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Gluten and Its
Association With Illness
Vitamin D Importance
In Prevention and Treatment of Illness
Allergies & Sensitivities: LDA (Ultra Low
Dose Enzyme Activated Immunotherapy)
Post Traumatic Environmental Stress Disorder
Peace of Mind: Holistic
Approaches to Anxiety and ADD
Bipolar Disorder Can Be Treated With Medication
and Naturally
ALLERGY REDUCTION:
Improving Mood and Energy
Hidden Factors Behind Your
Persistent Illness
Adult
ADD:
To Medicate or Go Natural
Cancer
–
Finding Your Best Advisor
Overweight - The Risk and the Remedy
Loss
of Sexual Interest
Approaches in Helping Bipolar Sufferers
Help for Panic and Anxiety Sufferer
Seasonal
Affective Disorder: The Winter Blues
Depression
Relief Speeds Health Recovery
Amino Acids
& Other Considerations in Depression Evaluation
Integrative
Medicine & Psychiatry
Blood
Pressure -
A Wake up Call
Addictions
- Breaking the Cycle
Suboxone: For Opiate Dependence
(for Western North Carolina Residents Only)
Spirituality:
The Core of
Healing in Integrative Psychiatry
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OVERWEIGHT
-
THE RISK AND BEST REMEDY
By
Ronald R. Parks, MD
It has been estimated that
$30 billion is spent each year in the U.S.A. on diet aids and
remedies. National surveys show that at least 25 to 50% of
adult Americans are on some sort of diet. According to the
CDC, at least 1/3 of Americans are 20% or more overweight
(about 11 million in U.S.A.) and about 34% have a weight in
excess of 120%. Overweight and obesity is considered a
disease or illness when the amount of body fat adversely
affects health. The degree or amount of fat accumulation as
well as where the fat accumulates can be associated with
increased risk of illness or death. For example the more one
moves into the obesity range, the greater the risk for
cardiovascular disease and non-insulin dependent diabetes.
Also if fat accumulated more in intra-abdominal areas and
storage areas around the abdominal organs, the “apple shape”
or proverbial “pot belly,” a greater risk to health can be
anticipated. If a man’s waist circumference is greater than
39 inches or more or if a women’s waist circumference is 35
inches or more, studies have shown increased illness risk.
There is less risk if fat accumulation is more in the lower
body, as in the “pear shape.”
There are different ways of
assessing and determining overweight, obesity and health risk.
Most research has used some type of standard measure for
weight, amount of body fat or its distribution in the body to
look for associated diseases and death risk patterns. One of
the more reliable measures has been the body mass index,
“BMI.” This
value can easily be obtained from standard charts available in
books on nutrition and health, or on the Internet. See
below on how to calculate your BMI.
Normal weight is considered
if your BMI is between 18.5 and 24.9. Overweight, or
pre-obese and increased risk of disease, is present if your
BMI is between 25 and 29.9. If your BMI is over 30, you would
be considered obese; you would have an increasingly severe
risk for multiple metabolic or structural disorders. Other
used measures have been the waist-to-hip ratio (smallest part
of waist divided by largest part of your hips). This should
be less than 0.8 for women and 1 for men. Skin fold measures,
amount of water displaced in a dipping tank, bio-electrical
impedance built into scales and measured through the feet (not
always accurate), weight by height tables and bone thickness,
and other measures, have also been used to determine degree of
overweigh and fat accumulation.
The increase in risk of
illness or death with overweight is from associated problems
as: hypertension; Diabetes type II; hyperlipidemia (increased
blood fats); coronary artery disease; degenerative joint
disease (backs and knees); psychosocial disability (social
costs of being overweight); increase risk of cancer in men
(prostate, colon and rectal cancers) and in women (uterine,
biliary tract, breast, and ovarian cancer); increase in
gallstones, reflux, and skin disorders; pulmonary function
impairment as sleep apnea; hormonal abnormalities; greater
surgery and OB risk. Death from all causes, including
cardiovascular disease, increase in proportion to obesity. It
is estimated that 300,000 death per year result from diabetes
and hypertension related causes. Overweight has been
associated with complaints of decreased vitality, physical
functioning, increase in body pain, and diminished quality of
life.
Western medicine has
attributed weight problems to such factors as: sedentary life
style; chronic ingestion of excess calories, fats, refined
carbohydrates; poor digestion and inadequate absorption of
vital nutrients as vitamins, minerals, amino acid and
essential fatty acids; and genetic influences as genes that
control appetite. Mutated genes can contribute to obesity.
The Ob gene and its protein product leptin, when defective,
leads to impaired formation of active leptin which controls
food intake, affects energy intake and body composition. Twin
studies have shown a genetic influence on body mass index of
the child and his/her biologic parents, which are independent
of the environment. An example would be the findings of an
obese child in an adopted home of thin adoptive parents and
non-biologic siblings, whereas the biologic parents with the
same genetic makeup were obese.
Typical medical evaluations
look at the age of onset, recent weight changes, family
history of obesity, occupation, eating and exercise patterns,
smoking and alcohol use, use of diuretics, hormones,
over-the-counter medications, supplements, and psychosocial
factors. Less than 1% of the overweight has an identifiable
secondary cause as low thyroid, or over active adrenal
glands. Medical assessment is done with checks of fasting
blood sugar, cholesterol and triglycerides, blood pressure
check for hypertension, tests for coronary artery disease and
other tests as hormone evaluations as thyroid function.
Conventional approaches have
used multidisciplinary approaches as a hypocaloric diet, with
behavior modification, aerobic exercise and social support
(support group, family and peers). Preferred diets have been
low-fat, high-complex carbohydrate, and high fiber, or high
protein, fat and low carbohydrate diets. Education into meal
planning, cooking and shopping classes, and record keeping of
food intake, exercise and activities are often part of
multidisciplinary programs.
Outcome research doesn’t
suggest great long-term success with these approaches. About
20% of people that successfully lose 20 pounds will maintain
the loss over 2 years. Only about 5% who lose 40 pounds will
maintain it over a 2-year period. There doesn’t seem to be
any advantage to diets that restrict complex carbohydrates,
advocate large amounts of protein, fats, or recommends
ingestion of foods one at a time. Uses of prescribed
medications have only been shown to be of limited helpfulness
and some have proven dangerous and have been pulled from the
market. An example would be Phen/Phen (fenfluramine/dexfenfluramine),
which was linked to valvular heart disease.
Also some herbal products as
those containing epedra have been associated with heart
arrhythmia and death. Too rapid weight loss has been shown to
cause fatigue, low blood pressure, fluid and mineral
imbalances, gout, gallbladder disease, and heart arrhythmia.
The uses of antidepressants as Prozac, Luvox (SSRI’s), or
Wellbutrin have been of limited help unless significant
clinical depression is present. Some new unproven drugs
decrease fat absorption, which could potentially lead to other
problems. Gastric surgeries as vertical band gastroplasty or
gastric bypass have been used in the massively obese (BMI over
40) but with complications and failure rates approaching 50%.
Botanical aids have been tried and studied without any clear
conclusions. These are reviewed in
Melvyn Werback’s book, “Botanical
Influences on Illness, 2nd Edition,” published by Third Line
Press. There has been efficacy demonstrated in controlled
human trails on weight loss with: use of balanced hypocaloric
diet; eating daily breakfast; substituting fructose for
glucose and sucrose; use of low-insulin response diet; low fat
hypocaloric diet, use of increased dietary fiber; omega-6
essential fatty acids as evening primrose oil;
5-hydroxytryptophan (natural precursor of serotonin a mood and
appetite regulator); Vitamin C, and chromium.
The obvious is the need to
reduce health risk by achieving healthy normal weight in the
most natural way that is best suited to individual differences
and needs. The studies of past civilizations and populations
around the world would point to the benefits and advantage of
traditional diets from different cultures, especially prior to
era when refined, processed and additive rich foods were
introduced. From the diverse fields of archaeology;
anthropology; comparative anatomy; and historical studies of
man, his early life and culture – a clear fact has emerged.
There seemed to be little, if any, of our modern diseases
present, including obesity and heart disease. Stone Age
cultures consumed primarily vegetable-quality foods,
containing 50 to 70 percent complex carbohydrates from plant
sources. Paleolithic primitive hunting societies contrary to
popular beliefs were primarily gathers of wild cereals,
grasses and foraged for plants, berries, roots and tubers.
With the introduction of farming in Neolithic times, domestic
grains replaced wild strains as the main staple in the diet
with supplements of beans, legumes, seeds and nuts, garden
vegetables, sea vegetables and seasonal fruits. They also ate
small amounts of fish, poultry, meat and other animal
products. Traditional societies not fully influenced by
modern culture today still get their main nourishment from
cooked whole grains and beans. (Kushi
and Jack, “Diet for a Strong Heart,” St. Martin’s Press, New
York, 1985, pp. 49-51).
The experience of many
followers and practitioners of the standard macrobiotic diet,
for example, is that weight loss is experienced in the early
months of the diet and then a gradual adjustment towards
optimal body weight occurs. This generally occurs with close
adherence to macrobiotic principles and nutrition that
encompassed many of the dietary habits present in these
earlier, healthy cultures and civilizations. This also
includes good chewing of foods for optimal digestion;
avoidance of poor quality foods as refined flour, sugar, fat
and other oily greasy foods; use of only high quality, good
source protein; getting adequate physical exercise; and
avoidance of excessive stress, especially around meal time.
Food cravings and the compulsive eating of rich foods
generally subside with the change in eating to a nutritious
structured diet as noted above. Counting calories is usually
not necessary with the moderation, simplicity and balanced
nutrition present as found in a macrobiotic diet. A typical
macrobiotic diet has 50 to 60 % whole grains, 5-10% soups, 25-
30% vegetables, 5-10% beans and sea vegetables with
supplemental foods as fish, seasonal fruits, nuts and seeds,
seasonings, pickles, condiments, natural snacks, desserts and
natural beverages. Other types of traditional nutritionally
balanced diets may also have a higher percentage of good
quality protein foods. As overweight and obesity seem to
increase in our modern society along with heart disease and
cancer; healthy bodyweight and lack of these degenerative
diseases prevail in traditional societies where nutrition has
remained in good balance with healthy unadulterated food
choices. (Kushi and Jack, “Diet for a Strong Heart,” St.
Martin’s Press, New York, 1985, pp. 214-215).
Good nutrition is very
satisfying and empowering to the individual. Every
practitioner of good nutrition has the opportunity to continue
to study, learn and develop their skills and intuition about
what works best for their individual nutrition, energetic
needs, conditions, living situations, and life stages. If
weight seems to be a problem for you, seek out a good
nutrition educator and cooking classes. If evaluation and
testing is needed, find an integrative health practitioner
with experience in nutrition and an openness to working with
you in an empowering partnership to meet your needs. Seek out
nourishment and fulfillment of body, mind and spirit.
How to calculate your BMI:
Calculate it by multiplying
your height in inches x .0245 and than multiplying this answer
by itself (squaring it). Take this result and divide it into
your weight in pounds multiplied by .45 and you have your
BMI. If you weigh 130 lbs. multiply it x .45 = 58.5. Divide
this number by the height in inches multiplied by .0245 and
than multiplied by itself (squared). If 68 inches, multiply
by .0254 and square it = 2.99 and divided into 58.5 = 19.6
BMI.
READING SOURCES:
1. Kushi and Jack, “Diet for a Strong
Heart,” St. Martin’s Press, New York, 1985
2. Jack, Alex, “Let Food
Be Thy Medicine,” One Peaceful World Press, Becket, MA, 1999
3. Kushi, Michio,
“Macrobiotic Way,” Avery Publishing Group, New Jersey, 1985
4. Murray and Pizzorno,
“Encyclopedia of Natural Medicine, 2nd Edition,” Prima Health,
CA 1998
5. Stipanuk, Martha,
“Biochemical and Physiological Aspects of Human Nutrition,”
W.B. Saunders Co., 2000
6. Werback, Melvyn,
“Botanical Influences on Illness, 2nd Edition,” Third Line
Press, CA, 2000
7. Werback, Melvyn,
“Textbook of Nutritional Medicine,” Third Line Press, CA, 1999
8. Tierney et al.,
“Current Medical Diagnosis & Treatment 2000, 39th Edition,”
McGraw-Hill, NY
Ronald R. Parks, M.P.H., M.D. has completed medical and
specialty training in internal, family and preventive
medicine, is board certified in psychiatry, and has studied
nutrition and macrobiotics at the Kushi Institute. His
current practice specializes in integrative medicine and
psychiatry in Asheville, NC. For consultations call:
828-225-1812
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