IS INTERMITTENT FASTING RIGHT FOR YOU?

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)

Is Sitting the New Smoking??

I hope this blog entry finds you all safe and well. It is the purpose of this blog to provide you with information you can use to maximize your good health. In previous entries (which are all still available) we have looked at the effects of unhealthy eating, hormonal changes, poor sleep, and too much stress on our overall health. Today I want to alert you to another important factor that might be endangering your health – TOO MUCH SITTING!

We have all seen the headlines that read, “Sitting is the New Smoking.” The implication of those articles is that our sedentary lifestyles are as dangerous to our health as cigarette smoking. This notion has become even more of a hot topic in the last several months as we have been sheltering at home due to concern over the spread of Covid 19. It is not just those adults who are working from home, it is also our children who are now attending virtual school who are being forced to sit for most of the day in front of a computer. With many of our normal activities being curtailed or cancelled, we are all sitting more than ever now.

It should be obvious to all of us that it takes more energy to walk than it does to stand still but it also takes more energy to stand that to sit. The simple act of holding your own body upright uses up more energy than letting a couch or chair support you. Not only are we sitting more at work and at school but our favorite leisure time activities often involve binging streaming videos, playing video games and scrolling social media. Granted, many of us have been getting out and taking walks, cycling and running more during the last few months. However, even a full hour of such activities every single day cannot compensate for the 8-12 hours a day spent sitting at a computer for work or school or for the hours on the couch binging Netflix or surfing the internet.

Our sedentary lifestyle is not entirely our fault. Just a quick assessment of the ways in which every day life has changed in the last 50 years offers some clues as to why we are more sedentary now. I am old enough to remember washing clothes on a scrub board and hanging them on a clothesline to dry. In the past many of us walked to school or had to walk considerable distances to the bus stop to get there. There were no remote controls. If you wanted to change the television channel, you had to walk across the room. There were no dishwashers or trash compactors doing simple tasks for us. We now even have little robots to vacuum our floors! The list goes on and on. The point is that as automation has increased, physical activity has decreased. As activity has decreased there has been an increased incidence of deadly diseases.

Studies have shown that our sedentary lifestyle has now become a public health problem. Sitting too much has been linked to an increase in the risk of obesity, heart disease, diabetes, depression and anxiety. In addition, there are direct physical effects of prolonged sitting. One of the most obvious effects of sitting is the weakening and wasting away of the leg and gluteal muscles. Many have witnessed such muscle loss in relatives whose medical conditions have left them bedridden. Weak muscles that are meant to keep you upright increase your risk of falling and of strained muscles when you do try to exercise! Moreover, prolonged sitting causes your hip flexors to shorten which can lead to hip problems. Too much sitting can also lead to back problems from poor posture which can be a cause of painful disc disorders.

The good news is that we are not doomed to becoming victims of the effects of prolonged sitting. There are many ways to build activity into our daily lives, even if we are spending more time at home. Most of the recommendations I am making are strategies that I have personally used to avoid prolonged sitting. We sit or stand still during some activities because it has become a habit to do so – not because that is the only way those activities can be done. For example, marching in place or walking around the room during your favorite tv show (or at least during the commercials) can be just as relaxing as watching it couch potato style. As long as you don’t wander out to the kitchen for an unhealthy snack, this one simple change can make a big difference. The same is true of making phone calls to check on friends and relatives during this time of social distancing. Consider walking around the room during those phone calls. You can also increase your activity at home by walking while you brush your teeth, heat up food or brew coffee. Break household tasks into smaller tasks like unloading your groceries one bag at a time from the car or making several trips to the laundry room instead of trying to take the entire load at once. If you venture out to shop for necessities, park as far from the door as you can to add some extra steps to the outing. Using an activity device and setting a step goal of at least 10,000 or more steps per day will keep you accountable to move more each day.

Like to get lost in a good book? Instead of curling up on the couch to read, try audiobooks and/or podcasts and listen to them during your walk, run or bike ride. In that way you are improving your body and mind simultaneously. (In the interest of safety, experts advise that you use only one earbud or use bone conducting head phones so that you can be aware of your surroundings.)

Whether you are going in to the workplace or school or working from home, find ways to move around in the course of your day. Consider investing in a standing desk or stack boxes or books so that you can stand while working at your computer. Charge your phone on the other side of the room and move the trash can so that you cannot reach it without getting up. Take the longest route to the restroom and the break room. Set a timer on your watch or phone to remind you to get up and walk around for a few minutes once per hour. A recent study found that just 2 minutes of walking for every hour spent sitting has a positive impact on your health. Do a few yoga stretches to work out the kinks in your neck and shoulders after your mini walk. Try to spend a portion of your lunch break going outside for a stroll or walking the stairs if the weather is unfavorable. You will be amazed how a short walk outside can improve your mood and make you more productive! It really is true that “movement is therapy.”

As all of us become accustomed this new existence in the wake of Covid 19, we will have to make adaptations so that we can each be the healthiest versions of ourselves. The recommendations in this blog entry are just words on a page until YOU decide to incorporate some of them into your life. I pray that you will find them helpful.

Stay Safe and 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)

Don’t Let COVID-19 Make You Unhealthy

From what I read on social media, a lot of you have given in to the notion that this order to stay home will inevitably lead to weight gain which can wreak havoc on your overall health.. I for one am determined not to let that happen. I am healthier and fitter now than I was 10 years ago and I refuse to let COVID-19 take that away from me. A lot of what is happening to us during this Pandemic is beyond our control. Whether or not we turn into junk food eating couch potatoes is entirely up to us.

What follows are just a few commonsense suggestions to help you stay healthy under the stay at home orders.

The first step to a healthy lifestyle begins in the grocery store. Leave the chips, candy, ice cream, and pastries in the store. If you cannot resist snacking between meals, stick to low sugar fruits and veggies and SMALL quantities of nuts and seeds. Make an effort to have at least 90 percent of what you eat be real whole foods instead of processed fake food with ingredients you can’t even pronounce. Make wise decisions when ordering foods from restaurants and try to prepare your own food at home as much as possible so you know exactly what is in it. Take advantage of this opportunity to try some new healthy recipes for you and your family now that you have the time. Think of eating a healthy diet as something you can do to help boost your immunity during this Pandemic.

Consider using that cell phone that is constantly with you to journal what you are eating and your exercise habits. Apps like My Fitness Pal and Lose It will keep you honest if you track everything you eat and how much you are exercising. It may sound like a pain but studies have proven that journaling is a very effective tool in the weight control arsenal. You can even use old fashioned pen and paper to accomplish this. If you are on lockdown, don’t tell me you don’t have time.

Practice portion control. Simple strategies like using smaller plates and utensils fool your brain into thinking that you are eating more than you really are. A saucer sized plate or small paper plate will hold as much as you need to eat at a meal. This is a good time to learn to eat more slowly to give your brain a chance to signal your stomach that you are full. You will automatically eat less when you do this. Remember, there is no reason to rush through your meals when there is no place to go!

Drink more water, especially when you are tempted to do mindless snacking. Sometimes what we perceive as hunger is really thirst. Aim to drink at least 64 ounces of water daily. All those trips to the rest room will help keep you off the couch.

Make a concerted effort to wait until you are stomach growling hungry before you eat. Try to distinguish between head hunger due to boredom and physical hunger. If you are already full but craving to eat something else, distract yourself by getting as far away from the kitchen as you can. Why not go out and walk around the block? As you are walking, the craving will likely go away. Getting some fresh air every day is important to prevent “cabin fever” and depression. You might also use the moment to call and check on a friend or loved one. Social distancing does not mean disconnecting from the people you care about.

Make staying active a priority. Even those of us who are allowed to go to work are still home more than usual. We now have more time to go for walks and runs, do home workouts and try the many workout videos that are available. If you don’t enjoy structured workouts, why not make a playlist of your favorite upbeat music and dance like no one is looking. This is also a great time to tackle some of those household chores you have been putting off. Even if you choose to binge watch your favorite series, you can get up and march in place for a few minutes between episodes. The point is just to get you to move as much as possible. Not only is activity good for your heart and your blood pressure, it can also ward off anxiety and depression. Like I always say, “movement is therapy.”

Last but not least, one of the best things you can do for your long term health is to GO TO BED EARLY! A lot of us are so conditioned to staying up late that we have forgotten how to go to bed early like we did when we were children. We have made it a habit to stay up watching late night television and often find ourselves mindlessly snacking. The average adult should get 7-9 hours of sleep per night yet most of us are lucky to get six. Look at it this way. You are going to wake up at whatever time you are used to getting up regardless so the easiest way to work toward getting adequate sleep is to get it on the front end. You will be amazed at how much better you will feel once you start getting adequate sleep!

I hope these tips will help all of us get through these difficult times without letting stress eating and inactivity get the best of us. If you have other tips you would like to add, feel free to leave them in the comments section. Be safe everyone!

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)

 

STAYING HEALTHY IN TIMES OF CRISIS: Updated (3/20/20)

I haven’t made an entry into this blog for a few months due to a series of personal and family struggles. As I continue to navigate the waters of grieving the loss of both my mother and my husband, I am now joined by all of you as we are grieving the loss of life as we knew it due to the impact of the Corona Virus. Along the way, I have learned some valuable lessons about what it takes to stay healthy in crisis situations. I would like to share what I have learned with my readers hoping that it might help someone else.

I have had numerous people inquire of me over the last few months “are you taking care of yourself?” I took those inquiries to heart and made conscious efforts to develop some simple strategies to keep myself healthy. Let me preface what follows with recognizing that it is the grace of God and the caring and prayers of others on my behalf that are getting me through these tough times. That said, I do feel that there are steps we can take in times of crisis that will help us to stay healthy.

1.GET ENOUGH SLEEP

Sleep deprivation in and of itself is a stressor on the body. Lack of sleep and chronic stress can cause elevations the stress hormone cortisol. This wrecks havoc on your immune system, increasing your risk of becoming ill. It is wise to establish a good sleep routine and stick to it as much as possible during stressful times.

2. FIND WAYS TO BE PHYSICALLY ACTIVE DAILY

I am sure that most of you have heard of the “runners high” which is the sense of well being that comes from the endorphins that are released by running. Well, you don’t have to be a runner to tap into that natural mood elevator. You can get it from any type of activity that you truly enjoy. That can be anything from a stroll in the park to dancing around your house to great music – as long as you are moving your body with purpose, it will make you feel better and will help ward off depression. There are countless workout videos available for FREE on YouTube. Even during the grief process, movement is medicine.

3. DON’T EAT YOUR FEELINGS

As a lifelong emotional eater who has now adopted a healthy lifestyle, I can report that the temptation to run to comfort foods in times of crisis never really goes away. Being comforted by sugary or starchy foods is embedded in our DNA. From the time we are infants, our parents and caregivers respond to every cry with a bottle or breast! It is no wonder that most of us feel a primal urge to eat in times of stress! If you choose to try to be your healthiest self in a crisis, you must continue to make healthy choices with your eating. Continue to choose real whole foods over starchy and processed convenience foods and drink plenty of water. The same is also true for those who find themselves losing weight when they are grieving because they neglect to fuel themselves properly. Eating foods that are healthy for you over the junk you may be craving takes a conscious effort. Don’t let time pressures be your excuse to eat poorly. Even fast food restaurants and grocery stores now offer salads and other healthy foods.

4.CARVE OUT TIME FOR PRAYER AND MEDITATION

There is nothing that nourishes a struggling spirit like a strong prayer life. Often the comfort and security you need can be found in daily quiet time communicating with God and meditating on His Word. Taking the time to meditate on the things you still have to be thankful for even in the worst of times can also help to lift your spirits during a crisis.

5. STAY CONNECTED TO OTHERS

Social distancing does not mean social isolation.The last thing you need to do in times of stress and grief is to isolate yourself from friends and loved ones. There is strength to be found in sharing your situation with family and close friends. This is a great time to take advantage of social media, texting, facetime, etc. Why not make it a point to phone a friend or distant loved one once a day?

6. BE WILLING TO ACCEPT HELP!

People do not usually offer to help you unless they mean it. They do, however, need for you to be specific about what help you need. Recognize that you cannot do it all and tap into the resources of others when you find yourself overwhelmed. A few hours of “me time” to focus just on yourself can make all the difference in the world. Taking time for a little self care is not selfish but is necessary to your overall well being.

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)

Love the Foods That Love You Back

When it comes to using food to help you lose weight and/or just be healthier, there can be a lot of confusion about what constitutes the healthiest eating plan. Patients have expressed to me how they are hesitant to try eating a healthy diet because there is so much conflicting information out there. When it comes to eating to promote your best health, we should not get the idea that one eating plan fits all. Take me, for example, a 66 year old prediabetic with a history of hypertension and childhood obesity. A LCHF (low carb healthy fat) lifestyle along with regular exercise is the approach that has made me healthier now than I was 20 years ago. Others whose medical profile or personal preferences are different might not find this approach either desirable or sustainable long term. That said, I believe there are some universal concepts that hold true no matter what WOE (way if eating) we choose. One of those concepts is that you must learn to love the foods that love you back!

Often when I try to advise patients on healthy eating they tell me that they cannot sustain a long term healthy eating plan because they “love” ice cream (or chips or cookies or cornbread, etc). My response to anyone who has struggled with their weight for this reason is, “what has ice cream ever done for you?” Having an unshakeable love for foods that are unhealthy for you is like being in a relationship with someone who is physicalIy abusing you. We keep letting that person back into our lives and expecting it to be different this time but it rarely is! We can’t keep returning to eating french fries and other junk foods every day and expect them to make us healthy this time around. That is part of the reason why 95% of people who lose a significant amount of weight gain it back within 2 years!

I totally understand the passion we have for food because I LOVE to eat. That love led me to take up interval running in my late fifties with the notion that “I run so I can eat.” That turned out to be a big fat lie! As I have said in a previous blog, you cannot “outrun”a bad diet. We need to acknowledge that we eat as much for enjoyment as we do for fuel. We just need to train ourselves to love the foods that love us back with positive changes in our health.

When you make a commitment to becoming a healthier you, why not take the focus off the foods you should no longer eat but instead focus on learning to love those foods that you know are good for you? The disease causing foods like sugar and sugary drinks, processed carbs (junk food) and deep fried foods pretty obviously have no place in your pursuit of good health. Regardless of which healthy eating plan you choose you will be told to reduce your intake of these foods. Instead of mourning the loss of the “bad” foods you shouldn’t eat, try to forget them and get excited about all the wonderful things you get to enjoy eating and still be healthy! You can take control of your own health by making this simple shift in your mindset!

Here is just a partial list of some of the wonderful things to eat that will promote wellness in your life. The closer any food can be to its natural state the better. Make it a habit to shop the perimeter of the grocery store to find the real food! I have included some of my personal favorites in this list but the list is not exhaustive by any means. Identify the good foods that you already like and eat more of those before venturing out to the foods you think you don’t like right now.

1. Green leafy vegetables, especially the dark leafy greens like spinach, mustard and collard greens and kale are encouraged in almost every diet I have ever seen (Lord knows I have tried them all). It is a good practice to eat a big salad topped with healthy proteins and fats every day as one of your meals.

2. Other non starchy vegetables that you should be eating on the regular include cabbage, cucumbers, broccoli, brussel sprouts, cauliflower and tomatoes. Learn to prepare these in ways that will tickle your palate and they will become your go to side dishes instead of the starches that gave you love handles but no love!

3. Foods containing protein and healthy fats like fatty fish (i.e. mackerel, lake trout, herring, sardines, albacore tuna and wild salmon) are excellent choices. Seafood, poultry, eggs, cheese and other dairy products and even meats can also be a part of a healthy diet depending on your medical history.

4. Raw Nuts and Seeds (i.e. almonds, pecans. walnuts, flaxseed, chia seeds, hemp) are also good choices in small quantities.

5. Berries – strawberries, blueberries and raspberries are preferred over the tropical fruits because their sugar content is so much lower.

6. Avocados. This stone fruit with a creamy texture is chock full of healthy monounsaturated fats, vitamins C, E, K and B6 as well as potassium and magnesium! This is the one healthy food that inspired me to write this post. I never even knew that I liked avocados until I found out how good they were for me. Now I eat them almost daily! During a recent run-cation to New England, we were celebrating my birthday at a nice restaurant. I ordered the lobster cocktail thinking I would eat the fresh lobster and bypass the sugar laden cocktail sauce. Imagine my sheer delight when they put it in front of me and it was topped with guacamole!! I was tempted to ask them to put a candle on it so I could pretend it was my birthday “cake!” I was even surprised at myself for getting that excited over unexpected avocado!! I can honestly say that I love avocados in the same way that I used to love potato chips! Amazing! Here is a picture of that lobster cocktail and it was delicious!

All joking aside, I hope you get my point. If you eat a food that you thought you didn’t like and it contributes to your feeling great, you will soon learn to love it!! Give yourself the chance to fall in love with healthy foods and I promise they will love you back by making you a healthier you!

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)

It’s Never Too Late

Those who know me well know that I am a big fan of in home exercising and using YouTube videos for fitness. While I LOVE interval running outside and try to do at least one half marathon each month, I never stray far from my Walk Away the Pounds videos from back in the day! Now such videos are as close as that cell phone that is always with you! I have shared with many of my patients that we no longer have any excuse not to exercise. That is why I was so excited when a friend posted this video about an 87 year old lady who has lost weight and gotten fit by ditching her unhealthy diet and walking daily INSIDE her 2 room apartment. If her story does not inspire you to get off the couch, I don’t know what will!

Be Blessed,

Yvonne Moore

“Dear Friend, I hope all is well with you and that you are as healthy in body as you are in spirit.

3John 1:2 (NLT)

What is Your Why?

2018 has been the year that I finally took charge of my own health and the results have been amazing. As I have shared this journey through this blog and in my conversations with my patients and friends I have been saddened to hear all the excuses that I used to make being told to me by others. The list of excuses for not adopting a healthy lifestyle is a long one but these are some of the most common that I hear.

1. I LOVE _______! Fill in the blank with your drug of choice: bread, desserts, potatoes, chips, chocolate, etc.

2. I don’t have the time or energy to exercise regularly.

3. I don’t like vegetables.

4. My job is so stressful that junk food is the only thing that calms me.

5. I have lost weight many times before and I always gain it back so what’s the point?

As I reflect on what it has taken for me to get to the place in my life where I have stopped making those excuses, I realize that it did not happen overnight. I have done you a disservice if I have given any of you the impression that the road to good health is an easy one. It most certainly is not. This is particularly true if you hate to exercise and/or have a love affair with unhealthy food as I did.

I have recently asked myself what it took for me to stop making excuses. What it took for me and what it will likely take for you is to find your own individual “why.” Finding your why has become a catch phrase in corporate America as the key to success in the workplace. It is also the key to the long term maintenance of a healthy lifestyle. Your why is that thing that motivates you from deep within yourself. It is that thing that is more powerful than any of the excuses you have ever made and any of the lies you might have told yourself. The German philosopher Frederick Nietzsche once said, “He who has a why can endure any how.”

The initial why that sparked my desire to get healthy was wanting to lower my blood pressure. Sitting at my mother’s bedside while she lay in a coma from a hypertensive stroke solidified my resolve to do whatever I could to avoid the same fate. During the time that I was trying to make exercise and healthier eating a priority, I found out that not only was I still requiring blood pressure medication, I had also become pre-diabetic. This shook me up even more because I have watched family members lose limbs, vision and kidney function from diabetes. I now had a more imperative why – I do not want to have hypertension OR diabetes! With that focus, I now see the junk food that I once loved as poison to my body! Fear of disease and infirmity can be a powerful motivator!

As we enter 2019, I would urge each of you to take a different approach with you into the new year. Instead of making a list of resolutions that are doomed to fail, take some time to discover “why” you want to be healthier and let that be your focus. You may be a parent whose motivation is to set a good example for your children. Perhaps you have grandchildren and you would like to have the stamina to have fun with them. Maybe you have noticed the beginnings of arthritis in your joints and have been told that walking will help you have less pain. Your why might be depression and you remember how much better you felt after exercising. Whatever your why is, make that the reason you are choosing to change to a healthier lifestyle in 2019! Whenever you are tempted to veer off track, remind yourself that your why matters more to you than whatever it is that might be tempting you in the moment. Keeping that all important why at the forefront of your mind will help you stick with your healthy lifestyle for the long run.

Happy New Year to all of you!

Be Blessed,

Yvonne Moore

“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)

KETO Is Not a Dirty Word

Most of us who have struggled with weight and health issues have heard of the ketogenic or “keto” diet. I have had several patients recently ask me if I “believe in Keto” as if it were some disreputable underground movement. Opinions about this dietary strategy are all over the map. Countless articles on the internet tell you how good it is while others warn of its dangers. The truth likely lies somewhere in between those extremes. Hopefully this blog post will clear up some of the confusion.

The ketogenic diet was originally a therapeutic diet that has been used since the 1920’s by doctors to treat seizures in children who did not respond to any other therapies. Basically the diet consists of a high percentage of fats with moderate protein and a very low amount of carbohydrates (20-50 grams/day). This is not to be confused with the Atkins diet so popular in the 70’s which was a very high protein diet. The science behind the effectiveness of the keto diet is that in the absence of carbohydrates the liver uses fat to make an alternative source called ketones to fuel the body. Without a heavy load of carbohydrates, the fat storage hormone insulin is reduced and the body can now access its own fat stores to produce the energy it needs throughout the body, including the brain. The use of ketones instead of glucose by the brain is felt to be responsible for the reduction in seizures. Somewhere along the way the ketogenic diet has made its way into the mainstream because while it can be therapeutic for some specific diseases, it can also be can be used to promote weight loss because of the increased fat burning.

So how does a diet that is so high in fat (up to 70%) promote weight loss? At the risk of sounding like a broken record, it is all about how the types of foods we eat impact insulin levels. Simple carbohydrates like sugar, bread, rice, pasta and potatoes cause an increase in insulin levels in order to lower the blood sugar. Protein has a lesser effect on insulin levels and fats have no effect at all. You should recall from an earlier blog post that insulin is a fat storage hormone. The carbohydrates we eat must be immediately used as fuel or insulin will cause the body to store it as fat. Fat is our body’s natural back up fuel supply. The problem is that we rarely use up all the fuel we take in from processed carbohydrates and it stays with us in the form of increasing body fat. This is why a diet that is low in carbohydrates has been documented to result in significant weight loss, at least in the short term. The ketogenic diet takes the standard low carbohydrate diet to the next level by severely limiting starchy carbohydrates and encouraging that most of one’s daily intake come from fats.

Proponents of the ultra low carbohydrate ketogenic diet tout these documented benefits:

1. Diminished hunger. One of the drawbacks to a high carbohydrate diet is the incessant hunger. An eating plan high in fats will help you stay satisfied because it is less likely to spike insulin levels to reduce your blood sugar and trigger hunger. This diminished hunger makes the ketogenic eating strategy much easier to stick to than a conventional low fat calorie restricted diet.

2. Improved cognition and mental clarity. This is thought to be due to the brain’s use of ketones instead if glucose for fuel.

3. Reduced cravings for unhealthy foods. The taste buds change over time and cravings for starchy foods diminish.

4. Improvements and reversal of prediabetes and diabetes. Again very low carbohydrate diets have been shown to improve insulin resistance. The more insulin resistant a person is the more beneficial it is to restrict the intake of simple carbohydrates.

5. Increased energy and improved athletic performance. Ordinarily the body’s supply of stored carbohydrates (glycogen) only lasts for a couple of hours of intense exercise. After a few weeks of a ketogenic diet, the body learns to use its much more plentiful fat for fuel leading to longer endurance without constantly having to re-fuel. Even the thinnest person has thousands of calories of energy stored in body fat.

6. A ketogenic diet can be a helpful adjuvant for the treatment of epilepsy and possibly other neurologic disorders. While first used for children with epilepsy, the diet is now being used in some adults to reduce the amount of medication required to decrease the number of seizures. Use of the diet is also now being studied to treat other neurological disorders as well as for the prevention of Alzheimer’s in persons with a strong family history of the disease.

Detractors of the ketogenic diet point to possible health risks:

1. Eating so much fat is bound to lead to high cholesterol and heart disease. There is much debate about whether consuming dietary fats increases the risk of cardiovascular disease. What we do know is that all fats are not created equal. Most experts agree that fats such as those found in processed convenience foods (trans fats) are artificially produced from hydrogenated vegetable oils are not good for anyone. On the other hand, naturally occuring monounsaturated fats like those in avocados, nuts and olives as well as the omega 3’s found in salmon and sardines are quite healthy and have been shown to actually decrease the risk of heart disease. The controversy lies with saturated fats from animal sources like meat, poultry, eggs and dairy products. You can find studies that support the deleterious effects of animal fats as well as many others that fail to show any link between the consumption of animal fats and heart disease. The good news is that there are enough good healthy fats available that you can achieve the benefits of a ketogenic diet without eating animal fats at all. It is even possible to be vegetarian and/or vegan and still adhere to a ketogenic diet. The diet can be personalized to taste preferences and genetic profiles.

2. The body, especially the brain needs carbohydrates to function normally. This is a medical myth. The brain is perfectly capable using ketones to fuel its daily function once a person becomes fat adapted.

3. The diet causes too many side effects. In the first few weeks on a ketogenic diet, some people can experience lethargy, dizziness, leg cramps, bad breath, constipation and decreased physical performance. We established in an earlier blog that simple carbohydrates can be addictive. The so-called “keto flu” that some experience when starting a low carbohydrate eating plan is in part due to withdrawing from dependency on carbohydrates. The dizziness and leg cramps are usually related to the electrolyte loss from the increased urination in the early stages and respond to magnesium and salt replacement. All of these symptoms go away as the body adjusts to the lower carbohydrate intake.

4. The diet is “dangerous.” There are some individuals who should not be on a ketogenic diet without medical supervision. This would include diabetics, hypertensive patients on medication, patients on medication for mood disorders and those with severely abnormal lipid profiles. Such supervision is necessary because the diet causes shifts in body chemistry which might affect medication dosages and side effects. Supervision is also needed with pregnant and lactating mothers and for children whose protein needs may not be met by the standard ketogenic diet.

Those of us who have switched to a low carbohydrate eating plan for health reasons and have reaped the benefits see it as a long term lifestyle and not a quick fix. The bottom line to successful weight loss and maintenance is finding an eating plan that you can adhere to over the long haul. The question for you to ask yourself before embarking on the severe carbohydrate restriction of the ketogenic diet is whether this is something you can live with indefinitely. Otherwise, keto becomes just like any other fad diet with initial success followed by rapid weight regain caused by returning to the eating patterns that caused you to gain weight in the first place.

Be Blessed,

Yvonne Moore

““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

Menopause and Weight Gain

I cannot tell you how many times over the course of my career that a patient has said to me “since I turned 40 (or 50 or 60) I just cannot seem to lose weight.” If you are over 40 and have not had this experience, consider yourself blessed! What follows is the result of my personal quest to find answers to this dilemma, not only for my patients but for myself. It will contain some truths that may be hard to swallow so please don’t shoot the messenger!

When it comes to the aging female body, there is good news and bad news. The bad news is that most us of gain weight as we age. The good news is that such weight gain is not inevitable or irreversible (praise the Lord)! For the pupose of this discussion I will be referring to those years up to, including, and beyond the menopause.

For those of you too young to know much about menopause, a few definitions may be in order. Perimenopause is defined as those years leading up to and including menopause. Menopause is the complete cessation of the menstrual cycle marked by 12 consecutive months without a period. Once this has occurred, a woman is considered to be postmenopausal. During this time the levels of the hormones estrogen and progesterone become erratic and ultimately fall significantly. There is also an entity known as surgical menopause which is more sudden following the removal of both ovaries prior to natural menopause. Such sudden menopause can also result from certain cancer treatments. The average age at which menopause occurs is around 51 but it varies widely from the early 40’s to well into the late 50’s. Thus a woman may spend many years in this state of fluctuating hormone production.

Many women notice that not only is losing weight more difficult during this transition but any weight that is gained has a tendency to accumulate in the abdomen leading to the loss of the “girlish figure” of youth. There are multiple factors that lead to these changes. Once we have a better understanding of the changes that take place during these years and how we can combat them, the more likely we are to maintain our good health and control our weight well into our 60’s and beyond.

Loss if Muscle Mass

During the menopausal transition a woman may lose as much as half a pound of muscle mass per year. This has the effect of decreasing the metabolism. So even if you eat exactly as you did in your twenties and do not increase your physical activity, the aging body does not burn that fuel as well and the excess will result in weight gain. A sedentary lifestyle is one of the biggest factors in midlife weight gain.

Fat is an Alternate Source of Estrogen

Once the ovaries stop making estrogen, the fat cells become the major alternative source of estrogen production. The fat cells are able to convert precursor hormones secreted by the adrenal glands into estrogen. The estrogen produced by the fat cells is a double edged sword. The estrogen that comes from excess fat can lessen some of the symptoms of menopause but obesity is a major risk factor for breast and endometrial cancer. So while the body is trying to hold on to fat cells as a source of estrogen, too much fat can be dangerous.

Poor Sleep

One of the cardinal symptoms of menopause is the dreaded night sweat. Many women are awakened nightly drenched in sweat to the point of having to get up and change night clothes and/or bed linen. Others suffer from insomnia likely related to milder vasomotor symptoms and other factors. As we discussed in a previous blog post, sufficient sleep is essential to good health. It is while we are sleeping that the hunger and fullness hormones reset and our insulin levels fall. When sleep is out of kilter, so are those hormones making us more likely to store fat. In addition, poor sleep increases the temptation to snack at night, crave high calorie comfort foods and take in excess calories.

Stress Eating.

There are numerous changes during midlife to which a woman may have to adjust. Changing roles in the lives of loved ones, (including children and parents), illness, job changes, divorce and death of a loved one can all lead us to turn to food for comfort. These stressors can also increase our blood of levels of the stress hormone cortisol which encourages our bodies to store belly fat. As alluded to a previous blog post, we must find alternatives to eating to handle the stresses in our lives.

Insulin Resistance.

Women who are very active (as I was) may find themselves gaining weight due to the effect of many years of eating a diet high in processed carbohydrates like bread, potatoes, sugar and chips and other junk foods. Even those high protein bars, low fat foods and commercially prepared smoothies are usually full of sugar! Those of us who have been chronic dieters relying on such foods to help us lose weight have set ourselves up for a world of trouble! A lifetime of high carbohydrate intake leads to increased insulin levels. Eventually the insulin stops performing as well to lower blood sugar and we become insulin resistant. This encourages our bodies to store the excess sugar as fat! In addition to poor nutrition, declining levels of estrogen during menopause has been linked to insulin resistance in susceptible women. It is estimated that at least 40-50 percent of postmenopausal women have insulin resistance which leads not only to weight gain but to an increased risk of diabetes, heart disease, hypertension, stroke and dementia.

Solutions to Menopausal Weight Gain

1. Fight back against the slowed metabolism and muscle loss with exercise. While we have already established that exercise contributes only modestly to weight loss, it is very beneficial to preventing weight gain. Both aerobic exercise like brisk walking, cycling and running as well as strength training are no longer optional but necessary to maintaining a healthy weight during the perimenopausal and post menopausal years. Regular exercise is also a great stress reliever and provides an alternative to stress eating! The key to success with exercise is consistency. Find activities you truly enjoy and enlist the support of others to hold you accountable.

2. Learn what your triggers are for the night sweats and hot flashes that interfere with sleep. These vary from person to person. Some of the likely culprits are caffeine, alcohol, spicy foods, and sugars. If your night sweats are severe, you might want to speak to your doctor about medications and or other lifestyle changes to minimize them.

3. Consider adopting a LCHF (low carb/healthy fat) eating pattern (see last month’s blog post). A diet that minimizes processed carbohydrates and has moderate protein and increased healthy fats reduces insulin levels leading to less fat storage. Another way to reduce insulin levels is with time restricted eating. This can be as simple as eliminating late night eating by vowing not to eat within 2-3 hours of bedtime. If you go at least 12 hours without eating and get your morning exercise while still fasting, you will teach your body to burn your stored body fat to fuel your exercise, thus enhancing weight loss.

On a personal note, I went through menopause in my mid 40’s and struggled mightily with managing my weight throughout my 50’s. Even as an avid walker then interval runner I continued to struggle with my weight, hypertension and prediabetes. In the past year, even though I am now 64, I have been able to make remarkable improvements in my health by making the changes I have suggested to you. Be encouraged! It is never too late to take control of your health!!!

Be Blessed,

Yvonne Moore

““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

Food is Medicine

This week marks a full 6 weeks since I stopped taking medication for high blood pressure. I attribute my being able to do this to 6 months of a low carbohydrate/healthy fat way of eating and a weight loss of over 25 pounds. I cannot tell you how much of a miracle this is to me! I had pregnancy induced hypertension with both of my now adult children and have struggled with my blood pressure ever since. After watching my mother lose her ability to walk due to a massive hypertensive stroke, I became determined make some positive changes in my lifestyle to improve my health. I have spent at least the last 4 years trying to exercise my way to better health. During that time I used interval running to train for and complete 44 Half Marathons. Not only did I continue to need blood pressure medication, but I also managed to put on about 10 lbs! It was not until I took the focus off exercise and switched to a way of eating that keeps my insulin levels low that I was able to see significant positive changes in my health. The fact that I am no longer requiring blood pressure medication is testimony to the impact that eating real whole foods and limiting processed carbohydrates can have on a person’s health.

Because I am also prediabetic (diabetes runs rampant in my father’s family), during my previous attempts to get healthy I was very careful to avoid desserts. However, I continued to eat a diet dominated by low calorie processed foods (like sugar laden protein bars and baked gluten free chips) and low fat foods in an attempt to keep from gaining weight. Boy did I have it all wrong! In an act of desperation last fall, I tried a popular weight loss plan that featured portion controlled meal replacements and one meal a day of green vegetables and protein. While I lost a few pounds doing this, what I learned was that any diet that reduces your carbohydrate and caloric intake will lead to short term weight loss if you stick to it. However, I also learned that I did not want to be told exactly what to eat for the rest of my life. You see, I really love to eat and I need to be able to eat and enjoy real food! I just needed to find out not only WHAT to eat but WHEN to eat in order to improve my health. I also needed to learn how sleep, stress levels, emotional eating and exercise fit into a healthy lifestyle. As I have made these discoveries, I have shared what I have learned in this blog.

I am so ecstatic to be medication free at the age of 64 that I am highly motivated to continue to do the things that got me here. Long term health is not a quick fix, it is a series of decisions we make every day. After 6 months of learning to make good decisions, I am convinced that with a little guidance, each one of us can take control of his or her own health! Toward that end I have developed the following lifestyle tips that I shared in part in an earlier blog. I consider them the guidelines by which I plan to live the rest of my life. Just as Hippocrates said hundreds of years ago, food truly is medicine!

Dr. Moore’s Lifestyle Tips to Promote Wellness and Avoid Disease

  1. Avoid added sugars, white bread, potatoes, pasta and deep fried foods as well as ALL junk food. There is a reason it is called junk! Ditch sugary drinks and fruit juices and drink more water! You are better off eating an orange with its fiber than drinking the orange juice.
  2. Increase your intake of non-starchy vegetables and green salads. Make berries your preferred fruits. These are less likely to spike insulin levels. Insulin is a fat storage hormone.
  3. Include a small amount of lean protein (fish, shellfish, lean meats, poultry, nuts, and eggs) at each meal.
  4. Incorporate foods containing healthy fats into your meals. Some examples of such foods are salmon, avocados, olive oil, olives, eggs and nuts. Healthy fats are important to satiety and controlling hunger. Consuming healthy fats at mealtimes will help you to stop snacking between meals.
  5. Time restricted eating – stop eating 2-3 hours before bedtime and eat breakfast only when you are physically hungry.  Your first meal of the day is still breakfast (breaking your fast), regardless of how late you choose it eat it. These periods without food result in lower levels of insulin which will help to prevent fat storage. This is a very gentle form of intermittent fasting.
  6. Try to get least 30 minutes of exercise most days, preferably BEFORE eating. This allows your body to rely on your stored fat to fuel your exercise. This can be as simple as taking a brisk walk. Try to vary your workouts to include cardio, strength training and flexibility training.
  7. Eat intuitively rather than recreationally. Eat only when you are physically hungry and stop when you are full. Practice portion control.
  8. Sleep 7-8 hours each night. Proper rest is important to control not only your insulin levels but also your hunger and fullness hormones. Try to reduce the amount of stress in your life by setting boundaries.
  9. Move around more during the day. Do not sit when you can stand. Take the stairs over elevators and escalators. Just because there is a people mover or moving sidewalk available does not mean you have to use it! Get an activity tracker and aim for 10,000 steps a day.
  10. EAT REAL FOOD!! When eating out choose whole unprocessed food and ask that your food be prepared simply and in a healthy way. Better yet, whenever possible, try preparing your own healthy meals at home! This way you will know EXACTLY what you are eating.

Be Blessed,

Yvonne Moore

“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)