The Holiday Stress Mess

Have you noticed that holiday sweet treats seem unusually irresistible?  Why is that?

Over and above the stresses of day to day life, this time of year is full of stress – both good stress and bad stress.  Searching for, and hopefully finding, the ‘perfect gift’ for the ‘impossible-to-buy-for’ loved one on your list.  The added financial stresses of gifts, dinners and perhaps travel expenses.  Stress at work is often on high given end of the year deadlines, too much to do before the holiday week hits and the prep stress for the New Year.   And of course, there is the stress of self-reflection back over the past year.  What changed?  What didn’t change?  The stress of unmet goals, and withered dreams.

And despite a honest commitment to limit sugar and refined flours you crave and cave – Bah, recommit.. Crave and cave… Harrumph,  recommit… Crave and cave…. Ugh!  What is going on?  Why do the holiday sweet treats seem unusually irresistible?

It’s the holiday hormone stress mess.

This intense crave and cave cycle is not your fault.  It’s your hormones – cortisol, insulin and ghrelin.

Cortisol, a key player in our fight or flight response, is a life saver hormone in a pinch – like when you needed to make a mad dash from a predator in days gone by.   Triggered by a surge of cortisol, our body almost immediately floods our bloodstream with glucose.  Your heart races, your breathing gets deeper, your muscles get twitchy and you are ready to run or pounce, whichever seems the most effective course of action.  No doubt about it, cortisol is life-saving in acute fight or flight emergency situations.  You have, at your immediate disposal, the energy you need to run if someone is threatening you with a knife.  Sprinting away, you burn off that energy, escape and survive another day.  It’s a beautiful thing.  Or at least it was.

Unfortunately, our body has only one emergency response system.  And in the 21st century, where chronic stress is the new normal, that acute emergency response system is on chronic overload.  Cortisol is always ‘on.’ We are on high alert, flooding our bloodstream with be-ready-just-in-case-fuel poised to pounce.  Then… nothing happens.  There is no need to pounce. There is nothing to run from.  It’s just your boss, or someone cutting you off in traffic, or you’re late for a meeting or you are navigating the holiday stress mess.  We are left with a bloodstream loaded with glucose, feeling jittery!

Worry not! Insulin to the rescue!  Sensing elevated glucose levels, our body releases insulin, our life saving energy storage hormone and insulin squirrels away the unnecessary be-ready-just-in-case-emergency-energy as body fat.  To make matters worse, yet another hormone, ghrelin our appetite regulation hormone, kicks in demanding we eat immediately because our emergency energy supply has been depleted and must be replenished just-in-case.  And during the holidays – guess what is everywhere?  Sugar and flour laden sweet treats!  KaBOOM.  Bye-bye weight loss commitment.

Whoa – this is crazy… One hormone triggers an energy surge draining our emergency energy supply, another hormone packs it away as body fat (predominantly around the middle) and, yet another hormone makes us feel hungry and crave snacks?  And because it’s the holidays, sugar and flour laden sweet treats are everywhere!  It’s a perfect storm.

How can we avoid this holiday hormone induced stress mess?

  • Notice and be aware. As with anything, awareness is the first step to intervention.  You cannot change something you are not aware of.  Simply recognizing when you are reaching for a sweet treat ‘just-in-case’ can abort the loop.
  • When you catch yourself reaching for sweet treats, take a brisk walk if you can, burn off some of that stress-induced excess energy (run from the predator so-to-speak.)
  • Acknowledge your hunger and reframe it. Tell yourself to chew on body fat for a few hours to meet its energy needs.
  • Decrease holiday-related stresses as much as possible. What can you eliminate?  What can you delegate?  What can you simplify?  Will the world implode if you do not find that perfect gift or if you don’t have 4 different types of homemade pie after turkey dinner with all the fixins’?  How can you rethink the holidays, and simply the family traditions?
  • Plan and choose. The truth is, the holidays are predictable.  Choose which activities are important to you and choose which activities you can skip.  Do you really need to attend festivities with your family, with the in-laws, with the blended-family-in-laws, with the ladies volunteer auxillary, with your office party and your spouses office party?
  • Decrease day to day stress – always a great plan, even without the holidays. Add a brisk walk daily, burn off some of that be-ready-just-in-case-fuel.  Take 10 minutes each day to be grateful.  Take a meditation class.  Learn to be mindful.  Stretch your body.  Learn to breathe deeply and release tension and stress with every exhale.
  • Manage your sleep. Sleep deprivation is rampant these days.  Adults need 7 – 9 hours of sleep daily.  Slow down your evening routine and dim the lights two hours before bedtime.  No screen time for at least 1 hour before sleeptime and please, no TV in the bedroom.

Understand the holiday hormone stress mess brewing below the surface.   Avoid the post-holiday regrets.   Start the New Year encouraged.

HAve a great week friends

To fast or not to fast?

In a world utterly obsessed with food and multiple meals and snacks daily, it sounds insane but I love, love LOVE fasting.  Most people believe they cannot miss a single meal, let alone five or six in a row.  Not only do I love intermittent fasting, I love short extended fasts.

So, yep, it seems I’ve tipped over the looney bin.  And that is okay with me!  I’ve never felt better!

I was first introduced to the idea of fasting, at a time in my life when I had pretty much resigned to my fat fate.  Buried deep in the googles, amongst mountains of nutrition nonsense I stumbled across the writings of Dr Jason Fung.  Here was this medical doctor making the outrageous claim that the Eat Less/Move More weight loss gospel was not only completely wrong, but should be considered malpractice.  Malpractice – whoa!  What? I read his book The Obesity Code in its entirety over the course of two days. I wanted to understand – desperately.

The day I finished that book, I stopped trying to make myself exercise, except for leisurely dog walks, I stopped calorie restricted meals, I stopped snacking limiting myself to 3 meals per day and I limited processed sugar and refined grains.  That day, I started fasting between meals for 4 – 5 hours and I fasted nightly ~12 – 13 hours after dinner to breakfast.

To my utter delight, within 4 months I easily passed through my previous never-obtained weight loss goal, and within 6 months, I was done.  For the first time in forty years, I was done trying to lose weight.  Astounded – I was done dieting!  Can you imagine? Done with dieting, forever.

To be honest, over a year later, I am still astounded, and I still occasionally fall back into my diet mentality thinking, with my if then, rules… my justifications/rationalizations… and my annoying internal arguments.

The hardest thing to unlearn was the fat is evil doctrine.  Fat was vilified in the late 70’s with the introduction of the American Food Guide and it’s deeply flawed recommendations.  Being nice (and perhaps lazy) the Canadian government adopted similar recommendations and the great North American experiment began.  Eat low fat.  We listened.  And we got fat.  And are getting fatter.  The experiment failed spectacularly.

It’s time to try something else.  Cut the sugar. Skip the flour. 3 meals a day.  No snacking. Fast at night.

I love the way I feel physically when my gut is empty, or at least near empty.  My sleep is deeper, longer and more refreshing.  I am happier and more optimistic.  My brain fog is gone, replaced with a mental clarity that is most welcome.  I rarely get sick.  My achy joints are resolved.  And contrary to common expectation, my energy is revved.

So yep – I totally LOVE fasting.

Give it a try – but shh! Don’t tell anyone.  They will think you are crazy.

Have a fantastic week,
Dr Karen

Self Sabotage Defeated

The best laid plans wither in the wake of self-sabotage.

Several decades ago, in my early 20’s I was a recreational runner.  I even entered a couple of 10km fun-runs, one of which I came in last.  Proud to have finished, I still have the race entry number of that dead-last event.  More recently, I set a goal to get back into running.   My personal trainer added it to my strength training program list of goals right next to my weight loss goal.  Though I will admit I gained considerable strength, neither my weight loss goal nor my running goal materialized, despite multiple years of consistent effort.   Sadly, that effort was also consistently steeped in self-sabotage.

Self-sabotage is rampant amongst women and we don’t even seem to notice.  Decades pass and little changes.  Somehow, we convince ourselves that tomorrow is better.  I understand why that is now, but I didn’t for the first 58 years of my life.  So, if you are one of the queens of self-sabotage, take heart – there is an explanation, and there is a solution!

It’s your brain, doing what is was designed to do and it is doing it exceptionally well.  Our brain was hard wired to survive in a hostile environment.  As such, it will always default into survival mode.  And to the brain, survival mode means familiar-good/change-bad.

To understand self-sabotage and what to do about it, let’s look at the inner workings of our brains for a bit.  The three players include the prefrontal cortex (thinky brain – deep in the middle of your brain), the frontal lobes (master sorter brain – the part of your brain that is behind your forehead) and the primitive brain (lizard brain – found near the base of your brain).

Thinky brain, is the creative part of your brain that plans, organizes, focuses attention, contemplates and deliberates, and makes decisions.  Master sorter brain plays a central role in memory and motivation and is a master shuffler of information.  All memories, experiences, and emotional reactions are stored throughout various parts of the brain under the supervision of master sorter brain.  Nothing is tossed – ever. That is why you cannot willfully forget an experience.  Information may be misfiled into the dusty filing cabinets of your brain but it is filed somewhere.  In fact, information is often misfiled during stressful experiences when other parts of the brain are on overload, making details of the experience impossible to recall.  Working remarkably well together, thinky brain and master sorter brain exchange information constantly and devise very practical and reasonable plans.

Self-sabotage as a problem arises because, though thinky brain and master sorter brain are able to plan meticulously, they are unable to execute the plan.  That job falls to lizard brain.  And lizard brain – hardwired for survival, makes in-the-moment choices based on the familiar-good/change-bad default.  Lizard brain believes change is lethal, to be avoided at all cost, and the best laid plans run amuck.

For example, thinky brain and master sorter brain devise a plan to go to the 7am spin class at the local gym three times this week.  You purchased the gym membership, dug out your workout outfit, and it’s neatly packed with runners and a towel, ready for that early morning buff-up.

When the alarm sounds the following morning, lizard brain chymes in…

“Seriously?  What are you thinking woman?!  It’s cold.  Let’s wait until daylight at least.  You haven’t had your cup of java yet and you know you get headaches without it.  Just sink back into the pillow, later is a better time.”

Then lizard brain gets really sly and recruits master sorter brain for evidence.  “Remember that smelly gym?  All the guys grunting, dripping sweat, staring at you?  You really don’t know what you are doing with all the viral covered equipment, anyway.  Isn’t that right sorter brain?”

Master sorter brain, somewhat confused because she helped devise the plan currently being aborted, but doing her job most efficiently, recalls a nasty encounter with some rude jock 5 years ago.

Sabotage complete.  Pillow wins.  Lizard brain kept us safe and secure, avoiding that potentially lethal change.

So, what’s to be done about this?  Seems hopeless.

Fortunately, simply knowing this is going on ‘behind the scenes,’ thinky brain can intervene in-the-moment, retrain lizard brain and form a new habit.  “Nope, it’s okay lizard brain. I am going to do this anyway.  Thanks for the information.”  It’s most effective if thinky brain has made a firm, very clear decision.  I am going to the 7am spin class at my local gym three times this week, rather a general plan to get fit.  Initially lizard brain may put up a fuss and the negotiations can be intense depending on the degree of change desired.  But if thinky brain persists, lizard brain will cede and a new habit will be formed.  Initially, in the moment, you may not ‘want’ to go to spin class – that is lizard brain pouting.  But thinky brain can decide to go anyway, rewriting the brain’s default habit.  Eventually lizard brain accepts the new spin class default as familiar and KaBOOM – self-sabotage resolved.

It is possible.  Honest.

Chat soon,
Dr Karen

Glucose the toxin Part 3 – You can override your brain

In part one of this short series, sugar was vilified for its unrelenting potentially lethal impact on human health.  In part two, refined grains were exposed as equally culpable in this lethal assault against humanity.

We now turn to what can be done about it.  Fortunately, it’s not all doom and gloom.

Sadly, fear is a terrible motivator.  Fear of all of those adverse health outcomes – heart disease, dementia, stroke, obesity, type 2 diabetes – simply does not work to motivate us to effect change.  If it did, all adrenalin addicted, chain smoking, sugar buzzed overweight business executives who survive a heart attack would voluntarily trade in the smokes for a pair of running shoes and a yoga mat, quit their high stress job, move to the quiet countryside, spend their days meditating and their nights in a blissful slumber.

It’s just not going to go over terribly well.

Cut the sugar and skip the flour.  Hmm.  What’s left on the menu?

Thankfully, we live in a global economy and are no longer dependent on our hunter-gatherer skills or the limitations of our local environment.  A huge variety of fruit from all over the world is available year-round.  Same for high quality vegetables.  Ditto for meat and fish.  Lack of choice or availability are not concerns in the 21st century.

We cannot even use a lack of culinary skills as an excuse.  Multiple food delivery services are just an email request away.

However, in the last century or so, we have been conditioned to believe we must eat multiple meals per day and that hunger is dreadful to be avoided at all cost.  Have you ever wondered when (and why) three meals a day became the accepted norm? And when did that norm morph into 6 or more meals or snacks a day?  I suspect three meals a day became the norm with the agricultural revolution, and that norm morphed in the late 1970s with the introduction of the faulty American dietary guidelines and its low fat recommendation.

Secondly, as alluded to in part one of this series, our brain was beautifully designed for survival in a hostile world where food was scarce.  It was specifically designed to seek/crave calorie dense foods and it rewards us (with dopamine, our “Oh nice” neurotransmitter) when we find and eat those calorie dense foods.  Thirdly our body was specifically designed to store excess energy as body fat for future famine, something it does extremely efficiently.  Thank you insulin.  We survived as a species because of these two key hormones – dopamine and insulin.

Fortunately, we no longer live in a hostile world, food is no longer scarce and famine is rare.  But evolution has yet to upgrade our brain or our body to match this hospitable food aplenty world.  The brain continues to crave calorie dense foods and the body continues to store excess energy as body fat.  And this default program in the hospitable food aplenty world of the 21st century, is detrimental to our well-being.

It’s quite a paradox – what historically ensured our survival is now threatening our survival.

So we believe hunger is awful, and dietary fat is bad.  But dietary fat is satiating (filling), and when we avoid it, we feel hungry.  To compensate we eat constantly. Hmm.

Add to that sugar’s calorie dense, addictive qualities, flour’s ability to fuel the fire and our hospitable, food aplenty world.  Hmm.

Add to that our brain’s default program to crave and reward calorie dense foods and the body’s exquisite ability to store excess energy as body fat.  Hmm.

Add to that all the energy saving conveniences of our sedentary lifestyle.  Hmm.

Is it any wonder we struggle?

While we wait for evolution to catch up, we must counter some very powerful brain neurophysiology and body physiology that served us exceptionally well for millenia.  Not only that, we must counter a society that covets the very issues that undermine our health.

Sounds impossible right?

Nope, it’s totally possible, because our brilliant brain has a pre-frontal cortex.  The pre-frontal cortex (PFC) is the part of our brain that directs what psychologists call our executive functions – planning, organization, creativity/imagination, focus/attention and decision making.  And best of all, the PFC can override the brain’s default program.  Unlike any other animal species on the planet, you can choose.  We just have to start to direct our pre-frontal cortex.

  • Your brain may crave calorie dense foods, but you can tell it “no, not today.”
  • You can choose foods that do not flood the bloodstream with glucose (no sugar, no flour, above ground vegetables, naturally occurring fats and go easy on the protein).
  • You can choose to fast (no snacks between meals and fast 12-14h overnight).
  • You can choose eating patterns that rev-up your energy not slow it down (time restricted eating or intermittent fasting).
  • You can choose to eat only when truly hungry (not to console).
  • You can choose to prioritize your own self-care.
  • You can choose to move your body.
  • You can choose to de-stress.
  • You can choose to rest and get sufficient sleep.
  • You can choose your thoughts.
  • You can direct your brain.

In essence, the default program directing the neuro-transmitter dopamine and the hormone insulin, can be re-written under the direct supervision of the pre-frontal cortex and the choices we make.

Manage your dopamine and change your perspective.
Manage your insulin and change your weight.
Manage your thoughts and change your life.

It is utterly and completely possible.
It’s your choice.  And again I repeat, choice is a precious gift.

Buff it up,
Dr Karen

Glucose the toxin – Part 2 – The many guises of glucose

In part one, sugar was vilified for the role it plays in a host of adverse health outcomes.  Sugar is insidiously destructive, slowly killing us with massive amounts of glucose.

But sugar is not the only dietary source of glucose.  Glucose is found in many guises in the foods we eat.  Starchy vegetables – eventually broken down into glucose during digestion.  The sugar found in fruits – fructose is converted to glucose by the liver.  The carbohydrates found in non-starchy vegetables – again glucose.  Excess protein is converted to glucose in the liver (a process called gluconeogenesis).  All of this glucose, regardless of origin, can be used as fuel or stored as body fat.

The difference between glucose from these various sources of glucose and sugar is its ease of digestion.  Sugar a simple carbohydrate (remember it is a disaccharide) is easily digested and rapidly absorbed.  One swing of the axe, and its ready for absorption.  Not so for the sugar in fruits, vegetables or starchy vegetables.  These foods contain complex carbohydrates and are considerably harder to digest.   Hundreds if not thousands of swings of the axe are needed to cleave off a glucose molecule, ready for absorption.

Protein has a completely different route of absorption and is broken down in the stomach into amino acids (the building blocks of protein), absorbed into the bloodstream in the small intestine, transported around in the blood to wherever new proteins need to be made, and then repackaged into protein.  Excess protein building blocks (amino acids) are transported to the liver for conversion to glucose.  Protein to glucose, is a long and drawn out process.

A much slower process, the digestion and absorption of these complex carbohydrate containing foods and protein does not flood the bloodstream with glucose anywhere near the same extent as sugar.  It’s a gentle stream versus a bursting dam.

Another key difference is complex carbohydrates are packed with nutrients – vitamins, minerals and anti-oxidants – that are essential for our health.  Sugar is void of nutrients.

Grains are missing from that list.  Whole grains are complex carbohydrates and are packed with fiber.  But whole grains are really hard to digest and often our digestive system simply cannot digest it.  So we just don’t eat it ‘straight up’ – instead we grind it up.

We grind whole grains into flour, a very fine powder.  And the grinding process removes/destroys fiber and any nutrients it may have contained.  In flour’s defense, manufacturers have added some vitamins back giving flour its enriched or fortified status.  The problem is, refined flour is easily digested and rapidly absorbed.  And as a derivative of grains which are complex carbohydrates, it breaks down into glucose (all glucose, no fructose as found in sugar) which is directly absorbed into our bloodstream.  Which means – you guessed it – flour floods our bloodstream with glucose and spikes a huge insulin surge.  And just as with sugar, insulin goes about the business of removing glucose, pushing it into our cells for all their energy needs and storing the excess as body fat.

Flour and sugar are often combined into delightful sweet treats for a whopping dose of glucose.  As far as the body is concerned, a molecule of glucose is a molecule of glucose regardless of origin.  And as we learned last week, glucose at massive doses is toxic.

Because flour does contain fructose it is not sweet.  But that does not mean it is innocent.  Flour spikes glucose in our bloodstream just as effectively, perhaps even more rapidly than sugar.  As such, flour is equally responsible for the host of adverse health outcomes (obesity, heart disease, high blood pressure, high cholesterol/dyslipidemia, type 2 diabetes, dementia, stroke, and major depressive disorder) blamed on sugar.

An irresistibly tasty killer combination, sugar and flour perpetuate insulin resistance and all the morbidity and mortality that follows.

Cut the sugar, skip the flour and feel better.

Next in the series, Cut the sugar and skip the flour – it is possible.

Buff it up,
Dr Karen

Glucose the toxin Part 1 – Sugar the con artist

Ahh, sugar!  We love, love, love it.  It’s such a powerful additive.  And what a ubiquitous additive it is – sugar is added to most everything processed.

Sugar is a highly concentrated form of carbohydrate derived from sugar cane, and other plants such as beets and corn (think high fructose corn syrup.) Chemically this delightful white crystal is a disaccharide – a simple sugar molecule composed of one part glucose and one part fructose.  Fructose, is so named because it is the sugar predominantly found in fruits, and is the component that makes sugar attractively sweet.  And when concentrated into high fructose corn syrup it packs one powerful sweet punch.  (High fructose corn syrup is the sweetener used in most soft drinks.)

Sugar is easily digested and is broken down into glucose and fructose then rapidly absorbed into our bloodstream. The glucose floods our bloodstream immediately, but fructose is diverted to the liver for processing and conversion into glucose before entering our bloodstream.  The pancreas, detecting glucose in the bloodstream, almost instantaneously releases insulin, our life saving energy management hormone.  Insulin then goes about the business of removing glucose from our bloodstream, pushing it into our cells for their immediate energy needs, storing a small easily accessible emergency energy supply (called glycogen) in our muscles and storing the excess energy as body fat.  This is all well and good.  Insulin is doing its evolutionary job – storing excess energy as body fat for future famine.

A critical point that seems long forgotten, is the fact that our body is specifically designed to burn predominantly fat for fuel, rather than glucose.  That is why we store excess energy as body fat – it’s for future use!  That is a key factor in our physiology that allowed us to survive when food was scarce during our hunter-gatherer days.  Another key evolutionary fact that contributed to our survival, is that our brain was designed to reward us for eating calorie dense foods.  As hunter-gatherers ‘calorie dense’ meant tubers (underground starchy vegetables), fruits when in season and animal meat after a successful hunt.  Wild blueberries, yum.  Potatoes, yum.  Steak, yum.  Not sugar in its 21st century can’t-get-enough-YUM-YUM-YUM concentration!

Our body is not well designed to handle sugar in this highly concentrated form.  It floods our bloodstream with massive amounts of glucose.  (Remember sugar is ultimately converted to glucose.)  The glucose in our bloodstream is tightly regulated and maintained at a concentration that is roughly the equivalent of 1 teaspoon of sugar.  ONE TEASPOON in our entire bloodstream.  Contrast that with 10 teaspoons of sugar in a single 375ml can of cola.  The amount of sugar we consumed as fruit and tubers as hunter-gatherers is miniscule relative to that can of cola.

The dose of sugar consumed daily in the 21st century is massive.  Just how massive? Roughly, 152 pounds per person per year.   That is just under ½ pound per day!  To put this into perspective in the 1700s sugar consumption was about 5 pounds per year, in the 1800s it was 23 pounds per year.  (Of note in the 1700s and 1800s, obesity and type 2 diabetes were extremely rare, versus the 21st century where both are epidemic and accelerating!)

We eat roughly ½ pound of sugar per day.  There are roughly 55 teaspoons in ½ pound of sugar.  We only need 1 teaspoon of sugar circulating in our bloodstream.  We eat 55 times more sugar than we need – daily.  (Kinda gives new meaning to the idea of a sweet tooth huh?!)

And that massive dose of sugar is converted to glucose.  And glucose at such massive doses is toxic to the body and over the long term wreaks havoc with just about every system in the body – the brain, the eyes, the kidneys, the heart and blood vessels, the nerves, and the gut.

So, instead of using our stored body fat for fuel, our body preferentially burns the incoming sugar for its daily energy requirements.  And insulin doing its evolutionary job, continues to store excess energy as body fat, predominantly around the middle.

Furthermore, because our brain is designed to seek/crave calorie dense foods, sugar in its highly concentrated form is not only toxic, it is addictive.  But unlike other addictive substances (nicotine, cocaine, heroine or alcohol), sugar does not have any obvious short term negative consequences – no hallucinations, no heart palpitations, no slurred speech, and no impaired judgement.  (Though, as a pediatrician in days gone by, I can attest to the hyperactivity inducing qualities of sugar and subsequent sugar withdrawal related behaviour challenges.)

In fact, the opposite is true – sugar soothes.  Sugar stimulates the reward center of our brain, predominantly via dopamine, our “oh-nice” neurotransmitter.  Eat a little sugar, “oh-nice” and we feel relieved, at least briefly.

Unfortunately, while sugar stimulates our brain’s reward center, delivering a nice soothing little bit of relief, the more we use it, the less dopamine our brain produces.  To make matters worse, the brain decreases its number of dopamine receptors (a phenomenon called down regulation) rendering the dopamine that is produced less effective.  And then, just like any other addictive substance, we need more and more sugar to elicit the same response.

Sadly, we have become a society of sugar addicts.

Though the short term consequences of sugar may be minimal, the long term consequences are staggering.  Sugar is insidiously destructive and takes decades to kill.  And if it does not kill us, it certainly causes considerable pain and suffering!  Over consumption of sugar is a known significant risk factor in a multitude of adverse health outcomes – obesity, heart disease, high blood pressure, high cholesterol/dyslipidemia, type 2 diabetes, dementia, stroke, and depression.

Collectively obesity, heart disease, high blood pressure, stroke and type 2 diabetes fall under the umbrella term of Metabolic Syndrome and Metabolic Syndrome accounts for the majority of chronic diseases afflicting western civilization.  And the central tenent of Metabolic Syndrome is insulin resistance.  Which means our cells no longer respond to insulin and as a result, glucose accumulates in our blood to toxic levels and we get sicker and sicker.  In an effort to compensate, but with limited options, our body makes more insulin and we store more energy as body fat, and we get fatter and fatter.   Unfortunately, we also increase our insulin resistance.  It’s a self-perpetuating downward spiral.

Sicker and sicker, fatter and fatter, and addicted.  Thanks sugar.

Except for concentrated calories, sugar is utterly void of nutritive value.  Sugar is sweet but not so innocent.

At the heart of many pathological processes that drive what ails us in the 21st century, over consumption of sugar has been implicated in inflammation (think joint pain), gut dysfunction (think bloating, pain), impaired cognition (think brain fog, dementia), volatile mood (think depression, stress, anxiety), and accelerated aging to name just a few.

So, weight loss aside, if you want to decrease joint pain, think clearer, feel less depressed or stressed or just want to feel better overall – cut the sugar.

Sugar – it’s quite the con artist.  And we are all victims of the con.  Cut the sugar – admittedly no easy feat, but there is so much to gain (or in the case of weight, so much to lose.)

In the next part of this short series – it’s not only sugar that is intoxicating.

Buff it up!
Dr Karen

Friends and friendship – the best medicine!

I don’t think anyone would argue that friends and friendship aren’t important.  They feed our soul and fill our heart.

Merriam Webster’s dictionary defines friendship, as “the state of being friends” and defines a friend as “a person who has a strong liking for and trust in another.”

Philosophers have been debating the meaning of and need for friends and friendship for centuries.  Aristotle, circa 350 BC, mused that friendship is a necessity for happiness.  More recently friendship has been described as a voluntary social relationship.

I disagree with the idea that friendship is voluntary.  Whom you choose as a friend may be voluntary (unlike your family) but having friends is essential to our health and well-being.  We survived as a species by belonging to a tribe.  We were able to rise to the top of the food chain in a hostile eat-or-be-eaten environment because we learned to cooperate.  The need to belong, that crucial relationship that extends beyond the family unit, was selected for over the millenia.  It’s in our DNA.

And that need to belong is powerful.  Our choice of friends influences everything and is of paramount importance developmentally.  As a child our family is the center of our world. But as we progress through the teenage years, our peers replace our family on the priority list.  Friends are everything to a teenager.  It’s why we did stupid stuff to fit in as a teenagers.  And if we were somehow ostracized, we were scarred for life.

As adults our friends have a tremendous impact on our lives and our habits.  If we exercise, if we smoke, if we are a non-drinker, social drinker or over drinker, if we over eat or under eat, even what we eat is influenced by our social circles.  Our friends influence our dreams and aspirations.  We become who we are, largely because of our friends and friendships.

Furthermore, friendship has been identified as one of the most important predictors of longevity.  Social isolation is known to be detrimental to our health.  It’s worse than smoking!  Seniors with longstanding friendships live longer, laugh more frequently and have a higher quality of life with than those living in isolation.

Think about it.  It is so much easier to keep a commitment with a friend than to ourselves.  Why is that?  The power of friendship.  I can attest to this power.  Myself and a friend committed to meet weekly to hike along the Bruce Trail, an 894 km footpath in Ontario that stretches from Queenston along the Niagara Escarpment up to Tobermory.  We have yet to miss a week. Though both of us admitted, this past week, neither of us would have braved the chilly rain and headed out before dawn on our own.  Both of us would have hit snooze and rolled over enjoying the warmth under the comforter, except for the power of friendship.

Yet, despite the importance of friends and friendship on our well-being, the ability to make friends and maintain friendships is often taken for granted.  And for many adults, trying to strike a balance between the demands of career and family, friends and friendships trickle down the priority list and fade unnoticed.  And sadly, the art of building friendship is withering in the shadow of social media.  We collect friends on social media like we used to collect rocks or trinkets and it’s not healthy.

Right alongside laughter, friends and friendships just might be the best medicine we could ever need!  Building friendships is not a luxury.  Friends are not optional.  Both are essential and need to be tended and nurtured as if our life depended on it.  Because it does.

Have a wonderful week my friends,
Karen

There is hope – LCHF!

Keeping myself up to date (just a little), I recently attended a presentation entitled Food Quality Matters:  Using Therapeutic Nutrition to Improve Health.  It was most encouraging.  The speaker’s opening comment sums it up beautifully.

“There is hope!  We are entering the era of diabetes reversal.”

Oh yes there is hope not only for individuals with type 2 diabetes, but the obese and the overweight, the stressed and the sleepless, the depressed and the anxious and I like to believe, hope for the prevention of dementia.  Eating a low carb diet works.  I have proven it for myself (my weight loss journey is documented elsewhere.)  And the medical community, slow as it tends to be, is starting to change its longstanding but incorrect, low fat diet recommendations.

The speaker started with the utter lack of evidence to support the low fat dietary recommendations currently accepted as irrefutable dogma.  Yes – the LACK of evidence.  There was minimal evidence available to support the sweeping low fat diet recommendations adopted for the US Food Pyramid, and the evidence that was available was deeply flawed.

Unfortunately, instead of conducting its own review of the available evidence and reaching its own conclusions, the Canadian Government aligned the Canadian Food Guide recommendations with those of the US.  So, most residents of North America excluding Mexico and the far North, were, unbeknownst to themselves, participants in a huge food based experiment supposing that high fat diets are a major factor contributing to death from heart disease.

Some 50 years later, the experiment has some astounding results.  Results, that despite being replicated many times, are largely ignored.  Low fat diets are slowly killing us.  Obedient citizens that we are, we ate low fat.  And we got hungry, moody, irritable and fat.

Since the low fat dietary recommendation was introduced in the late 1970s, rates of obesity, type 2 diabetes and other metabolic disorders have reached epidemic proportions.  Following along in parallel, rapidly rising rates of Alzheimer’s dementia are equally alarming.  “No, no, no” we are told, “it’s not low fat.  Rates are rising because we are living longer.”  Perhaps, but if living longer were the predominant cause of Alzheimer’s dementia those populations world-wide that tout the most centenarians per capita would also have the highest number of Alzheimer’s dementia.

Hmmm.

As a society we are a stubborn lot and the message ‘dietary fat bad’ has been heard loud and clear.  The result?  Paradoxically an unwell, fat fearing, fat society.

Secondly the speaker outlined mounting evidence that supports a low carbohydrate diet as an intervention for disorders known to be secondary to insulin resistance – most notably type two diabetes.

“We are entering the era of type 2 diabetes reversal.”  Astounding statement.  We are trained in medicine that type 2 diabetes is an irreversible, progressive and fatal disease.  Irreversible and progressive.  And now to claim type 2 diabetes is reversible by altering what we eat?  Absurd right?

Nope. Not at all.

It is possible.  It’s just not easy.  And your doctor keeps telling to eat your carbs and take your insulin enhancing medications.  With careful and close monitoring of your blood sugars, you can delay the inevitable… diabetic nephropathy (loss of kidney function requiring dialysis three times per week), diabetic retinopathy (loss of eyesight), peripheral neuropathy (loss of sensation in your feet), foot ulcers from poor circulation and perhaps ultimately an amputation.

“There is hope.”  You could try eating a low carb, high fat, real food (unprocessed) diet and stop the progression of this debilitating fatal disease in its tracks.

I for one, reversed my pre-diabetes, hypertension (high blood pressure) and obesity by eating mostly low carb despite my inconsistency.  And true or not, I am willing to believe choosing a low carb, real food diet, will at best prevent, or at the very least, slow the early onset non-Alzheimer’s dementia that affects the elderly women in my family.

To believe otherwise is pointless.

There is hope.  We can end this fattening, low fat diet experiment, that is making us miserable, and slowly killing us.  Eat two – three low carb, high fat, minimally processed meals, 4 – 5 hours apart with no snacking.  It is possible.  Change your health.

It’s your choice.  And, as I have written before – choice, is a beautiful thing.

Buff it up my friends,
Dr Karen

Burnout

Burnout.  It’s in vogue these days.  It seems to be turning into society’s new normal.  We are all busy keeping ourselves busy.  This busyness of society is not new,  Socrates commented on it centuries ago.

“Beware the barreness of a busy life.”

If you have been reading my musings, you know that I retired from my pediatric practice just over 2 years ago.  After closing my practice, it took me about 5 months to recognize I had been utterly burned out.  After reaching this blatantly obvious conclusion, I casually mentioned to a close friend, “I think I was burned out.”  Her response?  “Ya think?” It was one of several post-retirement “Dah-Doctor moments.”

Such is the nature of change I suppose.

Change, by definition, thrusts you into the discomfort zone of life – that uncomfortable place where you feel the edges of life a little too sharply.  The discomfort zone is also that beautiful zone where we rise to challenges, build courage, take risks and experience personal growth.

Sometimes change can land you deep in the panic zone – ‘the-OMG-what-have-I-done?-zone’ – also a place I’ve visited since my decision to retire.  We can all inadvertently end up in the panic zone – it’s just life sending us a wake-up/pay attention call.

I’ve also occasioned the bottom end of the spectrum – ‘the complacency zone’, which I refer to as the ‘Meh!-whatever-zone’ which, in my view, should be avoided whenever possible.

Two years after my Dah-Doctor revelation, I can honestly say I am recovered – no more burnout.  Being busy keeping myself busy, is no longer part of my vocabulary.  I have slowed my life down and I spend most of my time hanging out in ‘the comfort zone’ – that zone where you can relax and recharge after some inadvertent visits to the ‘panic’ or ‘meh-whatever’ zones.  I also venture into the discomfort/learning zone often, effectively expanding my comfort zone.

To prevent burnout, we need to spend most of our time in our comfort zone while venturing into our discomfort/learning zone often while being careful not to overshoot into the panic zone triggering a retreat into the complacency zone.   In essence, recharge yourself (comfort zone), challenge yourself (discomfort zone) and avoid too much stress (panic zone) or not enough stress (complacency zone).

Comfort zone – relax and recharge.
Discomfort zone – challenges, learn and grow.
Panic zone – what have I done?
Complacent zone – Meh, whatever.

What’s your comfort zone, and how often do you venture into your discomfort zone?  And have you built guardrails around the panic and complacency zones?

They should teach this stuff in high school!  What a better place the world could be!

Buff it up, my friends,
Dr Karen

Lessons from a carb-craving-munch-fest

Overall, I am happier than I have been in many decades, I have considerably more energy and I sleep much better.  All of which I credit to the changes I have made in my way of eating –  low carb (minimal sugar, minimal flour) with intermittent fasting and an occasional extended fast.

This new way of eating is fantastic.  I love the way I feel with this approach to eating and it offers tremendous flexibility.  Because, sometimes life needs a little flexibility.  Right?  I simply refuse to be rigid in my diet.  Life is short, and unlike last 40 years, I am not going to spend the next 40 years trying to lose weight.  I am done with that nonsense, forever.  Lose your excess weight, then be done.  Stop perpetually dieting!

For me, runnin’ on empty with a brain fueled by ketones feels fantastic.  As I eluded to in an earlier blog, the brunt of our daily energy expenditure is accounted for by the digestion and absorption of food.  When you fast for 24 – 36 hours, all that energy can be redirected elsewhere.  And contrary to common belief, you won’t die if you miss a meal or two!

When I completed my first extended fast of 5 days, after the first two days, I rarely felt hungry.  Even those first two days were not terribly miserable.  Hunger comes and goes and is never an emergency.  Master faster Jimmy Moore, co-author with Dr Jason Fung of The Complete Guide to Intermittent Fasting, routinely fasts 7 – 10 days.  He is of the opinion that if you are going to fast for 48h, you might as well extend it to 5 – 7 days, because the hard part is already over.  That has also been my experience.

I am not recommending you jump in with both feet and start a 7 day fast.  Please do not do that to yourself.  Fasting is like running, if you start with a marathon, you are unlikely to finish and if you do, you will likely be miserable for much of it, vowing never again!  You must be smart about it and build up to it.  Get yourself off sugar and processed foods stuffs and train your body to burn body fat for fuel.  Then all the amazing benefits of short extended fasts are yours!

To date, my longest fast has been 5 days (though I confess I take coffee with cream every morning, fasting or not – ‘cuz life is short.)  And at the end, I felt great – full of energy, with crystal clear mental clarity!  VROOM! VROOM!  Truly remarkable.

This past month, I was canoeing/portaging with some lifelong friends, and with that week long adventure, I was completely off my new way of eating.  And truthfully – I was and remain totally fine with my choices.  We had a fabulous trip – rain included!  Sugary snacks readily available (chocolate, every flavor jelly beans, and peanut butter, banana and chocolate gorp), early morning oatmeal and highly processed dehydrated (but amazingly tasty) evening meals, my carb-craves have returned big time!

It’s the first time in over a year that I overloaded on carbs daily for a week.  Since then, I have been fielding cravings for Baskin and Robin’s Jamoca Almond Fudge ice cream, Almond Crunch Cookies (one of my food nemesis’) and the salty crunch of Miss Vickies potato chips.  And I will confess I caved on more than one occasion!

Along with this carb-crave-munch-fest, I lost my crystal clear mental clarity and my inner critic has returned.  The mental clarity of low carb with intermittent fasting was incredible, but the silencing of my inner critic was astounding.

As I return to my new way of eating, I watch my brain fog slowly lift and listen to my inner critic as she recedes into silence again with curiosity.  Hmm, what can I learn from this?  This is such great information to know.  I already knew I was ‘sensitive’ to carbs.  A ‘cheat’ of some homemade banana blueberry muffins with homemade strawberry jam would add 2 – 3 lbs water weight for a day or two.

Now I have evidence that mental clarity and a silent inner critic are tied to my new way of eating.  Whoop!  Whoop! My cotton candy brain recedes.  I want that always.  AL-WAYS!

Who wouldn’t?  Many women who follow a low carb diet combined with intermittent fasting report an increase in their mental clarity but few mention a silent inner critic… I doubt I am a special unicorn in that regard, but if I am, I will take it thank you very much!

What about you?  Are you a special unicorn too?

Buff on my friends!
Dr. Karen

If you want to swap out some mental clarity for the brain fog, I can help.  Let’s chat.