Major Step in the Obesity Epidemic

The American Medical Association announced today that it will begin recognizing  obesity as a disease. A chronic disease has been defined by the National Institutes of Health as “the basis of the biomedical disease classification” including other diseases such as diabetes, asthma and depression. Until now, obesity has been viewed as a chronic illness, the “personal experience of living with the affliction that often accompanies chronic disease.” Because of this, obesity was not recognized by the health care field as a condition that “fit into a biomedical or administrative classification.”

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Obesity by the Numbers

America, by a huge margin, leads the world in obesity with 92,000,000 Americans with a BMI greater than 30%. Read that again, NINETY-TWO MILLION Americans are currently obese. 66% of Americans over the age of 20 are overweight and 33% are obese according to United States Obesity Statistics as of May 2013.

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What Does the New Designation Mean?

Although the AMA is not the end-all-be-all regarding disease recognition legally,  their statement, “RESOLVED, That our American Medical Association recognize obesity as a disease state with multiple pathophysiological aspects requiring a range of interventions to advance obesity treatment and prevention,”  is huge as it will pave the way for further studies and legislation that may result in more weight management, nutrition, health and wellness treatments being recognized and covered by health care insurance and other programs.

 

There is still much work to be done such as standardizing means of identifying and defining what it means exactly to be obese as the classic BMI system contains some arbitrary classifications that don’t take into other factors such as metabolic conditions etc. I’ll definitely be following this one closely.

– Michael

 

Avocado, Citrus and Fennel Salad

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This is a great little salad I like to whip up when it starts warming up outside. The avocados are a no brainer as I always have them on hand and they go in just about everything I eat. A great vegetarian source of protein, avocados contain all 18 essential amino acids to form a complete protein. They are also a great source of high density lipoproteins (the good cholesterol) and have incredible anti-inflammatory properties. Combine the peppery spice of the arugula with the sweetness of the citrus and the fennel’s aroma and it’s a win.

For those who know me, my favorite things to make are soups and sauces, and that includes dressings. There really is no reason for anyone to visit the salad dressing aisle in the grocery store other than to get some ideas of a dressing to make at home themselves in a batch to use and also store for later.

One of the first ingredients to look at in our diets whether it be for weight management, performance or just simply to be healthy is where our fat comes from. Rather than get into too much science here, for now let’s just stick with the refined oils used in salad dressings. When oils are processed, their chemical structures are manipulated by manufacturers in order to increase shelf life, maximize smoke points for high-temp cooking and any number of other reasons. These alterations also increase the likelihood of oxidation of the oil and making them molecularity unstable and potentially becoming carcinogenic free radicals within the body. The list below are oils to avoid and those recommended. Keep in mind that we are only talking about for cold uses. I will spend significant time in another post discussing oils safe for cooking as many listed here like olive oil are very dangerous to cook with for the same oxidation concerns.

Oils to Avoid: Canola, Corn, Vegetable, Soybean, Grapeseed, Sunflower, Safflower, Rice Bran

Oils Recommended: Olive, Sesame, Nut (walnut, pecan, macadamia), Flaxseed, Avocado

Next time you’re at the store, pick up a bottle or two or ten. Read the labels and I challenge you to find many if any at all that do not contain these processed oils. Look especially close at those that advertise being “Made with Olive Oil.” Sure, the are technically made with some olive oil, but there are no guidelines set as to what percentage must be olive oil and what can be the other junk.

The Ginger Citrus Vinaigrette recipe below is a great example of what you can do yourself. The ratio of vinegar to oil is one that can be kept standard for you in other dressings so with that you can get creative and play with other flavors from fruits to berries, nuts and spices. This leaves you in control not only of the flavors you are in the mood for, but also the quality of ingredients you are putting into your body.

Ginger Citrus Vinaigrette
1/2 cup blood orange juice (may substitute orange, lime, yuzu or any citrus juice)
1 teaspoon fresh ginger, grated
1 tablespoon finely chopped shallots
1 teaspoon Dijon mustard
1 teaspoon organic local honey
1 tablespoon sherry vinegar
1 cup olive oil
1/4 teaspoon salt
1/4 teaspoon pepper

Salad
4 cups arugula, rinsed
1 whole avocado, peeled pitted and sliced 1/4″ thick
1 whole fennel bulb with frond, bulb sliced very thin with knife or mandoline, with sprigs reserved for garnish
1/2 small red onion, sliced thin
1 grapefruit, cut into supremes

1. Mix all vinaigrette ingredients except oil, salt and pepper into a bowl and whisk together or blend with a hand mixer.
2. Very slowly drizzle oil while continuing to whisk until an emulsification begins to develop. Oil may be added a little faster at this point. Season to taste with salt and pepper.
3. Lay avocado slices across bottom of plate as a base for arugula.
4. Toss arugula, shaved fennel and red onion lightly with just enough vinaigrette to coat but not soak and wilt the leaves. Place on top of the arugula.
5. Garnish with supremes and fennel sprigs.
Note: for added protein, this salad goes GREAT with smoked salmon, ahi tuna or lump crab meat. Enjoy!!!

‘I Drank the CrossFit Kool-Aid ‘ by Bob Harper

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When I was first introduced to CrossFit, I found it to be the hardest workout that I’d ever done. It wiped the floor with me, and I fell in love with it immediately. The results that I have seen in my strength and physicality have been unparalleled to any other things I have ever done in my more than 20 years in the fitness business. I drank the CrossFit Kool-Aid.

I’ve been doing CrossFit for about 18 months now, and it all started because I was looking to try to bring something new onto my show for just one episode. There was a lot of talk about CrossFit, so I thought I’d give it a go. The rest was history. I walked into a box called Brick CrossFit in West Hollywood, and I got my ass handed to me. It was love at first burpee, and I’ve been hooked ever since, and now I incorporate this workout as my primary way to work out my contestants on The Biggest Loser.I believe in it that much.

Since I started CrossFit, I’ve read and heard about the critics talk about how unsafe it is, and my only response to that is any form of exercise can be unsafe if you don’t have the proper coaching, education and guidance. CrossFit is all about constantly-varied, high-intensity movements. And to do these movements, you have to have a certified coach to take you through this — or any type of physical activity.

I came from an endurance background of fitness that consisted of a lot of running, cycling and lighter resistance training. I created so much wear and tear on my body, not to mention that I was just getting bored with my workouts. I am 47 years old and am stronger than I have ever been with CrossFit. My metabolic conditioning is better, because I’m moving larger loads faster and for a shorter amount of time. There are some days that, with the exception of skill work in a session, my workouts can last only 10 minutes or less, and I love that.

I would tell anyone who is considering CrossFit as a workout option for them to make sure that the affiliate that they go to really has the knowledgeable coaches that are required to guide you through WODs (workout of the day) that consist of metabolic conditioning, gymnastics, Olympic lifting (my personal favorite) and power lifting. The CrossFit program is broad, general and inclusive, and most of all, the movements can be scaled down to any level of athlete. Just watch what I do with it on The Biggest Loser.

Image from Peter Lueders, from the April 2013 Issue of the Box Magazine, which features Bob Harper.

But My Doctor Told Me…

Beyond wanting to help people lead better lives, one of my motivating factors in returning to school to pursue a medical education is credibility. When speaking to a client about food choices with regards to weight-loss, performance and fitness, they trust my recommendations because of my background and education in fitness and they know it will be pleasing to the palate because of my background as a chef. But there a many times that a subject of overall health will arise that brings the concern of “But why do doctors say that…” or, “Why does My Plate recommend…” And regardless of the source of my research, it comes down to my word against the “experts.” I think we are finally seeing steps in the medical community away from the misinformation that has been fueled by the Washington lobby and government subsidies, but its not enough. People need to start hearing from physicians “What you have been told your whole life is wrong.”

This is a great article written by Dr. Dwight Lundell, the past Chief of Staff and Chief of Surgery at Banner Heart Hospital , Mesa , AZ. His private practice, Cardiac Care Center was in Mesa, AZ. Recently Dr. Lundell left surgery to focus on the nutritional treatment of heart disease. He is the founder of Healthy Humans Foundation that promotes human health with a focus on helping large corporations promote wellness.

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We physicians with all our training, knowledge and authority often acquire a rather large ego that tends to make it difficult to admit we are wrong. So, here it is. I freely admit to being wrong.. As a heart surgeon with 25 years experience, having performed over 5,000 open-heart surgeries,today is my day to right the wrong with medical and scientific fact.

I trained for many years with other prominent physicians labelled “opinion makers.” Bombarded with scientific literature, continually attending education seminars, we opinion makers insisted heart disease resulted from the simple fact of elevated blood cholesterol.

The only accepted therapy was prescribing medications to lower cholesterol and a diet that severely restricted fat intake. The latter of course we insisted would lower cholesterol and heart disease. Deviations from these recommendations were considered heresy and could quite possibly result in malpractice.

It Is Not Working!

These recommendations are no longer scientifically or morally defensible. The discovery a few years ago that inflammation in the artery wall is the real cause of heart disease is slowly leading to a paradigm shift in how heart disease and other chronic ailments will be treated.

The long-established dietary recommendations have created epidemics of obesity and diabetes, the consequences of which dwarf any historical plague in terms of mortality, human suffering and dire economic consequences.

Despite the fact that 25% of the population takes expensive statin medications and despite the fact we have reduced the fat content of our diets, more Americans will die this year of heart disease than ever before.

Statistics from the American Heart Association show that 75 million Americans currently suffer from heart disease, 20 million have diabetes and 57 million have pre-diabetes. These disorders are affecting younger and younger people in greater numbers every year.

Simply stated, without inflammation being present in the body, there is no way that cholesterol would accumulate in the wall of the blood vessel and cause heart disease and strokes. Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped.

Inflammation is not complicated — it is quite simply your body’s natural defence to a foreign invader such as a bacteria, toxin or virus. The cycle of inflammation is perfect in how it protects your body from these bacterial and viral invaders. However, if we chronically expose the body to injury by toxins or foods the human body was never designed to process,a condition occurs called chronic inflammation. Chronic inflammation is just as harmful as acute inflammation is beneficial.

What thoughtful person would willfully expose himself repeatedly to foods or other substances that are known to cause injury to the body? Well,smokers perhaps, but at least they made that choice willfully.

The rest of us have simply followed the recommended mainstream dietthat is low in fat and high in polyunsaturated fats and carbohydrates, not knowing we were causing repeated injury to our blood vessels. Thisrepeated injury creates chronic inflammation leading to heart disease, stroke, diabetes and obesity.

Let me repeat that: The injury and inflammation in our blood vessels is caused by the low fat diet recommended for years by mainstream medicine.

What are the biggest culprits of chronic inflammation? Quite simply, they are the overload of simple, highly processed carbohydrates (sugar, flour and all the products made from them) and the excess consumption of omega-6 vegetable oils like soybean, corn and sunflower that are found in many processed foods.

Take a moment to visualize rubbing a stiff brush repeatedly over soft skin until it becomes quite red and nearly bleeding. you kept this up several times a day, every day for five years. If you could tolerate this painful brushing, you would have a bleeding, swollen infected area that became worse with each repeated injury. This is a good way to visualize the inflammatory process that could be going on in your body right now.

Regardless of where the inflammatory process occurs, externally or internally, it is the same. I have peered inside thousands upon thousands of arteries. A diseased artery looks as if someone took a brush and scrubbed repeatedly against its wall. Several times a day, every day, the foods we eat create small injuries compounding into more injuries, causing the body to respond continuously and appropriately with inflammation.

While we savor the tantalizing taste of a sweet roll, our bodies respond alarmingly as if a foreign invader arrived declaring war. Foods loaded with sugars and simple carbohydrates, or processed withomega-6 oils for long shelf life have been the mainstay of the American diet for six decades. These foods have been slowly poisoning everyone.

How does eating a simple sweet roll create a cascade of inflammation to make you sick?

Imagine spilling syrup on your keyboard and you have a visual of what occurs inside the cell. When we consume simple carbohydrates such as sugar, blood sugar rises rapidly. In response, your pancreas secretes insulin whose primary purpose is to drive sugar into each cell where it is stored for energy. If the cell is full and does not need glucose, it is rejected to avoid extra sugar gumming up the works.

When your full cells reject the extra glucose, blood sugar rises producing more insulin and the glucose converts to stored fat.

What does all this have to do with inflammation? Blood sugar is controlled in a very narrow range. Extra sugar molecules attach to a variety of proteins that in turn injure the blood vessel wall. This repeated injury to the blood vessel wall sets off inflammation. When you spike your blood sugar level several times a day, every day, it is exactly like taking sandpaper to the inside of your delicate blood vessels.

While you may not be able to see it, rest assured it is there. I saw it in over 5,000 surgical patients spanning 25 years who all shared one common denominator — inflammation in their arteries.

Let’s get back to the sweet roll. That innocent looking goody not only contains sugars, it is baked in one of many omega-6 oils such as soybean. Chips and fries are soaked in soybean oil; processed foods are manufactured with omega-6 oils for longer shelf life. While omega-6’s are essential -they are part of every cell membrane controlling what goes in and out of the cell — they must be in the correct balance with omega-3’s.

If the balance shifts by consuming excessive omega-6, the cell membrane produces chemicals called cytokines that directly cause inflammation.

Today’s mainstream American diet has produced an extreme imbalance of these two fats. The ratio of imbalance ranges from 15:1 to as high as 30:1 in favor of omega-6. That’s a tremendous amount of cytokines causing inflammation. In today’s food environment, a 3:1 ratio would be optimal and healthy.

To make matters worse, the excess weight you are carrying from eating these foods creates overloaded fat cells that pour out large quantities of pro-inflammatory chemicals that add to the injury caused by having high blood sugar. The process that began with a sweet roll turns into a vicious cycle over time that creates heart disease, high blood pressure, diabetes and finally, Alzheimer’s disease, as the inflammatory process continues unabated.

There is no escaping the fact that the more we consume prepared and processed foods, the more we trip the inflammation switch little by little each day. The human body cannot process, nor was it designed to consume, foods packed with sugars and soaked in omega-6 oils.

There is but one answer to quieting inflammation, and that is returning to foods closer to their natural state. To build muscle, eat more protein. Choose carbohydrates that are very complex such as colorful fruits and vegetables. Cut down on or eliminate inflammation- causing omega-6 fats like corn and soybean oil and the processed foods that are made from them.

One tablespoon of corn oil contains 7,280 mg of omega-6; soybean contains 6,940 mg. Instead, use olive oil or butter from grass-fed beef.

Animal fats contain less than 20% omega-6 and are much less likely to cause inflammation than the supposedly healthy oils labelled polyunsaturated. Forget the “science” that has been drummed into your head for decades. The science that saturated fat alone causes heart disease is non-existent. The science that saturated fat raises blood cholesterol is also very weak. Since we now know that cholesterol is not the cause of heart disease, the concern about saturated fat is even more absurd today.

The cholesterol theory led to the no-fat, low-fat recommendations that in turn created the very foods now causing an epidemic of inflammation. Mainstream medicine made a terrible mistake when it advised people to avoid saturated fat in favor of foods high in omega-6 fats. We now have an epidemic of arterial inflammation leading to heart disease and other silent killers.

What you can do is choose whole foods your grandmother served and not those your mom turned to as grocery store aisles filled with manufactured foods. By eliminating inflammatory foods and adding essential nutrients from fresh unprocessed food, you will reverse years of damage in your arteries and throughout your body from consuming the typical American diet.