Posts Tagged ‘weight loss’

How To Raise Your Testosterone, Naturally

September 3, 2016

Andrew Siegel MD  9/3/2016


(CDC/Amanda Mills from Public Health Image Library)

Two weeks ago, my entry was about the medication Clomid–a nice alternative to testosterone replacement therapy. What about a non-pharmacological, natural approach to raising testosterone levels?

Testosterone (T) is produced mostly in the testes, although the adrenal glands also manufacture a small amount. T has a critical role in male development and physical characteristics. It promotes tissue growth via protein synthesis, having “anabolic” effects including building of muscle mass, bone mass and strength, and “androgenic” (masculinizing) effects at the time of puberty. With the T surge at puberty many changes occur: penis enlargement; development of an interest in sex; increased frequency of erections; pubic, axillary, facial, chest and leg hair; decrease in body fat and increase in muscle and bone mass, growth and strength; deepened voice and prominence of the Adam’s apple; occurrence of fertility; and bone and cartilage changes including growth of jaw, brow, chin, nose and ears and transition from “cute” baby face to “angular” adult face. Throughout adulthood, T helps maintain libido, masculinity, sexuality, and youthful vigor and vitality. Additionally, T contributes to mood, red blood cell count, energy, and general “mojo.”

The amount of T made is regulated by the hypothalamus-pituitary-testicular axis, which acts like a thermostat to regulate the levels of T. Healthy men produce 6-8 mg testosterone daily, in a rhythmic pattern with a peak in the early morning and a lag in the later afternoon.  Low T levels can be low based upon testicular problems or hypothalamus/pituitary problems, although the problem most commonly is due to the aging testicle’s inability to manufacture sufficient levels of T. T levels gradually decline—approximately a 1% decline each year after age 30—sometimes giving rise to symptoms. These symptoms may include the following: fatigue; irritability; decreased cognitive abilities; depression; decreased libido; ED; ejaculatory dysfunction; decreased energy and sense of well-being; loss of muscle and bone mass; increased body fat; and abnormal lipid profile. A simple way to think about the effect of low T is that it accelerates the aging process.

Lifestyle factors are strongly associated with variations in testosterone (T) levels, with healthy lifestyles correlating with higher levels of T and unhealthy lifestyles with lower levels.  Some physicians regard T level as a laboratory marker of male physical health.

One of the key factors responsible for some of the decline in T that accompanies aging is excessive body fat. In fact, there is an inverse relationship between obesity and T levels, with increased body mass index (BMI) correlating with decreased T.

Factoid: Every 5-point increase in BMI translates to a 10% dip in T–an equivalent decline as would typically occur with 10 years of aging.

Fatty tissue – particularly visceral abdominal fat (the “beer belly”) – contains an abundance of metabolically active factors and hormones including aromatase, an enzyme which functions to convert T to the female sex hormone estrogen. Men with large bellies consequently are often found to have lower T levels and higher estrogen levels, which can result in “emasculation” with loss of sex drive, diminished erections, the disturbing loss of penile length and the presence of gynecomastia (man boobs)

Factoid: In addition to the decline in T, for every 35 lb. weight gain there is a 1-inch loss in apparent penile length because of the pubic fat pad that hides the penis.  

The good news is that weight loss will increase T levels and is capable of improving all of the aforementioned signs and symptoms. This has been demonstrated with all means of  weight loss, ranging from caloric restriction to bariatric surgery.

Another important lifestyle factor associated with variations in T levels is the extent of one’s physical fitness. Exercise is clearly associated with higher T levels. The degree of potential increase in T is related to both the quantity and quality of exercise. In general, the more time invested in moderate intensity exercise, the greater the increase in T.  As important as aerobic exercise is for health, resistance exercise is superior in terms of increasing T.

Bottom Line:  To optimize your T level, maintain a healthy weight and engage in an exercise program emphasizing resistance training.  If you are obese and sedentary, it is likely that you have low T, a situation that can be reversed with a modification to a healthier lifestyle. 

Wishing you the best of health,

2014-04-23 20:16:29

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In the works is the female PelvicRx DVD pelvic floor muscle training for women.

Pelvic Rx can be obtained at, an online store home to quality urology products for men and women. Use promo code “UROLOGY10” at checkout for 10% discount. 


Sugar Substitutes

October 12, 2013

Andrew Siegel, M.D.  Blog #123

For many of us who have a “sweet tooth,” sweet tastes are delightful and we actively seek them out in accordance with our evolutionary drives. The first bite of that sugary Cinnabon is pure bliss. The brain’s reward pathway squirts out the neurotransmitter dopamine and we get a jolt of near ecstasy—the mind-body connection in action. Hopefully, within a matter of minutes, leptin—our satiety hormone that regulates appetite—will counteract the dopamine, making subsequent bites less rewarding and stopping us from gorging.

Sugar is ubiquitous in our diets, not just in the places you expect it, but also “stealth” sugar in breads, crackers, pretzels, chips, salad dressings, sauces, etc.  If you read food labels you might be shocked about the presence of sugar in many unexpected destinations. Sugar (sucrose) is clearly unhealthy and processing and refinement “advances” have permitted its consumption in unreasonable, immoderate and unwarranted amounts, contributing to America’s expanding waistlines and derrières.  So what’s the skinny on sugar substitutes?  Are they helpful in terms of losing weight? Are they better for our dental health than sugar? Are they helpful for diabetics?  Do they have risks?

Sugar substitutes duplicate the sweetness of sugar, but without the caloric (energy) load. Natural sugar substitutes originate from nature and include the following: agave nectar; date sugar; fruit sugar concentrate; honey; maple syrup; and molasses. Synthetic substitutes are concocted by chemists in a lab and are known as artificial sweeteners.   There are 6 “super-sweet” high-intensity substitutes approved for use by the FDA. The super-sweet sugar substitutes are the following: stevia (Truvia); aspartame (NutraSweet; Equal); sucralose; neotame (manufactured by the NutraSweet company); acesulfame (Nutrinova); and saccharin (Sweet’N Low).  Aspartame is the most popular artificial sweetener in United States and sucralose is not far behind.

Sugar substitutes are widely prevalent in our food supply—in processed foods, baked goods, dietary foods, dietary soft drink beverages, powdered drink mixes, canned foods, jams and jellies, dairy products, toothpastes, chewing gums, sugar-free desserts such as ice cream, yogurts, and puddings, and in vitamins and medicines including cough drops.

In terms of weight loss, sugar substitutes can be an effective and attractive means of consuming less calories since the substitutes are non-nutritive and have virtually no calories, while retaining the sweet taste of food substances.    This is in contrast to sucrose that has 4 calories per gram.  Additionally, sugar substitutes are dental friendly, as they—unlike sucrose—are not fermented by the bacterial flora that lives on the teeth and thus do not produce acidy waste products that cause tooth decay.   Sugar substitutes can be effective for diabetics who have trouble regulating blood glucose levels since sugar substitutes do not elevate blood sugar levels the way sucrose does.

Sugar substitutes, while providing a sweeter taste than sugar, contain few or no calories, which is why using them has been thought to aid weight management. Our food-reward system plays a critical role in regulating eating behavior and controlling the number of calories consumed. When the tongue perceives sweetness, the brain expects a glucose infusion, which increases levels of dopamine and stimulates reward centers in the brain.  Without the energy kick provided by actual sucrose, sugar substitutes cannot fool our brains into feeling satisfied. Sugar imposters yield no such reward and cravings can persist and cause more rebound consumption than eating sugar in the first place.

The Food and Drug Administration (FDA) is the governmental body responsible for the regulation of sugar substitutes. Over the years, health concerns have been raised with respect to the use of substitutes and they have been the subjects of intense scrutiny. The general consensus is that there is no sound evidence that any of the substitutes approved for use in the United States cause serious health problems and that they are generally safe in limited quantities. However, there is ongoing and unsettled controversy regarding whether substitute usage is problematic in terms of health risks. We remain muddled in a debate about the health implications of substitutes and whether they might be linked to obesity, cancer, Alzheimer’s disease, ADD, autism, etc.  Search on the Internet and you will learn about the “conspiracy theories” concerning artificial sweeteners.

Saccharin (Sweet’N Low) was the first artificial sweetener, originally synthesized in 1879.  It is 400 times as sweet as sugar.  Although saccharin was previously considered hazardous when it was discovered to cause cancer in rats and carried a warning label, the warning label was subsequently repealed and saccharin has been removed from the hazardous list.  Cancer in laboratory rats has not been found to necessarily correlate with cancer in humans.

Aspartame (Equal; NutraSweet) was discovered serendipitously in 1965 when a scientist at Searle was working on a drug for peptic ulcer disease and spilled some of the chemical on his hand. He accidentally noted its sweet taste, and the rest is history.  It is 200 times as sweet as sugar and derives from 2 amino acids, aspartic acid and phenylalanine.  It is undesirable as a baking sweetener because, when heated, it breaks back down into its constituent amino acids.  It has sometimes been linked to headaches.

Stevia is a natural sweetener that is derived from the stevia plant; its leaves have been used as a sweetener in South America for centuries. It is 300 times as sweet as sucrose.  It was discovered by botanist Petrus Jacobus Stevus, which is why it was named Stevia.

Sucralose (Splenda) is a chemically modified form of sugar that was discovered in 1976 and is about 600 times as sweet as sucrose. It is stable when heated, so is appropriate for use in cooked foods.   Most of consumed sucralose passes out of the body unchanged, with only a small amount getting absorbed.

Neotame (from NutraSweet) is chemically similar to aspartame, but is significantly sweeter, being the sweetest of the group.  It is the only artificial sweetener deemed safe by the Center for Science in the Public Interest (CSPI).

Acesulfame is calorie-free and 200 times as sweet as sucrose; it is formed by adding potassium to aceto-acetic acid.  It is not metabolized by the body, but is excreted unchanged.  Because it is heat stable, it can be used in cooking and baking.

Sugar alcohols are carbohydrates that occur naturally in certain fruits and vegetables, but can also be synthesized.   They do contain calories but they are lower in calories than sucrose. They are used in many processed foods and household items including chocolate, candy, frozen desserts, chewing gum, toothpaste, mouthwash, baked goods and fruit spreads.

Bottom Line: The take-away message is “everything in moderation.” Whether you indulge in items sweetened with sugar derived from sugar beet or sugar cane, sugar alcohols, or any of the natural or artificial sweeteners, consumption should always be kept in check.

Andrew Siegel, M.D.

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

Available on Amazon in Kindle edition

Author of: Male Pelvic Fitness: Optimizing Sexual and Urinary Health, in press. Will be available in e-book and paperback formats in later 2013.

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Exercise Vs. Diet To Lose Weight?

March 9, 2013

Andrew Siegel, M.D.   Blog # 97

An article in the International Journal of Obesity (Katz DL: Unfattening our children: forks over feet: Int J Obesity 2011; 35: 33-37) concluded that when it comes to weight loss, diet plays a more important role than exercise.

To quote Dr. Katz’s conclusion:  “Feet and forks are master levers of medical destiny. Diet and physical activity patterns exert powerful influences on weight and health. There can be no choosing between them when it comes to overall health: physical activity is the vital, conditioning work of the human machine, diet is its fuel. But forced to choose a side of the energy balance equation to favor in weight control, it is forks over feet for fundamental reasons of modern living. One may readily out-eat even somewhat extraordinary levels of physical activity, but most will find it very difficult to out-exercise even fairly ordinary levels of dietary intake.”

If you would like to read the full article, which is quite worthwhile:

Dr. Katz’s article confirmed what I reported in Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food.  The following is a verbatim excerpt from pages 117-118 from the chapter entitled “Raw Facts and Truths”:

As important as exercise is, calorie restriction is the most efficient means of achieving weight loss: exercising restraint over eating trumps exercising our bodies in terms of weight loss.

This is not to denigrate exercise in any way, as getting moving andactive is a fundamental part of any weight loss regimen. Exercise is incredibly important to our health, fitness and well being and can aid the process of weight loss. There are a host of compelling reasons to exercise, including the following: augmented caloric expenditure; aerobic and cardiovascular fitness; improved strength, physical conditioning and self-image; and a productive means of dealing with many of the emotions that drive eating. Ironically, though, burning calories via exercise will leave many of us with a vigorous appetite that can be potentially detrimental to a weight loss program. As important as exercise is, it is not very efficient in terms of weight loss. It takes a great deal of effort to burn a lot of calories and the resultant increased hunger can often negate the effort. For example, I can run for 30 minutes at a good clip and burn 300 calories. By the same token, I could consume 300 calories in two minutes by eating a few cookies. When it comes down to degrees of ease, it is a lot easier to take calories in by eating than it is to expend calories by exercising. Therefore, as important as exercise is, with respect to weight loss, a reduction in caloric intake is of paramount importance and is more efficient than exercise.

Bottom Line:  If you want to drop the pounds, drop the fork…and the most efficient exercise with respect to weight loss is to exercise restraint in terms of eating!  It is simply very difficult to “out-exercise” dietary intake.  Another perspective is that eating less will help you to look better clothed, but exercise will help you look better naked.  In terms of overall health, there is no substitute for the synergy of healthy eating and exercise.  If you commit to one, you will have a better chance of staying on track for the other.

Andrew Siegel, M.D.

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

Available on Amazon in paperback or Kindle edition

Blog subscription: A new blog is posted every week.   On the lower right margin you can enter your email address to subscribe to the blog and receive notifications of new posts in your inbox.  Please avail yourself of these educational materials and share them with your friends and family.

Eat It Raw

August 11, 2012

Blog # 70   Andrew Siegel, M.D.


There are numerous health advantages to eating raw produce.  As a general premise, the less our food is processed, the healthier it is—and cooking is certainly a form of processing.  There is often some degree of nutrient loss as a vegetable or fruit is cooked.   If weight loss is a concern, raw is particularly good because one expends more calories just to break down raw food as opposed to cooked food, which is essentially “pre-digested.”   Also, since raw foods are less calorie-dense because of increased water content, they not only are more filling, but also require more energy to heat the increased water content to body temperature.  The need to use additional calories to burn calories is called the thermogenic effect.  For example, eating raw broccoli has a strong thermogenic effect; drinking soda has very little thermogenic effect.

Clearly, raw food is less digestible and more bulky and filling than its cooked brethren. Raw foods require more chewing and thus more exercise of our masseter muscles of the jaw—hence more calories burned. This increased requirement for chewing—think raw carrots vs. cooked—forces us to eat more slowly and increases our satiety.  The high fiber content of raw fruit and vegetables slows digestion and minimizes glucose fluctuations, modulating insulin spikes and thus helping to prevent fat deposition and weight gain, in addition to its beneficial effect on bowel regularity.

Forget about all of the potential benefits for health and vitality for a moment.  On a more primal level, there is nothing like the delight derived from a piece of ripe, juicy, aromatic summer fruit bursting with sweetness and intense flavor. The vibrant color appeals to our vision, the sweet scent is alluring, the feel in our hands and mouth is pleasing, in addition to being downright delicious and a reminder of the beauty of the simple and natural things that life has to offer.

By no means am I recommending a totally raw produce diet, but it is reasonable to shake it up and consume some vegetables and fruits in their natural state.  Most people eat some raw vegetables in the form of salads, and raw fruit is often the norm for most of us.   But many of us would be well served to increase the amount and variety of raw veggies in our diet.   Think of a nice crudité platter as opposed to mushy cooked vegetables. Keep in mind a beautiful red delicious apple vs. a baked apple or applesauce.

Advice of the day: Eat a salad with crunchy vegetables before a meal to help decrease caloric consumption during the meal.  Throw in some strong flavored veggies like radicchio, scallions, radishes or arugula because their intensity is so stimulating that they can induce satiety, allowing us to eat less. Alternatively, a piece of fruit before a meal will achieve the same endpoint.  Experiment with how you use raw fruits and vegetables—the results can be a delightful change for your palate, and a slimmer waistline.

Andrew L. Siegel, M.D.

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

Available on Amazon Kindle