by Dr. G. Pepper | Aug 25, 2010 | diet, diet and weight loss, fitness, general health & nutrition, health, hormones, metabolism
Due to the potential for abuse and high cost, growth hormone treatment in adults is the subject of much controversy. I believe that treating adults with growth hormone deficiency is many times an appropriate and beneficial choice. Firming up my conviction for treating adult growth hormone deficiency is a recent study conducted in the Netherlands and UK published in the Journal of Endocrinology and Metabolism (JCEM 95:3664-3674, 2010). The researchers compared Body Mass Index (BMI), waist circumference, triglycerides, and HDL (good cholesterol), between normal adults and those with low growth hormone levels due to deficient pituitary function (hypopituitarism). All measurements of obesity and lipid metabolism were significantly worse in the young adults (younger than 57 years) with growth hormone deficiency compared to normal adults of a similar age.
As I pointed out in previous articles at metabolism.com, growth hormone levels naturally decline as we get older. The authors of the present study note that growth hormone levels decline 14% per decade in adults. I conceive of this as one of the ways nature gets rid of us after we complete our biological/reproductive functions, since without growth hormone our muscles, immune and nervous systems, decline, leading to death. It’s planned obsolescence… what is typically referred to as aging. In the recent study senior citizens have equivalent levels of obesity and abnormal lipid metabolism as young adults with growth hormone deficiency. The authors note the effect on the body of growth hormone deficiency in young adults is equivalent to 40 years of aging. The theory that growth hormone functions to preserve our tissues during youth and aging results from its absence, appears confirmed by these results.
Most normal young adults aren’t growth hormone deficient and the population that would qualify for growth hormone treatment from this group is small. What about older adults with low growth hormone who are troubled by the “natural†decline in their body function? Should or could we treat this much larger population with growth hormone? It is my experience that private and federal insurers will not pay for this treatment regarded as “cosmeticâ€. On the other hand, there will be physicians who will comply with a request for growth hormone treatment from individuals who possess enough cash and motivation. Less affluent or determined individuals will have to contend with natural aging just as our ancestors have done for thousands of years.
This information is for educational purposes only and is not intended as medical advice or treatment.
Gary Pepper, M.D.
Editor-in-Chief, metabolism.com.
by Dr. G. Pepper | Jun 11, 2010 | blood pressure, diabetes, diet, general health & nutrition, health, Uncategorized
The adrenal glands sitting on top of the kidneys make several hormones critical to life. The central part of the adrenal makes the hormone we refer to as adrenalin, technically from the group known as catecholamines. This is the stress responsive hormone causing rapid heart rate, sweating, increased mental alertness, preparing the body for “fight or flight”. The outer portion of the adrenal makes the hormone cortisol, also known as cortisone. Cortisol maintains, among other things, the blood pressure, fluid and salt balance. Without sufficient cortisol production by the adrenals, life cannot be sustained. What is surprising is that excess cortisol can be as harmful to health as insufficient cortisol.
Deficient cortisol production is referred to as adrenal insufficiency (Addison’s disease is one form of this), while excess adrenal function is termed Cushing’s Syndrome. During certain types of stress such as severe infection the adrenal gland can produce up to 10 times the normal amount of cortisol. If cortisol levels remain elevated for prolonged periods of time the hormone’s destructive nature is revealed by the break down of soft tissue such as skin and muscle and weakening of the immune system with frequent and aggressive infections occurring sometimes with fatal outcome. Heart disease has not been associated with high cortisol levels until a recent study suggested this possibility.
Researchers from the U.K. examined morning cortisol levels in 1066 men and women with Type 2 diabetes participating in the Edinburgh Type 2 Diabetes Study. A positive relationship was discovered between cortisol levels and the occurrence of heart disease such as heart attack and angina. The higher the cortisol levels were the greater the risk of heart disease. Cortisol levels in diabetics were found to be higher than in non-diabetics, in general. The researchers could not explain why the cortisol levels caused heart disease or why levels were higher in diabetics. (From the April edition of the Journal of Clinical Endocrinology and Metabolism 95:1602-1608).
‘Adrenal fatigue’ is a recently proposed diagnosis used to explain a variety of general symptoms such as fatigue, moodiness, muscle aches, and diminished mental function. Supposedly, adrenal fatigue results from mild impairment of cortisol production. Practitioners who diagnose “adrenal fatigue” are prescribing synthetic versions of cortisol as treatment. The possibility of heart disease resulting from excess cortisol should be a factor that patients and medical professionals must consider before embarking on adrenal “supplementation” programs.
This information is for educational purposes only and is not intended as medical advice or treatment.
Gary Pepper, M.D.
Editor-in-Chief, Metabolism.com
by Dr. G. Pepper | Feb 21, 2010 | diet, diet and weight loss, fitness, general health & nutrition, health, metabolism, weight gain, weight loss
While many members of metabolism.com struggle with low metabolism, fatigue and weight gain, there are those who struggle with the opposite. Being underweight can be as difficult to cope with as being overweight. Here is advice from one of our members who is an emergency medical technician, on how he has adjusted to this issue.
BeachEMS writes:
I am 28 y/o 5′9″ and I weigh 146 lbs. I have a high metabolism and it bothers me, too. I currently go to the gym at my rescue squad (which is free, thank god!) 3 days a week. I know that I have to eat more protein, carbs and high calorie foods in order to “pack on the lbs†especially since I workout regularly, but it is difficult to really discipline myself to eat them daily and in abundance because I get tired or sick of eating them. Anything worthwhile isn’t easy so its discipline, discipline, and more discipline.. and its pasta, pasta, and more pasta lol
I used to be really stressed out through highschool and college, too.. because of being in school, being underweight, having mild acne, not sleeping much at night, etc. Finally, I am in a good place in my life. I am with EMS, got a good job as an EMT, I go to the gym frequently, manage my stress levels with quiet/down time to myself and have cleared my acne.. I am slo getting plenty of sleep at night, which is a huge factor for those of you who work out in the gym.. because you know your muscles need time to repair and rebuild (plenty of water helps, too.. ) STRESS can cause weight loss so it might be a good idea for those of you with high stress levels to MAKE time for yourself to reduce stress. Consider every day events and feelings that cause you stress and work on eliminating them.. not for peace of body, but for peace of mind, too. Pilates, yoga, breathing exercises, meditation and a good self image are all good sources of stress relief.
How you see yourself is who you are. If you see yourself as being weak and nothing then you are telling yourself thats who you are.. and ultimately that is who you will be. A huge part of becoming someone you want to be (the best version of yourself) is to become that person from the inside out. Think like the beast and tell yourself “I am a raging beast!†When you’re at the gym, let out some groaning and moaning or shout something aggressive when you reach your peak rep of whatever set you’re doing. It will push you to go harder. What you put into the gym is what you get out of it and I have learned that recently. I’ve got to “step it upâ€.
Plenty of water, good/lean protein, carbs, vitamins, sleep at night (at least 8 hrs) and aggressive workouts are doing it for me, little by little, but I’ve got to step it up. My goal is 160 lbs by summer 2010. I am going to acheive my goals.. ARE YOU??
by Dr. G. Pepper | Feb 10, 2010 | diet and weight loss, fitness, general health & nutrition, health, weight gain, weight loss
Action Guide to Weight-Loss Barriers
By the weight-loss experts at Mayo Clinic and Donald Hensrud, M.D., M.P.H.
Authors of The Mayo Clinic Diet: Eat well. Enjoy life. Lose weight.
Long term success with a weight program sometimes follows a bumpy, uneven path. Many obstacles can keep you from achieving a more healthy weight.
Learning to identify potential roadblocks and confront personal temptations is an important part of being successful in losing weight. To make it past the rough spots, it’s important to have strategies ready to guide your response as problems arise.
This easy-to-use action guide identifies common weight-loss barriers and practical strategies for overcoming them. If you find a strategy that helps you, include it with your weight-loss program.
The barriers are grouped into three categories: nutrition, physical activity and behaviors. To lose weight — and to maintain that weight loss — it’s important that you address all of these components.
Behaviors obstacle
I’ve tried to lose weight before, but it didn’t work. Now, I don’t have confidence that it’ll work this time.
For many people, losing weight will be one of life’s most difficult challenges. Don’t be discouraged if you’ve tried losing weight in the past and you weren’t able to — or you lost weight but gained it all back. Many people experiment with several different weight-loss plans before they find an approach that works.
Strategies
Following these tips may help you succeed this time around.
* Think of losing weight as a positive experience, not a negative one. Approaching weight loss with a positive attitude will help you succeed.
* Set realistic expectations for yourself. Focus on behavioral changes and don’t focus too much on weight changes.
* Use problem-solving techniques. Write down the obstacles that you experienced in previous attempts to lose weight, and come up with strategies for dealing with those obstacles.
* Make small, not drastic, changes to your lifestyle. Adjustments that are too intense or vigorous can make you uncomfortable and cause you to give up.
* Accept the fact that you’ll have setbacks. Believe in yourself. Instead of giving up entirely, simply start fresh the next day.
Behaviors obstacle
I eat when I’m stressed, depressed or bored.
Sometimes your most intense longings for food happen right when you’re at your weakest emotional points. Many people turn to food for comfort — be it consciously or unconsciously — when they’re dealing with difficult problems or looking for something to distract their minds.
Strategies
To help keep food out of your mood, try these suggestions.
* Try to distract yourself from eating by calling a friend, running an errand or going for a walk. When you can focus your mind on something else, the food cravings quickly go away.
* Don’t keep comfort foods in the house. If you turn to high-fat, high-calorie foods whenever you’re upset or depressed, make an effort to get rid of them.
* Identify your mood. Often the urge to eat can be attributed to a specific mood and not to physical hunger.
* When you feel down, make an attempt to replace negative thoughts with positive ones. For example, write down all of the positive qualities about yourself and what you plan to achieve by losing weight.
Behaviors obstacle
I have a hard time not eating when I’m watching television, a movie or a live sporting event.
There’s nothing inherently wrong with eating while watching a show, film or live event, but when you’re distracted, you tend to eat mindlessly — which typically translates into eating more than you intended to eat. If you’re unable to break this habit, at least make sure you’re munching on something low in calories.
Strategies
Here are suggestions you might consider.
* If you’re at a theater or stadium, order a small bag of popcorn with no butter and work on it slowly.
* Eat something healthy before you leave home so that you’re not extremely hungry when you arrive.
* Drink water or a calorie-free beverage instead of having a snack.
* Try to reduce the amount of time that you spend watching television each day. Studies show that TV watching contributes to increased weight.
Behavior obstacle
When I go to parties, I can’t resist all of the snacks and hors d’oeuvres.
In most social situations where food is involved, the key is to treat yourself to a few of your favorite hors d’oeuvres, in moderation. If you try to resist the food, your craving will only get stronger and harder to control. By following a few simple strategies, you can enjoy yourself without overeating.
Strategies
Next time you step up to the hors d’oeuvre table, try these strategies.
* Make only one trip and be selective. Decide ahead of time how much you’ll eat and choose foods you really want.
* Treat yourself to one or two samples of high-calorie or fatty foods. Fill up on vegetables and fruits, if you can.
* Take only small portions. A taste may be all that you need to satisfy your craving.
* Nibble. If you eat slowly, you’ll likely eat less — but don’t nibble all night long.
* Don’t stand next to or sit near the hors d’oeuvre table. As the old saying goes, “Out of sight, out of mind.”
* Eat something healthy before you arrive. If you arrive hungry, you’ll be more inclined to overeat.
Behavior obstacle
I’m a late-night snacker.
Avoid eating late at night because loading up on calories right before bed only intensifies the challenge of not overeating. There’s less chance for you to be active and burn off those calories until next morning. It’s better to eat during the day so that your body has plenty of time to digest the food before you go to bed.
Strategies
Here are suggestions if you often find yourself battling the late-night munchies.
* Make sure you eat three good meals during the day, including a good breakfast. This will help reduce the urge to snack late at night, simply because you won’t be so hungry.
* Don’t keep snack foods around the house that may tempt you. If you get late-night munchies, eat fruits, vegetables or other healthy snacks.
* Find something else to keep you busy in the hours before bedtime, such as listening to music or exercising. Your snacking may be more of a mindless habit than actual hunger.
Behavior obstacle
When I lapse from my eating plan, it’s hard for me to get back on track.
Lapses happen. Many times a minor slip — a busy day when you couldn’t find the time to eat right or get exercise — leads to more slips. That doesn’t mean, though, that you’ve failed and all is lost. Instead of beating yourself up over a lapse, accept that you’re going to experience bumps along the way and put the incident behind you. Everyone has lapses. Think back to the initial steps you took when you first began your weight program and put them to use again to help you get back on track.
Strategies
Here are suggestions to prevent a lapse from turning into a full-blown collapse.
* Convince yourself that lapses happen and that every day is a fresh opportunity to start over again.
* Guilt from the initial lapse often leads to more lapses. Being prepared for them and having a plan to deal with them is important to your success.
* Keep your response simple. Focus on the things that you know you can do and stick with them. Gradually add more healthy changes until you’re back on track.
* Open up an old food record and follow it. Use those meals like a menu to help get you back to a healthy eating routine.
The above is an excerpt from the book The Mayo Clinic Diet: Eat well. Enjoy life. Lose weight., by the weight-loss experts at Mayo Clinic and Donald Hensrud, M.D., M.P.H. The above excerpt is a digitally scanned reproduction of text from print. Although this excerpt has been proofread, occasional errors may appear due to the scanning process. Please refer to the finished book for accuracy.
Reprinted from The Mayo Clinic Diet, © 2010 Mayo Foundation for Medical Education and Research. Published by Good Books (www.GoodBooks.com). Used by permission. All rights reserved.
About Donald Hensrud, M.D.
Donald Hensrud, M.D., M.P.H., is chair of the Division of Preventive, Occupational, and Aerospace Medicine and a consultant in the Division of Endocrinology, Metabolism and Nutrition at Mayo Clinic, Rochester, Minn. He is also an associate professor of preventive medicine and nutrition at the College of Medicine, Mayo Clinic. A specialist in nutrition and weight management, Dr. Hensrud advises individuals on how to achieve and maintain a healthy weight. He conducts research in weight management, and he writes and lectures widely on nutrition-related topics. He helped publish two award-winning Mayo Clinic cookbooks.
About Mayo Clinic
Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. Doctors from every medical specialty work together to care for patients, joined by common systems and a philosophy that the needs of the patient come first. Over 3,600 physicians and scientists and 50,000 allied staff work at Mayo, which has sites in Rochester, Minn.; Jacksonville, Fla.; and Scottsdale/Phoenix, Ariz. Collectively, Mayo Clinic treats more than 500,000 patients a year.
For more than 100 years, millions of people from all walks of life have found answers at Mayo Clinic. Mayo Clinic works with many insurance companies, does not require a physician referral in most cases and is an in-network provider for millions of people.
For more information, please visit www.goodbooks.com/mayoclinicdiet.
By Gary Pepper, M.D.
