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Mel Siff’s Take on Pilates

11 Sep

Greetings, Bloggers and Readers of the Like.

The following is an excerpt from 2002 that Mel Siff commented on concerning Pilates. At this time, Pilates was gaining momentum in this country and Pilates classes were popping up all over. This is one of the most comprehensive opinions I’ve come across concerning Pilates. Mel’s comments are indicated using “***”:

Here is one of several similar letters which I [Mel] received privately after my
article entitled “Pilates Naked” appeared in the magazine:

“Dr Siff — I enjoyed your discussion of the Pilates method. You are the
first person I found on the Internet who seemed willing to look at their
claims logically.” [from Dr R M G]

No sooner had this letter arrived than I came across a magazine article which
proclaimed that it had been written to help the fitness professional to
really understand what Pilates is and what its benefits are. For a brief
moment, I thought that some genuine validation of their often exaggerated
claims would be forthcoming, but I discovered before reading to the end of
the first column that this was not to be.


What Is Pilates? — Understanding and teaching this popular movement method

By Colleen Glenn & Roberta Morgan

[Personal Fitness Professional Feb 2002: 12]

[Colleen Glenn is a managing partner at Goodbody’s Wellness Center, director
of the GoodBodys Pilates Education Series and vice president of The Pilates
Method Alliance. Roberta Morgan is PR Director with Center Studio in Los
Angeles and is a board member of the PMA.]

Invented in the early 20th century by Joseph Pilates, Pilates was created by
combining Eastern modes of exercise such as Yoga and Tai Chi with Western
practices such as aerobics and weight training. Even with the boom in Pilates
that has taken place throughout the world over the last 10 years, there are
still many people, even in the world of fitness and/or rehabilitation, who
are not clear on how this method works and why a new trainer must study long
and carefully in order to teach it. >

*** It is amazing that so many folk make it seem as if their fitness or
wellness methods almost require the intelligence and training of a “rocket
scientist”. Even old Joe Pilates himself didn’t have a very good grasp of
movement science, even for those times. Moreover, the glaring lack of
scientific research into the alleged uniqueness of Pilates training means
that there is a great shortage of intellectual matter that has to be studied.
Even the “scientific” or anatomical material that has to be studied
produces such gems that Pilates “produces thinner, less tight muscles” than
weight training — what more needs to be said about education that seems to
be so impoverished?

This means then that the extensive time necessary to even teach one exercise
on the “Reformer” or the “Cadillac” has to be spent on simply practising a
human movement that certainly does not require any skill which even vaguely
compares with a single axel on the ice, an Olympic snatch, a baseball strike
or a back salto in gymnastics or diving. Anyhow, many groups try to create
an aura of mystique or complexity about their special training method because
this makes it more marketable and attractive to the easily-bored fitness

Although the authors state that “there are still many people, even in the
world of fitness and/or rehabilitation, who are not clear on how this method
works”, a quick reading of this article shows that even the experts do not
seem to be very clear about “how” this method works and what science really
exists to validate their claims for uniqueness.

The article continues:

<The Pilates Elders, the original remaining students of Joseph and Clara
Pilates, have stated that, “Pilates is a movement technique as well as a
lifelong learning process of training your body with an expectation toward
health and wellness. ” Joseph Pilates believed that since the mind built the
body, training the physical in this way sharpens mental acumen as well.

Pilates promotes good posture through breathing, proper muscle use and
coordination building core strength and flexibility and the use of
resistance-based equipment developed by Joseph Pilates. The Pilates body is
not one of bulk and restricted movement or of the runner’s sometimes anorexic
appearance. This is a dancer’s body at its agile best – long, lean, toned and
trim. Many people claim Pilates actually adds an inch or more to their
height. Other benefits include:

– Relaxation and stress reduction, encouraging overall health

– Mental and physical control of the body, leading to actual re-training of
neural pathways and physical grace of movement

– Gentle, safe, yet challenging non-impact exercises that build abdominal and
back muscles, which stabilize the spine, protect the lower back and tighten
and strengthen the buttocks

– Improved posture and stability, better coordination and balance
Strengthened bones and improved circulation

– Prevention of body pains and limitations associated with aging. Increased
mental and physical stamina and energy

– Fewer repetitions that are indefinitely (sic) more effective in changing
the body

*** As usual, no references or web resources are cited which support any of
these claims (of course, we will be told that in such magazine articles,
these would be out of place). Instead, we read nonsense on “retraining”
neural pathways (whatever that is supposed to mean in the healthy person),
implications that non-impact exercise is safer and more effective than
impulsive exercise, claims that Pilates PREVENTS body pains, and implications
that the fewer repetitions of Pilates are more effective than higher
repetition training, irrespective of training goals. All other claims are
not unique to Pilates — many other forms of exercise can claim the same
benefits and even more.

The article again:

<Pilates re-educates and promotes a process that truly enhances the mind/body
connection. Joseph Pilates promised that in 10 sessions of Pilates, you will
feel the difference. In 20, you will see the difference, and in 30, you’ll
have a whole new body. Given patience and persistence, you can improve
breathing capacities, align, stretch and strengthen the spine, improve
posture and tone the entire musculature. It has proven benefits for
conditions such as osteoarthritis and osteoporosis. Everyone from
post-rehabilitation patients to athletes see results.>

*** If ANY form of fitness training with or without weights did not produce
similar changes within those periods, something must be gravely amiss. For
the average gym user, 30 sessions is more than 3 months of training and, if
serious weight training were used for that time, I have little doubt that
most free weight trained subjects would visibly and in terms of physical
performance be superior to most Pilates-trained subjects. Muscle hypertrophy
(without those Pilates-condemned “bulges”), fat loss, strength, power and
even flexibility (if full range loaded exercise is used) invariably would be

The article once more:

<While some Pilates exercises can be performed on a mat with teacher
guidance, the equipment certainly enhances the experience and results. Most
of the equipment designs utilize spring mechanisms that the client employs
while moving the body, carefully noting its positioning. The spring system
assists and enables the body to achieve greater flexibility and range of
motion in the different planes of movement, thereby enhancing proprioception,
restoring joint mobility and providing an ultimate physical and mental

*** Springs offer resistance which do not load the joints and muscles in
optimal patterns of action, especially since spring resistance increases with
extension, whereas joint torque capabilities decrease after reaching a peak
well before any full movement is completed. Springs do not specially
“enhance proprioception” — I wonder if the authors would clarify what they
mean by proprioception and how one can alter it. I doubt if the Pilates folk
even know how one can combine elastics (or springs) with free weights to
enhance strength and power training, thereby extending the capabilities of
springs on their own. All that they seem to believe is that weights will
make you bulky, short-muscled, stiff and clumsy — now where have we heard
that before?

Do they really believe that spring training provides the “ultimate physical
and mental challenge”? If so, I am astounded, because even combined weights
and band training can be very wearisome if used very extensively in all
training. Maybe Pilates folk are just very easy to please! However, I would
rather not spend money on playing with spring laden machines, when I can do
many hundreds of exercises on a single free weights bar alone for nothing.

The article again (read my article on Pilates on the site for
more information on these toys):

<The most well-known piece of equipment is the Universal Reformer. Other
visually simple but deceptively effective Pilates equipment includes such
items as Low Chair, Electric Chair, Trapeze Table (which Joseph Pilates
called The Cadillac, seeing it as the ultimate in his designs), Ped70-Pul and
Spine Corrector.

The Low Chair, sometimes called the Wunda Chair, was developed when Joseph
observed Chinese acrobats maneuver on a box. Since he had strong beliefs
about how people should stand, walk, sleep and sit to stay healthy, he wanted
the Low Chair to be in every hotel and home; he believed that modem chairs
compromised internal functioning and posture.

From its origins as a massage and therapeutic table, the Trapeze Table, or
Trap Table got its name from the circus trapeze. Pilates developed the table
to resemble a single four-poster bed with springs, wooden bars and hanging
trapeze-type equipment to challenge even the most physically fit individuals.
Concentration is very important to work the arms, legs, trunk and entire body
against the various spring tensions and positions this equipment affords.

A movement technique requires learning fundamentals to build upon, time to
physically acquire skills and mentally understand them. It is about
repetition, refining and a depth of understanding, something that requires
many hours of practice and apprenticeship. Professionals attending
introductory seminars and short programs do gain invaluable concepts and
preparatory exercises to incorporate in private and/or group settings, but it
is just a start. Teaching the Pilates’ concepts is quite different from
teaching exercises. The latter is surface; the former is unique and profound.>

***On many occasions I have openly requested just some scientific information
to validate the oft-repeated Pilates claims, especially regarding its alleged
uniquenesses, but none has yet been forthcoming, other than complaints about
“Dr Siff always picking on us – why, oh why?” (the usual sidetracking
techniques which try to disguise the likelihood that there is no information
available). If the science is not there to quote, what complexity and depth
can there be that one has to study?

Proclaiming that “teaching the Pilates’ concepts is quite different from
teaching exercises” is yet another gross exaggeration, unless they mean that
it is even simpler to teach Pilates exercises. Further, it is massively
misleading to add that teaching exercises is “surface”. Have they really
tried to teach the physical and mental skills necessary to master any complex
skills in any coordinated sport or even the more demanding weights exercises
such as the snatch?

The article continues:

<Pilates could not come of age in a better time. In 10 years, over 76 million
people in the US will be middle-aged or elderly. Older populations require
low-impact programs laced with variety that also address physical
limitations. Emphasis needs to be placed on health, function, quality as well
as prevention. Pilates addresses the needs of the current aging exercise
populations. As a result, Pilates is one of the fastest growing forms of
exercise today. As a professional, the question is not if you need to learn
Pilates but rather when and how.>

*** Once again, they proliferate the belief that low-impact exercises
necessarily are superior and safer (for people of all ages), even though
research shows that moderate levels of impact or more heavily resisted
exercise seem to play a very important role in increasing the degree of bone
mineralisation and halting the progress of skeletal deterioration. Bone
scans, for example, show that lifters who have used weights for several years
have significantly greater bone density than members of the general public –
I would be interested to see a comparison of the bone scans of lifters and
Pilates practitioners of comparable experience.

Although many older folk who have spent rather sedentary lives may be quite
frail, it is incorrect to assume that ALL older folk should avoid more
demanding forms of exercise. As a professional, it is more of a question if
you know enough about strength and fitness training in general, than if you
know a great deal about how to teach only a single limited form of training.

Sure, there can be a very useful role for Pilates, but it is not universally
superior to all other forms of exercise. To suggest that it can serve as a
total replacement for other systems of training or that it is definitely
superior in most ways to weights and other forms of overall training is
irresponsible and misleading, unless, of course, your aim is to attract more
business the way of Pilates!

The article went on:

<Formed last year, the Pilates, Method Alliance (PMA) is as international
non-profit organization of teachers, teacher trainers, studios, manufacturers
and facilities dedicated to preserving the legacy of Joseph and Clara
Pilates. The PMA states that, “The Pilates Method is an exercise process that
creates an internal physical transformation and integration of mind and body.
In order to be a teacher, one must experience it (the transformation) first,
understanding that it’s never complete but & constant evolution of learning.”>

*** Once again, we are exposed to this so-called “New Age” mind-body
integration mantra, as if this is unique to Pilates. Even though some sports
will not specifically pay attention to making deliberate efforts to integrate
the use of the mind into their physical training, this integration usually
happens quite naturally without effort by simply taking part in the sport
seriously. It is inconceivable to lift heavy weights, run long distances,
swim for hours, sprint a 100m in less than 11 seconds, sink a golf put from
15 metres, do a somersault on a skateboard……without mind-body
integration, so that claim is redundant. In fact, it is virtually impossible
to take part in any physical activity (and yes, that includes sex!) WITHOUT
mind-body interaction.

The article once more:

<The PMA recommends that anyone who would like to teach the Pilates method of
exercise attend a comprehensive training program and maintain a commitment to
education. Here are some questions to help you find a training program that
is right for you.

1. Are there any requirements for entry into the program? Most comprehensive
Pilates programs require prior Pilates exercise experience, knowledge of
anatomy and/or an entrance exam for a prerequisite.

2. Does the training program offer instruction on a pieces or just a specific
piece of equipment with a limited repertoire of exercises?

3. Does the program meet weekly or monthly? How long does it take to complete?

4. Are lecture, observation, apprenticeship and practice hours involved?

Pilates is a time-proven and enormously effective movement technique that
greatly enhances the mind, body and spirit.>

*** Now we note that Pilates also integrates the SPIRIT into the whole human
equation! — maybe if they returned to a soapbox at that famous street
intersection in San Francisco, Haight-Ashbury, or on the grass at Woodstock,
a few more people might buy that line, but, even in the hugely gullible
fitness and health world, that really is stretching one’s luck a bit far.

Do they really believe and KNOW that indulging in physical games on Pilates
devices is magically going to enhance what happens in the spiritual realms?
Maybe this little-known Pilates prayer has something to do with it:

Our integrated father-mother which art in Pilates heaven,
Hallowed be thy games
Thy playground come,
Thy exercises will be done on the mat as it is in the Cadillac heaven
Give us this day our daily flat muscles
And forgive us our trespasses for using free weights
As we forgive them that trespass on our machines
And lead us not into temptation to use heavy weights or ballistic bounces
For thine is the Pilates kingdom
The commercial power and the physical glory
For ever and ever


Mel Siff


FIT Makes a Another Memory

23 Jul

On June 1, my nine-year old daughter, Keala, won her school fundraiser at Lakewood Elementary School in Sunnyvale by selling the most  tickets to a San Jose Giants baseball game. This would not have been possible without the generosity of Thom and Tracey, several of my clients and my fellow trainers  for buying tickets to the game – a big THANK YOU!!  Thom and Tracey graciously bought a ticket for every student in Keala’s class and her brother’s, my son, Tristan, kindergarten class. Because of everybody’s contributions, Keala and Tristan had a great time watching the game, eating ribs, and playing various games outside of the stadium.

As the number one seller, Keala received several memorable team-signature gifts: a jersey, bat and ball; and, most importantly, she threw out the first pitch of the game (kept that ball also). In short, the following pictures should speak for themselves:

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As a funny sidenote, because Keala had such a great time, she mentioned she would like to be the number one winner next year, however, her brother has a problem with that as he mentioned he wants to win. I will certainly let you know what is the outcome next year. 🙂

Tune in next year for the update!

Thank you again to ALL!

Is There Such a Thing as Type 3 Diabetes?

30 Mar

The short unconfirmed-by-the-scientific-community answer to the Title of this article is: YES.

According to a paper published this past January in the journal Drugs written by Dr. Suzanne M. de la Monte, Type 3 diabetes is otherwise known as Alzheimer’s disease, the most common cause of dementia in North America. Growing evidence supports the concept that Alzheimer’s is fundamentally a metabolic disease that results in progressive impairment in the brain’s capacity to use blood sugar (i.e. glucose), because the brain cannot respond to insulin and insulin-like growth factor (IGF) stimulation. Insulin is an important hormone that behaves as “the gatekeeper” to get glucose into our cells, including brain cells. Insulin in the brain not only modulates glucose uptake, but also promotes the health of brain cells — their growth, survival, remodeling, and normal functioning.

De la Monte presents a plethora of data that strongly support the notion that there is clearly a similarity between Type 2 diabetes and Alzheimer’s disease (AD) that could not be ignored. The biochemical, molecular, and cellular abnormalities that precede or accompany AD neurodegeneration, are characteristically common, yet they lack a clear origin. Reevaluation of the older literature revealed that impairments in brain metabolism occur early as the symptoms of AD develop. This led de la Monte’s team to develop the concept that impaired insulin signaling has an important role in the pathogenesis of AD. Because this is similar behavior of muscle cells prior the onset of Type 2 diabetes,  de la Monte proposed that AD represents “type 3 diabetes.”

Type 1 diabetes mellitus  is “juvenile” diabetes that is diagnosed early in life as the pancreas does not produce insulin. Type 2 diabetes, the most common form, is caused by insulin resistance in peripheral tissues, but not the brain necessarily. However, Type 2 diabetics have a 50% chance of developing AD.  Individuals with Type 2 have high blood sugar and high blood-insulin because the insulin and glucose are not properly absorbed into the targeted cells.

Therefore, Type 3 diabetes is suggested to have similar physiological symptoms as Type 2 diabetes, however it is only specific to the brain, not necessarily in the rest of the body. A diagnosis of Type 3 diabetes would suggest that the brain alone does not absorb insulin properly. De la Monte’s hypothesis gained more support this past week as another study showed that insulin resistance in the brain precedes and contributes to cognitive decline above and beyond other known causes of AD.

Because we know that lifestyle and dietary choices influence the development of Type 2 diabetes, perhaps the same should be suggested for Alzheimer’s disease. Diabetes is a disease defined as an inability to properly utilize insulin. This would suggest that we should monitor our dietary choices that keep insulin at a low-to-moderate level and participate in regular activities. Talk to your doctor if you have a family history of AD and/or diabetes and what you may be able to do in order to minimize developing either of these.

PhD and RD talks Sports Nutrition

21 Jun


SNI: Which protein is best (if any) for promoting gains in skeletal muscle mass? Or are all proteins created equal?

Dr. Lowery: Well, there are plenty of very good protein sources, from meats to eggs to dairy. If I had to pick, I’d suggest whey or casein. Research varies somewhat as to which is superior for different age groups or times of the day but the dairy proteins seem to have real partitioning effects (preferentially helping one build muscle mass.) For me, it’s whey or a whey-casein blend pre- and post-workout, then casein like cottage cheese or a whey-casein supplement at bed time. I like whey-casein blends because of their versatility; the whey remains fast acting, raising circulating amino acids and protein synthesis while the casein portion clots in the gut for a more steady, ‘anti-catabolic’ effect. I do think eggs and moderately lean meats are a close second, though, due to other nutrients they provide.

There are several ways of determining protein quality, from biological value to protein effeciciency ratio, to the PDCAAS (protein digestibility-corrected amino acid score). If one considers the PDCAAS the ‘gold standard’ as many do, he can see that several proteins score very highly. Still, I try not to get bogged down by these ratings and consider the whole food and all it entails. For example, meats are solids and give one something tasty to chew on and enjoy, which is important for dietary compliance.

SNI:  Is there a finite amount of protein one should consume per meal?

Dr. Lowery: Fairly recent research on egg protein suggests the number is 20 grams per feeding – about three eggs or one scoop of protein powder. That dose could be different for other protein types. It’s not so much a question of ‘How much can I digest at one time?’ as many persons wonder, but rather the limitation stems from one’s internal anabolic environment. Once those amino acids enter the blood, there’s a certain requirement for anabolic hormones for example. Any amino acids not used for protein synthesis will just be stripped of their nitrogen and oxidized (burned) or used to make new blood sugar. Some dietitians will tell clients that excess protein becomes body fat but that’s mostly just a plausibility argument based on protein’s 4 kcal per gram. Ask yourself this; How many persons do you know who became obese eating skinless chicken breasts, egg whites and low-fat cottage cheese?

Also, some persons over-conclude that at a 20g ‘ceiling’, even with six meals per day, one would only ever need 120g of protein daily. Although this is a good number for many healthy persons, I personally think athletes with particular goals such as fat loss or recomposing their bodies, could consume more. And for those who feel ample protein intakes are unhealthy (which they are not), consider this; one has to eat *something* when he’s hungry! Protein foods are rich in other nutrients, satiating (filling, satisfying) and have a much higher thermic effect of food (TEF) than carbohydrates and fats.

SNI: What is your opinion on soy protein?

Dr. Lowery: I don’t think soy is a bad protein. Its PDCAAS is very high. Still, I remain a little wary that soy foods bring with them phytoestrogens that are still being studied as far as all of their health effects (breast cancer risk, etc.). Plus, after it’s track record of blunders, the agro-food industry doesn’t instill confidence in me. From this industry there is a LOT of promotion of soy – for example through sponsorship of professional dietetic events – and I sometimes worry about bias in the positive messages that get promulgated. I think that, for those who may be concerned but strive for dietary variety, going meatless once per week (with soy foods and others) can be a nice, moderate policy.

SNI: Why does the myth that high protein diets harm kidney function seem to persist? How do you combat such a myth?

Dr. Lowery: This is controversial but I sometimes think that there are longstanding professional issues of reputation, money and politics – as well as dogma – that tend to keep concerns over ample protein diets around. As Upton Sinclair once said; ”It is difficult to get a man to understand something when his salary depends on his not understanding it.’ For example, for decades dietitians have witheld protein from patients with kidney disease (which is itself less conclusive in the literature than one might think) and this has spilled over erroneously into recommendations for healthy populations. If I were a renal dietitian getting insurance company or government reimbursement for witholding protein from patients, I might not be especially critical of the practice. Or if my lauded and profitable nutrition care of overzealous athletes involved protein dissuasion, I might embrace what my colleagues believe or what introductory textbooks have told me rather than going outside my group to the primary literaure for a current, balanced view. Admitting I’ve been wrong all this time would be rough. I’m not saying this narrow-mindedness always happens but I am saying that my conversations with scientists tend to be very different in tone from the conversations I have with clinicians on the issue. I think there can be a disjoin or lag between the two groups. Change takes time and requires impetus. Maybe the nation’s obesity epidemic will serve as such an impetus to give (satiating, metabolism boosting, muscle-preserving) higher-protein diets a fairer shake.

In summary, consider this: Many clinicians and health educators are busy, are well paid for practicing the status quo, see the world in a bit more black-and-white way than do scientists, and move in fairly insular circles. They thus tend to stick to their guns. Unfortunately, those ‘guns’ can be almost silly when it comes to protein, as we catalogued in a 2009 ISSN paper. This documenting of what’s being taught – and comparing it to the actual (lack of) evidence thereon – is one way to combat the high protein myth.

SNI: What is the difference between a dietitian and a sports nutritionist?

Dr. Lowery: This depends on the state. Nutrition and dietetics licensure differs across the country, with some states requiring the Registered Dietitian credential (with follow-up state licensure) to give nutritional advice or to use titles like Nutritionist. Some states do not require this. There is also the more specific sports dietetics certificate but this is more optional, depending on one’s educational background. As a dietitian with a Masters in Nutrition and three degrees in Exercise Physiology including a doctorate, I for example would feel a bit silly going back to get this certificate in order to justify my involvement in exercise and sports nutrition.

I personally am glad that certificates from any particular group are not legal requisites. I do not feel that study for a four-hour exam on a Saturday is equivalent to a four-year degree (or more) in the field of interest. The university degree should obviously carry more weight. Certificates simply help document one’s expertise if he or she wants to do so. A sports nutrition certificate, from whichever group, is simply a way to prove one has successfully met the competency requirements in the included topics. It helps other professionals and consumers judge one’s expertise. I feel that certificates in a free market, with healthy competition, help consumers overall by presenting options and preventing monopoly by one potentially opinionated or insular group. Having said that, it is important for the public to have some idea which groups and which certificates are most rigorous and most legitimate.

Interview with Dr. Volek on Low-Carb Diets

15 Jun

Dr. Volek: First let me thank you for the opportunity to discuss low carbohydrate diets. This has been a focus of my research for nearly 15 years. Low carbohydrate diets are commonly practiced but seldom taught. As a result, whether by design or neglect, mainstream medicine has either ignored or relegated this powerful tool to casual use. Together with Dr. Steve Phinney, a physician-scientist with extensive knowledge of low carbohydrate diets, we recently published a definitive book on the topic. In The Art and Science of Low Carbohydrate Living, we provide an unabridged and in-depth perspective on this controversial and often misunderstood topic.

SNI:Define what a ‘low carbohydrate’ diet is? That is, at what % carbohydrate does a diet become low? Also, is there a difference between a ketogenic diet and a low-carb diet?

Dr. Volek: Defining a low carbohydrate diet could be done in two ways:

What a Person Perceives: A low carbohydrate diet is one that limits carb intake to a level that results in resolution of all signs of carbohydrate intolerance. What’s carbohydrate intolerance? Like other food intolerances (lactose, gluten) carbohydrate intolerance is characterized by an undesirable response to carbohydrate. Since the inability to properly metabolize dietary carbohydrate is the direct result when insulin action is impaired, insulin resistance is synonymous with carbohydrate intolerance. In other words a low carbohydrate diet is one that improves the features of insulin resistance or metabolic syndrome. People vary widely in their level of carbohydrate intolerance. One person with early signs of metabolic syndrome may only need to restrict carbs to under 80 grams per day to lose weight and keep it off whereas another person may need to stay under 40 grams per day to put a frank case of type-2 diabetes into remission.

What Happens Metabolically: In this case, a low carbohydrate is defined by the level below which there is a fundamental shift away from glucose as a primary fuel that allows most of your daily energy needs to be met by fat, either directly as fatty acids or indirectly by ketone bodies made from fat. This process begins for most people when total carbohydrate is restricted to less than 60 grams per day. After a few weeks at this level, ketones begin to rise ~10 fold in plasma, resulting in a commensurate reduced need for glucose. Further restriction of carbs causes greater ketone production up to a point. The keto-adaptation that occurs gives human metabolism the flexibility to deal with famine or major shifts in available dietary fuels. This should not be confused with ‘diabetic ketoacidosis’ which is a completely different metabolic state.

SNI: What’s the data show regarding the effects of low carbohydrate diets on cardiovascular health?

Dr. Volek: How low fat and low carbohydrate diets impact risk for heart disease is one of the great nutrition debates of all time. For more than 3 decades, mainstream medicine and nutrition policy has been based on the diet-heart hypothesis. The syllogistic logic of the diet heart hypothesis is that lowering fat intake (specifically saturated fat) will decrease blood cholesterol which in turn will decrease risk of heart disease. Rather than growing stronger as new data has accumulated over the last 40 years, today the diet-heart paradigm is on razor thin ice, and the temperature is increasing. To understand why as a country we went down this path, no one has written a more definitive in depth analyses than Gary Taubes in Good Calories Bad Calories and more recently in Why We Get Fat. While several lines of evidence from recent studies have illuminated the short-comings of low fat/high carbohydrate diets, the real question is whether low carbohydrate diets are a better alternative. All my research and that of several other groups have found that a well formulated low carbohydrate diet consistently improves all the features of metabolic syndrome including two of the most important risk factors for heart disease, the level of small LDL particles and the level of inflammation. The unremitting high prevalence of obesity, metabolic syndrome, and diabetes – all states that increase risk of heart disease but more importantly all states can best be described as carbohydrate intolerance – coupled with the very limited efficacy of traditional low fat diets may be a case of trying to fit a square peg in a round hole. Over the lifetime of each individual, a majority of us will find that we are better suited to a diet that restricts carbohydrate. Even if this is not you now, aging can often bring on carbohydrate intolerance with increasing weight, metabolic syndrome, or diabetes.

SNI:  What’s the data show regarding the effects of low carbohydrate diets on body composition?

Dr. Volek: We dedicate a complete chapter to body composition because it’s quite common to hear critics say that you can lose pounds faster on low carb diet, but it’s mostly water and muscle rather than body fat.There is an amazing story behind this myth that has survived over 30 years. In short, there is now overwhelming evidence that not only do groups of people randomized to a low carb diet lose more weight than on higher carb intakes, but they also lose more body fat. The myth of water and muscle loss came from brief studies (a few weeks or less) in people who never completed the adaptation phase of the low carb diet, in which there is often substantial water loss because of the diuretic effects of the diet. If you lose 5 pounds of fat and 5 pounds of water in the first 2 weeks, yes, half of your initial weight loss was not from fat. But if you then stay on the diet for 18 more weeks, losing two-and-a-half pounds of fat per week (but keeping all of your muscle), after 20 weeks you’ve lost 55 pounds, 50 of which was body fat. How to get this result, losing almost all fat and retaining or even increasing your strength and well-being, is explained as the sum of many factors which together we define as ‘a well-formulated low carb diet’.

SNI:  Can endurance and/or strength-power athletes follow a low carbohydrate diet?

Dr. Volek: YES and to appreciate how and why you need to understand keto-adaptation. Keto-adaptation, while well studied and documented, is not well-understood by most physicians, nutritionists/dietitians and trainers. This is primarily due to the emphasis in standard nutrition training placed on dietary carbohydrates for physical performance. Maintaining high carbohydrate availability is challenging and physiologically problematic, whereas switching metabolic preference to non-carbohydrate lipid-based fuels makes athletes get more out of their limited glycogen. Keto-adaptation affords even a very lean (10% body fat) athlete access to >40,000 kcal from body fat, rather than starting a prolonged event depending primarily on ~2000 kcal of glycogen. The human body takes at least 2 wk to complete metabolic adaptation to a very low carbohydrate diet, after which fat becomes its primary fuel. Additionally, keto-adaptation will likely reduce the inflammatory and oxidative stress response to exercise and allow for more efficient recovery.

A very low carbohydrate diet can also be followed by strength/power athletes. In one of our experiments, we had men train intensely with weights for 3 months while consuming either a very low carbohydrate diet or a low fat diet. The men consuming the low carb diet showed the greatest decreases in percent body fat and actually traded fat for muscle while improving functional capacity. Why would decreasing body fat be advantageous? Beyond the obvious aesthetic and health reasons, decreasing body fat is relevant for athletes who need to maintain a specific body weight as a demand of their sport (e.g., wrestling, boxing, powerlifting, Olympic lifting, judo, mixed martial arts, etc.) or for sports where physical appearance is a component of success (e.g., bodybuilding, gymnastics, dancing, fitness model competitions, figure skating, platform diving, etc.). From a functional perspective, a loss in body fat, and therefore body weight, improves the power to weight ratio, a very important determinant of endurance performance as well as speed and quickness which is relevant for athletes who participate in sports demanding short high-intensity and explosive bursts. Bottom line, there has been an overemphasis on the obligate nature of carbohydrate for athletes. A strong case can be made that lower carbohydrate intake or slow release forms of carbohydrate are preferred for active individuals seeking improvements in metabolic health and performance

SNI:  What are the top 3 myths regarding the effects of low carbohydrate diets?

Dr. Volek: Not including those issues discussed above, three additional myths revolve around these themes:

Saturated Fat is Harmful: Saturated fat gets blamed for a lot of bad things. The truth is that saturated fats only become problematic when they accumulate in the body. And the guilty party for saturated fat accumulation, in most cases, is dietary carbohydrate. This may seem counter-intuitive because we love to say “you are what you eat” but dietary intake of carbohydrate – not saturated fat – is the major driver of plasma levels of saturated fat. Prior studies have reported lower plasma levels of saturated fat in response to diets that contained 2-3 fold greater intake of saturated fat but were lower in carbohydrate. Even in controlled feeding studies in weight stable individuals (which necessitates a high intake of dietary fat), low carbohydrate diets decrease plasma saturated fat levels. In short, the level of carbs in the diet controls how you process saturated fat, keep carbs low enough and saturated fat becomes a preferred fuel, and this reduces their level in the blood.

Low Carb Diets Only Work Short-Term: Unfortunately, all too frequently people lose weight on a low carbohydrate diet and then promptly regain it all back. A common reason is they failed to view a low carbohydrate diet as a lifestyle. If you respond really well to a low carbohydrate diet as a weight loss tool, part of the reason is your willpower, but the other reason is that your body is probably not good at processing carbohydrates. For most people, this difficulty metabolizing carbohydrates does not go away even after you’ve lost some weight. So after losing 15 or 150 pounds, if you transition back to a diet with too much carbohydrate, you will likely regain much of the weight, even if the carbs you eat are the apparent ‘healthy’ ones. Yes, it is possible that you might be able to add some carbs back into your diet once you have reached your goal weight, but be very cautious. Listen to your body as much if not more than you listen to your dietitian. Adding back too much carbohydrate can put you on a slippery slope back to your former weight. To prepare yourself for long term success, from the very start you need to view your low carbohydrate diet as a permanent lifestyle, not just a temporary weight loss tool.

Low Carb Diets are Extreme: The mainstream nutrition establishment loves to claim that restricting an entire macronutrient class is extreme, especially carbohydrates which are known to give us quick energy. Encouraging moderation in all foods and a ‘balanced diet’ seems to make sense on the surface. After all, how can you argue against quick energy, moderation and balance? The answer depends to some degree on preconceptions around the meaning of moderation and what you consider ‘good’ nutrition. If consuming lots of carbohydrate provided some essential nutrient that would otherwise be lacking, then we might agree that a low carbohydrate diet is unbalanced or even extreme. But that’s clearly not the case. Think of it this way – what if you lived in California and planned a vacation in Hawaii. Would you believe someone who told you going that far was ‘extreme’, and therefore you ought to try flying just half way there instead? In this analogy, practicing this form of moderation would land you in seriously deep water. ‘Moderation’ and ‘balanced’ are meaningless terms when we are talking about ‘islands of safety’. And if your body is carbohydrate intolerant, eating a low carbohydrate diet is your island of dietary safety. Should a person with gluten intolerance consume moderate amounts of gluten so they can have a balanced diet? Of course not. Then why should a person with carbohydrate intolerance consume moderate amounts of carbs to meet some arbitrary criterion of a ‘balanced’ diet? From the point of view of essential nutrients and adequate energy to power your body, a low carbohydrate diet is ‘balanced’.

Source: Sports Nutrition Insider

Gall Stones = Celiac Disease?

9 May

A few weeks ago, around four o’clock I received a phone call from my lovely girl friend stating she had mid-back pain since 11 o’clock.  She said that the pain had not minimized at all throughout this time and was accompanied by shortness of breath and slight nausea

At first we thought it might have been from some sort of muscle pain caused by a workout or holding something heavy for a long amount of time, but muscle pain would have minimized in five hours and she had not exercised strenuous enough to cause such pain.

After a couple more questions concerning what she had eaten for breakfast, I regretfully suggested that she might have gallstones.  She had no idea what those were or what might have caused them. Long story short and an ultrasound later, she was positive for gallstones.

The occurrence of gallstones has bewildered scientists for some time, and many within the scientific community believe that it involves an inherited mis-management of cholesterol by the liver.  For example, according to the Kaiser Permanente Medical Center’s informational brochure on gallstones, “when there is too much cholesterol in the bile, it forms crystals which gradually enlarge to form stones. The amount of cholesterol in bile has no relation to the blood level of cholesterol.”

However, this explanation does not get to the root of the matter of what actually causes the gallstones to appear in the first place.  We eat cholesterol in food, such as seafood.  We manufacture cholesterol naturally in our liver.  So, why would it suddenly create gallstones?

 There is a theory in the world of science that gallstones are created in individuals that have undiagnosed celiac disease.  Celiac disease is defined as an autoimmune disease caused by gluten, a protein found in wheat, rye, barley and millet.  Grains contain a variety of proteins, some called lectins.  According to this theory, over time these lectins damage the villi on the wall of the small intestine.  When the intestinal wall is damaged, the chemical messenger that tells the gall bladder to release bile into the small intestine, called cholecystokinin (CCK), is not released.  When this signal is blocked, we do not properly digest our foods, particularly fat and protein. The lack of bile released allows cholesterol crystals to form in the gall bladder, which leads to gall stones.

Usually individuals with gallstones have their gall bladder removed and they may return to their old way of eating, which in this country consists of a high-carbohydrate, grain-based diet.  However, if the gluten-allergy-gallstone hypothesis is true, the sensitivity to gluten does not end even when the gallbladder is removed. Celiac patients still have sensitivity to gluten.  Just because there is less bile available to create the gallstones, reminding an individual of this sensitivity during a painful gallstone attack, the autoimmune disorder still requires nutritional caution.  Additionally, these people are at greater risk of developing rheumatoid arthritis, lupus, Sjögren’s, multiple sclerosis, vitiligo, Huntington’s, etc., which would require a gluten-free and/or lectin free diet, i.e. removing all grains, legumes and dairy.

Therefore, if the gallstone-celiac disease theory is correct, gall bladder removal may be viewed as a partial remedy to the problem.  Individuals may want to consult with their physician concerning a celiac test to determine if he/she may be diagnosed with a gluten-allergy.

 Personal Note

On a final note, this will be my last newsletter article for a while, due to time constraints in pursuing new challenges in the Wellness coaching world.  I have appreciated all of the dialogue and feedback over the last 8.5 years.

Low Carbohydrate Diet May Reverse Kidney Failure in People With Diabetes

25 Apr

Low Carbohydrate Diet May Reverse Kidney Failure in People With Diabetes

ScienceDaily (Apr. 21, 2011) – Researchers from Mount Sinai School of Medicine have for the first time determined that the ketogenic diet, a specialized high-fat, low carbohydrate diet, may reverse impaired kidney function in people with Type 1 and Type 2 diabetes. They also identified a previously unreported panel of genes associated with diabetes-related kidney failure, whose expression was reversed by the diet.

The findings were published in the current issue of PLoS ONE.

Charles Mobbs, PhD, Professor of Neuroscience and Geriatrics and Palliative Care Medicine at Mount Sinai School of Medicine, and his research team evaluated mice that were genetically predisposed to have Type 1 or 2 diabetes. The mice were allowed to develop diabetic nephropathy, or kidney failure. Half of the mice were put on the ketogenic diet, while the control group maintained a standard high carbohydrate diet. The researcher founds that after eight weeks, kidney failure was reversed in the mice on the ketogenic diet.

“Our study is the first to show that a dietary intervention alone is enough to reverse this serious complication of diabetes,” said Dr. Mobbs. “This finding has significant implications for the tens of thousands of Americans diagnosed with diabetic kidney failure, and possibly other complications, each year.”

The ketogenic diet is a low-carbohydrate, moderate protein, and high-fat diet typically used to control seizures in children with epilepsy. Many cells can get their energy from ketones, which are molecules produced when the blood glucose levels are low and blood fat levels are high. When cells use ketones instead of glucose for fuel, glucose is not metabolized. Since high glucose metabolism causes kidney failure in diabetes, researchers hypothesized that the ketogenic diet would block those toxic effects of glucose.

Considering the extreme requirements of the diet, it is not a long-term solution in adults. However, Dr. Mobbs’ research indicates that exposure to the diet for as little as a month may be sufficient to “reset” the gene expression and pathological process leading to kidney failure.

The researchers also identified a large array of genes expressed during diabetic nephropathy not previously known to play a role in the development of this complication. These genes are associated with kidney failure as a result of the stress on cellular function. The team found that the expression of these genes was also reversed in the mice on the ketogenic diet.

Dr. Mobbs and his team plan to continue to research the impact of the ketogenic diet and the mechanism by which it reverses kidney failure in people with diabetes, and in age-related kidney failure. He believes the ketogenic diet could help treat other neurological diseases and retinopathy, a disease that results in vision loss.

“Knowing how the ketogenic diet reverses nephropathy will help us identify a drug target and subsequent pharmacological interventions that mimic the effect of the diet,” said Dr. Mobbs. “We look forward to studying this promising development further.”

This study was funded partly by the National Institutes of Health and by the Juvenile Diabetes Research Foundation Michal M. Poplawski, Jason W. Mastaitis, Fumiko Isoda, Fabrizio Grosjean, Feng Zheng, Charles V. Mobbs. Reversal of Diabetic Nephropathy by a Ketogenic Diet. PLoS ONE, 2011; 6 (4): e18604 DOI: 10.1371/journal.pone.0018604

All or Nothing Syndrome

8 Apr

Last month I attended a wonderfully catered company party with a mix of clients and co-workers. It was probably one of the healthiest and tastiest catered events I have ever attended.  There was a full assortment of veggies, nuts, fruits, baked meats and cheeses.  If there was ever an opportunity to maintain healthy eating at a social event, it was certainly this one.

Anybody who knows me also knows that I have a sweet tooth. Growing up in the Midwest, and having a mother who loved to bake for family and strangers alike, I would routinely smell and eat various pies, cookies and cakes for no reason other than my mother liked to make them (homemade doughnuts beat the crap out of Krispie Kremes any day!).

Following the healthy array of food, there was a wonderful assortment of desserts.  There was a large plate of small, assorted baked pastry-like cookies, a triple-layered chocolate mousse, a strawberry mousse, and lemon ice.  All were so delicately presented and eye-appealing that nobody would dare to be the first to destroy such master pieces…but then there is me – the guy who has more child-like patience toward desserts than a five-year-old.  So, I was ready to jump in like Val Kilmer at Hometown Buffet.

Once I had completed my sweet indulgence, I had four to five plates of just dessert under
my belt, I received plenty of comments from those who have not seen me eat like this. Such as: “How can you eat so much of that…?” “Why should I listen to you about nutrition?” and “More!?”

This brings me to the point of this article (anybody hungry now?): eating healthy does not imply  I do not occasionally splurge. I do not adhere to, nor do I advise, an “all or nothing lifestyle” that restricts food.  I do not eat five plates of dessert every night, every weekend, or even every six months.

If an individual eats five to six times per day, 35-42 times per week, one meal of indulging will certainly not destroy an individual’s attempt at maintaining a healthy diet. In fact, because of the psychological release of such an indulgence, I encourage my clients to eat whatever they want for one meal a week, not for one entire day.  For example, the following morning after the party, I was back to eating my normal breakfast of an apple, a scoop of almond butter and a cup of coffee.  It must also be understood that an “indulgence meal” does not have to be a large consumption of calories in one sitting, as my example portrayed.  It may also include eating just one piece of dessert, or eating French fries that would normally be a side salad, or having a milk shake.  It’s not even necessary to eat the entire portion.

It is continuous, daily eating of refined-carbohydrates and processed foods that cause an assortment of diseases.  Just how often is “too much” depends on each individual’s current health, fitness level, and wellness goals.  For example, if a male’s body fat percentage is greater than 26 percent, this is considered above average, he will need to reduce the amount of processed food and refined-carbohydrates in his diet to reduce body fat percent to healthier levels.

Eat to improve your health, and make choices to attain your goals, but don’t fall into the “all or nothing” frame of mind.  This is a formula for failure in the long run.  In case you were wondering, at the time I am writing this article, I weigh less than the day I ate those desserts ☺

Probiotics and Their Uses

9 Mar

Probiotics are a group of live microorganisms and yeasts that may beneficially affect the body by improving the balance of microflora (i.e. bacteria that are naturally occurring in the small and large intestine, mouth and vagina). The scope of this article will focus on the benefits of probiotics for a healthy and balanced digestive system.

Thus far, scientists suggest that a healthy human digestive tract contains about fourteen various genus of microorganisms, making a grand total of approximately 400 types of bacteria that reduce the growth of harmful bacteria and promote a healthy digestive system. The largest group of probiotic bacteria in the intestine is lactic acid bacteria, of which Lactobacillus acidophilus (found in yogurt) is the best known. However, there are other species of Lactobacillus that have also been shown to be beneficial, such as L. plantarum, L. rhamnosus, L. casei and L. bulgaricus.

The Function of Microbes in the GI Tract
The gastrointestinal tract of animals represents a complex ecosystem in which a delicate balance exists between the intestinal microflora and the host. The host and microflora live in a synergistic environment – the host providing a comfortable environment for the microbes to survive while the microbes thrive and produce beneficial metabolic byproducts that aid the host’s GI tract and immune system. This synergistic relationship begins to develop while we are babies, starting at delivery and continuing during breastfeeding and receiving kisses from family and friends.

The inhabitation of microbes in a developing GI tract has been hypothesized to not only be important in the neonatal period and during infancy, but also in an individual’s health throughout life. The small intestine is lined with lymph nodes that support our immune system. The byproducts and metabolites of the intestinal microflora developed during infancy are important for maturation of the immune system, the development of normal intestinal form and structure, and to maintain a chronic and immunologically balanced inflammatory response. The microflora reinforce the barrier function of the intestinal lining, helping to prevent the attachment of pathogenic microorganisms and the entry of allergens.

Some members of the microflora may contribute to the body’s requirements for certain vitamins, including biotin, pantothenic acid and vitamin B12.  Alteration of the microbial flora of the intestine, which may occur with the use of antibiotics, disease, and aging, can negatively affect its beneficial role. This is where the potential benefits of supplementing with probiotics may help to balance or re-balance what has been destroyed.

When to Use Probiotics
If you believe that probiotics may be beneficial for your condition, but you do not know what to look for on a product’s label, here is what the current research suggests:

Among the probiotics, only S. boulardii, Enterococcus faecium and Lactobacillus species have been useful in preventing antibiotic-related diarrhea. S. boulardii appears to be the most superior form of treatment when diarrhea is caused by Clostridium difficile, a bacterium often associated with antibiotic related diarrhea. The results of some early studies suggest that probiotics found in yogurt may help prevent diarrhea caused by antibiotics. However, more studies are needed to confirm that yogurt is effective. To offer benefits, the yogurt must contain active cultures.

Anti-Inflammatory for GI Conditions
Because of a reduced fecal concentration of various probiotics in individuals with active ulcerative colitis, Crohn’s disease, active pouchitis, inflammatory bowel disease, and irritable bowel syndrome, researchers have noted that probiotics may be beneficial for individuals with these conditions. However, thus far, the
results have been inconclusive and more research is needed.

Some lactic acid bacteria, including L. plantarum, L. rhamnosus, L. casei and L. bulgaricus, have demonstrated immuno-regulatory effects that may help protect against some allergic disorders. There is some evidence that some of these probiotic strains can reduce the intestinal inflammation associated with some food allergies, including cow’s milk allergies among babies.  Research has shown that breastfed infants given Lactobacillus significantly improved atopic dermatitis or eczema, compared with infants not exposed to this probiotic.

There are in vitro studies, as well as animal and some preliminary human studies suggesting that some probiotics can bind and inactivate some carcinogens, which can directly inhibit the growth of some tumors and inhibit bacteria that may convert pre-carcinogens into carcinogens.  L. acidophilus and L. casei have exhibited the latter activity in human volunteers. There is some preliminary evidence that L. casei may have reduced the recurrence of bladder tumors in human studies, although confirmatory trials are needed.  Animal work has suggested that some lactic-acid bacteria may help protect against colon cancer.  Again, more research is needed.

The effectiveness of probiotics is dependent upon their ability to survive in the acidic stomach environment and the alkaline conditions in the upper small intestine, as well as their ability to adhere to the intestinal lining and to colonize in the colon.  Some probiotics, such as L. casei, L. rhamnosus, and L. plantarum, are better able to colonize than others.  A major problem is that there are many probiotic products available, and not all of them have been tested for every potential treatment listed above. These products contain various Lactobacillus and Bifidobacterium strains and combinations of probiotics and prebiotics. Additionally, typical doses of probiotics range from one to ten billion colony-forming units (CFU) a few times a week.  Because of the inconclusive data of probiotics, the optimal number of CFU’s for a healthy GI tract is unknown. Trial-and-error may be needed to find the most beneficial dose, but there is very little risk in overdosing.  Usually probiotics are well-tolerated, unless you have a prior condition that may warrant caution.  Discuss the use of probiotics with your physician or healthcare provider.  The animal and in vitro studies continually show there may be more benefits of probiotics to help with the delicate balance of our bodies.

Scott Gets His Blood Checked

10 Feb

After a discussion with my mother concerning my family’s health history and heart disease, I did some investigating into heart healthy diets.  I was influenced by the low-carbohydrate research referenced in Good Calories, Bad Calories by Gary Taubes, and the Paleo Diet by Loren Cordain.  According to these books, and a recent review published in the American Journal of Clinical Nutrition in March, 2010, in order to decrease cardiovascular risk we should reduce excess body fat and limit refined carbohydrates in our diet, such as processed starches (i.e. crackers, pastas, breads) and sugar.  That sounded like an interesting proposition to test for myself.  In addition, I wanted to challenge the notions that 1) dietary fat does not raise LDL cholesterol (the “bad” cholesterol), 2) that sugar and refined carbohydrates do raise LDL cholesterol, and 3) a high saturated fat diet would actually increase HDL (the “good” cholesterol) .

I have followed the guidelines of a low-carbohydrate diet for approximately two years that kept overall carbohydrate intake (including fruit and vegetables) to approximately  100 grams per day, ate little to no bread, and consumed a higher-fat diet, especially saturated fat.  While I am at work, with poor meal-preparation and needing to eat between clients, I have two Muscle Milk shakes and/or a protein bar(s) per day.  During the week, I eat an assortment of meat, seafood, nuts, fish and whole eggs.  As for vegetables, I eat primarily dark green veggies, such as broccoli, spinach, arugula and asparagus, but I also include cauliflower and watercress. Additionally, I exercise 4-5 times per week with at least 3 intense Crossfit routines ranging from 8-30+ minutes and 2-3 heavy lifting exercise routines.  I am 35 years old, with two children (4 & 7 years old).  My current body fat is around 10%, I average six hours of sleep six days per week, and I sleep in on Sundays.

There has been an extensive amount of research concerning the benefits and consequences of a deficiency in vitamin D.  With the importance of an adequate vitamin D level in mind, and because I go to work and return home in the dark during the winter (vitamin D is called the “sunlight vitamin” because our bodies make it from sunlight), I inconsistently supplement with 5,000-10,000 IU of vitamin D3.  Unfortunately, a specific test needs to be ordered to determine an individual’s vitamin D level – it is not a part of a regular physical exam blood profile.  So, I was looking forward to seeing my lipid profile and vitamin D level in order to determine how healthy my blood might suggest I am.  Otherwise, exercising regularly and eating a specific diet is not worth missing the lounging around, consuming pies and doughnuts, and watching television. ☺

Here are the results of my lipid profile:

Component                            My Value                        Standard Range*
CHOLESTEROL                        144                                      < 200-  mg/dL
TRIGLYCERIDE                        79                                        < 150-  mg/dL
HDL                                              69                                        > 55-65-  mg/dL
LDL CALCULATED                  59                                        <100-129-  mg/dL
VITAMIN D, 25-HYDROXY    34                                        30-100 ng/mL

*Standard range based on desirable or optimal ranges

My physician said my laboratory tests all look great.  At one time, the cholesterol ratio was considered better for physicians to assess a patient’s risk of heart disease, but it appears times have changed.  Physicians are more interested in the raw numbers.  However, my lipid profile is unique in that my HDL cholesterol is actually higher than my LDL cholesterol.  I attribute this aspect of my lipid profile to my higher-fat diet.  Short-term and long-term low-carbohydrate studies consistently show to increase in HDL cholesterol with increased saturated fat intake.

As for the vitamin D results, although I am in the “normal range”, I am alarmed that I am in the low normal range after supplementing with vitamin D3.  The conversion of vitamin D3 in the body is dependent on the concentration of a certain enzyme, and the concentration varies among people.  Although controversial on the optimal level, evidence suggests vitamin D3 level should be above 50 – 80 ng/dL.  Therefore, either I need to increase my vitamin D3 supplementation, get more sun, or a little bit of both.  Either way, I need to have another vitamin D3 test in another three months to see if I am increasing my levels effectively.

In conclusion, I am happy with my results, but the vitamin D test was a novel piece of health knowledge. Everybody should have a yearly physical to record personal markers of health, and identify detrimental changes.

So, when is the last time you had your blood tested?