Category Archives: weight gain

Share Childhood Food Memories to Help Combat Childhood Obesity


Without question the eating habits we develop as kids helps determine if we are going to be a heavy adult. Almost a third of children and adolescents in the US are classified as either overweight or obese (JAMA 2014; Ogden, CL).  Many of these children become obese adults. If a child’s parents are heavy their risk is doubled for becoming an overweight adult.

Metabolism.com is involved in finding ways to reduce childhood obesity. The first step is to raise awareness of the dangers of childhood obesity and how crucial it is for young people to learn how to eat properly. For this reason we are kicking off a Facebook and Instagram campaign called “ Food Flashback”.  The campaign is being hosted on the Facebook page “CSSdiet” and Instagram @CSSdiet.

Food Flashback means sharing memories of how each of us first learned about food and nutrition. Most of us have some vivid recollections of family meals, watching our parents cooking, favorite foods and snacks as a child etc. Help us to increase awareness by sharing your childhood food experiences at “CSSdiet”  on Facebook or @CSSdiet on Instagram.

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Obesity Related Type 2 Diabetes is More Severe in Teens than Adults


Overweight TeenObesity Related Type 2 Diabetes is More Severe in Teens than Adults

by Gary Pepper, M.D. and Andrew Levine, Pre-Med, Univ of Central Florida

The recently published TODAY study found obesity related type-2 diabetes mellitus (T2DM) is more severe as a teen than as an adult, and high risk of developing diabetes could be tied to weight gain at an early age.

Between 2004 and 2009 the “Treatment Options for Type 2 Diabetes in Youth Study Group” (TODAY) gathered 700 participants who met the American Diabetes Association’s criteria for this disease.  The participants were monitored for between two to six years.  TODAY’s goal was to assess treatment options and the clinical progression of obesity related T2DM in youth.  The mean age of the 700 participants in the TODAY study was thirteen, the majority being female. Sixty percent of the 700 participants were African American or Hispanic, with the remainder being Caucasian. The mean duration of diabetes for the study’s’ participants was less than seven months. A major worrisome finding from the study is a majority of participants were also discovered to have dyslipidemia, an abnormally high amount of fats (cholesterol, triglycerides) in the blood, as well as high blood pressure (hypertension). Continue reading

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7 Ways to Boost Your Metabolism When Quitting Smoking


smoker (1)Gaining weight after quitting smoking is a common and dreaded experience.  Fear of weight gain often discourages people from trying to take the first steps toward giving up the smoking habit. What is the reason for this unwelcome “side-effect”? Perhaps most importantly, smoking raises the heart rate substantially.

While smoking a cigarette, the heart rate increases 10-20 more beats per minute. (This can lead to heart diseases in the future.) This elevated pulse boosts the metabolism because of the energy it takes to keep the body functioning at this high rate. When a smoker quits smoking, the heart rate will return to its normal, natural rate. This will cause a decrease in the metabolism. However, there are several ways to boost your metabolism after smoking cessation  to avoid the weight gain that often occurs.

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What Product Contains 5 Times a Child’s Daily Sugar Allowance?


sugar babies Poor eating habits are contributing to the rise of type 2 diabetes and obesity in children and adolescents.  One of the major nutritional culprits is the high consumption of sugar contained in soda.  The amount of sugar in soda is astounding.

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What is Behind the Epidemic of Obesity and Type 2 Diabetes in Children and Teens in the U.S.?


by Gary Pepper, M.D. and Andrew Levine, Pre-med

If you ask the average person to define diabetes, a typical response might be “it’s when you have unhealthy eating habits and an overabundance of sugar in your blood.”  Although that is not far from the truth, a more accurate definition is that diabetes is a disorder in the way our body uses insulin to process digested food for energy and storage. A good part of what we eat is broken down into glucose, the principle form of sugar in the blood. Diabetes occurs when there is not enough insulin to push the glucose into our cells. This deprives the body of the energy it needs because glucose is metabolized as fuel by all the organs in the body. Therefore in diabetes despite an elevated amount of sugar in the blood,  the cells are actually starving for energy.  We sometimes conceive of glucose in the blood as the enemy , but without it we would die. Continue reading

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Low Vitamin D Linked to Obesity and High Triglycerides


Understanding of the various ways vitamin D effects the body is growing rapidly. Originally this vitamin was thought to only effect calcium in the blood and bone but recent research shows it possesses important influences on the immune system and cancer development. A study just published in Journal of Endocrinology and Metabolism June 2012 now shows that this same vitamin can possibly influence metabolism. A common disorder of metabolism known as Syndrome X or the Metabolic Syndrome is characterized by high triglycerides and low good cholesterol (HDL), abdominal obesity, along with elevated blood pressure and blood sugar. The researchers discovered those with vitamin D levels between 16 and 20 were 75% more likely to develop the Metabolic Syndrome within 5 years than those with vitamin D levels above 34 (levels below 30 are considered low).

Whether low vitamin D is the cause of the Metabolic Syndrome is unclear. Vitamin D prevents fat cells from reproducing, helps the natural process of triglyceride breakdown and helps regulate blood sugar by making insulin work more efficiently. Without enough vitamin D the fat cells could multiply faster, triglyceride levels accumulate and blood sugar rise as is seen in Metabolic Syndrome.

As I have explained in previous posts at metabolism.com, vitamin D is also related to development of hardening of the arteries (atherosclerosis) and obesity in Type 2 Diabetes which could be considered a more advanced form of Metabolic Syndrome.

Doctors’ efforts to monitor vitamin D levels are being hindered by new regulations by Medicare and private insurance carriers to deny payment for vitamin D screening. Lately, a number of my patients’ vitamin D tests were denied by insurance carriers with patients being charged over $200 per test because it was not “indicated”.

Recommendations for vitamin D supplementation are debated. When skin is exposed to sunlight it manufactures vitamin D so there is thought that people who get sun exposure should not need vitamin D supplement but that is not borne out in reality. Previously the recommended daily allowance (RDA) was 400 units per day an amount which has been increased slightly for the elderly. Some experts recommend 1000 unit daily or more. In my practice I generally recommend starting at 1000 units and then rechecking 25 hydroxy vitamin D levels a few months later. Some individuals require 4000 unit or more daily to achieve vitamin D levels over 30. When purchasing vitamin D the D3 form appears to be converted in the body more rapidly than the D2 variety. High priced brands of vitamin D, in my opinion, are a waste of money.

Gary Pepper, M.D.
Editor-in-Chief, Metabolism.com

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Coconut Milk as Health Food? You’ve Got to Be Kidding.


Much as has been said recently about the health benefits of coconut milk and coconut oil. Coconut milk is a white liquid mixture of water and the white “flesh” of the coconut and is considered a more diluted form of coconut oil a thick clear liquid. Coconut extracts have been used in commercial food products, non-dairy creamers and cooking for many years but lately there has been a burst of publicity for coconut oil and milk as a new form of health-food with beneficial properties including increasing energy, preventing cancer and speeding weight loss.  I have seen it being added to ice cream and even bottled water. I want to sound a note of warning here.

 

Most physicians and nutritionists will advise against having too much fat in the diet for a number of reasons. First, and most obvious, fats have lots of calories. In addition dietary fat can increase the bad cholesterol (LDL) content of the blood leading to increased risk of heart attack and stroke. Among the different kinds of fat that raise LDL the worst are the saturated fats. One tablespoon of coconut oil contains about 120 calories with about 90% of the coconut oil being saturated fat.  In fact the saturated fat, palmitic acid, takes its name from the plant that produces coconuts, the palm tree. Compare this to the fat in dark chocolate which is 30% oleic acid, the healthy monounsaturated fat found in olive oil.

 

Oils which are far more beneficial for preparing foods are unsaturated fats including the monounsaturated and polyunsaturated fats. I like canola, safflower and olive oil due to their high content of these healthier fats.

 

Coconut oil has many other applications which are useful outside the body. It can be used as a diesel fuel, deodorant, insect repellent, to make soap, and as a moisturizer for hair and skin.  My advice is to think twice however, before supplementing your diet with it.

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Infertility to Acne: Treatment and Prevention of Polycystic Ovarian Syndrome. Part 2


Worried about pregnancyIn part one of this series we looked at the cause of polycystic ovarian syndrome (PCOS) and the many complications it causes. Weight gain, acne, excess hair growth on the face and body,  high cholesterol and high blood sugar due to insulin resistance are among the problems associated with PCOS.  One particular area of concern for PCOS sufferers is infertility due to lack of ovulation. PCOS is the cause of anovulatory infertility in  3 out of 4 cases. Before the acceptance of medical therapy for infertility due to PCOS  a surgical approach referred to as a wedge resection of the ovary was performed which allowed patients with PCOS to ovulate and conceive normally. Low success rates with this procedure, complications of surgery and improved medical therapies have all resulted in the end of this type of treatment in most situations.  At present, treatment of infertility associated with PCOS generally consists of using a drug to combat insulin resistance known as metformin often in combination with the fertility drug clomid, which has a high rate of success.

Treatment of the excess hair growth associated with PCOS often consists of using the drug spironalactone and the use of birth control pills. Spironalactone is a very interesting drug used for decades as a salt depleting diuretic but also has an effect to block the action of the male hormone testosterone. The action of spironalactone to block testosterone was discovered when it was noticed that men using this diuretic developed tender nipples and breast enlargement (gynecomastia). Oral contraceptive agents are also useful to combat hirsutism because these agents also cause reduce testosterone levels by putting the ovary in a dormant “resting” state.  Cosmetic procedures are always another option to treat unwanted hair growth. Laser hair removal appears to be replacing the older modality of electrolysis for this purpose.

Can PCOS be cured? Once PCOS develops it can be controlled but not cured unless the ovaries are removed. At menopause  PCOS-related problems diminish as the ovary stops making sex hormones including testosterone which is one of the culprits during the reproductive years. A recent study published this year in the journal Pediatric Endocrinology showed that using metformin treatment in pre-adolescent girls thought to be at risk for PCOS reduces the risk and/or the severity of PCOS in later years. It may do this by blocking fat accumulation in the abdomen and liver which seems to set off the insulin resistance. Metformin is not FDA approved for this purpose and as a generic drug there is little profit potential in developing this treatment. I expect it will be many years before preventive therapy for PCOS will come before the FDA for approval .

This information is strictly for educational purposes. Due to high risk of toxicity of medical therapy in young women who can potentially become fertile under treatment for PCOS, no drug should be taken without the close supervision of a physician. The reader agrees to the Terms of Service of this website, metabolism.com

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Polycystic Ovarian Syndrome Is Common in Adolescent Girls


Polycystic Ovarian Syndrome (PCOS) sounds like a rare disorder but it is surprisingly common. This is a disorder with onset in early adolescence effecting up to 10% of young women. Characteristic signs and symptoms include increasing facial and body hair, hair loss from the scalp, muscular or heavy build, acne, thickening and darkening of the skin known as acanthosis nigricans, blood sugar problems including type 2 diabetes, high cholesterol and irregular menstrual cycles and infertility. In older women with PCOS coronary artery disease is more common. In severe cases deepening of the voice and enlargement of the clitoris (clitoromegaly) can be seen. Before the underlying hormone disorders were clarified, the main method of diagnosing this disorder was by finding multiple cysts on the ovary. We now understand that the main problem is not the ovarian cysts but metabolic disorders including insulin resistance and elevated male hormone levels (testosterone) in the blood.

Another misconception about PCOS is that it only occurs in overweight women. Obesity is common in PCOS but thin women are also capable of developing PCOS. The underlying hormone problems are complex but are thought to be at least in part due to high insulin levels in the blood resulting from insulin resistance. With insulin resistance the body requires high levels of insulin due to insensitivity of the tissues to insulin’s presence.
What treatments are available for PCOS? There are very few, if any, drugs specifically approved for the treatment of PCOS. This is probably because of the low profit potential for treating this disorder. Drug companies cannot afford to invest millions of dollars in research because almost all of the existing standard therapies are generic drugs. Some of the most useful medications for treating PCOS are drugs used to treat type 2 diabetes because of their effect to reduce insulin resistance. These drugs are metformin and Actos. Metformin is the most popular oral medication for diabetes treatment in the U.S. Actos has been available for about 10 years but due to recent negative publicity about an unproven risk of bladder cancer, its popularity is declining. Neither drug is approved by the FDA for treatment of PCOS but multiple studies confirm the clinical and hormonal benefits of using these medications in this disorder. In 2011 research was published in the Journal of Clinical Endocrinology and Metabolism suggesting that the generic cholesterol lowering drug, simvastatin may also show benefits similar to metformin for the treatment of PCOS.

In the late 1980’s, I along with Dr. Lester Gabrilove at Mt. Sinai Hospital in New York, published our research showing that an anti-fungal medication, ketoconazole, could reverse the hormonal, physical and metabolic problems associated with PCOS. Due to the potential toxicity of ketoconazole this therapy never gained wide spread acceptance. The manufacturer refused to fund additional studies to determine how to more effectively use this drug, due to the low profit potential and liability concerns.

This information is strictly for educational puroses. Due to high risk of toxicity of medical therapy in young women who can potentially become fertile under treatment for PCOS, no drug should be taken without the close supervision of a physician. The reader agrees to the Terms of Service of this website, metabolism.com

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Getting the Right Amount of Sleep Helps Prevent Diabetes


One aspect of lifestyle that is often overlooked is time spent sleeping. Getting adequate sleep is often sacrificed due to the demands of job and family. In the Sleep Heart Health Study over 1400 men and women were surveyed about their sleep habits and its relationship to diabetes and prediabetes. It was found that sleeping less than 6 hours per night was associated with increased risk of having diabetes. Interestingly, in those sleeping more than 9 hours per night there was an increased risk of diabetes and prediabetes.The authors of the study recommend trying to get between 7 and 8 hours of sleep per night to minimize the chances of developing blood sugar problems. To learn more about ways of preventing diabetes see pages 90 to 98 in my ebook “Metabolism.com”

Maintaining ideal body weight with diet and exercise is also crucial for avoiding diabetes and prediabetes.In overweight adults for each2.2 pounds(1 kilogram) gained per year the risk of developing diabetes increases about 50% over the next ten years. By losing 2.2 pounds per year the risk of developing diabetes is reduced about33% for the next 10 years (J Epidemiol Community Health. 2000; 54(8):596-602).

Speak to your healthcare professional to find out if you are at risk for developing diabetes and to learn ways you can avoid it.

Gary Pepper M.D.

Editor-in-Chief, Metabolism.com

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