Last weekend I had the good fortune to co-teach a workshop with my partner Debbie Gilman, who is an amazing and seasoned yoga teacher from the Yoga Room Berkeley (Iyengar) tradition. I thought it was going to be straight forward – she teaches the asanas and I teach the anatomy. But we realized the topic was so broad that it became a really difficult task to pull together a comprehensive three hour workshop that we could both agree on! I also wanted to shar what I’ve learned about back care from my 18 years as a chiropractor, in a context that was congruent to a class of (mostly) yoga teachers. Below are some of my handouts for the class. [Read more…]
Why We Get Fat
Patients often ask me what they should eat to be healthy or to lose weight. There is no good answer, and frankly, the more I learn, the more confused I get! I grew up in the 60’s through 80’s and we were told to avoid fat and eat plenty of carbs such as breads and cereals. There have been and continue to be many fads and diets, and time has shown that most either don’t last or simply don’t work. There are two issues with food consumption that I am concerned about here. The first is whether it will help someone to lose weight (ie lessen their fat composition), and the second is whether it is good for one’s overall health.
My trainer recently introduced me to the book “Why We Get Fat (and what to do about it)” by Gary Taubes. Gary is also the author of “Good Calories, Bad Calories” and “The Case Against Sugar.” WWGF is a concise and quick read meant for both the lay person and the busy medical professional. I found it well thought out, indexed and backed up by a plethora of scientific studies.
As I understand it, his premise is as follows: The accepted way of thinking about losing weight since the 1950’s is based on the erroneous concept of calories in / calories out. It states that in order to lose weight and to keep weight off, one simply needs to move more and eat less. It is based loosely on the physics concept of thermodynamics. Gary presents this argument and then dismantles it. Rather, he shows that the scientific literature doesn’t support the conclusions of our generation of food scientists. He shows how near-starvation diets not only make people miserable, but they simply don’t work! The less one eats, the more the body goes into starvation mode, which entails storing away more energy!
Gary uses the metaphor of a car’s gas meter. Picture E (empty) and F(Full) to rather stand for Energy and Fat storage. If the needle points to F, energy is shunted into storage which can’t be easily utilized, and if it points to E, energy gets shunted to the muscles and is burned. He argues that some people excessively exercise not to lose weight but because they have a metabolism that sends energy to their muscles. In other words, they can’t help it – they need to move! And some people have a metabolism with a needle that tends to point to Fat storage, and consequently they don’t exercise much in part because they lack the accessible energy to! This argument is vindication for those poor souls on whom society has unfairly plopped such labels as slothful, lazy and glutenous. I think of this like a bank account vs a retirement fund. You could have a full IRA and an empty checking account, but if you’re only 30 you can’t access your money! It seems the same in the metabolic equation. Even if you are starving, your body may not let go of its fat storage.
Instead of focusing on the energy in / energy out model of dieting, Gary focuses on fat metabolism. The key player is Insulin. By now, most of us have heard of the term “Insulin resistance.” Insulin is the key that unlocks cells’ ability to absorb and utilize glucose. Carbohydrates are long or short chains of glucose. The shorter the chain, the sweeter the taste (simple carbs). I liken simple carbs to airplane fuel. It burns fast and hard, and the body will utilize this first. Our diets are full of the stuff, and when the system is flooded with it, the Pancreas manufactures more and more Insulin. To the point that these “locks” become insensitive to it and need ever-more insulin in order to work. Additionally, Insulin stimulates other hormones which triggers further fat storage, and inhibits yet other hormones, leading to a decrease in the breakdown of Triglycerides and the breakdown of fat in storage.
In short, anything that triggers Insulin leads to this nasty cycle of fat accumulation and poor metabolic health. It seems that our system has two different engine technologies, much like a Hybrid engine. If gas is available, we turn to (gas) combustion, and if it’s not, we turn to (electric) battery power. So what is the correlate in the body? In very basic terms, if carbs aren’t around but fat and protein is, the body will (eventually) flip into Ketosis mode (ie electric in my analogy). This will efficiently burn energy. If carbs abound, it will flip to the ATP-making Krebs-Cycle mode (ie gas combustion). I acknowledge it’s not this simple, but that’s how I make some sense of it.
Gary’s argument is that we should not fear fat and protein consumption, and that the real problem in our modern diets is the excessive amount of simple carbohydrates (in fact, even excessive protein can be a problem, but data is showing us that excessive fat isn’t! How’s that for turning everything we’ve ever learned about diet upside down?!). Our ancestors for millions of years roamed the prairies as hunter-gatherers. Consequently, our genes evolved to work most efficiently with protein and fat (animal kills, and often the fatty left-overs from another animal’s prey), occasional complex carbs (roots and berries) and periodic fasting (time between catches). Our genes are shaped more by the roughly 1.5 million years as hunter-gatherers. Agriculture was only developed around 12,000 years ago, and Industrialization just 200 years ago. This constitutes 99.5% of human history, more than a hundred thousand generations…compared to 600 generations as farmers and 10 generations living in the industrial revolution. And yet we’re told to eat plenty of breads and cereals, vegetables and fruits. Our ancestors when possible consumed 85% of their diet as animal products.
What blows my mind is that carbohydrates are not even required for a healthy human diet! Mild Ketosis is actually a very natural state, not one of starvation as we are taught to think about it (note, we are not talking about ketoacidosis). The brain functions better on Ketones, which are created from fat broken down in the liver. Other energy, released as Triglycerides, are broken down from fat storage as is glucose broken down in the liver from fat storage. Who would have guessed that our ancestors were running on the first (internal) electric drive trains?! Gary states that this mild ketosis is the “normal state of human metabolism when we’re not eating the carbohydrates that didn’t exist on our diets for 99.5% of human history.
At this point, I must defer to the book in question, and to other resources to guide you further. The first conclusions I personally made were to cut out obvious simple carbs such as breads, cereals and sweets, and even limit fruit (Fructose). And eat more meat. Did you now that the body has a built-in system that won’t let you over-eat protein and fats? It’s a molecule called cholecystokinin or CCK. We don’t have that fail-safe system for Carbs. Picture watching a football game while drinking beer and eating chips. Get the idea? This could go on and on!
Below are some resources, in addition to this book, which I sincerely hope you will read.
Christopher Gardner, PhD, is a top Stanford researcher. Here he summarizes his findings in a major research study, supporting this hypothesis: “The Battle of Weight Loss Diets, is anyone winning (at losing)?” https://www.youtube.com/watch?v=eREuZEdMAVo
Facebook Resources:
Blogs:
Low Back Pain – A Nutritionist’s Perspective
This week, I invited our resident nutritionist and acupuncturist Srinika Narayan to give her perspective on the causes of low back pain:
Many people live with chronic low back pain. They have tried manual therapies such as acupuncture, chiropractic, physical therapy, or massage, but nothing has helped for any prolonged amount of time. Sometimes the back pain never even started with a significant injury. Could there be another reason for their pain besides physical misalignment, muscular tension, or strain?
The answer is yes. I have been discovering, through Nutritional Analysis, that many of these cases have underlying causes other than just musculoskeletal. If a person does not respond to acupuncture, or other types of bodywork, I know to look a bit deeper to find the root cause. The possibilities are numerous: from chemical or heavy metal burdens in the body, to active or past infections, or even from unhealed scars elsewhere on the body. Once these challenges are dealt with, the pain goes away. Let’s look at some of these possible culprits.
Prolotherapy Phase 1
I had Prolotherapy done to my left shoulder this past Tuesday, I did this procedure at Hemwell Center for Orthopedic Regenerative Medicine in Alameda. Dr Donna Alderman is an Osteopath with a specialization in this form of intervention (for more information goto www.prolotherapy.com). My particular intervention involved the extraction of both blood and fat from my body (think mini-liposuction…a weird experience indeed!). They take the samples and spin them in order to extract the stem cells. This is what they inject around the damaged tissues. The actual procedure involved my moving my arm while Dr Alderman observed the tissues through a diagnostic ultrasound. She then injected the stem cells very specifically to damaged structures around the Rotator Cuff. This didn’t feel very good, but it was bearable. (By the way, this procedure is done with only minor local anesthesia!). [Read more…]
Decompression, Prolotherapy & Vortex Healing
So much has happened over the past couple weeks concerning my shoulder journey. I had a session with an advanced Vortex Healing energy therapist, Nathan Whiteside, who worked on the subtle energies (divine webbing, energy bodies, etc) of my shoulder. I am familiar with this work, because I actually trained it (not to as accomplished a level as Nathan!) perhaps 10 years back. On a completely different wave length, I was in a professional training this past weekend at UCSF in the Orthopedics & Physical Therapy center, where we learned how to use Myofascial Decompression. Think Chinese Medicine Cupping along areas of fascial restriction. Lots of bruising and painful practicing involved. The results were pretty good though, and my shoulder got some deep work by Dr DaPraddo, the instructor. [Read more…]