ymoore4health

Today’s blog post will be a bit of a departure from my previous entries and a little more personal. Today (March 30, 2022) is my 68th birthday!! I am incredibly grateful to God not only to see this birthday but to get here as a healthier me than I was when I was 50!

While others much younger than me are retiring, I am finding my career more rewarding than ever as I am able to use much of my life experience along with my medical knowledge to encourage my patients toward positive lifestyle changes that will make them healthier as they age. It has become something that I am quite passionate about.

In the year since my last birthday, God blessed me to finally complete my bucket list goal of completing half marathons in each of the 50 states as well as DC, Canada, Mexico and Puerto Rico. Since completing that goal last October, I have done 4 more half marathons in four different cities just for fun. In December I completed my 8th consecutive St. Jude Half Marathon, raising over $2800 for the children as a St. Jude hero. I was given the opportunity to encourage others toward active aging both on the local news and by being featured in an article in a local Health and Fitness magazine.

Based in part on the contents of this blog, I now serve as volunteer nutrition and lifestyle coach to a wonderful group of women in what we call the “Healthier You” support group started by my good friend Penne Allison. The group meets weekly via conference call. We have seen some amazing changes among our group members with not only weight loss but also improvements in fitness and in chronic diseases like diabetes and markers of cardiovascular disease.

Through my social media presence I have been able to encourage others spiritually by sharing daily devotional readings from the several that I read each morning. I use my Facebook group, No Gym-No Problem, to share YouTube workout videos that I enjoy as well as fitness challenges in the hope of inspiring others to get off the couch. I am amazed at the sheer number and variety of FREE workouts that are available on the internet!

I am sharing the way I have chosen to live this season of my life to make a point. I firmly believe that only God knows how long each of us will live but He has given us the free will to make choices that will enhance the quality of our lives. I was not active as a child and minimally active for most of my adult life. In an attempt to keep my weight down I would starve myself all day then reward myself with pizza or chocolate chip cookies and late night snacks. Being diagnosed with both hypertension and prediabetes finally convinced me to make the lifestyle changes I needed to make to get healthier. I was already 59 when I did my first half marathon and 64 when I finally made the permanent dietary changes that reversed my prediabetes and got me to a healthy weight without regaining it for the first time in my adult life. Now I like to think of myself as a living advertisement for active aging and good nutrition. I am out to prove that it is never too late to become your healthiest self!

For the last few weeks leading up to my birthday I have been doing a lot of reading and listening to podcasts during my walks about so called “successful aging.” You tend to read about that which is important to you personally. At 68, it has become increasingly important to me to understand this aging process so that I can make the most of whatever time I have left.

According to healthy aging expert Daniel Levitin, successful aging has nothing to do with status or financial security. He describes the three components of successful aging as as low probability of disease and disease-related disability, high cognitive and physical functional capacity, and active engagement with life. In other words, being able to do the things you want to do for as long as possible is the goal of successful aging.

How to accomplish successful aging involves the choices we make both before and after we earn that little red white and blue Medicare card. While there may be some disagreement about the best ways to age well, there are some tips on which most experts agree. Let’s explore some of these universal truths.

1. You must “eat as if your life depends on it.”Regardless of which way of eating you choose; vegan, plant based, paleo, low carb, Mediterranean or whatever, it is important to minimize your consumption of processed foods and foods high in refined sugar and simple starches. Processed foods are highly inflammatory and contribute to many of the diseases common in older people. A healthy diet as we age centers around simple whole foods and not processed fake foods. Every bite you eat is either feeding good health or feeding disease. Another important dietary consideration is that, contrary to popular belief, protein needs increase with age to combat the muscle loss (aka sarcopenia) that naturally comes with age. Make it a point to have some kind of protein at every meal.
2. You simply MUST keep moving. I am not saying you have to join a gym or train for a marathon but you do need to move your body with purpose every single day for at least 30 minutes. There is no magic formula but experts agree that you should vary your activities and get in some kind of cardio (walking, running, biking, dancing, swimming etc.), some resistance exercises to help combat muscle loss as well as movements that improve flexibility and balance. It is important to find activities you enjoy which makes it more likely that you will stick with them.
3. Reduce stress. This may be simple advice but likely the hardest thing to do. We often have no control over the aspects of our lives that cause us stress but we do have control over our responses. For me that involves daily quiet time with God to start each day. For others that might mean daily meditation, yoga or getting a massage. Also, the above mentioned physical activities are also great stress relievers.
4. Sleep Well. Most people think that our need for sleep declines with age when in actuality it becomes MORE important as we age. During sleep is when our bodies repair themselves and our batteries get recharged. The time honored advice of trying to sleep at least 8 hours a night becomes crucial as we get older.
5. Get outside daily if you can especially on sunny days. The sense of wellbeing that comes from getting fresh air and sunshine comes from the release of serotonin, the feel good hormone. The sun also boosts vitamin D which is important to bone health. The benefits of as little as a 15 minute walk outside in nature is priceless. Even if your mobility is limited, just being outside can boost your mood.
6. Keep your mind engaged by continuing to learn new things, visit new places and by staying connected with others. Become a lifelong learner. (I just found out that several universities offer free classes to high school graduates over 60). Join a book club. Try a new form of exercise, make some new recipes, learn a new language or get a new hobby. The possibilities are endless.
7. Remember to have FUN!!! If you are not going to enjoy your life in your 60’s and beyond – then when??

If you have lived your life up until now in unhealthy ways, make today the day you decide to change course. It is my prayer that you will take these tips seriously and apply them to your own life so that you too can live that “abundant life” and that you will finish strong.

Be Blessed,

Yvonne Moore, MD

“Dear friend, I hope all is well with you and that you are as healthy in body as you are strong in spirit.” 3 John 1:2 (NLT)

This blog entry will discuss one of the most prevalent but misunderstood conditions in medicine – prediabetes. A diagnosis of prediabetes means that your blood sugar is elevated but not high enough yet to be diagnosed with type 2 diabetes. It is estimated that one in every 3 adults has prediabetes and that the vast majority of them, 84 percent by one estimate, do not know that they have it. Persons with prediabetes are at significantly increased risk of developing full blown type 2 diabetes, heart disease and stroke.

Over the years I have seen many patients in my practice who have been told that that their blood sugar is a “little high” or “borderline.” What they likely have is prediabetes. Prediabetes is not just diabetes lite, it is a serious health condition in itself. Normally the pancreas produces insulin which causes the cells in the body to take in sugar from the blood to be used as energy. Persons with prediabetes have become insulin resistant. This means that the cells in the body do not respond normally to insulin which causes the body to make more and more insulin trying to get the cells to respond. This chronically high level of insulin that does not work properly is at the core of the problem. While this excess insulin no longer works properly to lower blood sugar it is very efficient at storing body fat. This is why persons with prediabetes tend to hold on to belly fat and have trouble losing weight!

Before the blood glucose is high enough for a diagnosis of diabetes, a person may have prediabetes for years because there are no reliable symptoms. If a treatment plan is not instituted, up to 30 percent of them will progress to type 2 diabetes within 5 years. Complications of diabetes are numerous and include heart disease, kidney damage, nerve damage and impairment of vision. Fortunately, if a diagnosis of prediabetes is made early it can often be completely reversed such that the person might never develop diabetes.

Risk Factors for Prediabetes

It is important to know if you are at risk for prediabetes so that you can discuss being tested for it by your primary care provider. It should be noted that African Americans, Latino Americans and American Indians and Pacific Islanders are at greater risk for developing prediabetes. If you have any of the following risk factors, you should be tested for prediabetes.

1. Being overweight or obese

2. Being age 45 or older

3. Having a parent or sibling with type 2 diabetes

4. Exercising fewer than 3 times a week

5. Having a history of gestational diabetes or of delivering a baby over 9 pounds

6. Having a history of polycystic ovary syndrome

One simple test that does not requite an overnight fast is the hemoglobin A1C. This test tells what the blood glucose level has been averaging over the last 3 months. An A1C level below 5.7% is considered normal. An A1C level between 5.7% and 6.4% is considered prediabetes. An A1C level of 6.5% or higher on two separate tests indicates type 2 diabetes. Once a diagnosis of prediabetes is made, it is usually within your power to return your blood sugar and A1C values to normal with a few very simple lifestyle changes.

How to Reverse Prediabetes

1. Eat a healthy diet! Remember that it is the sugars, simple starches and processed “junk” foods that keep the insulin levels high and lead to fat storage. Work with a nutritionist to learn which foods are likely to spike blood glucose and insulin the most so that those foods can be avoided. The optimal carbohydrate intake will vary from person to person but should certainly be significantly lower when trying to reverse prediabetes.

2. Losing weight. If you are overweight, losing as little as 5-10 percent of your current weight can improve your blood sugar levels. The weight loss should come naturally as you implement the above mentioned diet lower in simple carbs and processed foods.

3. Exercise regularly to reduce insulin resistance, increase your energy level and improve your mental health. The goal is 30 to 60 minutes of moderate activity at least 5 days a week. Regular exercise is also a great stress reliever. Walking, jogging, dancing, biking, swimming, exercise classes or videos are just a few examples of moderate exercise.

4. Quit smoking. Smoking is a risk factor not only for heart disease and lung disease but for insulin resistance, prediabetes and type 2 diabetes. Smoking has no place in a healthy lifestyle.

5. Drink plenty of water as a healthy alternative to sugary sodas, juices and energy drinks. How much you should drink depends on your size, activity level and climate. The color of your urine will tell you if you are drinking enough water. If your urine is dark yellow rather than pale yellow, you are likely not drinking enough.

6. Limit or avoid alcoholic beverages. Not only is alcohol a source of empty calories but it lowers your inhibitions making you less likely to make healthy choices with your meals.

In some cases, prediabetes is so far advanced that the lifestyle changes we have discussed may not be enough. If you have made those changes and continue to have abnormally high blood glucoses, your primary care provider may suggest medications to lower your blood glucose as an adjunct to your lifestyle changes.

On a personal note, my own diagnosis of prediabetes in my early 60’s turned out to be a blessing in disguise for me. I had nearly every risk factor on the list. However, once I made the lifestyle change of markedly reducing my consumption of simple carbohydrates, my glucoses and A1C levels returned to and have remained normal without medication. It is my prayer that if you you have been diagnosed with prediabetes, you too will be able to make the changes that will reverse the condition.

“Dear friend, I hope all is well with you and that you are as healthy in body as you are strong in spirit.” 3 John 1:2 (NLT)

Yvonne Moore, MD

The health and fitness industry has been all abuzz in recent years about intermittent fasting (IF) or time restricted eating as if it is something new. Fasting simply means going for a period of time without eating. Many of the religions of the world have been using periods of fasting as a spiritual practice for centuries. There really is nothing new under the sun. All of us fast every day while we are sleeping. The only thing that makes today’s concept of fasting different is that research has now proven that extended periods of fasting can have a number of health benefits.

For the purpose of this blog entry, I will be giving you a basic introduction to the concept of time restricted eating of 24 hours or less without food based on the research as well as my personal experience. I will not be discussing the more extended fasting regimens that might go on for several days or even weeks. These extended fasts are best done under the supervision of a medical professional.

HOW INTERMITTENT FASTING PROMOTES GOOD HEALTH

Our bodies are always in either one state or the other, we are either in the fasted state or the fed state. During the fasted state our bodies are resting and repairing themselves. One of the most important aspects of the fasted state is the reduction in the hormone insulin which you will recall from previous blogs entries is known as the fat storage hormone. Any time you can lower your insulin levels for prolonged periods of time you are less likely to increase your body fat. In addition, fasting can reverse insulin resistance which has been linked to the development of obesity and Type 2 Diabetes. When the body no longer has food for fuel it turns to the glycogen stored in the liver. Once the glycogen stores are depleted, the body begins to burn its own fat. Hence, intermittent fasting has became a valuable tool for many of us both for weight loss and weight maintenance and for our attempts to achieve good overall health.

In addition to weight loss and the prevention of obesity and diabetes, intermittent fasting has been shown to have numerous other health benefits including improved mental focus, better digestion, decreased overall inflammation, better heart health and an improved immune system. Intermittent fasting also can play a major role in management of the symptoms of the perimenopause and menopause in women. As an aging woman, I have experienced those benefits myself and have begun recommending IF to patients.

TIME RESTRICTED EATING PLANS

1. Short fasts are fasts between 12 and 15 hours in a 24 hour period. For example, a 12:12 fast means that you fast for 12 hours each day. All of your meals are eaten within a 12 hour “window.” This usually means that you simply stop eating 3-4 hours before bedtime and have your first meal of the day 12 hours after whatever time you had dinner. If you are a nighttime snacker, this simple change in your eating habits will be a challenge at first but it is a great way to decrease your overall food intake. Close your kitchen by 8pm, stop eating for the night and you are well on your way to a fasting lifestyle. These short fasts are thought to be the easiest of the fasting approaches because most of the fasting is done while you are sleeping.

2. The most popular IF plan is 16:8 in which your eating window is only 8 hours per day. During your fasting window you are encouraged to drink water and 0 calorie beverages like black coffee and tea. With this plan you can usually get in two meals during the eating window. Some experts believe that unless you fast at least 16 hours you may be missing out on some of the health benefits of fasting. Some choose to stretch out their fasting window to 17 to 23 hours daily. These longer daily fasts are thought to be necessary to reap benefits of autophagy wherein the body begins to clean out the old, unwanted, and unneeded cellular material, as well as fixing and recycling damaged parts. Autophagy is thought to be important for being our healthiest selves as we grow older.

3. The 23:1 mode of daily fasting is also known as known as One Meal a Day or OMAD. You get to decide which single meal you choose to have but most OMAD users fast from dinner to dinner so they can have the evening meals with family and/or friends.

4. Eat Stop Eat is a strategy that has you refrain from eating for a full 24 hours once or twice a week and to eat normally on the non fasting days.

5. The 5:2 plan, also called the modified Alternate Daily Fast method, restricts calories to 500 on 2 non consecutive days of the week with normal eating on the other days. Many argue that this is technically not a fasting regimen but I include it here for the purpose of informing you of the option.

MYTHS ABOUT INTERMITTENT FASTING

1. Fasting starves the body and will zap your energy. The truth is that even lean individuals carry hundreds of calories in their livers in the form of glycogen and in their body fat. That is why we have stored fat in the first place, to use as a food source when food is not available. No one ever starved to death going a few extra hours without food. We have been told for years that we need to eat 5 times a day to keep our blood glucoses up. That is simply not true but is certainly what the food industry would like for you to believe. In the decades that we have followed this advice we have seen the rates of obesity and diabetes skyrocket. There must be a better way!

2. You will be ravenously hungry if you fast. A lot of the eating we do is out of habit because we have trained our bodies to eat at certain times. We can also train our bodies NOT to expect to eat by easing into the fasting lifestyle gradually. Most people have what I call head hunger at the expected mealtimes the first few days of a fasting lifestyle. That why it is a good idea to start a fast after a satisfying meal followed by overnight sleep then pushing your first meal of the day an hour later each week. Drinking water and zero calorie beverages are a big help in curbing hunger and cravings in the early weeks of a fasting lifestyle. Cutting back your consumption of sugar, simple starches and processed foods will also make you more successful at fasting. The body will learn to crave whatever you regularly feed it. If you continue to eat sugary treats, you will continue to crave sugary sweets.

3. Fasting will make it difficult to concentrate. Most people report that once their bodies adjust to a fasting lifestyle they actually have better mental acuity. It is not true that humans need food to be mentally sharp. Quite the opposite is true. Think of how sleepy you get after a big meal when the blood flow to the brain is compromised by digestion. Studies have shown that there is actually increased brain activity in mammals in the fasted state.

4. You can eat whatever you want during in your eating window. This is the most dangerous myth of all! Let us not forget that this is a healthy living blog. The key to a healthy lifestyle is not just when you eat, it is also WHAT you eat as well. You cannot use fasting as an excuse to pig out on junk food regardless of what you see on social media! Unless you nourish your body with leafy greens, protein, healthy fats and fiber, fasting alone will not help you reach your wellness goals.

WHY SHOULD YOU CONSIDER FASTING

According to Dr. Jason Fung, author of the Obesity Code and the Complete Guide to Fasting, there are several reasons to consider a fasting lifestyle.

1. Fasting is simple and convenient. Even if you eat just one less meal a day that is one less meal you have to plan and prepare and take the time to eat. Think of the time you will save.

2. Fasting is free. After all the money most of us have spent on diet programs, we finally have a strategy that doesn’t cost a penny. Not only that but you will be cutting your food budget by at least one third! In a sense you are being paid to lose weight and improve your health!

3. Intermittent fasting is flexible. It can be used with the dietary eating style of your choice. Because I am pre-diabetic, I use 16:8 daily IF in combination with a low carb/healthy fats eating style. Low carb eating is a great way to get rid of cravings and hunger and makes it easier to be a consistent faster. However, IF can also work wIth other healthy eating plans like vegetarian, vegan, plant based, whole 30, paleo, keto, etc. Once you find the eating plan that works with your health needs and goals, time restricted eating is a great adjunct to make that plan even more effective.

4. Intermittent fasting is great for maintenance of weight loss. Regardless of the method you use, 80-90% of persons who lose weight will regain it within 2 years. Intermittent fasting is a lifestyle that you can use forever in order to stay at a healthy weight.

On a personal note, I originally started IF 2 years ago searching for a way to maintain the weight loss I had attained by switching to a low carb way of eating. I was determined not to do what I had done so many times before when I regained the weight. Not only was I able to maintain the weight loss, I was able to do all my morning workouts in the fasted state without feeling hungry! I have even done several half marathons in the fasted state with no need for carbs before, during or after the races. In the past few weeks I have been experimenting with stretching my fasting window to up to 23 hours a couple of days a week and I am amazed at the amount of energy I have on those days. I can also report that my gimpy left knee hardly ever talks to me any more. I think she likes this fasting lifestyle!

As always, I do not claim to have all the answers to how to become a healthier you but it is my prayer that the information you find here will help you in your journey. I encourage you to share the blog with your friends and family and to contact me in the comments if you have questions.

Be Blessed,

Yvonne Moore, MD

“Dear friend, I hope all is well with you and that you are as healthy in body as you are strong in spirit.” 3 John 1:2 (NLT)