Strength and Health

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Mark and Mark Rippetoe

I’ve never been a “gym rat” and, like most people, until a few years ago I had no clear idea of exactly of what I was trying to achieve in the gym or how to most effectively go about it. That all changed about four years ago when I read the book Starting Strength by Mark Rippetoe.

Just a couple of weeks ago I attended a three day advanced workshop with “Rip” at his gym in Wichita Falls, Texas, and learned some of the finer points of coaching the the four essential movements — the squat, deadlift, overhead press, and bench press. They were very intense 12 hour days but very much worth it, and I was able to get extra instruction on how to coach older, debilitated people who are currently being helped by Mark and his staff.

Rippetoe argues that strength is the most important thing in life, and although on a philosophical level I would disagree about that (I would argue that cognitive integrity is probably more important), he makes a very valid point. We also differ a little about how important it is to be lean and how that affects metabolic strength/resiliency.

I see patients coming in to my clinic every day suffering from pretty severe frailty, meaning they have issues with balance, strength, or both, and many are so weak that they are using a cane or pushing a walker. Bone loss leading to osteoporosis and fractures is also rampant among the late middle age/elderly population. If you are elderly and break a hip, your chances of death within the following year approaches 20%.

It doesn’t have to be this way. Proper care of your body including the maintenance of good muscle mass and bone mass is achievable with proper resistance training (with free weight lifting being the best form of this), along with a proper diet, and maintenance of a favorable hormone status. This can keep you strong, balanced, and appropriately lean as you age, and markedly reduce your risk of fractures. This is what I call movement health, for lack of a better term, because your ability to move through your environment is critical to maintaining your happiness and your independence as you age. It is virtually never too late to start a program of strength training.  

I very strongly encourage, almost to the point of insistence, that my preventive medicine patients commit to a program of weight training for the above reasons, and I train them to do it correctly. It is truly amazing to see the changes that occur and once an individual sees and feels that strength and balance are increasing, he or she becomes a believer.

Posted in Body Mass Index (BMI), Coronado Preventive Medicine, General Preventive Medicine, Mark M. Scheurer, Physical Conditioning | Comments Off on Strength and Health

Full Speed Ahead on Cholesterol — You Can Have Your Lobster Now

Imagine that there was a trusted judge in your town who had been making important decisions for many decades. Let’s say for the sake of argument that he had sent a person to prison many decades ago, but just recently decided to review the case and realized that he had made his decision for conviction without any evidence of guilt. Therefore, he was changing his mind and releasing that person from prison. Gee, sorry….

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Guilt-Free Lobster For Dinner

What would you think about that judge? Would you have faith in his decisions going forward? It’s not a rhetorical question.

The Federal Government has been making dietary recommendations to the American people for many decades, mainly through two agencies: the Department of Health and Human Services and the Department of Agriculture. Every five years, bureaucrats appoint scientists to a panel called the Dietary Guidelines Advisory Committee, which then makes detailed recommendations to those bureaucrats about what constitutes a healthy diet, and then the guidelines are made official by the agencies.

For almost 40 years, the committee has recommended a limit on dietary cholesterol. Currently, the published recommendation is no more than 300 milligrams per day. A single egg or a small lobster contains a little over 200 milligrams, which pretty much blows your allowance, since there’s smaller amounts of cholesterol in many other foods you’ll consume.

Earlier this year, the Dietary Guidelines Advisory Committee decided that there never was any basis for the recommendation to limit cholesterol, so they removed the 300 milligram limit. Now there is no limit. Basically, cholesterol was sent to jail about 40 years ago, and it was just released because the appointed scientists finally decided to wake up to the fact that there was never any evidence to convict it in the first place.

In the words of Robert Eckel, a professor at the University of Colorado and co-chair of the panel, “Looking back at the literature, we just couldn’t see the kind of science that would support (cholesterol) dietary restrictions.” The previously recommended figure of 300 milligrams, Eckel said, is “just one of those things that gets carried forward and carried forward even though the evidence is minimal.”

What does this say about the credibility of every other recommendation they’ve made, are making now, or will make in the future?

Besides lobster, there are high amounts of cholesterol in other tasty foods such as shrimp, red meat, butter, and bacon. What a coincidence, I eat most of those things almost every day!

So go ahead and enjoy your lobster, and take “official” dietary advice with a grain of salt.

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The Truth About Getting A Firm Butt

It’s the Holy Grail — a firm, toned butt. And the amount of misinformation out there with regard to how to get one is pretty amazing! The desire to optimize this area of the body seems to be particularly strong among women. I don’t think there is a man out there who hasn’t at some point been asked the question, “How does my butt look in these jeans?” (and probably stumbled over figuring out the correct answer!!)

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Alessandra Ambrosio

A few years ago, this model (Alessandra Ambrosio) was featured in a program which taught that high repetition dance-type exercises was the way to get a shapely behind. She’s obviously young and very lean, but not because of the dance moves she advocated. Millions of dollars were spent on DVDs teaching these exercises, but I very strongly doubt anyone got anything of value out of them. The reason why is pretty simple….

The shape of your backside is dictated by paired muscles, the gluteus maximus (the largest muscle in the body) and the gluteus medius, along with an overlay of subcutaneous fat. These muscles serve to extend the leg away from the body as well as to move the leg laterally away from the midline. These muscles must be strong and toned (which go together), and even more importantly, the subcutaneous fat reduced, to have a firm, shapely behind.

The only way to really tone and strengthen any muscle is to make it work against resistance, because that is what muscles are designed to do. Muscles move things that resist that movement — the most important “thing” being our own bodies. But even more than that, we want to be able to move objects in our environment around — whether that means pushing something along the ground or picking something up and carrying it somewhere else. Moving heavy things is what gives muscles their strength, bulk and tone. The bottom line is that you can’t get there with a pill, surgery, a specific dance move, or a powered vibrating machine. One must move heavy things.

Moving heavy things is called resistance training.The best form of resistance training uses free weights (preferably barbells) which by definition are not attached to anything. Why free weights? Because moving weights in this way not only strengthens and tones the muscles but also entrains the nervous system’s coordinated innervation of the muscles, as well as one’s sense of balance. You can’t do these things when you’re pushing a weight that will only go in one specific direction because it is hooked up on the rail of a machine. It’s no coincidence that free weight training mirrors the tasks we are confronted with in real life — if you want to pick up an object in real life, it probably won’t be attached to a rail or pulley like you would find on a Nautilus machine.

The best exercise for strengthening and toning the gluteal (butt) muscles — by far — is the squat. It is done with a loaded barbell, preferably across the back of the shoulders (advanced trainees can also place the bar on the chest). The squat also happens to be the centerpiece of any well-rounded weight training program for generalized strength, and unfortunately, it is rarely done correctly. One must learn to squat properly to get the best tone in your butt muscles, period. Very few people know how to teach or perform a proper squat. Form is critical to maximize gains and avoid injury.

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Minimum Depth at Bottom of Squat (Depending on Bar Position)

Then there is the issue of the subcutaneous fat. Some people store more fat around the buttocks than others, but the fact is, you cannot “spot reduce” fat anywhere in the body. It generally comes off in the order it came on, and in most people, that means more or less symmetrically. A lean (low-percentage body fat) body comes from two things — mainly a proper diet, and secondarily an optimal hormone environment. For example, most women don’t realize that to have optimal muscle tone and leanness, they must also have optimal levels of testosterone, which declines with age just as progesterone and the estrogens do. Women  worry about getting too bulky, and this is totally unnecessary. Instead, women should worry about muscle atrophy.

A woman will never bulk up like a male bodybuilder, or even remotely close, unless she takes testosterone or its synthetic derivatives in high amounts. This is what is going on when you see a woman who looks like a man on the cover of a muscle magazine. They don’t tell you that, but it’s true.

An integral part of my preventive practice is teaching patients how to lift weights with barbells for the above reasons. It might sound crazy for a doctor to be taking his patients to the gym to lift weights, but I do it because it is so important. Resistance training maintains muscle mass which leads to good bone mass and the avoidance of frailty in old age. The earlier you start a well-formulated resistance training program, the better off you will be. Having a firm butt is a very nice dividend but it’s just a small part of the overall picture!

Posted in Body Mass Index (BMI), Coronado Preventive Medicine, Diet, Drugs, General Preventive Medicine, Hormone Replacement, M.D., Mark M. Scheurer, Physical Conditioning | Comments Off on The Truth About Getting A Firm Butt

Processed “Food”

A few months ago, after advising a patient to stop eating processed food, he stopped me and asked me to define what processed food is. It’s such a simple question and is one that isn’t asked often enough.

Processed “food” (I use quotations marks to distinguish it from actual food) has to go through a process to make it edible. Hence processed food.junk-food

These processes require factories with complex machines and usually a host of chemicals. This is in distinction to unprocessed “whole” foods such as an orange, a Halibut, or a piece of Broccoli. You don’t have to do anything complicated to these foods to eat them. Thousands of years ago, when there was no Kraft-Nabisco or General Mills corporations with giant factories to produce the “food” we’ve been eating and getting sick on, all we ate was whole foods. Our bodies became adapted to digest these whole foods and live off them in a healthy manner. Our bodies have no idea what to do with a Twinkie — except get sick.

Good examples of processed foods are all the seed oils (Canola, Cottonseed, Safflower, etc.) which then are used to make other processed foods like Doritos and Oreos. We were never meant to digest the seeds from which these oils come.

Over the millennia in which we evolved, plants also evolved in the struggle to survive. One of the ways plants did this was by making seeds as part of a fruit or flower which would not be broken down after being eaten by an animal, but instead would pass through animal’s digestive tract unscathed.  Whichever animal ate the seed would then egest (fancy word for poop) the seed along with some bonus fertilizer some distance away from the plant. That was the deal that evolved — the animal gets food, the plant gets its seeds spread around.

One of the processed seed oils we consume in the MAD (Modern American Diet) is Canola oil. The Canola plant is almost brand-new. It came about through the breeding of the Rape plant. Canola is a made-up name — an acronym for Canadian Oil Low-Acid. Coming up with a new name was an advantage for the seed oil manufacturers since many people probably wouldn’t be inclined to buy “Rape Plant Oil,” but “Canola” sounds pretty benign.

The 5 minute YouTube video above is a fascinating look at how this particular processed “food” is made. I love the upbeat music throughout the video which suggests the scientific advancement of it all!

There are multiple parts to the video which I find particularly interesting — first, the fact that the seeds only produce some oil after they’ve been crushed under hundreds of tons of force between steel rollers. Second, the fact that much of the oil is extracted through washing seed remnants with an organic solvent —  they don’t name the solvent but it is actually hexane (very similar to octane), a hydrocarbon that your car would run really well on if you put it in you gas tank. Third, the fact that the smell of the oil is eliminated by washing it with sodium hydroxide, an extremely caustic chemical which is the main ingredient in Drano. Lastly, another charming feature of this process is seen at about 3:15 where they show the removal of the waxy residues of the oil but reassure us that we can still buy those residues as vegetable shortening. Sign me up!!

Health-wise, canola oil is high in omega-6 fatty acid which we consume way too much of, contains trans fats as a result of the extensive processing, and may contain some of the solvents and other chemicals used in its extraction.

Wouldn’t you rather consume an oil such as avocado, olive, or coconut that doesn’t require any chemical processing at all and which humans have been consuming for millions of years?

As I mentioned in an earlier post, any time one tries to “beat” nature and do an end-run around the natural forces under which we evolved into who we are physiologically, bad stuff happens.

Eating processed foods is a good example of that. We are not adapted to eat processed foods! So I don’t recommend you eat them, and I certainly don’t recommend them for children either.

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Some Nutrition Basics

Many people have had minimal exposure to the basics of nutrition — so I’m going to try to provide some essential information about it here and expand upon other areas in future posts.

Nutrition can broadly be broken up into macro and micro categories. Your body needs calories in pretty large amounts, on average 1500-2000 per day for just the basics of life, which implies a macro or large intake. How you get those calories is classified as macronutrition.

Your body also requires specific micronutrients (much smaller amounts) such as vitamins and minerals which are used mainly to make enzymes run. Enzymes are special proteins which accelerate and direct the production of molecules which are critical for life, or help the body tear molecules down so they can be burned or excreted.

Focusing on macronutrition for the moment, there are only three broad classes of substances which your body can use for energy: carbohydrates, fats, and proteins.

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Glucose, a simple sugar

Carbohydrates are comprised of sugars and starches. Starches are nothing more than polymers (long chains of repeating elements) of sugar and are all broken down to simple sugars in the gut. This is why a couple pieces of bread (whole wheat or otherwise) will give you roughly the same blood sugar spike as a Snickers bar – all that starch in the wheat is broken down to simple sugar and the only real difference between the bread and candy is the amount of fructose involved (which is a very complicated and interesting form of sugar I’ll explore in another post).

Fats are molecules made up of long chains of carbon atoms linked together. If there are no double bonds between the carbon atoms, the fat is called “saturated” (with hydrogen atoms) because there is no way to attach more hydrogen atoms to that particular fat. If a fat is monounsaturated, there is one double bond between two of the chain of carbon atoms, and polyunsaturated fats have more than one double bond. A very important characteristic of the double bonds in unsaturated fats is whether the hydrogen atoms on either side of the double bond are close to each other or further apart – either situation is Trans-cis-fatty-acidpossible. If the hydrogen atoms are close together this is called a cis-configuration and if they are far apart this is called a trans-configuration. If the hydrogen atoms are in the trans-configuration then the fat is a trans-fat. Trans-fats are only found in minute amounts in nature, but are found in large amounts when fats undergo factory chemical processing called hydrogenation in which the fat is bombarded with protons. This factory processing is what is referred to when you see the words “hydrogenated” or “partially hydrogenated” on a food label. Your body doesn’t know what to do with trans-fats – they “gum up” the biochemical machinery your body uses for fat metabolism and cause a marked inflammatory response. It only took the FDA about 50 years to figure this out. Trans-fats are a good example of the recurring theme that when you try to “beat nature” and eat something you’re not adapted to, you will get sick.

Proteins are long chains of amino acids. There are about 20 different amino acids. They are called amino acids because they all have an amine group and an acid group (a carboxylic acid group to be specific) that are used as linkage points to one another. amino acidMost proteins are easily broken down into their component amino acids in the gut, and these amino acids are then either burned for energy or used to create new proteins. Think of this latter process as similar to tearing down a Lego creation and then building a new, different Lego structure out of the individual Lego bricks.

Your body has requirements for protein and fat intake because it does not have the capability of making some amino acids and fats which are essential for life.

Conversely, there is no requirement to consume any carbohydrate whatever! Your body can manufacture all the carbohydrate (sugars and starches) it needs. Isn’t that amazing!! This is important for reasons I will go into in subsequent posts.

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Soccer Snack Autopsy

Anyone who has had kids is familiar with the goody bag that is often distributed to children after soccer games. I’ve decided to do a nutritional analysis on a snack handout that one of my kids was given recently.

These pictures are actual items from a recent bag given out to each child. Let’s look at the apples first — nothing wrong with the apples themselves but the caramel is high fructose corn syrup, the same thing essentially as table sugar, along with hydrog20150321_204859enated (chemically processed) coconut oil. Hydrogenation is a process whereby the oil is bombarded with protons and virtually always results in trans fats which have been proven to cause inflammation and other harmful effects such as atherosclerosis. If a product such as this contains less than 500 mg of trans fat (still a large amount, especially for a child), it can be labeled having none. There are numerous preservatives listed, such as potassium sorbate, which have been shown to alter a healthy gut flora and may have toxic effects on the immune system. Carageenan, a sludge which is industrially concentrated from seaweed, has also been added. It is used to thicken the consistency of processed foods, and also has negative effects on the gut. Annie’s “homegrown” cheddar bunnies with the cute “rabbit of approval”  are basically just wheat starch, sunflower oil, and a little bit of cheese, with virtually no vitamins, minerals, fiber, or other nutritional value whatever. Sunflower oil is extremely high in omega 6 fatty acids which have been shown to strongly promote inflammation in humans and is suspected as a cause of numerous degenerative diseases. Starch is simply a polymer (individual molecules linked together) of glucose, which means that the large amount of starch in this food (18 grams) is really the same as just asking the child to eat about 4 teaspoons of sugar. Wheat starch is broken down to sugar very quickly in the gut, leading to a sugar high and then a crash which usually causes a variety of adverse mental health reactions in children such as anxiety, hyperactivity, brain fog, and irritability. 

Lastly, the Capri Sun fruit punch doesn’t have a label but I looked it up online and it is simply flavored water with high fructose corn syrup added. More sugar.20150321_204937

There was a lollipop in the bag as well, intended as dessert, but I’m not sure what happened to it.

These “snacks” in summary are essentially nothing but starch, sugar, processed seed oil, and chemicals. Taken as a whole, they will do nothing to provide any actual nutrition for a child and in fact will make him or her sick. These snacks are poison. It is really a testament to the physical resiliency of children that they do not suffer more obviously than they do while consuming foods like this.

People wonder why we have an obesity epidemic in America, and why some young children are even having gastric bypass surgery now because their weight is so out of control. These foods are the reason. A child’s health starts with his or her diet which should ideally include no processed foods whatever.

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Self Defense

Last Summer I was walking out of a Starbucks and almost bumped in to a young man who stepped in front of me on the sidewalk. I never touched him but he became very agitated, and it was obvious by his manner that he was impaired in some way. In other words, he appeared to be high on something.

I apologized and tried to go on my way but he seemed intent on a confrontation and physically threatened me. Fortunately, I was able to get away from him before an attack but there was no question that he was far younger and quicker than me, and probably a lot more familiar with fighting.

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Chris Leben

Getting away from a situation like that is far preferable than becoming physically engaged with someone. However, there may be times when escape is not possible. This incident really bothered me for several days after it happened and it took me a little while to figure out why. I came to realize the reason was that I would have had almost no chance to avoid serious injury or even death if this were to happen again and I was forced into a physical altercation. I didn’t grow up fighting. I had no training, no experience, and no tools to defend myself. I was completely unprepared.

I decided to do something about that. After some research, I ended up getting quite a bit of training in UFC-style fighting (a combination of Muay Thai, kickboxing, and Brazilian jiu-jitsu). My instructor was Chris Leben, a fighter who recently retired from the UFC and is now an instructor and coach at Victory MMA in Point Loma. I worked one-on-one with Chris over a three month period. It was a fantastic experience. Chris is not only extremely knowledgeable but also is able to explain techniques and strategies clearly so that a complete novice like myself can understand them. Not to mention he is a very funny and an incredibly nice guy.

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Chris and Mark

Chris was able to simulate all kinds of different attacks and how to counter them, and I was able to learn numerous ways of disabling an attacker, for example by occluding the airway, interrupting the flow of blood to the brain, or by maneuvering an opponent on the ground into positions whereby ligaments in the extremities can be torn with appropriately leveraged force. Needless to say, at the end of each hour’s lesson, I also had gotten a great workout.

To reiterate, there is absolutely no question that getting away from a threatening person before a fight happens is the best option by far. But in cases when that may not be possible, it is best to be prepared. That means having some degree of training and maintaining the physical conditioning that will at least give you a chance. It’s something to think about.

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Lies, Damn Lies, and Statistics

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Mark Twain

“Lies, Damn Lies, and Statistics” is frequently attributed to Mark Twain but no one is completely sure where the phrase comes from. But the basic idea is this: that lying is one thing, telling a bad lie is another thing, but manipulating statistics to lie may be even worse than the first two. I hope to feature many blog posts regarding various medical studies, because these reports from medical journals are considered so important when it comes to guiding public opinion about what we should try to do to be healthy.

However, as I and many other physicians have noted, there’s a big problem — a huge number of these studies are severely flawed for any number of reasons. One of which is that obscure methods of statistical analysis are sometimes used to manipulate the study results such that those results can be steered in virtually any way the authors of the study want them to come out. No one really reads the studies or can understand the complex analysis, so the public (and the vast majority of physicians) takes the authors’/journal editors’ word for it that the study has the meaning they say it has.

So as a glaring example let’s look at one recent study on testosterone supplementation in men which has scared the living daylights out of a lot of people. The study can be found here. This study appeared in JAMA (Journal of the American Medical Association, an “elite” journal). Before we continue, please read the basic abstract. Pretty scary, huh? Makes one not want to take testosterone supplementation!

Now let’s look at the basic study. It’s not a complicated study. The authors looked at about 9,000 male veterans who had both low testosterone levels and had undergone a coronary angiogram over a six year period, and compared the outcomes of these low testosterone men who had been placed on testosterone supplementation vs. those who had not had any supplementation. The outcomes or “end points” were death, heart attack (“MI”), and stroke.

The authors concluded that the “Kaplan-Meier estimated cumulative percentages with events were 19.9% in the no testosterone therapy group vs 25.7% in the testosterone therapy group, with an absolute risk difference of 5.8%.” In other words, the statistical analysis revealed that taking testosterone increased one’s chances of having one of these bad events by a significant amount.

OK, lets look at the actual numbers of the patients in the study (this is in the abstract, I’m not about to make anything up here — go ahead and check my figures if you want).

There were 8,709 men total. 1,223 were on testosterone. 7,486 men were not on testosterone. Of the 1,223 men on testosterone, 67 died (5.5%); 23 had a heart attack (1.9%); and 33 had a stroke (2.7%). Of the 7,486 men who didn’t take testosterone, 681 died (9%); 420 had a heart attack (6.6%); and 486 had a stroke (6.5%). Yes, look at those percentage differences again, there’s no mistake. Testosterone/No testosterone: death 5.5% vs 9%; heart attack 1.9% vs. 6.6%; stroke 2.7% vs. 6.6%.

The men who took testosterone had approximately half the risk of the adverse events as the men who did not, but the authors of the study were able to completely flip these numbers to reach the opposite conclusions based on their absurdly complex “statistical analysis.”

It is very hard for a layperson to understand what is real and what isn’t in medicine. The unfortunate truth is that there are many hidden agendas out there and it is often difficult to see the truth without a lot of training and experience, and that is really, really unfortunate.

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Paleo Before Paleo

Diets come and go. Just in the last few years, it seems as though a new diet comes out every week. There is a diet which recommends, of all things, to eat a certain way based upon one’s blood type. What happened in the two million or so years before blood types were even known? People were condemned to eat poorly because they didn’t know enough to match their blood type to the proper foods?

It’s no wonder people are confused, because nutritional science has been so flawed for so long. Navigating the subject requires a good knowledge of physiology and the willingness to ask first whether a given theory is both biologically plausible and second, whether it is supported by evidence of efficacy.

Although I do not advocate a strict Paleo diet (mainly because I have not seen good evidence that dairy and legumes are harmful in moderation in most people), I find the Paleo approach attractive based on both biological plausibility and efficacy. The basic idea is that our genes, which determine the means by which we are adapted to our environment, have not evolved to consume the modern American diet which is very high in sugars, starches, and processed foods. Since we know that genes change very slowly, and we also know that up until about 10,000 years ago (or about 0.4% of the time humans have been on the planet) we ate a diet with almost no sugar or starch, this makes a lot of sense. We should eat the foods we are adapted to eat.

It might seem as though the paleo/restricted carbohydrate approach is just another fad, however the notion of eating this way as a treatment for obesity has been around longer than any other dietary approach. And it just so happens to work, quite well.

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William Banting

William Banting was a 5’5” 200+ pound wealthy undertaker in London in the mid-1800s. He wrote one of the earliest diet books ever, “A Letter on Corpulence,” a very short pamphlet you can read in about 15 minutes, which can be found here. Banting was miserable with his weight and desperate to slim down. He sought all manner of help for his obesity from conventional medical doctors and basically was told, as Michelle Obama advises, to “eat less and move more,” but he kept gaining weight year after year. 

Ultimately, by chance he consulted with an ENT physician, Dr. William Harvey, for hearing loss. Dr. Harvey not only practiced ENT but also had a strong interest outside of his specialty in physiology and general medicine, and to Banting’s surprise, Harvey took an interest in Banting’s obesity. He prescribed Banting a Paleo-type diet very low in sugars and starches, but with generous portions of meat at every meal. This resulted in Banting’s loss of 50 pounds over several months.

Banting was so pleased by the results, which he deemed “miraculous,” that he printed and distributed his pamphlet all over Europe and ultimately founded a hospital for alternative medical approaches. He lived into his 80s without ever gaining the weight back that he lost with the help of Dr. Harvey.

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Going Down With Crestor

Every time I see this commercial I actually feel nauseated. This ad is almost perfectly emblematic of what is wrong with medical care in America.

An overweight doctor gives a very overweight woman a pill, causing her to rejoice because she is under the impression that this is her path to better health. To be perfectly clear, I do not blame people for being overweight. Putting on excess pounds is almost inevitable if one follows standard dietary guidelines.

There is a lot of controversy about the magnitude of benefit for cholesterol-lowering medications such as Crestor, which is part of a family called of drugs called statins. When I was an ER doctor in the late 90s, I remember seeing many, many patients coming into the ER on statins with “normal” cholesterol levels having heart attacks. When Tim Russert died a few years ago, I found it interesting that he too had been on a statin and had a low cholesterol level (his LDL when he died was in the mid 70s), because it mirrored my experiences. About half of all heart attack victims have “normal/desirable” cholesterol levels. Elevated LDL or “bad cholesterol” is a very weak correlational risk factor for heart disease.

After doing extensive reading on this subject, my conclusion and that of many other independent physicians is that virtually all studies which have been done with statins, such as Crestor, show that lowering “bad” cholesterol in women and the vast majority of men does nothing to extend their lifespan. Further, statin medications are associated with a whole host of potentially serious side effects such as muscle damage, nerve damage, liver damage, increased incidence of diabetes, and damage to the brain manifesting as memory loss, depression, anxiety, or other problems.

Statins work by essentially poisoning the body’s pathway by which cholesterol is manufactured. This is called the mevalonate pathway and is featured in the sidebar for you science geeks.

724px-Mevalonate_pathway.svgThat’s right, your body manufactures cholesterol! Why would it do that? The answer is that cholesterol is essential for life. Yes, you cannot live without cholesterol. For example, cholesterol is the starting point for numerous hormones in the body such as estrogen and testosterone, is a critical component of cell membranes, and is secreted by the liver as a component of bile which allows you to digest food. Cholesterol is particularly important for brain function; 25% of all the cholesterol in your body is found in the brain.

What would happen if you could get your “bad” cholesterol (LDL) down to zero? Well, you’d be dead. Leaving aside the fact that LDL is not cholesterol – it is a complex particle in the blood comprised of proteins and various lipids including cholesterol – LDL is part of the means by which the liver is able to export fat to fat cells.

One of the other products in the mevalonate pathway is a substance called CoQ10, also known as Ubiquinone. This molecule is essential for the proper function of all cells by allowing them to generate energy in the cells’ internal powerplants, called mitochondria. Good evidence suggests that a major mechanism by which statins’ side effects are mediated is via deficiency in CoQ10, and the consequent disruption of energy production in virtually every cell in the body. For this reason, I recommend that supplemental CoQ10 be taken by every person who chooses to take a statin medication. Interestingly, Merck filed for a patent on a combined statin/CoQ10 medication in the 90s but never marketed this drug combo, possibly because it would have represented a recognition of this statin side effect and created a liability issue for them.

Recent drug company-sponsored research suggests that half of all adults over the age of 40 should be on statins, which coincidentally would mean billions of dollars in additional profits for drug companies. Does it make sense that our body’s basic physiology is so defective that this could possibly be true? I don’t think so.

All living things, including human beings, have evolved over millions of years to function beautifully given the right environmental inputs, including good food, avoidance of toxins, adequate sleep, and exercise. Some people are born with genetic tendencies for diseases which can be mitigated with medications, however these are rare situations.

In virtually all people, health cannot be found by taking drugs. Instead, it is the result of healthy lifestyle choices – nothing more and nothing less.

Posted in Coronado Preventive Medicine, Diet, Drugs, General Preventive Medicine, Mark M. Scheurer | Comments Off on Going Down With Crestor