Posts Tagged ‘healthy eating’

Eat Your Way To Better Sex

March 31, 2018

Andrew Siegel MD   3/31/18

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Thank you, Max Pixel, for image above of a healthy salmon and salad meal (maxpixel.freegreatpicture.com)

You are what you eat…

Our cells and tissues require food for energy to fuel our body functions.   Equally as important, nutrients present in foods serve as the building blocks of our cells and our tissues during the process of remodeling, restructuring and refashioning–that occurs in all tissues including the genitals–as old cells are replaced by new cells.  While optimal sexual functioning is based on many factors, it is important to recognize that food choices play a definite role. What we eat—or don’t eat—can certainly impact our sex lives, and this is equally applicable to both men and women, even though this entry is geared towards men.

Sex is important…

Although not a necessity for a healthy life, sexuality is an important part of our human existence. Healthy male sexual function requires an adequate sex drive, the ability to obtain and maintain a reasonably rigid erection, and the capacity to ejaculate and experience a climax. When sexual functioning goes south, the aftermath can be a loss of confidence and self-esteem, embarrassment, a sense of isolation, frustration and, at times, depression. There is a good reason the word “cocksure” means possessing a great deal of confidence.

Sex is complicated…

Sexual functioning is complex and dependent upon a number of systems working in tandem– the endocrine system (which produces hormones); the central and peripheral nervous systems (which provide executive function and nerve control); the vascular system (which conducts blood flow); the smooth muscles (erectile tissue within the arteries and sinuses of the erectile chambers); and the skeletal muscles (the pelvic floor muscles that help maintain high penile blood pressures necessary for erectile rigidity).

A canary in your trousers…

Sexual function is an indicator of underlying cardiovascular health– Poor erections can be a warning sign that an underlying problem exists. On the other hand, the presence of rigid and durable erections is an indicator of overall cardiovascular health. Since the penile arteries are generally rather small (diameter 1-2 mms) and the coronary (heart) arteries larger (4 mms), it stands to reason that if vascular disease is affecting the tiny penile arteries, it may affect the larger coronary arteries as well—if not now, then at some time in the future. In other words, the fatty plaques that compromise blood flow to the smaller vessels of the penis may also do so to the larger vessels of the heart and thus erectile dysfunction may be considered a genital “stress test.”

A marvel of engineering…

A healthy sexual response is largely about blood flow to the genital and pelvic area. The penis is a marvel of engineering, uniquely capable of increasing its blood flow by a factor of 40-50 times over baseline, this surge happening within seconds and responsible for the remarkable physical transition from flaccid to erect. This is accomplished by relaxation of the smooth muscle within the penile arteries and erectile tissues. Pelvic muscle engagement and contraction help prevent the exit of blood from the penis, enhancing penile rigidity and creating penile blood pressures that far exceed normal blood pressure in arteries. For good reason, Gray’s Anatomy textbook over 100 years ago referred to one of the key pelvic floor muscle as the “erector penis.”

Like well-inflated tires…

Blood flow to the penis is analogous to air pressure within a tire: if there is insufficient pressure, the tire will not properly inflate and will function sub-optimally; at the extreme, the tire may be completely flat. Furthermore, slow leaks (that often occur with aging and failure of the smooth muscle within the penile arteries and erectile tissues to relax) promote poor function.  As your car declines in performance if it is dragging around too much of a load, so your penis can function sub-optimally if you are carrying excessive weight.

Obesity steals your manhood…

Abdominal fat (beer belly) is not just fat, but is a hormonally active organ that is chock full of the enzyme that converts the male hormone testosterone to the female hormone estrogen. Less testosterone translates to less sex drive and more estrogen often promotes man-boob development.  Obese men are also more likely to have fatty plaque deposits that clog blood vessels–including the arteries to the penis–making it more difficult to obtain and maintain erections. As the belly gets bigger, the penis appears smaller, lost in the protuberant roundness of a large midriff and the abundant pubic fat pad.  It is estimated that there is a 1 inch loss in apparent penile length for every 35 lb. of weight gain. So, if your sex drive is lagging, your penis is difficult to find, your man-boobs are prominent and your erections are not up to par, it may be time to rethink your lifestyle habits.

Those were the days, my friend, but now…

Do you remember the days when you could achieve a rock-hard erection—majestically pointing upwards—simply by seeing an attractive woman or thinking some vague sexual thought? Chances were that you were young, active, and had an abdomen that somewhat resembled a six-pack. Perhaps now it takes a great deal of physical stimulation to achieve an erection that is barely firm enough to be able to penetrate. Maybe penetration is more of a “shove” than a ready, noble, and natural access. Maybe you need pharmacological assistance to make it possible.  If this is the case, it is probable that you are carrying extra pounds, have a soft belly, and are not physically active. When you’re soft in the middle, you will probably be soft where it counts.  A flaccid penis is entirely consistent with a flaccid body and a hard penis is congruous with a hard body.

The Golden Rule: Treat your penis well and it will treat you well…

Healthy lifestyle choices are vital towards achieving optimal quality and quantity of life. It should come as no surprise that the initial approach to managing sexual issues is to improve lifestyle choices. These include healthy eating habits, keeping your weight down, exercising, sleeping adequately, drinking alcohol in moderation, avoiding tobacco and minimizing stress.

Bad choices…

Studies have shown that apart from known lifestyle risk factors, dietary practices such as decreased intake of vegetables and fruit and increased intake of unrefined and processed foods, dairy and alcohol are strongly associated with sexual difficulties in young men. Poor dietary choices with meals full of calorie-laden, nutritionally-empty selections (e.g., fast food, processed foods, excessive sugars or refined anything), puts one on the fast track to obesity and clogged arteries that can make your sexual function as small as your belly is big.

Good choices…

Healthy eating is important, obviously in conjunction with other smart lifestyle choices. Maintaining a healthy weight and fueling up with wholesome, natural, and real foods will help prevent weight gain and the build-up of harmful plaque deposits within blood vessels. Healthy fuel includes vegetables, fruits, legumes, nuts, whole grains and fish. Animal products (meats and dairy) should be eaten moderately and when indulging, lean cuts are healthiest. A Mediterranean-style diet is ideal for optimizing health and minimizing sexual dysfunction and heart disease. Rich in vegetables, fruits, whole grains, legumes, olive oil and lean protein sources (fish and chicken vs. red meat), the Mediterranean diet has been shown to improve sexual function, perhaps by alterations in glucose and fat metabolism and increasing anti-oxidant defenses, arginine levels and nitric oxide activity.

Bottom Line: If you want a “sexier” lifestyle, start with a “sexier” style of eating that will improve your overall health and make you feel better, look better and enhance your sexual function.  Smart nutritional choices are a key component of sexual fitness.

Wishing you the best of health!

2014-04-23 20:16:29

A new blog is posted weekly. To receive a free subscription with delivery to your email inbox visit the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.

Dr. Siegel has authored the following books that are available on Amazon, iBooks, Nook and Kobo:

 MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health 

PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food

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These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.

Dr. Siegel is co-creator of the male pelvic floor exercise instructional DVD (female version is in the works): PelvicRx

 

 

 

 

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10 Ways To Maintain Sexual Fitness

December 31, 2016

Andrew Siegel MD  12/31/16

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(Thank you, Pixabay, for image above)

It is fundamental to understand that your genitals are not separate and independent entities, but part and parcel of your body as a whole. If your health is compromised by illness or poor lifestyle, you should not expect your penis or vagina to function any better than rest of your body, but in parallel with your general health. If you are overweight, “malnourished” on the basis of a poor diet, do not challenge your body with regular exercise, use tobacco, consume too much alcohol, are over-stressed, sleep deprived, etc., your sexual function will likely suffer in concordance with your general health. The bottom line is that general health drives genital health and that healthy sexual functioning is an excellent marker of general health.

 

Sex is a healthy and natural part of life.  A healthy sexual relationship is an important part of an overall healthy relationship, “cementing” the bond between those in the relationship.

Whether male or female, the concept of “sexual fitness” has recently come into vogue. The idea is that sexual health is related to overall health and that optimal functioning in the bedroom can only be achieved with an  healthy state of mind and body and that the root cause of declining sexual performance is  when general health is compromised.

Blood flow is our lifeline and defines our existence. The key to life is the unimpeded flow and delivery of oxygen and nutrients to every cell and tissue in the body to maintain proper function.  Cardiovascular health is thus imperative for general and sexual health and when blood flow is jeopardized, both general health and sexual function will suffer.

Cardiovascular fitness is based upon maintaining a healthy weight, consuming a nutrient-rich diet (lean proteins, abundant fruit, vegetables, legumes and avoidance of nutrient-poor processed foods, excessive sugar and refined foods, etc.), daily activity and exercise (including aerobic, resistance, core and pelvic floor), avoiding excessive stress, getting sufficient sleep and avoidance of toxins including tobacco and excessive alcohol. Negative behaviors pursued on a chronic basis can sap one’s health and vitality that is critical to sexuality.

Our human ability to perform physically—in any domain—declines as we age, explaining why most professional athletes are in their twenties or thirties. Sexual function is no exception, with sexual response generally declining gradually over time, most often predicated upon impaired blood flow and altered function of the cells and tissues that comprise the genitals.

One option is to wait for your sex life to go south and then be “reactive,” incorporating healthy lifestyle measures in an effort to reverse the damage. A better approach is to be “proactive” with attention to the following ten recommendations.

10 Ways To Maintain Sexual Fitness

  1. Maintain a Healthy Weight  This will help prevent fatty deposits that clog up your blood vessels, including the arterial supply to the penis and vulva/vagina.
  1. Eat Healthy  The bottom line is that you want your body running on premium fuel. Nutritionally wholesome, natural foods will help prevent the build-up of harmful fatty deposits that compromise genital blood flow. Poor dietary choices with calorie-laden, nutritionally-empty selections (e.g., fast, processed, or refined foods) puts you on the fast tract to clogged arteries that can make your sexual function as small as your belly is big.
  1. Minimize Stress  Stress causes the release of the hormones adrenaline and cortisol. Adrenaline narrows blood vessels, which has a negative effect on sexual response. Excessive cortisol secretion drives appetite and causes the accumulation of the bad belly fat (as opposed to fat under the skin).
  1. Eliminate Tobacco Tobacco contains nicotine and a cocktail of toxins that impairs blood flow and decreases the supply of oxygen, as well as promotes inflammation, compromising every organ in your body, including those vital for sexual function.
  1. Alcohol in Moderation  In small amounts, alcohol can alleviate anxiety and act as a vasodilator (increasing blood flow), but in large amounts it can be a major risk factor for sexual dysfunction. Everything in moderation!
  1. Sleep Tight  Sleeping has a critical restorative function. During this important downtime there is an increased rate of tissue growth and a decreased rate of tissue breakdown, vital for maintaining the integrity of our cells and tissues. Sleep deprivation causes a disruption in endocrine, metabolic, and immune function, resulting in increased appetite, increased cortisol, and higher amounts of sugar in the bloodstream. If you are exhausted, your genitals will be equally weary.
  1. Exercise   Exercise has a robust effect on sexual function through stress busting, mood improvement, fatigue reduction, increase of energy and better quality sleep. It reduces risk of diabetes, heart disease, stroke, high blood pressure, some cancers, osteoporosis, chronic medical problems, and physical disability. It improves muscular strength and tone, reduces body fat and helps weight control. It makes your heart a better and stronger pump, your blood vessels more elastic, and your muscles better able to use oxygen. Exercises that work out the muscles involved in sex—the core muscles, the external rotators of the hip, and the all-important pelvic floor muscles—will improve bedroom performance. 
  1. Pelvic Floor Muscle Exercises The pelvic floor muscles play a vital role with respect to all aspects of sexual function, from arousal to climax. Numerous scientific studies have documented the benefits of pelvic exercises (Kegels) in improving sexual function.
  1. Stay Sexually Active   Keep your genitals fit by using them on a regular basis for the purpose they were designed for. In other words, stay sexually active as nature intended! Sexual activity is vital for maintaining the ability to have ongoing satisfactory sexual intercourse. Regular sexual activity increases pelvic and genital blood flow and optimizes tissue health and elasticity, while orgasms tone and strengthen the pelvic floor muscles“Disuse atrophy” is a condition when the genitals adapt to not being used, with tissue wasting, genital shrinkage and weakness of the pelvic floor muscles. Use it or lose it!
  2. Maintain a Healthy Relationship.  It takes two to tango, so relationship harmony plays strongly into healthy sexual functioning just as discord and interpersonal issues profoundly contribute to sexual dysfunction.

Note that sexual intercourse in and of itself is a great form of general exercise because of the kinetics involved and the demands on the cardiovascular system, core, pelvic floor and other skeletal muscles. Of the “10 ways to maintain sexual fitness,” staying sexually active covers 6 of them (maintaining a healthy relationship, staying sexually active, pelvic floor exercises, general exercise, sleeping tight and minimizing stress).

Bottom Line: The “Golden Rule”: Treat your genitals kindly (in terms of a healthy lifestyle) and the favor will be returned; treat your genitals poorly and they will rebel. The proactive approach will keep you functioning smoothly for many years. General health and fitness will foster sexual health and fitness, and staying sexually active is a vital means of maintaining general health and fitness.

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a practicing physician and urological surgeon board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  Dr. Siegel serves as Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community that is in such dire need of bridging.

Author of MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health http://www.MalePelvicFitness.com

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health  http://www.TheKegelFix.com

 

Investment Advice

May 3, 2014

Blog # 152

This blog is a new iteration of a previous posting from 2013, but modified significantly and certainly worthy of reiteration!

 

It is advisable not to take investment advice from a physician, but nonetheless I have some hot tips for the purpose of making you richer.

Q: What is the most important asset in your life? Who owns that asset? Specifically, what durable capital asset is the most valuable investment you can make?

A: The most valuable investment is your health, because without that, you’ve got nothing at all. Your health is your wealth, and we can refer to it as health-wealth.

When health is absent, wisdom cannot reveal itself, art cannot become manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied.”… Herophilus

Health is our most valuable possession.” …Hippocrates

Life without health is not worth living.” …Plato

Protecting and developing health must rank even above that of restoring it when it is compromised. … Huang-Di (the emperor who laid the foundation for traditional Chinese medicine 4500 years ago)

Many of us make an effort to save for retirement, earmarking funds for IRAs, 401K plans and other retirement vehicles in preparation for when we will no longer be working and will need to tap our savings to live…and hopefully, we will be living for many years after retirement, perhaps reaching the human potential of 100 years or so. First we need the health and wellness to have the quality of life to enjoy our golden years and second we need the financial wherewithal to thrive economically for the (hopefully) many years of retirement. Ralph Waldo Emerson summarized it in five words: “The first wealth is health.”

Sweat equity is the contribution of time and effort that is fundamental to the success of a business. Projecting its use to the health arena, I propose that we have Sweat Equity Accounts—aka, Fitness Accounts. The principles of obtaining and maintaining a fitness account parallel those of a retirement account:

  • Have a plan. Understand the need for and the importance of your account. If you invest wisely, it will create great health wealth.
  • Pay yourself first. Commit to it automatically, guaranteeing that it is a priority not to be tampered with. This will ensure regular deposits to build your fitness nest egg.
  • Slow and steady approach. A moderate amount of investment capital (exercise), deposited to the account on a diligent and regular basis, will ultimately allow for complete funding.
  • Long-term perspective. The greater the investment in terms of time invested, the larger the nest egg builds. The commitment to this plan needs to be a lifetime endeavor. No gimmicky investments, shortcuts, tricks or instant rewards! No nonsense!
  • Seek counseling. Not everyone is capable of managing his or her own portfolio, so seek the services of a professional advisor (personal trainer or fitness instructor). Their services will be well worth their cost.
  • Diversify. Deposit into your account a broad range of investments (aerobic and endurance activities, weight training, core, flexibility exercises, etc.).
  • Eliminate debt. Pay down and eliminate debt (excessive body weight and the burden of bad lifestyle choices) and reap the benefits of becoming debt free.
  • Start early. The earlier you begin accruing savings, the more time available to work the magic of compounding, when the investment returns themselves earn further returns. You will earn returns in the form of “interest and dividends” (improved quality of life) and “capital gains” (longer quantity of life). If you failed to start early, don’t waste another minute.

Your contributions to your account will ultimately make you “healthy-wealthy.” When sickness or disease inevitably surfaces, you will be well equipped to strike the noblest of fights because of your years of investment in your most valuable capital asset.

Andrew Siegel, M.D.

Please check out my brand new book:  Male Pelvic Fitness: Optimizing Sexual and Urinary Health; available in e-book (Kindle, iBooks, Nook); paperback coming soon.

www.MalePelvicFitness.com

 

 

Fat: Location, Location, Location Matters

September 14, 2012

Andrew Siegel, M.D.     Blog #74

 

We all have body fat; even elite athletes have a body composition that is a svelte 5-10% fat—this translates into roughly 10-20 pounds of fat for a 180-pound athlete.  What is important is that all fat is not created equal—where the fat accumulates in our bodies dramatically effects how that fat behaves.  So, the very location where your fat takes up residence has a tremendous influence on your health.

Fat on our body surface is much less problematic than fat deep within our body. Humans have two basic types of fat: subcutaneous fat and visceral fat. Subcutaneous fat—also known as “love handles,” “spare tires,” “muffin tops,” or “middle-age spread”—is present between the skin and the abdominal wall. When present in normal amounts, it gives us nice contours and makes us look less bony and skeletal and more smooth and curvy. When present in excessive amounts, it makes us look plump, roly-poly and pear-shaped. A moderate amount of subcutaneous fat is of little danger to our health and, in fact, provides us numerous advantages including padding and insulation to conserve heat and help with temperature regulation, a means of storage of fat-soluble vitamins, and a ready source of energy. Visceral fat—also referred to as a “pot belly,” “beer belly,” or “Buddha belly”—is internal fat deep within the abdominal cavity that can make us apple-shaped.  It wraps around our internal organs including our liver, kidneys, and pancreas. Visceral fat is always unhealthy fat that can have dire metabolic consequences. In general, waist circumference is a reasonably good measure of visceral fat. (Of course, morbid obesity due to either type of fat can prove extremely  dangerous to one’s health.)

It’s kind of like real estate, the value of which is predicated on location, location, location. Think of visceral fat as prime, expensive beachfront property on the gold coast with a short walk to the ocean, the ocean of metabolic disasters.  Think of subcutaneous fat as less expensive, inland property, quite removed from this ocean of metabolic disasters.  Clearly, visceral fat is fat that behaves badly and fat that is strongly desirable to avoid.

In many ways, the distinction between subcutaneous and visceral fat parallels the distinction between good fats and bad fats in our diet.    The not unhealthy one or two inches of subcutaneous fat that you can pinch around your waistline can be thought of as a good fat such as the fat in olive oil, avocados, or nuts.   On the other hand, the unhealthy visceral fat that causes a man to have a big protuberant abdomen—creating an appearance not unlike a very pregnant female—can be thought of as bad fats such as the partially hydrogenated fats present in vegetable shortening that are commonly used in fast foods and other processed baked goods.

Visceral fat storage is not static but dynamic, meaning that there is continuous mobilization of our fat (as fatty acids) and storage (as triglycerides).  Lipolysis is the chemical reaction in which the fat is broken down into fatty acids that the body can use as energy. This can occur very readily in visceral fat. Likewise, accumulation of visceral fat can occur in a very rapid fashion. Excessive intake of calories will be rapidly stored as visceral fat, whereas under circumstances of a reduced calorie intake, the visceral fat is broken down to provide fuel for our bodies’ metabolic processes, particularly muscle contraction.

Visceral fat is not just a bland collection of fatty tissue sitting inertly within your belly causing an oversized appearance to your abdomen.  It is an extremely metabolically active endocrine organ with a life of its own.  Fat is the largest endocrine organ in our bodies and it releases a myriad of pro-inflammatory factors, hormones and immune cells that can affect metabolism and other bodily functions. Fat has an abundance of the hormone aromatase, which converts testosterone to the female hormone estrogen.  One consequence of too much fat in men is excessive conversion of testosterone to estrogen. Men with plentiful visceral fat often will bear the consequences of lower testosterone and higher estrogen levels, including sexual issues and breast development as well as numerous other negative consequences of insufficient levels of testosterone.

Visceral fat is intimately connected to the inflammatory process and can result in insulin resistance, metabolic syndrome, cardiovascular disease and an entire array of negative health ramifications, including chronic diseases such as arthritis and cancer.  This is in contradistinction to subcutaneous fat, which produces far less inflammatory chemicals. Since men have a tendency towards visceral fat collection whereas women have a tendency towards subcutaneous fat collection, this might explain why women are less susceptible to cardiovascular disease then men are.

Insulin is the principal regulator of fat metabolism. After a sugar and carbohydrate load, insulin is released to get the fuel into our cells. When we go without food, as happens when we sleep, insulin levels decrease and fat is released to be used as fuel.  Insulin levels are determined primarily in response to our carbohydrate intake in order to keep our blood sugar regulated. Insulin has much to do with the way our bodies store or burn fat. You can think of insulin as our fat hormone—when insulin levels are elevated, we accumulate fat; when levels are low, we burn fat for fuel.  So if you have a substantial collection of visceral fat, it becomes highly desirable to reduce sugar and refined carbohydrate intake to decrease insulin and burn away that bad, pro-inflammatory fat as fuel. The good news is that by losing abdominal fat, the potentially bad health repercussions can be reversed. The dangerous visceral fat submits relatively easily to diet and exercise whereas the less harmful subcutaneous fat at the waist is more stubborn and resistant to reversal measures.

How To Burn Fat:

  • Eat in accordance with nature’s design—meaning whole foods.  Avoid processed foods.  The best diet is an “anti-processed-atarian” diet.
  • Avoid “naked” calories (stripped of fiber), so restrict sugar, simple white carbohydrates, and liquid calories. Specifically avoidsugared drinks, white pasta, white rice, white bread, doughnuts, bagels, potatoes, etc.  Aggressively steer clear of high fructose corn syrup.
  •  Eat high-quality, whole-grain, high-fiber carbohydrates (whole grain pasta, brown rice, whole grain breads, legumes, whole fruits and vegetables), lean protein sources (easy on meat and dairy) and healthy fats (vegetable and seafood-origin).
  • Avoid giant meals in which the caloric load will be stored as fat; substitute with multiple smaller meals in which the calories will be used for immediate energy.
  • Limit after dinner snacking since unnecessary calories at a time of minimal physical activity will be stored as fat.
  • You must incorporate exercise into your lifestyle, achieving balance between aerobic, resistance and core workouts.  Aerobic exercise has great potential in burning fat for fuel and interval training seems to really rev up our fat-burning capabilities.
  • Portion control is the name of the game: in order to burn fat, energy intake must be less than energy output.  Even if you eat only the healthiest of foods, if calories in exceed calories out, you will not burn fat for fuel.
  • Minimize stress; if you can’t eliminate it, work to manage it.
  • Get adequate amounts of quality sleep.  See my previous blog entitled “Sleep To Slim” to find details: https://healthdoc13.wordpress.com/2012/07/20/sleep-to-slim/

The bottom line is that while body fat in any excessive amount is unhealthy and unattractive, it becomes a potentially life-threatening issue depending on its location in our bodies.  An enormously protuberant belly can lead to processes that result in disease—and even death.

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food

www.PromiscuousEating.com

Now available on Amazon Kindle

 

Man-Oh-Pause: When Things Are Not So Good Under The Hood

September 1, 2012

Blog #73     Andrew Siegel, M.D.

 

“T”  (an abbreviation for testosterone) has become a very commonly used and in vogue term. Many of my patients come into the office specifically asking for their T levels to be checked.  The pharmaceutical industry has been responsible for direct-to-consumer advertising of testosterone replacement products, a practice that has promoted this recent grass-roots awareness of testosterone issues, a subject that was previously the domain of urologists and endocrinologists.

T is that all-important male hormone that goes way beyond male sexuality.  Testosterone has moved to the endocrine vanguard and is now regarded as a key factor in men’s health. Current evidence suggests that a man’s testosterone level might serve a function as a good indicator/marker of general male health.

Aside for contributing to libido, masculinity and sexual function, T is responsible for the physical changes that commence at the time of puberty, including pubic, axillary and facial hair, deepening voice, prominent Adam’s apple and increased bone and muscle mass.  Additionally, T contributes to our mood, bone and muscle strength, red blood cell count, energy, and general mojo.  Most testosterone is manufactured in the testicles, although a small percentage is made by the adrenal glands.

There is a gradual decline in T that occurs with the aging process—approximately a 1% decline each year after age 30.  This will occur in most men, but will not always be symptomatic.  40% of American men aged 45 or older have low or low range T.  Low T is associated with metabolic syndrome and diabetes, bone mineral loss, and altered sexual function.  Specifically, symptoms of low T may include one or more of the following:  fatigue; irritability; depression; decreased libido; erectile dysfunction; impaired orgasmic function; decreased energy and sense of well-being; loss of muscle and bone mass; increased body fat; abnormal lipid profiles. Essentially, low T can accelerate the aging process.

Belly fat is literally the enemy of masculinity and a testosterone-choker that can push you in the direction of the female gender.  Perhaps when you are standing naked in the shower and you gaze down towards your feet, all you see is the protuberant roundness of your large midriff, obscuring the sight of your manhood.  Perhaps you’re wondering where your penis is hiding.  In most cases, the abundant pubic fat pad that occurs coincident with weight gain obscures the penis—the “turtle effect.”  If your belly blocks your view of your penis, your pubic fat pad makes your penis difficult to locate, your breasts have filled out, and your libido and erections are sub-par, it may just really be time to rethink your lifestyle habits!

Abdominal obesity—an accumulation of fat in our midsections—not only is unattractive from a cosmetic standpoint, but can have dire metabolic consequences that can affect the quality and quantity of our lives. Obesity has a pivotal role in the process leading to low T and waist circumference is a reasonable proxy for low T. Fat is not just fat—it is a metabolically active endocrine organ that does way more than just protrude from our abdomens.  Fat has an abundance of the hormone aromatase, which functions to convert T to the female sex hormone estrogen (E).  The consequence of too much conversion of T to E is the potential for gynecomastia, aka man boobs.  Too much E slows T production, and with less T, more abdominal obesity occurs and even more E is made, a vicious cycle (literally a vicious circus) of male castration and emasculation.

Obesity can steal away your masculinity, male athletic form and body composition, mojo, strength, and also one of your most precious resources—the ability to obtain and maintain a good quality erection.  Remember the days when you could achieve a majestic, heaven-pointing erection simply by seeing an attractive woman or thinking some vague sexual thought?  Chances were that you were young, physically active, and had a svelte build with a hard abdomen. If those days are mere memories, it is probable that you are now carrying extra pounds, have a soft and protuberant belly, and are not physically active.  When you’re soft in the middle, the consequence is that you will probably be soft down below. The good news is that by losing the abdominal fat, the unfortunate consequences of low T can often be reversed.

How To Turn On Your Testosterone Boosters: 

  • A healthy lifestyle, including good eating habits, maintaining a healthy weight, engaging in exercise, obtaining adequate sleep, moderation with respect to alcohol intake, avoiding tobacco, and stress reduction are the initial approaches to treating low T engendered by abdominal obesity.  Insufficient sleep can lower T.  Excessive alcohol increases the conversion of T to E.  Maintaining an active sex life can help maintain T.
  • It is of paramount importance to lose the abdominal fat, with the caveat that a sufficient caloric intake of quality food and nutrients is necessary to prevent the body going into “starvation mode,” which can substantially decrease T production.
  • In terms of exercise, a healthy balance of aerobic, resistance, and core training is best, but in particular, vigorous resistance exercise is crucial.  This will help the flabby abdomen disappear and build lean muscle mass, which in turn will increase metabolic rate.

If lifestyle modification fails to improve the symptoms of low T and T remains measurably low via a simple blood test, a trial of T replacement under the supervision of your doctor can provide a meaningful improvement of your quality of life.

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food

www.PromiscuousEating.com

Available on Amazon/Amazon Kindle: http://www.amazon.com/Promiscuous-Eating-Understanding-Self-Destructive-ebook/dp/B004VS9AC6

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Human Building Blocks

July 28, 2012

Blog # 68  Andrew Siegel, M.D.

 

I no longer give a lot of thought to healthy eating, but instead react in habit-like fashion to whatever food that is in front of me.  I don’t think big picture, I don’t think long-term and I don’t think about weighing myself often.  When it comes to food and nutrition, I like to be in the moment and think about the present—the here and now.  Most of the time, I don’t think forest, I don’t think trees, but I think leaves.

Over the years, I’ve put a lot of conscious thought into eating and nutrition and the important role it plays in determining our health destiny.  I have carefully read food labels and educated myself through paying attention, reading and research. What has happened is that conscious thought processes have evolved into subconscious actions—habits.  Now, when I consider putting some food into my mouth I reflexively and subconsciously weigh its benefit as a potentially valuable building block that will be used by my body as fodder to restore, replenish and regenerate those cells and tissues that are undergoing constant turnover.  Like parts for my car or home, I want to use the highest quality materials.  I recognize that in my lifetime I will have many cars and probably several homes and I will endeavor to take excellent care of them, but I have only one body, so I want to make an extraordinary effort to treat it with the utmost of respect and stewardship.  I don’t want a body that is a house of cards! As important as this concept is for full-grown adults, it is even more so for children who need healthy building blocks for actual growth and not just replacement.

So, if I have a handful of almonds or an apple or a Greek yogurt in front of me, my subconscious gives me a green light; if it is a doughnut, a greasy slice of pizza with pepperoni or a hot dog, my reflexes give me a red light.  Do I ever make exceptions?  My reflexes guide me, but of course I will have a slice or two or three of pizza (typically with veggies on top) and other indulgences that make me happy—such as chocolate or rum raisin ice cream—but my habits shepherd me to moderation.  If you take care of the leaves, you will have healthy trees comprising a hardy forest.

The following is an excerpt from The Huffington Post written by Dr. David Katz entitled: “Un-junking Ourselves.”  Although the subject of Dr. Katz’s discussion is a child, it is relevant to adults as well.  And yes, this excerpt was included in one of my blogs from a few weeks ago, but it’s so important that it is worth repeating:

Think about a child — or former child — you love. This should be pretty easy for any parent, grandparent, aunt, uncle, or just about anybody else who has known a kid or ever been one.

Now, think about that child’s growth from year to year and ask yourself: What were they growing out of? What was the construction material? Matter can’t be constructed out of nothing — it comes from somewhere. If a child’s head is four inches higher off the floor this year than last year, then that four-inch platform of extra kid was built out of… something. What?  Food and nothing else. Food is the construction material — the only construction material — for the growing bodies of children we love.

We are, no doubt, all familiar with the expression “you are what you eat,” but given how most of us eat, it’s quite clear we don’t take it very seriously. And for some pretty good reasons. The human machine, and human fuel tank, are stunningly forgiving. We can throw almost anything in the tank, and run reasonably well for decades. We can’t build a machine fractionally so accommodating.

And, of course, we don’t look like what we eat. We eat donuts, and don’t sport big holes through our middles. We eat French fries, and don’t sprout French fry antennae. But you can’t judge what we are made of by what we look like, any more than you can judge a book by its cover — or a house by its paint. Our houses are, often, made mostly of wood — but look nothing like trees. Trees are cut down and, if you will, “digested” in a timber mill to produce wood that is turned into lumber. The lumber is then used to build houses that look nothing like the trees. But if that lumber is rotten, the house in question may look all right at first — but it will fare quite badly when the first big storm comes along. The quality of a house is rooted in the quality of its construction materials.

Ditto for us. The growing body of a child is built out of food. Nutrients are extracted from food, just as wood is extracted from trees. Rotten wood makes rotten houses. Rotten food makes… sick kids. The kids may look, and even feel, fine for a while. But every cell their bodies build depends on the quality of the available construction material it is offered. Every muscle fiber, every enzyme, every brain cell, every heart cell, every hormone. Maybe not right away — but eventually, rotten construction material catches up with us all.

No one I know throws any old junk into the tank of a car they hope will run well for the foreseeable future. No one I know willingly builds a home out of junk, or of rotten wood. But food is the one and only building material for the growing body of a child you love. How’s “junk” sounding now? And, by the way, every one of us adults is turning over literally hundreds of millions of cells daily. These need to be replaced, along with spent enzymes, hormones, neurotransmitters and the like. Where do WE get the construction material for this job? Think about it.  Right you are.

Words to heed, to make part of your conscious and, ultimately, your subconscious, so that your food choices automatically become healthy ones.

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food

www.PromiscuousEating.com

Available on Amazon Kindle

A Tribute To One Of The Father’s Of Public Health

July 14, 2012

A Tribute To  Lester Breslow

Andrew Siegel, M.D.      Blog # 66

 

The field of public health is of utmost importance to the vitality and well being of humankind. Public health and sanitation saved more lives than any other cause in the 19th century—the Century of Hygiene; in the 20th century—the Century of Medicine—vaccines, antibiotics, transfusions, chemotherapy, etc., helped contribute to longevity; the 21st century will be the Century of Behavior Change—where longevity will be furthered by reducing risky behavior and making positive changes with regards to exercise and nutrition.

One of the father’s of the field of public health, Lester Breslow, M.D., M.P.H., died earlier this year at the age 97.  Originally intent on becoming a psychiatrist, he changed to public health because he believed it was an appropriate match for his desire to be a political activist for disadvantaged people.  His seminal contributions to the health of our society are more than worthy of a blog.  He was one of the first to prove that we can live longer and healthier by modifying our habits including tobacco use, sleep and diet.  He changed the direction of public health from a discipline with an emphasis on communicable infectious diseases to a field focused on lifestyle, the effects of community and the environment and the emergence of chronic disease.

Dr. Breslow joined the California Department of Public Health in 1946 to found the Bureau of Chronic Diseases. He then became a professor at UCLA School of Public Health and subsequently chairman of the UCLA School of Medicine’s Department of Preventive and Social Medicine. He served as Dean of the UCLA School of Public Health from 1972 to 1980.  President Truman appointed him director of a commission to assess the health of the nation in 1952.  He was elected president of the American Public Health Association and was the founding editor of The Annual Review of Public Health and the editor-in-chief of The Encyclopedia of Public Health. He was also president of the International Epidemiological Association and the Association of Schools of Public Health.

In the 1940’s and 1950’s, he was responsible for some of the earliest studies on the hazards of tobacco and three of these were cited in the surgeon general’s report in 1964 linking tobacco to lung cancer.

One of his major accomplishments was the Alameda County Study, a long-term investigation of the lifestyles of almost 7000 residents of Alameda County, California.  Using quantitative analysis, the study unquestionably proved that one’s lifestyle strongly influences longevity.  The study concluded that to achieve maximal longevity, one must do the following: avoid tobacco; consume alcohol moderately; sleep seven to eight hours a night; exercise at least moderately; eat regular meals; maintain a healthy weight; and eat breakfast.  Dr. Breslow concluded that a 60-year-old man who heeded all seven recommendations would be as healthy as a 30-year-old man who heeded fewer than three.  Considering that this study was initiated in 1965, its results were quite remarkable, although in the 21st century, we take his recommendations for granted.

In 2010, at the ripe age of 95, he co-authored a paper on the life expectancy of a group of Californian Mormans.   The study, conducted during the previous 25 years, concluded that the Morman life expectancy exceeded the life expectancy of the general population of Caucasian males by 10 years on the basis of the Mormans’ clean lifestyle. Although not a Morman, Breslow practiced what he preached, even growing his own organic vegetable garden.  Given his longevity, his healthy lifestyle seems obviously to have supported many of his theories.  He was a man of enormous vision and his contribution to the field of public health was profound.

*Credit to Douglas Martin, writer of Dr. Breslow’s New York Times’ obituary, for much of this information.

Andrew L. Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food

www.PromiscuousEating.com

Available on Amazon Kindle


Heart Attacks Among My Fit Friends

July 7, 2012

Andrew Siegel, M.D.    Blog # 65

 

My good buddy V. had a heart attack a few weeks ago. He is a urologist in his mid 50’s, a non-smoker of medium build, and an avid recreational cyclist who puts in several hundred miles every week. If it wasn’t for his company and support, I would never have completed the 3 hour challenging bike ascent up Mt. Mitchell (elevation 6683 feet) in Asheville, North Carolina a few years ago.

After some intense cycling, he was taking a breather to wait for one of his cycling partners to catch up with the rest of the group when he developed extreme left shoulder pain and unrelenting sweating.  The unremitting pain was of intensity unlike any that he ever experienced, and in the ambulance in route to the hospital he gazed at his own EKG seeing the classic findings of a myocardial infarct.  He was given morphine for pain, nitroglycerin, aspirin and oxygen and after arriving in the ER was rapidly whisked to the cardiac catheterization lab.  He was found to have a complete occlusion of the right coronary artery and it wasn’t until a wire was passed through the occlusion that he felt dramatic pain relief.  After a stent was placed in the occluded artery, he was sent to the coronary care unit for monitoring.  He was discharged the following day on numerous medications and prescribed rest, time off work, and a specialized diet; he was also admonished to stop exercising until he finishes a program of cardiac rehabilitation.

When I spoke to him, he was extremely depressed about the situation, never having previously had any symptom of heart disease.  He had survived a life-threatening event, going from no medications to seven and having to severely restrict the physical activities that brought him so much pleasure.  To repeat, he was not overweight, not a tobacco user, and did not have high blood pressure, although his cholesterol ran on the high side of normal.  He did not have any family history of heart disease.  He had been a strong recreational cyclist for many years. He never paid attention to his diet because of his fast metabolism and vigorous exercise regimen, which always left him at a healthy weight.  V. is Italian and loves pasta, cheese and meat dishes and has always eaten anything and everything that he wanted.

——————————————————————————————————-

Now for the story of A., my good friend from surgical internship:  He became a heart surgeon and practiced in the Midwest for many years, but has recently relocated to the Southeast, where he is the Chief Medical Officer of a hospital.  Like V., A. was always in tip-top shape, a non-smoker and a running enthusiast.  As interns and surgical residents, we spent countless hours running the hills of the north shore of Long Island and each ended up having sibling chocolate Labrador Retrievers as pets.

A few years ago, several hours after a vigorous workout in his home gym, he was relaxing in the living room with his wife. As he stood up, he crumpled to the floor, obviously having passed out.  His wife found him to be pulseless and not breathing. Fortunately she was a RN and managed to maintain her composure and promptly initiated CPR after calling 911.  She continued the cardio-pulmonary resuscitation until the emergency team arrived.  When hooked up to a cardiac monitor he was found to be in a very abnormal rhythm called ventricular fibrillation.   After he was shocked, his heart resumed normal rhythm and he started breathing spontaneously.  Angiography in the hospital demonstrated severe coronary artery disease, and he underwent angioplasties and several stent placements.

A. was of average weight, a non-smoker, and a compulsive exerciser; however,  he had a strong family history of cardiac disease and never paid much attention to his diet. I recall his fondness for ice cream and his not uncommon consumption of a pint of Hagen-Daz at one sitting.

——————————————————————————————————–

The point that I wish to make is that maintaining a good weight, avoiding tobacco and pursuing regular exercise is not always enough for vitality and a healthy heart.  Particularly when there is a family history of heart disease, but also as a general health axiom, all efforts must be put in place to stem cardiovascular disease, the number one cause of death in the United States.  In addition to maintaining a good weight, avoiding tobacco and exercising, healthy eating is an indispensable and essential part of the effort—a sine qua non.

The quality and quantity of what we eat play an essential role in determining our health destiny.  The following is an excerpt from The Huffington Post written by Dr. David Katz entitled “Un-junking Ourselves.”  Although the subject of Dr. Katz’s discussion is a child, it is relevant to adults as well.

Think about a child — or former child — you love. This should be pretty easy for any parent, grandparent, aunt, uncle, or just about anybody else who has known a kid or ever been one.

Now, think about that child’s growth from year to year and ask yourself: What were they growing out of? What was the construction material? Matter can’t be constructed out of nothing — it comes from somewhere. If a child’s head is four inches higher off the floor this year than last year, then that four-inch platform of extra kid was built out of… something. What?  Food and nothing else. Food is the construction material — the only construction material — for the growing bodies of children we love.

We are, no doubt, all familiar with the expression “you are what you eat,” but given how most of us eat, it’s quite clear we don’t take it very seriously. And for some pretty good reasons. The human machine, and human fuel tank, are stunningly forgiving. We can throw almost anything in the tank, and run reasonably well for decades. We can’t build a machine fractionally so accommodating.

And, of course, we don’t look like what we eat. We eat donuts, and don’t sport big holes through our middles. We eat French fries, and don’t sprout French fry antennae. But you can’t judge what we are made of by what we look like, any more than you can judge a book by its cover — or a house by its paint. Our houses are, often, made mostly of wood — but look nothing like trees. Trees are cut down and, if you will, “digested” in a timber mill to produce wood that is turned into lumber. The lumber is then used to build houses that look nothing like the trees. But if that lumber is rotten, the house in question may look all right at first — but it will fare quite badly when the first big storm comes along. The quality of a house is rooted in the quality of its construction materials.

Ditto for us. The growing body of a child is built out of food. Nutrients are extracted from food, just as wood is extracted from trees. Rotten wood makes rotten houses. Rotten food makes… sick kids. The kids may look, and even feel, fine for a while. But every cell their bodies build depends on the quality of the available construction material it is offered. Every muscle fiber, every enzyme, every brain cell, every heart cell, every hormone. Maybe not right away — but eventually, rotten construction material catches up with us all.

No one I know throws any old junk into the tank of a car they hope will run well for the foreseeable future. No one I know willingly builds a home out of junk, or of rotten wood. But food is the one and only building material for the growing body of a child you love. How’s “junk” sounding now? And, by the way, every one of us adults is turning over literally hundreds of millions of cells daily. These need to be replaced, along with spent enzymes, hormones, neurotransmitters and the like. Where do WE get the construction material for this job? Think about it.  Right you are.

Bottom Line:  In the quest for fitness, vitality and health, it is necessary to maintain a healthy weight, exercise regularly and avoid tobacco. These efforts are important, but not sufficient to avoid cardiovascular disease; an essential additional factor is what we eat.  The quality of the foods that we ingest for fuel, metabolism and tissue rejuvenation are of great importance in terms of vitality and avoiding fatty plaque deposition in our arteries and cardiovascular disease.  It comes down to a largely plant-based diet with an abundance of different fruits and vegetables, whole grains, legumes, and lean protein sources.  Meat and dairy, unrefined carbohydrates, sugars, processed, junk and fast foods need to be consumed in moderation.  We literally are what we eat and the plaque lining our arteries is a reflection of our cumulative diet over our lifetime.  While genetics and luck are beyond our control, our lifestyle—including what or what not we decide to use as human building blocks—is well within our domain.  Today in my office, I skipped the Carvel ice cream cake and grabbed a Granny Smith apple instead…just not worth it!

My two friends are literally lucky to be alive as many are not so fortunate and succumb to cardiovascular disease.  A., being a cardiac surgeon and having put his event well behind him, has adapted well to his situation.  V. is currently somewhat depressed and is suffering from a form of post-traumatic stress disorder that not uncommonly follows the occurrence of a heart attack.  It behooves all of us to try to avoid potential life-threatening cardiac issues by maintaining a good BMI, eating healthy, exercising and avoiding tobacco.  We need to be especially vigilant when there is a strong family history and/or elevated cholesterol and under these circumstances, proactive cardiology care is certainly warranted.  Family history or not, it makes the utmost sense to keep in mind that “we are what we eat.”

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food

www.PromiscuousEating.com

Available on Amazon Kindle

Vitality Does Not Demand Exercise Nor Super-Healthy Eating

May 25, 2012


Andrew Siegel, M.D.   Blog # 60

 

“Hey, how are you doing?”

“Not bad.”
“Anything good going on?”
“Nah, not really…same old.”

 

In many circumstances—as above—the absence of bad is as favorable as the presence of good, and that, dear reader, is the premise for the ensuing discussion.

As ridiculous, simplistic and absurd as it may sound, you do not need to eat a super-healthy diet and exercise regularly to have a vital existence.  Rather, what you do need to do is to avoid eating harmful foods and abstain from a sedentary existence.

The Hippocratic oath teaches us Primum non nocere, a Latin phrase meaning “First, do no harm.”  It is a useful doctrine that physicians practice on a daily basis.  In many situations, avoiding mistakes and errors is the key to success.  This is also applicable to sports—for example, tennis—where a match can be won without hitting many clean winners by simply not making many errors.

The aforementioned is totally relevant to our eating and exercising habits.  You don’t need to eat a vegan diet, a Paleolithic diet or a Weight Watcher’s diet to be healthy, nor do you need to be a gym rat to be fit.  What you do need to do is to try to avoid processed and junk foods and stay active, energetic and kinetic. Don’t get me wrong—there is a difference between the intensity, duration and type of exercise necessary to improve sports performance versus that needed for health and vitality. Staying active is not the same as sport-specific training, in which we work on discrete exercise skills, accompanied by endurance and weight training that culminates in adeptness, conditioning, efficiency and adaptation.

Our bodies will always adapt to the stresses placed upon it, whether the stresses are strenuous exercise, staying active, or being sedentary.  The changes in terms of insulin resistance, blood glucose, fat-fighting enzymes, metabolism and energy level resulting from strenuous exercise and staying active are quite positive, but those resulting from a sedentary existence are quite negative.  If you want bulging biceps and pectorals or a ripped six-pack or to train for a triathlon, you’re going to have to earn that with healthy eating and lots of “formal” exercise; however, if your endpoint is optimal health and not glamour nor excelling in sports, you just need to do some moving.  Many health benefits can be derived without doing “formal” exercise—the physical activity does not need to be particularly exertional, but does need to involve locomotion.  The problem is that two-thirds of us get absolutely no exercise whatsoever; being a couch potato not only is unnatural, but also has grave health consequences in terms of the maladaptive response of our bodies to this sedentary existence.

Integrational exercise is a means of incorporating exercise and movement into your daily activities. You don’t need special equipment, gym clothes, a fitness center, a heart rate monitor or a personal trainer. The key to integrating exercise into your daily routine is keep moving—it has even been shown that being fidgety is a form of exercise that burns calories in the form of nervous energy.  Take the stairs instead of the elevator; when at an airport, climb the stairs instead of using the escalator and walk to the gates instead of using the conveyor; at the mall, instead of circling around looking for that close-to-the-entrance spot, park the car as far away from the shops as possible and walk the distance; “power” vacuum your rugs; mix batter for a cake by hand as opposed to using an electric mixer; use hand tools instead of power tools; garden; shovel snow; mow the lawn; saw tree branches; walk the dog; carry a heavy laundry basket; take out the recycling; carry your child on your back; dance; stand upright while talking on the telephone, etc. These integrational exercises may not result in weight loss, but they will keep you active and moving, making you healthier and enjoying a longer life.

Non-Exercise Activity Thermogenesis (NEAT) is the term applied to how we reap major benefits through thousands of minor movements each day.  NEAT is the body’s means of fighting inertia.  Interestingly, some of us do not gain weight despite increased caloric intake because of compensation via subconscious movements including taking the stairs; trotting down the hall to the water cooler; bustling about with chores; even fidgeting in one’s seat.  Standing has been shown to cause us to reap substantial benefits as opposed to sitting.

A few days ago, I played doubles tennis for two hours and then played a round of golf in which I walked the course.  This really was not much in the way of aerobic, resistance, or core exercise—my lungs weren’t heaving, my heart wasn’t racing, I wasn’t sweating much, my muscles were not sore—but nonetheless, it was six hours or so of energetic movement.

Another way in which one can reap the health benefits of the “good” by essentially avoiding the “bad” is in the food arena.  In our modern society, if you want to stay on track regarding a healthy diet and weight, it is not so much what you choose to eat that counts, but what you elect not to eat.  Making a concerted effort to avoid unhealthy, unwholesome and unnatural foods as much as possible will ensure the intake of an abundance of natural and wholesome foods. There are a great variety of quality foods that can nourish us, and it is not important what your specific choices are as long as there is balance, sufficient intake of macro-nutrients (protein, fats and carbohydrates) and micro-nutrients (vitamins and minerals), and avoidance of excessive calories. The key is to stay away from processed, reconstituted, unhealthy, mystery, faux foods.

Humans are remarkably omnivorous, meaning that there are a great variety of different foods—plant and animal in origin—that can both provide energy for our metabolic processes and sustain us in terms of tissue replenishment. I borrow Michael Pollan’s maxim and reverse it in an effort to summarize what not to eat: Imitation food, a lot of it, mostly animal-based…and there we have the Western diet—processed foods, lots of meats, refined carbohydrates, fats and sugar—the eating style that has contributed to two-thirds of Americans being overweight or obese and responsible for the scourges of Western civilization, namely hypertension, diabetes, cardiovascular disease and some cancers.

Bottom line: The active pursuit of a healthy diet and regular exercise certainly go a long way in terms of shaping our health destiny, but are not essential for our vitality and longevity.  What is essential is the avoidance of an unhealthy diet and refraining from a sedentary existence, simple actions that can be transformative.  The science is crystal clear that powering ourselves with poor-quality fuels and sitting motionless on a chair or couch for prolonged periods of time are unhealthy and disease-promoting behaviors.

A few years ago, I wrote a book entitled Finding Your Own Fountain of Youth: The Essential Guide to Health, Wellness, Fitness & Longevity.  Through the process of interviewing many youthful elderly persons (referred to as “YEPpies”) I concluded that the cornerstones of vitality were the following:

  • Having a sense of purpose
  • Staying physically active
  • Passions and hobbies
  • A healthy diet
  • Avoiding self-abuse: junk food, obesity, tobacco, immoderate alcohol, excessive sun exposure, etc.
  • Close relationships
  • Optimism and the ability to adapt to life’s changes
  • Preventative maintenance
  • Respecting yourself and living well

Always remember:

Food and lifestyle have the power to prevent, reverse, and even cure
most chronic illness, the cause of endless personal suffering and an

unsustainable burden to our global economies and social fabric.

(Mark Hyman, M.D.)

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food

www.PromiscuousEating.com

Available on Amazon Kindle

Gluttony, Sloth, & Cardiac Care or Healthy Lifestyle & Wellness

February 4, 2012

Blog # 44   Andrew Siegel, M.D.

 

February is American Heart Month, so I put my heart into this narrative about this amazingly engineered, all-important organ that serves us tirelessly and relentlessly. Like our pet canines, this organ requires to be  well fed, to be exercised, and to be given tender loving care.  Be kind to it and it will return the favor big time.

Two hundred years ago, the following words on angina pectoris (chest pain from coronary artery occlusion) from John Warren, M.D. were published in the very first issue of the New England Journal of Medicine and Surgery:

The disease itself is excited more especially upon walking up hill,

and after a meal; that thus excited, it is accompanied with a sensation,

which threatens instant death if the motion is persisted in;

and that on stopping, the distress immediately abates, or altogether subsides.

 

Two centuries later, we are infinitely wiser regarding the diagnosis and management of heart disease, yet unfortunately this illness is more prevalent than ever.  The saddest aspect of this is that coronary artery disease is largely a preventable and avoidable problem.  Every day, many hearts are broken because of the premature and unnecessary demise of loved ones who succumb to cardiac disease. It is my heart’s desire that we become better caretakers of ourselves and avoid the 600,000 deaths to heart disease and 130,000 deaths to strokes that occur every year in the USA.

Cardiovascular disease (CVD), including heart disease and stroke, is the number one cause of death in the USA and other industrial countries.  The only year since 1900 in which CVD was not the leading cause of death was in 1918, the year of the influenza pandemic.  CVD is also the leading cause of death in every region of the world except for sub-Saharan Africa.  The burden of CVD is increasing because of our longer life spans, continued tobacco use, physical inactivity, unhealthy food consumption, obesity, high blood pressure, elevated LDL cholesterol and prevalence of type 2-diabetes.

The following paragraph is a brief historical perspective of some of the important medical advances with respect to the management of heart disease.  The 50-year cardiovascular Framingham study (1948-1998) linked high blood pressure and high cholesterol with angina and heart attacks and originated the novel concept that coronary artery disease and its complications could be prevented.  The advent of the coronary care unit (CCU) vastly decreased the death rate of patients admitted with acute heart attacks by provided sophisticated monitoring with electrocardiograms, closed chest cardiac massage, and external defibrillation (using electric paddles to shock the heart back into a normal rhythm).   Cardiac catheterization and coronary arteriography lead to the birth of cardiac surgery and coronary revascularization (coronary artery bypass).  The field of interventional cardiology enabled balloon angioplasty revascularization of occluded coronary arteries without the need for cracking one’s chest open, using access through a thigh artery.  Cardiac stents, initially metal and currently drug eluting, were developed to prevent coronary re-occlusion.  Statin medications to lower LDL-cholesterol levels and many new and potent cardiac drugs have provided significant advances.  Implantable pacemakers and implantable pacemaker-ventricular defibrillators have further improved the prognosis of those suffering with cardiovascular disease. Sophisticated tests including echocardiograms, treadmill tests, isotope stress tests, Holter monitoring, and computerized tomography of the heart are readily available to help pinpoint the precise cardiac diagnosis.

Despite all of the aforementioned incredible technological advances, coronary artery disease remains highly prevalent and is a major widow-maker and widower-maker.  Why?  It’s really very simple—those all-important, tiny blood vessels that provide the lifeline of blood flow of oxygen and nutrients to that vital organ that pumps our blood 24/7/365 get blocked with fatty plaques.  With clogged coronary arteries, when increased demand is placed on our life-sustaining pump, not enough oxygen can get delivered through the compromised coronary arteries and we develop angina and possibly sustain damage to the heart muscle (a myocardial infarction or heart attack) or its electrical conduction system (an arrhythmia).  Tragically, this compromise to our heart and blood vessels is too often self-induced through bad eating habits, physical inactivity, and the use of tobacco.

To quote the insightful and poetic Dr. David Katz who says it all:

“We are all offspring of predecessors who lived in a world where calories were relatively scarce and hard to get, and physical activity constant, arduous and unavoidable. We now live in a world where physical activity is scarce and hard  to get, and calories constant, effortless and unavoidable.

Atherosclerosis is the process that gives rise to the fatty plaques in our arterial walls that compromise blood flow to our organs.  Atherosclerosisis a chronic arterial inflammation that develops slowly, gradually and progressively over many years.  It happens in response to the biological effects of risk factors.  It begins with changes in the endothelial cells, the unique cells that line arteries.  When subjected to these risk factors, endothelial cells change their permeability and allow white blood cells and LDL cholesterol entrance into the cells.  The risk factors include the following:

  • high blood pressure within the arteries
  • oxidative stress from free radicals (highly reactive molecules known as free radicals are created as a consequence of how our body reacts with oxygen; these interact with other molecules within cells and cause oxidative damage)
  • biochemical stimuli (chemicals from tobacco, high levels of bad fats like LDL cholesterol in the blood, food toxins)
  • inflammatory factors

The presence of white blood cells and LDL cholesterol within the endothelial cells gives rise to a cascade of chemical reactions that causes proliferation of both endothelial and smooth muscle cells and the formation of plaques.  Plaques lead to symptoms by restricting flow through the arteries involved, or alternatively, by provoking clotting that interrupts blood flow.  If the plaque ruptures, more clotting will occur at the site of the disruption, perpetuating the restricted flow, and additionally, the ruptured plaque can travel and jam other blood vessels.  LDL cholesterol is clearly a major culprit and atherosclerosis occurs in direct proportion to LDL levels.

Occlusion of the coronary arteries is a big deal because damage of the blood flow to the heart—the most important organ in our body—is a major concern.  However, it is important to know that the process of atherosclerosis is by no means unique to the heart—it is just that the effects of atherosclerosis on the heart—including angina, heart attacks, arrhythmias and death—are ever so dramatic.  It is critical to realize that if you have atherosclerosis in your coronary arteries, you can bet you have it in every artery in the body—including the aorta and those arteries providing blood to the brain, kidneys, intestines, legs, genitals, etc.  This can give rise to strokes or transient ischemic attacks, kidney disease, pain in the abdomen after meals, pain in the legs when walking, sexual dysfunction, etc.  Suffice it to say that intact blood flow to transport oxygen and nutrients to every cell in our body is our lifeline and we don’t want it compromised.

It is nothing short of wonderful that the medical fields of cardiology and cardiovascular surgery have become so evolved and sophisticated and that we have the medical and surgical resources to manage CVD so well.  Countless lives and loved ones have been saved from premature deaths.  That being the case, I must make an appeal from the bottom of my heart for preventive and pre-emptive measures that can keep the disease away and the cardiac team at bay.  Nature and nurture have roles in CVD and we can’t do a thing about the genetic blueprint that we inherited from our parents that can predispose us to CVD, but we do have incredible power to shape our health destiny with our lifestyle.  In my heart of hearts, I can assure you the truth and the validity of the following statement: Genes load the gun, but lifestyle pulls the trigger.  Even if genetics has been unkind to you, you have the authority and choice to pull the trigger, keep your finger on the trigger, or withdraw your finger from the trigger.

Prostate cancer is the number one cancer in men and one that I spend a great deal of my time managing and treating. Can you guess what the leading cause of death is in prostate cancer patients?  If your answer was prostate cancer, you are wrong.  The leading cause of death in men with prostate cancer is CVD.  After CVD, cancer happens to be the second leading cause of death in the USA and in most developed countries.  Most of our knowledge regarding lifestyle and dietary change for CVD prevention applies to cancer prevention as well.  One of the most dramatic reductions in both CVD and cancer has been through smoking cessation.   A heart-healthy diet and lifestyle will contribute to health improvements in every part of our human anatomy, whether it is the heart, colon, prostate or genitals.

As individuals, we must take responsibility for our health and make every effort towards maximizing our fitness and well-being.  We are the stewards of our own health destiny—no one else is.  Yes, we have physicians, sophisticated diagnostic tests, medications and surgery to help us when things go south, but simply by being smart and living a healthy lifestyle, we can avoid personal grief and the grief of our families.

Please take the following advice to heart:

Pearls to keep your heart ** healthy:

  1.  No smoking or tobacco
  2.  Maintain a healthy weight
  3.  Eat a healthy diet: nutrient-dense, non-processed, whole foods; lean protein including seafood which is abundant in heart-healthy omega-3 fats; eat meat and dairy sparingly (use fat-free dairy products); fruits, vegetables and legumes; nuts and seeds; whole-grain carbohydrates
  4.  Exercise daily: walking is great, but try to get some exercise that makes you sweat, breathe hard and gets your heart pumping. Exercise is all about adaptation. Our hearts and bodies are remarkably adaptable to the “stresses” that we place upon them, whether they be vigorous exercise or sitting on the couch.   
  5.  See a medical doctor for periodic health check-ups: don’t take better care of your car than you do of yourself!
  6.  Minimize and manage stress
  7.  Know your blood pressure and cholesterol levels and maintain them at healthy levels

 ** And every other organ in your body as well.

 

Heartfully Yours,

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food

www.PromiscuousEating.com