Metabolic Health Ask Me Archives


Question:
As I am sure you are aware , there are a lot of very popular diets around at the moment that promote burning fat as a fuel source as apposed to glucose . I understand that of of the aims in your web pages advice control of blood sugar. Especially if glucose tolerance or sugar addictions are an issue. I would very much appreciate your opinion, concerning this type of diet as a “alternative cure” for blood sugar problems and whether or not you recommend it.

Answer:
Burning fat as a fuel source is always better than burning glucose. Most of us through the years have trained our body to burn glucose, and thus the body breakdown with resulting diabetes, lipid abnormalities, just to name a few. Sugar addiction takes 2-3 years to overcome for most, and I encourage sugar balancing to help in this respect. Aside from controlling sugar balance, changing the body’s fuel source from sugar to fat should be the ultimate aim (good fat, mind you) provided that the body of the person is metabolically typed to accept fat as the source. Many people do well on complex carbo as primary source of fuel and will do poorly on fat as well, especially those of Type B blood and relaxed personality (type B personality). This is in contrast to Type O blood type and Type A personality who do well on high good fat (monounsaturated fat such as olive oil for non-high heat use, and coconut oil (saturated fat) for high heat use.


Question:
Exactly what is ‘trans fatty acid’, how do I recognize it in a food ingredient label?

Answer:
Trans fatty acids were invented by humans in the past 40 years by hydrogenating polyunsaturated fat (like corn oil) so that it remains stable in room temperature, resulting in margarine and solid fats which we now know can clog up your arteries and become carcinogenic. Federal law is behind times as far as food labeling is concerned, but you can detect it by looking for the words “hydrogenated fat” in the label.
Read more about it here: A Big Fat Lie


Question:
I have some of the indicators of hyperinsulinemia/Syndrome X such as high triglycerides, low HDL, mild obesity, and high two hour insulin reading on a GTT (the two hour glucose reading was high/normal, 138). HOWEVER, at the same time, my baseline glucose level is quite normal — my last two readings have been 81 and 84, and my uric acid level is normal as well. Also, my blood pressure is consistently below the 140/90 threshold. After reading your very informative article, this just didn’t all seem to compute. Recognizing that you can’t give medical advice over the internet; do you have any general thoughts on these test results?

Answer:
You have pre-syndrome X. The fact that your insulin reading on GTT is high normal is not very ideal. At the same time, your cells are able to remove the blood sugar from the high insulin. While you do not yet have diabetes, you are heading towards that direction if your trigylceride remains high and another few years. You are smart to catch it early and do something. Reduce grain intake and all will take care of itself.


Question:
I have been ill for about a year and a half. I started feeling fatigued, then had chills and fevers lasting about 3-4 hours, forgetfulness, losing hair, joints swelling especially elbows (they became red raw and very sore), I developed a rash under my arms and on my rear and was losing weight. I visited the Doctor 7 times over that period and the only thing she found was slightly raised thyroid levels. In December the doctor suggested I come back in 3 or 4 weeks and hve my enzyme levels checked again, a week later I stopped working and couldn’t get out of bed. Two weeks later I was in the hospital having lost apx 70 pounds most of my hair along with all the other symptoms and was anemic. I was seen by 10 different specialists and none could figure out what was wrong with me. I came home and have been receiving treatment in the form of Prednisone and Synthroid for the thyroid condition, I have improved somewhat and am now on a regieme of reducing the Prednisone. However The only thing the Doctor can tell me is that I have Rhuemtoid Arthritis. Apparently the Doctor thought I might have Lupus however I don’t test positive for Lupus. I am at a loss and am afraid as I certainly don’t feel well and have very low energy and don’t know what the prognosis is for me. I realize this is a very long missive but I would appreciate any information you might have or could give me. (I also have a liver disease called NASH which the gastroenterologist doesn’t know how I got since the triggers are obesity, diabetes. high blood pressure and high colestrol, none of which I have.

Answer:
The picture you have presented is diffuse and hard to put a precise handle on. It appears that a generalized inflammatory response is underway systemically, causing a mass array of symptoms not easily identifiable. Some of syndrome that can cause this include dysfunction of thyroid, auto-immune process, infection (unlikely), and possibly hormonal imbalance. These may all happen together at the same time. No doubt you have already had extensive workup, so you probably know the above. If organ specific test have all been negative, you have to start thinking of metabolic issues, such as toxins etc. Starting a detox program will only benefit and have no harm. There are many things we cannot identify yet in the body, but that does not mean they do not exist. A metabolic workup would include toxic metal, enzyme and vitamin levels. It?s called functional medicine.
If you have been overweight before, the weight itself will have significant undesirable side effect, though normal it is not so acute. Have you checked your fasting insulin level? Make sure you ask your doctor to see that you do not have syndrome X (also called reaven syndrome, insulin resistance, or cardiovascular dysmetabolic syndrome) which have some of the symptoms you specify. If you are on a lot of soy food like tofu, it has been associated with hypothryoidism as well. Lastly check your female hormones and adrenal functions to ensure you do not have adrenal exhaustion.


Question:
I’m a 63 year old male (5’9″, weight 201, BMI 30) whose most recent (5/25/02) lipid profile had the following values:
Triglycerides: 321
Total Cholesterol: 237
HDL: 26
LDL: 147
TC/HDL: 9.1

I also had a fasting glucose value of 117 MG/DL and then a 2-hour glucose tolerance test value of 140 MG/DL. My homocysteine level is very low (I’ve been taking a B Complex with 400 mcg of folic acid for 2 years. I started taking (daily)in early May, 2002: 6,000 mg Vitamin C, 1,000 mg L-Proline, 1,000 mg L-Carnitine, and 3,000 mg L-Lysine, in addition to 400 IU of Vitamin E and 2,000 mg of niacin (as inositol hexanicotinate). I have increased the niacin to 3,000 mg/day, and added 4 fish oil capsules/day for EPA/DHA (640/428 mg) in addition to my month-old regimen of 45-60 minutes of treadmilling 6 days/week. I’m also taking 400 mcg of chromium picolinate and 2 tablespoons each of ground flaxseed and lecithin granules/day. I take 50 mg of Cozaar and 25 mg of atenolol in the AM and 25 mg of Cozaar in the PM to maintain a daily average BP of 120/80 and a pulse rate of 70. I’m considering adding policosanol (10-15 mg/day) to my supplement, dietary (3 fruits & 4 vegetables + 4 oz lean meat/day), and exercise regimen. What do you think?

Answer:
Your current regiment of nutritionals is good and sounds like you are on the Rath protocol, but not good enough.

  1. To reduce triglyceride, you must cut down your grains intake. That includes sugar and potato and rice.
  2. As your triglyceride comes down, your LDL will go up, as LDL is a calculated measurement which you may or may not know.
  3. You HDL is very low, and fish oil may help. The best is exercise which you are doing already
  4. Consider pantethine 900 mg a day. It will reduce cholesterol, increase HDL.
  5. Polycosinol and guccolipid are two more nutrients that can help
  6. Only take low glycemic fruits like apples. Eat lots of green leafy vegetables (50% of your diet). Stay away from melons which are high in sugar
  7. Get your blood homocysteine level, C reactive protein, and Lipoprotein (a) level checked up.

Your picture is consistent with Syndrome X (Reaven Syndrome) of insulin resistant, dyslipidemia, and hypertension. You risk of CHD is very high. Check this out: Syndrome X.
The good news is that you are doing something about it. Keep it up. Always check with your doctor before you do anything. The above information is for general education purposes only. Each person is different; You have medical issues to deal with and not just trying to do well when you are in optimum shape, so to say. In other words, you are “behind the ball”, if I may say. So you are doing some catching up.


Question:
Can you tell me what the daily fat allowance for a man is please? I am trying to reduce my body fat down to 10% for the purpose of developing my abdominals and this is the level I have been informed of that I must get my body fat down to. My understanding of this is that if a man is allowed 95 grams of fat in his diet per day then I am only allowed 10% of this allowance? Is that correct?

Answer:
The general recommended fats in a diet are around 25-30%. You need this for optimal health. There are some diets that recommend only 10% fat. I don’t think this is feasible.
For a man eating around 2000 calories, 25-30% fat = 55-67 gm of fat.
1 oz of meat/chicken/fish/cheese = 5 gm fat
1 tsp butter/marg/oil = 5 gm fat
Exercising at 60-70% your targeted heart rate will also help you to burn more fat. Low-intensity activities such as walking strongly stimulate breaking down of fats. In contrast, the rate of fat oxidation is highest during moderate activity such as easy jogging.


Question:
How many grams of sugar should I consume per day? Or how much is the daily limit for women?

Answer:
Assuming you are talking about simple sugar. The best and ideal advice is not to use sugar at all. Sugar appears also in the form of fructose, honey, corn syrup, glucose, sorbitol, maltose, maltose extract. In your desserts, you are getting more than enough sugar. The sugar in a can of soft drink is 9-12 tsp. The rule of thumb is to take only 1 sweet thing a day whether they are candy, cakes, cookies, pop drinks.


Question:
I am taking low dose asprin (81mg) to reduce platlet stickiness. I have NIDDM with glucose fairly well controlled (July; Sept. – a1c = 6.1).
I understand that asprin inhibits prostacyclin (PGE) production. Prostacyclin is has been proven to reduce ED. The picture as I see it for anti-aging is that increases in the hormones to levels that are closer to those normal for 40 year olds would be reversing the aging process for a man in his 60s. (I’m 66). Therapy objectives: to obtain a more favorable Omega 6/Omega 3 ration, to reverse ED, to gain muscle mass and strength, to reduce cortisol, to increase c AMP.
Question: Are therapies nullifyling each other?
Prescription drugs:
metformin 500 mg. x 1/d, allopurinol 30 mg. x 1/d, Lescol 40 mg. x 1/d; Accuretec 15-12 x 1/d.
Supplements:
Fish Oil capsules 2gm x 2/d, L Arginine 2 gm x 2/d, Vit. E 200 IEU x 2/d, chromium picolinate 2/d, alpha lipoic acid 2/d, multiple vitamin-mineral 1/d, folate 1/d, guar gum, psysillum 3 gr. x 1/d, goat weed, milk thisle, saw palmetto,
Started tribulis terr. 1/22/02.
Exercise: walk about 30 minutes x 5/wk. fairly consistently.
Fiber One cereal for breakfast – 18 gm fiber.

Answer:
You have presented a very knowledgeable and interesting picture. While in theory much of what your goals are is quite noble, I think in your particular case, some other considerations are warranted.

  1. Low dose aspirin generally is too low to cause ED problems and causes the metabolic dysfunction you mentioned.
  2. Your NIDDM is well control which is good. Chromium polynicotinate supplementation has worked for many to get off diabetes meds. You should study that more.
  3. There are numerous ratios to balance, including omega 3 vs. 6, hdl vs ldl, estrogen to testosterone, etc. etc. too many ratios to mention. Don’t concentrate on just one or two. Look at the whole body, and don’t treat based on numbers. Listen to your body and it will tell you how you feel.
  4. What you are taking is good in supplement is good, but not comprehensive enough as it does not really address the immunity axis and the hormonal axis. It is also unclear on the dosage of the supplement you are taking whether it is optimum or not so I cannot comment other than the fish oil which is good.

I think you have to take a step back and look at the whole personal metabolically. At your age, I would concentrate on:

  1. Getting off the medications as soon as possible. That is step one. This can be done through nutritional supplementation in optimum doses and in a much more comprehensive program than what you appear to be taking. Your current program of supplements can be continued.
  2. Balancing your hormones if indicated through DHEA, pregnenolone, androstenedione, growth hormone secretatgogue etc which will “tune up” your body in a optimized package. Since you are NIIDM, all these will have to be on hold until your diabetes is cured.
  3. Tribulus is a stimulant for short term. If it works, that is wonderful. But it does not balance and rejuvenate your body. You may want to consider zinc supplement which increase testosterone level as a more gentle way to go. Though the effect is not so fast.
  4. Your fiber intake is good. Keep it up. Make sure you take some enzymes and probiotics too.
  5. Your aerobics program is good. Make sure you do strength training as well, especially with large muscle groups like chest and back which will increase your growth hormone level.
  6. To reduce cortisol, you want to reduce grains and sugar intake to start, and then reduce stress as well.

Once your body is metabolically balanced, you will be able to feel a lot better, and many of your concerns will resolve by itself, such as ED etc.


Question:
How much sugar can a woman take in per day without becoming unhealthy?

Answer:
That is an excellent question. The amount needed is dependent on the number of calories you need to sustain life. Generally speaking, adult women need only about 1500 calories to maintain good health. The majority of us are taking way more than this. If you fall into the average category, follow my 30/60/90 rule: reduce calorie by 30%, increase in green leafy vegetables intake by 60%, and reduce sugar intake by 90%. Sugar in this case would mean refined sugar such as cookies, icecream, potato chips. Grains such as rice, potato should also be reduced. Follow my anti-aging Food Choice Pyramid and you will be all right.


Question:
My triglyceride level has been measured at 323 mg/dl and 284/mg/dl. I understand that this is something that I can control fairly well through diet. I am a 48 yr, somewhat lactose intolerant male. Can you suggest a diet for me which will help reduce my triglcerides?

Answer:
My low glycemic food plan is perfect for you. Yes, triglyceride is 100% related to grain intake, and you will see rapid drop if you follow the plan in a matter of weeks. Here are two important links for you to study:
Food Choice Pyramid,
Triglyceride


Question:
I would like to lose some weight. I would like to know what kind of medication I should take. I am concerned about certain medications? I would like to know what would happen after I lose the weight and stop taking the medications. I would also like to know if any of this type of medications can cause heart diseases or any type of diseases. I want to be really careful about any medications that I can take. It would be really helpful if you can send me some information.

Answer:
Losing weight is not easy. Medications are available but that has to be conducted under the supervision of a physican due to side effects. Over the counter type diet pills and supplements comes in many different kinds. The ones you should be careful of are those containing Ma-huang and epredrine. Both are stimulants have been linked to cardiac problems, especially for those who are weak or have a sensitive heart. The best way to lose weight is by reducing food intake gradually and exercise. Here is my detoxificaiton weight loss program that works provided that you do it slowly. Do not attempt to loose more than 1/2 to 1 lb a week. The key is to be consistent.
Here is my protocol: Detox Diet