find anything to eat.

As a result, humans evolved to be able to function without food for extended periods of time.

In fact, fasting from time to time is more natural than always eating 3–4 (or more) meals per day.

Fasting is also often done for religious or spiritual reasons, including in Islam, Christianity, Judaism and Buddhism.

Summary

Intermittent fasting (IF) is an eating pattern that cycles between periods of fasting and eating. It’s currently very popular in the health and fitness community.

Intermittent Fasting Methods

There are several different ways of doing intermittent fasting — all of which involve splitting the day or week into eating and fasting periods.

During the fasting periods, you eat either very little or nothing at all.

These are the most popular methods:

  • The 16/8 method: Also called the Leangains protocol, it involves skipping breakfast and restricting your daily eating period to 8 hours, such as 1–9 p.m. Then you fast for 16 hours in between.
  • Eat-Stop-Eat: This involves fasting for 24 hours, once or twice a week, for example by not eating from dinner one day until dinner the next day.
  • The 5:2 diet: With this method, you consume only 500–600 calories on two non-consecutive days of the week but eat normally the other 5 days.

By reducing your calorie intake, all of these methods should cause weight loss as long as you don’t compensate by eating much more during the eating periods.

Many people find the 16/8 method to be the simplest, most sustainable and easiest to stick to. It’s also the most popular.

SUMMARY

There are several different ways to do intermittent fasting. All of them split the day or week into eating and fasting periods.

How It Affects Your Cells and Hormones

When you fast, several things happen in your body on the cellular and molecular level.

For example, your body adjusts hormone levels to make stored body fat more accessible.

Your cells also initiate important repair processes and change the expression of genes.

Here are some changes that occur in your body when you fast:

  • Human Growth Hormone (HGH): The levels of growth hormone skyrocket, increasing as much as 5-fold. This has benefits for fat loss and muscle gain, to name a few.
  • Insulin: Insulin sensitivity improves, and levels of insulin drop dramatically. Lower insulin levels make stored body fat more accessible.
  • Cellular repair: When fasted, your cells initiate cellular repair processes. This includes autophagy, where cells digest and remove old and dysfunctional proteins that build up inside cells.
  • Gene expression: There are changes in the function of genes related to longevity and protection against disease.

These changes in hormone levels, cell function and gene expression are responsible for the health benefits of intermittent fasting.

SUMMARY

When you fast, human growth hormone levels go up and insulin levels go down. Your body’s cells also change the expression of genes and initiate important cellular repair processes.

A Very Powerful Weight Loss Tool

Weight loss is the most common reason for people to try intermittent fasting.

By eating fewer meals, intermittent fasting can lead to an automatic reduction in calorie intake.

Additionally, intermittent fasting changes hormone levels to facilitate weight loss.

In addition to lowering insulin and increasing growth hormone levels, it increases the release of the fat burning hormone norepinephrine (noradrenaline).

Because of these changes in hormones, short-term fasting may increase your metabolic rate by 3.6–14%.

By helping you eat fewer and burn more calories, intermittent fasting causes weight loss by changing both sides of the calorie equation.

Studies show that intermittent fasting can be a very powerful weight loss tool.

A 2014 review study found that this eating pattern can cause 3–8% weight loss over 3–24 weeks, which is a significant amount, compared to most weight loss studies.

According to the same study, people also lost 4–7% of their waist circumference, indicating a significant loss of harmful belly fat that builds up around your organs and causes disease.

Another study showed that intermittent fasting causes less muscle loss than the more standard method of continuous calorie restriction.

However, keep in mind that the main reason for its success is that intermittent fasting helps you eat fewer calories overall. If you binge and eat massive amounts during your eating periods, you may not lose any weight at all.

SUMMARY

Intermittent fasting may slightly boost metabolism while helping you eat fewer calories. It’s a very effective way to lose weight and belly fat.

Health Benefits

Many studies have been done on intermittent fasting, in both animals and humans.

These studies have shown that it can have powerful benefits for weight control and the health of your body and brain. It may even help you live longer.

Here are the main health benefits of intermittent fasting:

  • Weight loss: As mentioned above, intermittent fasting can help you lose weight and belly fat, without having to consciously restrict calories.
  • Insulin resistance: Intermittent fasting can reduce insulin resistance, lowering blood sugar by 3–6% and fasting insulin levels by 20–31%, which should protect against type 2 diabetes.
  • Inflammation: Some studies show reductions in markers of inflammation, a key driver of many chronic diseases.
  • Heart health: Intermittent fasting may reduce “bad” LDL cholesterol, blood triglycerides, inflammatory markers, blood sugar and insulin resistance — all risk factors for heart disease.
  • Cancer: Animal studies suggest that intermittent fasting may prevent cancer.
  • Brain health: Intermittent fasting increases the brain hormone BDNF and may aid the growth of new nerve cells. It may also protect against Alzheimer’s disease.
  • Anti-aging: Intermittent fasting can extend lifespan in rats. Studies showed that fasted rats lived 36–83% longer.

Keep in mind that research is still in its early stages. Many of the studies were small, short-term or conducted in animals. Many questions have yet to be answered in higher quality human studies.

SUMMARY

Intermittent fasting can have many benefits for your body and brain. It can cause weight loss and may reduce your risk of type 2 diabetes, heart disease and cancer. It may also help you live longer.

Makes Your Healthy Lifestyle Simpler

Eating healthy is simple, but it can be incredibly hard to maintain.

One of the main obstacles is all the work required to plan for and cook healthy meals.

Intermittent fasting can make things easier, as you don’t need to plan, cook or clean up after as many meals as before.

For this reason, intermittent fasting is very popular among the life-hacking crowd, as it improves your health while simplifying your life at the same time.

SUMMARY

One of the major benefits of intermittent fasting is that it makes healthy eating simpler. There are fewer meals you need to prepare, cook and clean up after.

Who Should Be Careful or Avoid It?

Intermittent fasting is certainly not for everyone.

If you’re underweight or have a history of eating disorders, you should not fast without consulting with a health professional first.

In these cases, it can be downright harmful.

Should Women Fast?

There is some evidence that intermittent fasting may not be as beneficial for women as it is for men.

For example, one study showed that IF improved insulin sensitivity in men, but worsened blood sugar control in women.

Though human studies on this topic are unavailable, studies in rats have found that intermittent fasting can make female rats emaciated, masculinized, infertile and cause them to miss cycles.

There are a number of anecdotal reports of women whose menstrual period stopped when they started doing IF and went back to normal when they resumed their previous eating pattern.

For these reasons, women should be careful with intermittent fasting.

They should follow separate guidelines, like easing into the practice and stopping immediately if they have any problems like amenorrhea (absence of menstruation).

If you have issues with fertility, and/or are trying to conceive, consider holding off on intermittent fasting for now. This eating pattern is likely also a bad idea if you’re pregnant or breastfeeding.

SUMMARY

People who are underweight or have a history of eating disorders should not fast. There is also some evidence that intermittent fasting may be harmful to some women.

Safety and Side Effects

Hunger is the main side effect of intermittent fasting.

You may also feel weak and your brain may not perform as well as you’re used to.

This may only be temporary, as it can take some time for your body to adapt to the new meal schedule.

If you have a medical condition, you should consult with your doctor before trying intermittent fasting.

This is particularly important if you:

  • Have diabetes.
  • Have problems with blood sugar regulation.
  • Have low blood pressure.
  • Take medications.
  • Are underweight.
  • Have a history of eating disorders.
  • Are a woman who is trying to conceive.
  • Are a woman with a history of amenorrhea.
  • Are pregnant or breastfeeding.

All that being said, intermittent fasting has an outstanding safety profile. There is nothing dangerous about not eating for a while if you’re healthy and well-nourished overall.

SUMMARY

The most common side effect of intermittent fasting is hunger. People with certain medical conditions should not fast without consulting with a doctor first.

Frequently Asked Questions

Here are answers to the most common questions about intermittent fasting.

  1. Can I Drink Liquids During the Fast?

Yes.  Water, coffee, tea and other non-caloric beverages are fine. Do not add sugar to your coffee. Small amounts of milk or cream may be okay.

Coffee can be particularly beneficial during a fast, as it can blunt hunger.

  1. Isn’t It Unhealthy to Skip Breakfast?

No. The problem is that most stereotypical breakfast skippers have unhealthy lifestyles. If you make sure to eat healthy food for the rest of the day then the practice is perfectly healthy.

  1. Can I Take Supplements While Fasting?

Yes. However, keep in mind that some supplements like fat-soluble vitamins may work better when taken with meals.

  1. Can I Work out While Fasted?

Yes, fasted workouts are fine. Some people recommend taking branched-chain amino acids (BCAAs) before a fasted workout.

You can find many BCAA products on Amazon.

  1. Will Fasting Cause Muscle Loss?

All weight loss methods can cause muscle loss, which is why it’s important to lift weights and keep your protein intake high. One study showed that intermittent fasting causes less muscle loss than regular calorie restriction.

  1. Will Fasting Slow Down My Metabolism?

No. Studies show that short-term fasts actually boost metabolism. However, longer fasts of 3 or more days can suppress metabolism.

  1. Should Kids Fast?

Allowing your child to fast is probably a bad idea.

Getting Started

Chances are that you’ve already done many intermittent fasts in your life.

If you’ve ever eaten dinner, then slept late and not eaten until lunch the next day, then you’ve probably already fasted for 16+ hours.

Some people instinctively eat this way. They simply don’t feel hungry in the morning.

Many people consider the 16/8 method the simplest and most sustainable way of intermittent fasting — you might want to try this practice first.

If you find it easy and feel good during the fast, then maybe try moving on to more advanced fasts like 24-hour fasts 1–2 times per week (Eat-Stop-Eat) or only eating 500–600 calories 1–2 days per week (5:2 diet).

Another approach is to simply fast whenever it’s convenient — simply skip meals from time to time when you’re not hungry or don’t have time to cook.

There is no need to follow a structured intermittent fasting plan to derive at least some of the benefits.

Experiment with the different approaches and find something that you enjoy and fits your schedule.

SUMMARY

It’s recommended to start with the 16/8 method, then perhaps later move on to longer fasts. It’s important to experiment and find a method that works for you.

Should You Try It?

Intermittent fasting is not something that anyone needs to do.

It’s simply one of many lifestyle strategies that can improve your health. Eating real food, exercising and taking care of your sleep still the most important factors to focus on.

If you don’t like the idea of fasting, then you can safely ignore this article and continue to do what works for you.

At the end of the day, there is no one-size-fits-all solution when it comes to nutrition. The best diet for you is the one you can stick to in the long run.

Intermittent fasting is great for some people, not others. The only way to find out which group you belong to is to try it out.

If you feel good when fasting and find it to be a sustainable way of eating, it can be a very powerful tool to lose weight and improve your health.

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Keep Your Blood Sugar in Balance

Keep Your Blood Sugar in Balance

Sugar is the fuel that powers cells throughout the body. Blood levels of this energy source ebb and flow naturally, depending on what you eat, how much you eat, and when you eat. But, when something goes wrong and cells aren’t absorbing sugar effectively, the resulting high blood sugar can damage nerves, blood vessels, and organs.

The A1c blood test measures average blood sugar level over the previous three months. A normal reading is below 5.7%. A reading between 5.7% and 6.5% indicates prediabetes and a reading above 6.5% indicates diabetes. Any reading above normal means that toxic amounts of sugar are building up in your bloodstream.

Often, high blood sugar causes no obvious symptoms, at least at first. However, as more sugar circulates in the blood, the body tries to get rid of it by spilling the excess sugar into the urine which draws water out of the body. So, one of the first signs of high blood sugar is frequent urination and increased urine volume.  This, in turn, causes dehydration making you thirsty. Some people also feel extremely hungry and may have headaches.  Another early symptom of high blood sugar is fatigue.  A person with high blood sugar can feel tired, weak and sleepy while performing normal day-to-day activities.

The longer-term complications of chronic high blood sugar (diabetes), are well-known and affect the body from head to toe.  High blood sugar, untreated, causes serious irreversible damage to your eyes, kidneys, brain, and cardiovascular and nervous systems.  Diabetes is the major cause of limb amputations.

Many people don’t know they have diabetes because the symptoms build subtly over time.  But, being attentive to the early signs of high blood sugar can prompt you to have an A1c test.  If the A1c test confirms high blood sugar seek treatment immediately to avoid serious health consequences down the road. 

The best approach, of course, is prevention.  Adopt lifestyle habits that naturally keep your blood sugar in the healthy range.  Maintaining a healthy weight, eating right and exercising regularly all contribute to keeping your blood sugar in check.

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Be in Control of Emotional Eating – Insight and Tips

Be in Control of Emotional Eating – Insight and Tips

(contributed by Linda Anegawa, MD, FACP)

We all eat emotionally to some degree, and it’s not necessarily pathological.
Soothing ourselves with treats has roots in childhood. Anyone remember a parent handing you a lollipop after you fell off your bike and scraped your knee? Or making you soup when you were sick? These associations can become firmly rooted for life. After all, certain foods are known as “comfort foods” for a reason.

For some of us, our tendency to reach for snacks whenever we hit a rough patch becomes a concern. This can occur after a string of difficulties, or a personal trauma. In addition, even chronic low-level exposure to stress in our normal daily lives can lead to more snacking than normal. Over time, we may find ourselves reaching almost unconsciously for food in response to any unpleasantness at all. Food distracts us from feeling the pain, the sadness, the loneliness, the irritability, the boredom. One patient told me, “food filled the empty place inside me” following the death of her mother. The emotional eating can then become more and more entrenched over time.

Whatever the reason for over-indulging, the end result is often similar.   

Any soothing effect of food is only temporary, and the negative emotions/stressors are still there for us to face.  Plus we begin to feel guilty or ashamed about setting back our health goals, and then we beat ourselves up.    This is how emotional eating sets us up in a vicious cycle.

Here are some ways to begin to break free:

(1) Start a journal.  You may wish to try tracking what you eat – tracking can increase awareness of both your physical hunger and non-hunger eating triggers.   There are some great apps for this, or even a simple notebook will do.   Tracking can give us a “hunger reality check”.  For example, if you had a full meal 1 hour ago, it’s highly likely that the hunger you have is more emotional than physical.

(2) Practice Mindfulness.  Giving yourself the opportunity to pause for even 5 seconds prior to eating is important.  Try to take one slow deep inhale and exhale before taking a bite.  Notice physical and mental sensations.  Keep breathing slowly as you eat, chewing each bite of food at least 10 times.  Notice how your body feels as your stomach becomes more full with each swallow of food. 

(3) Make it easier on yourself.  Get rid of the foods that lead you astray – don’t buy trigger foods such as sweet or salty snacks, especially from big-box stores that sell them in giant bags.  Nothing is a bargain if it makes you feel angry at yourself for eating it!

(4) Set regular mealtimes.  Due to our hectic lifestyles and tendency to multi task, we rarely sit down to just eat and do nothing else.  This can worsen mindless and emotional eating.  Even committing 15 minutes for a lunch break for example is far better than wolfing down something from the drive-thru while on errands.

(5) Focus on FATS, proteins, and greens – these help us to feel more physically full so the temptation to graze and snack won’t be as strong.  A large tossed salad with a protein of choice and olive oil dressing makes a great lunch, and it’s quick and easy to prepare. 

(6) Watch for boredom.  When that restlessness starts to settle in, keep a list on your phone of things to do to distract yourself so you won’t eat.  Take a quick 10 minute walk, or call a friend, paint your nails, take a shower, etc. – ANYTHING to avoid snacking when you really don’t want to.

(7) Know when to get help.  Consider therapy to help learn better coping skills or to help handle severe stress. A trained psychotherapist can also screen you for an eating disorder such as Binge Eating or Night Eating Disorder. Even if you don’t have one of these though, the road to lifestyle change can be filled with speedbumps and setbacks, so highly qualified support can be critical for your long term success. 

For support and resources right now, the National Eating Disorders Association provides trained helpline volunteers that you can call or text. For community support, join our private Facebook group where others who have struggled with emotional eating challenges provide support and encouragement based on their personal health journeys. CLICK HERE for a comprehensive guide to the signs of an eating disorder, common treatments, etc.

You aren’t alone in this struggle, reach out today!

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Social Eating Tips

SOCIAL EATING TIPS

(contributed by Linda Anegawa, MD, FACP)

Have you ever struggled to say “NO” at family gatherings and other social events, when you’re offered food that you know is not good for you?

It’s a fact that even when loved ones know you’re trying to lose weight and get healthier, we often feel pressured to make a bad choice, have seconds, or eat dessert.  This doesn’t necessarily mean that others want to sabotage you or ruin your success – it can just be history, culture, and a habit of food being a gift to share with those you love.

Here are some things you can say at social gatherings to stay on track with your wellness goals, when you’re offered something you don’t want to eat:

“I sure wish I could have some!  But I’m so full, from all the other delicious food right now.  Maybe a little later.”

“Thanks, I’ll pass and just keep you company while you enjoy!”

“No, thank you” (firmly, without explanation at all).

When offered seconds: “No, thank you, it was delicious.  Can I have the recipe?”

“No thanks.  Hey, how are your kids doing – I haven’t seen them lately!” (diversion tactic!)

“You know, I realized that my stomach doesn’t feel good when I eat _____, so now I try to avoid feeling like that.”

“I have _____ (high cholesterol, prediabetes, etc.) so I’m making changes in what I eat to improve my health.”

“My doctor told me I can’t eat that, but it smells amazing!”

If you feel a need to explain, or are pushed further, you can say “Sorry, that just doesn’t agree with me” or “Sorry, I need to choose what I eat more carefully for my health.”