First, a little biochemistry, seriously, just a little. Basically, there are two routes for sugar(s) to be processed. The type of sugar will determine the preferred route (glucose, fructose, sucrose, lactose, etc…).  One route is the blood. All sugar being processed via this route is taken up by the muscles and brain to be either used or stored as energy (stored version known as glycogen).  This route will increase acute insulin response, and if insulin resistance is high that will force the sugar to be stored as fat, rather than go into the muscle (basically because the muscle is unresponsive to the insulin). The alternative route is through the liver. All sugar taken through the liver is first processed for liver glycogen, then the remainder is turned into glycerin and released into the blood where it scavenges for free form fatty acids to form triglycerides, which a re then stored as body fat. Sugars processed by the liver cause a minimal rise in acute insulin, are the most likely to be stored as body fat, contribute the most to fatty liver disease, and have the largest long term effects on insulin resistance and risk of type 2 diabetes. Okay, liver bad, blood good, got it.

So, what goes where? 80% of glucose is processed via the blood, while 20% is processed via the liver.  80% of fructose goes to the liver, while 20% to the blood. Alcohol (yes, it is a sugar also, but now in the form of alcohol, which has to be turned back into sugar) processes identical to fructose, so it should be no shocker that they cause the same health problems.

So how does HFCS differ from table sugar. Table sugar is exactly 50/50 glucose/fructose while HFCS is 45/55 glucose/fructose. Honey is 25/75 glucose/fructose and agave nectar is 5/95 glucose fructose (hence its very low Glycemic Index, it all goes to the liver!). So does that mean that table sugar is better than honey? Basically…yes. Isn’t fruit all fructose? Mostly. But fresh, raw fruit normally has quite a bit of fiber and antioxidants which offset the negative effects of fructose. However, as it sits after being picked or if it is cooked,  it dramatically looses nutrient and antioxidant content. So buy it fresh and eat it quickly or even better buy it fresh frozen.

There are a few other differences between HFCS and sugar. The most notable, however, is that table sugar will cause nausea if you eat a lot of it, whereas HFCS will not. For example, the original recipes for old school sodas had 10 teaspoons of sugar per 8 oz serving. That was enough for one soda to cause you to regurgitate. Soda companies battle this problem by “cutting” the drink with phosphoric acid which offsets the urge to vomit as it has a stomach “settling” effect. Today’s sodas use HFCS rather than table sugar but the acid is retained to maintain the old flavor. Many of our older patients actually recall getting sick from eating too much candy, but no one has had that problem for at least 20 years because of the universal change to HFCS. So to the food companies benefit, and your loss, you can eat all you want now and never get sick. In addition, the effects of the increased fructose consumption over years (and sugar overall) lead to high insulin levels and problems with maintaining blood sugar levels. This causes crashes and a desire to eat more sugar, which creates a vicious downward spiral toward obesity and diabetes.

So the take home message? Stay away from sugar unless it comes in edible container also known as a fruit or vegetable. But if you absolutely have to have sugar sweetened substance, table sugar is slightly better than HFCS and honey and agave nectar are worse.

Many suggest that you should avoid fish and stick with plant sources. However, no plant source will provide adequate amounts of DHA or EPA. Both of these fats are vital for health, particularly for the heart and brain. Roughly 50% of the brain is made of fat. The type of fat is preferably DHA, a type of Omega-3. This can be consumed from plant sources, but they are primarily ALA which your body will convert into DHA. Unfortunately, the ratio is very poor. It is about 9% for EPA and 3% for DHA. Both are good for you , but again, DHA is the primary target. You need about 900 mg of DHA/EPA combined. So you would have to consume a bout 100 grams of Flaxseed oil per day to get enough EPA/DHA. It has been suggested that you eat what fish eat to get theirs, algae. First of all, yum yum. Grass is an equivalent source of omega 3, which is why all grazers (that actually are fed grass) are equivalent sources of omega 3’s. But you are not going to eat grass, well you might, but probably not. In addition, most fish eat crustaceans or other fish, including salmon which is considered a primary source of omega 3’s. The reality is that if you where going to the original source (green grasses and algae), you would have to eat that as your primary food source to get enough (and then some). It is far more efficient to eat animal sources,  which have already done the converting for you. So plant sources are a good source for omega 3’s, but an inefficient source of DHA and EPA, the specific omega 3’s that your brain and heart need.

So what about the animal sources? Well, in reality, anything that eats large amounts of grass or algae, or eats another animal that does so, will be a good source of omega 3’s. The closest animal to the original source is usually the best to eat. For instance, nearly every grass fed grazers are equivalent sources for you omega 3’s. Bison has almost identical fatty acid profile as tuna for instance. The best grazer in North America, that I am aware of, is elk, which has a profile almost identical to sardines. In addition, the closer the animal is to the plant source, the less toxins that it will contain. Swordfish, which eats large amounts of smaller fish, has enough mercury in one steak to make you test positive for mercury poisoning. Sardines, a primary food source of most larger fish, eats algae and has only trace amounts of toxins (including PCB’c and mercury). In addition, fresh water and farm raised fish, have the most toxins and the least omega 3’s. Farm raised fish, have very little omega 3 content due to the feed used. This is often neglected in the recommendation of fish (general) as an omega 3 source. In addition, certain low grade fish oils use farm raised fish, which again, have little to no omega 3’s and the highest levels of toxins (particularly PCB’s).  The short version of this message if to eat large grass gazing animals and small (wild) fish for your best omega 3 sources.

What about supplements? I recommend that you use only pharmaceutical grade fish oils and that you know the source. My favorite is krill oil, which is what salmon eat. It is about 3 times more bioavailable than fish oil (you can take a 3rd of the dose), has more antioxidants and no toxins. Krill is also the largest biomass in the world. Sardine oil is also a great source. It is very high in DHA and EPA and again has almost no toxins. Cenegenics carries both of these, in purified, completely toxin free, pharmaceutical grade formulas. This is what I recommend. There are only two over the counter fish oils that I recommend: Carleson’s or Nordic Naturals. Both are great and hold up to the standards year after year in independent testing. That being said, they are about half as efficient for getting your DHA and EPA (even in their EPA formulas) so you will need to take twice as much.

Researchers also found a correlation with toothbrushing frequency and other risk factors, as people who brushed the least were the likeliest to be obese, smokers, the least active and have the lowest income. But the results were consistent even after adjusting for all other risk factors.  So, it appears that those with the healthiest teeth are the likeliest to be healthy. This is confirmed by several other studies that examined tooth health and all cause mortality (death by any cause). Several authors have suggested that this suggests that people who are the healthiest are the likeliest to have healthy teeth. Previous studies analyzing the association between gum disease, flossing and CRP suggest that the most likely culprit is actually the bad bacteria in your mouth, which causes systemic inflammation (indicated by elevated CRP).  Combined with the study on brushing frequency, it suggests that those with the healthiest mouth hygiene are likely to be the healthiest. With clear associations between diet and tooth health, it would also suggest that excessive sugar consumption would play a role in this equation. Not forgetting that the bad bacteria in your mouth actually feed on sugar—something we all have “known” since grade school.

Research in this area has exploded in recent years, producing a barrage of interesting studies. The greatest and latest seems to be about Green Tea consumption. With the plethora of research on the many health benefits of at least 1 cup of green tea per day, including weight loss and prevention of heart disease, diabetes and cancer, researchers decided to see what else it may help. As it turns out, the “active ingredients” in green tea are also antimicrobial (kill bad bacteria and viruses) and antifungal, and even go as far as preventing the surviving bacteria from attaching to your teeth. Green tea consumption may help prevent all forms of periodontal disease including cancer of the mouth.

So in short, brush your teeth at least twice per day. Floss every day. Visit your dentist twice per year. Eat a low sugar diet. Drink your green tea and you will have healthy teeth be less likely to die from all disease, particularly heart disease, which is the number 1 cause of death in the US.

But before we get into the details, I need to state a clause:

-If you have wide hips and narrow shoulders you can workout like a mad woman and you will not likely put on a lot of upper body muscle (but you will lean down and likely loose weight).  You will put on some muscle in you legs and hips (but again you will lean down).

-If you have narrow hips and wide shoulders, you will respond “better” to exercise as it will be easier for you to put on muscle and lean down than most women. It is most notable in your ability to add upper body muscle.  That being said, it is still highly unlikely that you are the one in 100,000 women that can indeed build muscle as well as a man (without a bit of “hormonal help”, meaning a massive dose of steroids).

Okay, lets get to the good stuff. Men and women both have a hormone response to exercise and to some extent it is to different types of exercise. I am going to focus primarily on women for this post. Women can temporarily increase their Human Growth Hormone levels by about 100% for approximately 6 hours after a workout if they do the right workout. This increase is where you get the most benefit from your exercise. For 99% of women, that means that you lean down considerably while adding small amounts of muscle. To put things into perspective a man can get an 800% increase in Human Growth Hormone Levels and a 75% increase in testosterone (which is about 10-15 times higher at baseline than yours and you get no increase). This is why men have a far greater ability to build muscle than women. Interestingly, women actually have their greatest response in middle age (must be nice, we peak at 18-20). Think about it, how many times have you seen a 45 year old soccer mom that looks great and is kicking some 20 year old’s tail in the gym. Often enough to be noticeable if you are paying attention. Most of the time we just shrug it off as more discipline and dedication. That is part of it, but the other part is double the hormone response, which means double the improvement, and that means double the motivation.

Now you just have to do the work, which leads me to my next point. What kind of work, and how much? The good news is that the primary stimulator of this response is Blood Lactate, or lactic acid in the blood. That is also the bad news. The simple version is that high intensity work causes lactic acid to build up in the muscle. As that approaches toxic limits the body will begin to remove it from the muscle to process it systemically (blood lactate) and if needed will begin to off load it in the stomach to vent it (regurgitate). So why did I say that it was also the bad news? You have to work a lot of muscle at one time (exercises like squats and deadlifts performed for 10 sets of 10 produce the best results), and do a lot of it. There are two ways to do this but both have to be intense. For example, you could do multiple sets of 10 at a 10 rm on squats (about 45-60 seconds and heavy enough to keep you from going over 60 seconds) or you could run 300-400 meters as fast as you can (again 45-60 seconds at a speed that you can’t sustain longer than 60 seconds) multiple times. 1 set will not build up enough to cause significant blood lactate increases, and if your rest is over about 90 seconds you will begin to buffer it out forcing you to do even more sets to accomplish your goal. This is why large exercises performed in a circuit are beneficial for weight loss. For example you could do 30 yards of lunges, 30 squat jumps, 30 push-ups, 10 chin-ups, run 100 meters rest 1 minute and repeat 6 times. Or you could do 10 sets of 10 on squats. If you wanted to lean down you would do the circuit If you wanted to lean down and put on a little muscle you would do the squats (a typical women trying to put on muscle is lucky to add 3-4 pounds of muscle per year which is barely noticeable if spread over the entire body as it would be with this type of work).  There are a number of combinations that you can use but they should be goal derived.

The next trick is not to undermine it with a poor diet. Your workout and diet should work together, but they can easily work against each other. For example carbohydrates in excessive amounts, will increase your insulin. When your insulin is high it blocks the growth hormone receptors at the cellular level, meaning lots of growth hormone and nothing for it to do. So it is very important to eat the appropriate amount of carbs for your body and activity level. This amount can vary greatly from one person to another but is 60-90 grams per day on average. It is also important for you to eat adequate protein as the growth hormone is made of amino acids which must be eaten to sustain optimal levels of the hormone. The most important times for you to eat protein are immediately post workout (research suggests that 30 min pre-training is good as well) and about 30 minutes before bed as post workout and night time is when your growth hormone is highest and most responsive to amino acid loading. A glutamine (5-15 grams) drink during the workout will help as well.  I know that many of you think that you shouldn’t eat before bed, but what you eat is the important part. Cookies will make you a fat insomniac that pees all night. Turkey will make you sleep like a baby and help you lean down (and not pee all night…test it for 2 weeks- meat and veggies for dinner, no fruit or sweets and 4 ounces of turkey or cottage cheese 30 minutes before bed, you should notice progressively improved sleep in the second week). As a note, you do not produce urine in a deep sleep, and growth hormone helps induce deep sleep.

So ladies, put all of this together and in a few weeks you should see the beginnings of a leaner, healthier, more rested, more energetic you. Most will not start to plateau until 8-14 weeks and that is where some more advanced workouts progressions come into play.

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So unfortunately, we have another diet myth busted, and is demonstrated once again that there is no magic pill. Though it was demonstrated rather well that a 500 calorie/day diet is very effective for weight loss. This is of course, unreasonable for any extended period of time, and based on other research, I would suggest that quite a bit of muscle was lost, but effective none the less.

Until a magic pill is actually discovered, my advice is to keep your diet relatively strict (reasonably so) and try to get at least 20 minutes of daily exercise. Eat lots of vegetables and most importantly, listen to your body and try to feed it what it responds to, as everyone’s body is different.

Live Strong

First, what are the proposed advantages of adding HCG, in small daily doses, to a diet? Supposedly it has an appetite suppressing effect. This is great if it is true, as it would make sticking to the diet much easier. I always tell patients “calories effect your weight, the type of calories will decide what the weight looks like”, which means that if you want to drop weight (and do not care if it is fat or muscle), drop your calories. If you want to loose a lot of weight quickly, you aren’t particularly concerned with your long term health, cutting your calories to 500 per day will certainly do the trick. In this instance, anything that suppresses appetite will help.

So question is: “Does HCG actually suppress appetite?”. The answer….maybe. There is a growing body of evidence that suggests that HCG, when directly introduced to a cell, does increase Leptin. Leptin is a hormone that tells you that you are satisfied and encourages fat to be burned as energy. A few studies even suggest the when directly introduced to fatty tumors, cell size is reduced. This is very promising and does suggest that HCG would aid in achieving the desired results, assuming that it has the same effects when used systemically (effect on entire body).

That is the question that we will address in part 3: Does HCG have a systemic benefit for weight loss?

What is the HCG diet anyways? As far as that goes, what is HCG? HCG is also known as Human Chorionic Gonadotropin, and is a hormone that has similar function to Luteinizing Hormone (it has many functions including increasing testosterone). The diet incorporates a very low dose of daily HCG with a very strict 500 calorie per day diet. In addition to an ultra low calorie diet with virtually no fat intake, lotions or creams containing lipids are not allowed either. As you can imagine, the diet alone will result in quite a bit of weight loss (with or without exercise).

According to the sources, the addition of the daily HCG will help curb hunger and may reduce the typical metabolism reduction associated an extremely low calorie diet.

In my next post, I will discuss the science behind these claims. As you can imagine, with anything that is half of a century old, there is plenty to discuss.

Internally, the body looks even worse. As hormone levels change, and time and stress take their toll, the body’s well-being diminishes. A build-up of fat and loss of energy leads to higher blood pressure and cholesterol. The heart grows weaker, and even the brain loses its function. Bones get brittle and dowager’s humps form. And the risk for diseases such as cancer, hypertension, and diabetes skyrockets. Ugh.

The good news is that science is making the aging process a lot easier to deal with, inside and out. Americans spend billions of dollars each year fighting the effects of getting old…

Read the full article here.

Names of sports heroes