A few extra pounds, Good or Bad ???

July 6, 2009

I came across an interesting article from Reuters news service. My comments will follow.

A few extra pounds can add years to your life: study
Wed Jun 24, 2009 4:04am EDT

NEW YORK (Reuters) - Carrying a little extra weight may actually be good for you, according to a Canadian study that showed a few pounds appear to protect people from an early death. Researchers found that while underweight and extremely obese people die earlier than people of a normal weight, people who are slightly overweight actually live longer than those of a normal weight. The findings of the new study were published online in the journal Obesity by researchers at Statistics Canada, Kaiser Permanente Center for Health Research, Portland State University, Oregon Health & Science University, and McGill University.

To read the entire Reuters article... http://www.reuters.com/article/lifestyleMolt/idUSTRE55N0C720090624?sp=true

Interesting study. I read only part of this article the first time I saw it. I was too busy eating my Five Guys Burger and Fries!!

Mmm Mmm Good !!!

But back on topic...

To understand this study better, let me first introduce you to medical definitions from the NIH (National Institutes of Health) that helps to determine if a person is overweight. The method that experts believe is best is to measure a person's body mass index (BMI). BMI is a calculation derived from your height and weight. A calculator to determine your BMI can be found at http://www.nhlbisupport.com/bmi/

Adults with a BMI between 25 and 29.9 are considered overweight. There are exceptions. For example, an athlete may have a higher BMI but not be overweight.

Adults with a BMI greater than 30 are considered obese.

Anyone more than 100 pounds overweight is considered morbidly obese.

My electronic medical record is able to calculate your BMI for you. Just ask the next time you are at the office.

So is evaluating your health as simple as placing you into the following categories of underweight, average, or overweight?

No !!

Does looking like magazine supermodels make us healthy?

I'll answer that for you as well. NO!!! Most supermodels are underweight and even malnourished. Many have eating disorders. So while they may have fame and fortune, they do not necessarily have their "health".

So what does weight have to with health??

First you must answer why I chose this topic for a newsletter?

1) I was bored and felt like writing
2) My daughter is away at overnight camp, which left me with more free time.
3) It is important to advise my practice that while weight management is important for your overall health, the "number of pounds" that you weigh is only one indicator of you overall health.
4) I am trying to promote the idea that health and wellness is more than just monitoring your weight.

The answer is all of the above !!!

At The Institute For Medical Wellness, we use different methods and also different types of healthcare professionals to help you determine your overall health risk factors. Your weight is one factor. Your lab results may be another. What about your diet and exercise? Yes, we use that as well. Family History?? Extremely important!! I could go on and on, but then I may be giving away too many of my trade secrets ; )

But one thing we do, and do well, is think outside the box when it comes to your care. So before you say you are unhealthy and put yourself on a diet to "improve your health", look to The Institute For Medical Wellness to make sure you are on the right track. Our goal has always been to give you individualized, non-biased health guidance, regardless of what the so-called experts or majority say. When we are working with you, only two votes count, ours and yours!!

To Good Health !!!

Steven Horvitz, D.O.
Board Certified Family Medicine
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311
http://www.drhorvitz.com/

So Easy A Caveman Can Do It ???

May 27, 2009

So easy a caveman can do it??

No that is not my college yearbook picture !!! Although I would not mind the hair ; )

It is the popular caveman from the Geico commercials. In the commercials, the caveman acts like a normal everyday 21st century individual, until he sees the Geico slogan, "So easy a caveman can do it". Then he gets annoyed and I don't blame him.

But what does this have to do with your health?

Let me explain.

It is now 2009, and it goes without saying that we are more technologically advanced than our caveman ancestors. We have hospitals, doctors, surgeons and antibiotics. We have nurses, therapists, and a whole host of other healthcare providers, (just look at our Wellness Network), to help treat and cure disease. Our healthcare choices are plentiful. That may change if the federal government passes new healthcare legislation, but let me get back on topic.

So are we healthier than the caveman?

NOPE !!!!

Let me explain.

While we are more technologically advanced than our caveman ancestors, we still share over 99% of their DNA. So in essence, we are not that different, just more civilized? I know, another off-topic conversation.

Our 21st century diet and lifestyle are much different than our ancestors and not necessarily for the better!

Today I will focus on diet.

Our caveman ancestors lived off the earth and were known as hunter-gatherers. They did not go to Wegmans for their produce, Papa Johns for their pizza, or make reservations for dinner. They hunted and gathered for all their food on a daily basis. Their diet is said to have consisted of fresh fruits and vegetables, greens, nuts and seeds, as well as hunted wild game. They ate fish and foraged for eggs. Their nutritional status was heads and tails above present day man. Their foods contained no preservatives or added hormones. Today's processed foods, while having a long shelf life, easy to read nutritional labels and easy to prepare microwave instructions, has far less nutritional value than fresh food. Less nutrients in today's diet set us up for many Diet Related Diseases or DRD's. I am sure you have heard of the following DRD's:

Obesity
High Blood Pressure
High Cholesterol
Diabetes
Arthritis

There are many others but I think I made my point.

Oh well, I am on a roll so I'll make another point!

Did cavemen eat Cheerios? Bagels? Ice Cream? Pepsi? Pizza? ............. NO!

How bout eggs? apples? tomatoes? fish? chicken? .............. YES !!

Pearl of the day:

If you want to improve on, or prevent your Diet Related Diseases,

the solution may be,

"So easy a caveman can do it".

Steven Horvitz, D.O.
Board Certified Family Medicine
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311
http://www.drhorvitz.com/

To celebrate the end of the school year, for the month of June, all schoolteachers can receive $10 off a 1 hour massage, or $15 off a 1.5 hour massage from Julie Fischer, our certified massage therapist at The Institute For Medical Wellness. And if you refer a friend for a massage, you both will receive $5 off your next massage.

To view previous newsletters
To view Insitute For Medical Wellness Network events

Cheers or Jeers for Cheerios??

Excerpts From Yahoo News

Popular cereal is a drug, US food watchdog says

Tue May 12, 10:05 pm ET

WASHINGTON (AFP) – Popular US breakfast cereal Cheerios is a drug, at least if the claims made on the label by its manufacturer General Mills are anything to go by, the US Food and Drug Administration (FDA) has said.

"Based on claims made on your product's label, we have determined that your Cheerios Toasted Whole Grain Oat Cereal is promoted for conditions that cause it to be a drug," the FDA said in a letter to General Mills which was posted on the federal agency's website Tuesday.
Cheerios labels claim that eating the cereal can help lower bad cholesterol, a risk factor for coronary heart disease, by four percent in six weeks.

Citing a clinical study, the product labels also claim that eating two servings a day of Cheerios helps to reduce bad cholesterol when eaten as part of a diet low in saturated fat and cholesterol, the FDA letter says.

Those claims indicate that Cheerios -- said by General Mills to be the best-selling cereal in the United States -- is intended to be used to lower cholesterol and prevent, lessen or treat the disease hypercholesterolemia, and to treat and prevent coronary heart disease.

The rest of the Yahoo News article can be found here.

Now how silly is this?

Doesn't the FDA have anything better to do than go after the number one sold cereal in the country?

Is accusing Cheerios of being an illegally marketed drug just a little bit over the top?

I can see the news headlines.

Just Say No to Cheerios !!!!

Let us look at how silly this is on many levels, as Cheerios claims and the FDA's claims are both inaccurate.

Cholesterol, by itself, does not cause heart disease, although it can be used as a marker for heart disease. Taking cholesterol lowering drugs makes it more difficult to stratify your level of heart disease risk by masking your true cholesterol levels. If you knock out a radar station, does that mean that incoming missiles will be prevented? Just because you do not see the missiles coming in (high cholesterol levels on your bloodwork), does not mean they are not there. I use cholesterol levels taken off of medication to be a truer reading of risk.

Cheerios, being a processed carbohydrate, will raise your sugar levels, thereby raising your insulin levels, which leads to an increase in vascular inflammation in your arteries. This will increase your risk of heart disease. Not exactly what Cheerios advertises!!

Lowering bad cholesterol (LDL) without knowing your good cholesterol (HDL), triglycerides, and total cholesterol is not helpful. So any statement about lowering your bad cholesterol, without mentioning the effects on your good cholesterol, is misleading. Don't believe what you see advertised on food, especially if approved of by the FDA. Approvals are based more on politics and profits than health.

I have found the lowest heart disease risk in patient's whose Total Cholesterol divided by their Good Cholesterol (HDL) is below 4. The higher risk individuals have this ratio above 5. I have also seen many people lower their bad cholesterol, but also lower their good cholesterol and actually increase their heart disease risk. This can happen more frequently when on a low fat diet.

Who do you think has the lower risk of heart disease based on cholesterol levels alone?

Patient #1) Total Cholesterol = 240
HDL Cholesterol = 60
LDL Cholesterol = 145
Triglycerides = 110

Patient #2) Total Cholesterol = 180
HDL Cholesterol = 30
LDL Cholesterol = 115
Triglycerides = 100

Answers will appear later.

My opinion....

The FDA is playing games with the food industry and the public and I am not sure of their intentions. In the past, the FDA almost always tended to side with big business to promote sales of their products. In fact, the FDA food pyramid, which was formulated by our federal government with backing from all the major food industries, has for years encouraged an abundance of carbohydrates in the diet, with cereals produced by American industry at the forefront. This is not my view of the healthiest way to eat, and it has contributed to an increase in heart disease. But things are now changing in Washington. The FDA appears to be going after certain industries that were previously immune. When I figure out why the change of heart, I will be sure to let you know.

As for the purported health claims that Cheerios will lower your risk of heart disease, if you believe that I have a bridge in Brooklyn I would like to sell you!! Cheerios is a processed man-made breakfast food product, made up primarily of processed carbohydrates. As previously mentioned, processed carbohydrates, when eaten in abundance has been linked to an increase in heart disease, as well as obesity and diabetes. My suggestion is to pass on Cheerios, as well as most processed cereals.

OK, so getting back to my cholesterol quiz, which patient has a lower risk of heart disease based solely on cholesterol measurements?

Patient #1 has higher levels of all the cholesterol components and triglycerides. Patient #1 also has a ratio of 240/60 = 4.0

Patient #2 has lower levels of all the cholesterol components and triglycerides. Patient #1 has a ratio of 180/30 = 6.0

The envelope please.............

Patient #1 has a lower risk of heart disease based on the ratio of 4.0 . Why??The HDL or good cholesterol, in theory goes through the body and scavenges up or cleans up after the bad cholesterol or LDL. The best way to improve your ratio is too lower your processed carbohydrate intake, increase your healthy fat, protein and fiber intake, increase your exercise, and if able supplement with fish oils. This will raise the amount of good cholesterol (HDL) and lower your ratio to healthier levels.

For more information, or too develop a personalized wellness plan to include tips on healthy eating, please schedule your annual wellness exam.

As Ben Franklin once said, " An ounce of prevention is worth a pound of cure! "

Steven Horvitz, D.O.
Board Certified Family Medicine
Founder of The Institute for Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone: 856-231-0590
Fax: 856-294-0311

For more information about Dr. Horvitz and The Institute for Medical Wellness.
To view upcoming Wellness Network Events.
For previous newsletters.

High Blood Pressure- What treatments are best for you?

May 2, 2009

High Blood Pressure, also known as Hypertension is said to affect 1 in 3 U.S. adults, or about 73 million Americans over the age of 20. It has been called the "silent killer" as many people have this condition for years without ever knowing it. So what is the problem?? Well, untreated high blood pressure leads to an increased risk for heart disease, stroke, congestive heart failure, kidney failure, peripheral artery disease, and aortic aneurysms.

So, just what is blood pressure and what do the numbers mean? When we measure blood pressure we record two readings. The top number is the systolic pressure. This is the pressure generated when the heart contracts (pumps). It reflects the pressure of the blood against arterial walls. The bottom number is the diastolic pressure. This is the pressure when the heart is filling and relaxing between beats. The so called average blood pressure for an adult is 120/80, but each adult may have a different "normal" blood pressure. High blood pressure in adults is defined as a consistently elevated blood pressure of 140 mm Hg systolic and 90 mm Hg diastolic or higher.

It is important that your blood pressure be taken accurately. Improper size cuffs, calcified arteries and arm positioning can give false readings. If your blood pressure is elevated on 3 consecutive readings on different days or if your systolic pressure is 160 or above, or your diastolic pressure is 105 or above, treatment is indicated.

OK, so what treatment or approach is right for you?


There are many different treatments available and medications that can be used, but I prefer to use medications only after lifestyle changes are explained, taught and implemented. One of the reasons I started the Institute For Medical Wellness was to give my patient's more choice in the treatments available. Medications when used properly are safe and effective. But exercise, lifestyle changes and proper diet can also bring many high blood pressure readings back to normal.
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For a Naturopathic perspective on high blood pressue, Dr Jennifer Phillips, affiliate of The Institute For Medical Wellness has prepared the following:

Naturopathic approach to hypertension

High blood pressure (hypertension) is one of the leading causes of disability or death due to stroke, heart attack, heart failure and kidney failure. It's also the most common chronic illness Americans face. Despite the importance of these observations, blood pressure is poorly controlled in the United States. An estimated 25% of all American adults have high blood pressure, and only 27% have it under control. Conventional drug therapy consists of Diuretics, ACE inhibitors, Beta-blockers, Vasodilators, and Calcium-channel blockers. Side effects of these meds can include fatigue, depression, weight gain, and bone loss, so many patients are eager to find alternatives. If you are one of these patients, read on!
Diet Priniciples

Diet should be low in sugar, high in complex-carbohydrates (such as whole fruits and vegetables). Grains should only be eaten in moderation (3 or fewer servings daily, and only whole grains), nuts, seeds, legumes (beans), fish. Meat and poultry should be limited to free-range and/or organic varieties to avoid chemicals and hormones. Increase foods rich in potassium, calcium and magnesium (carrots, spinach, celery, alfalfa, mushrooms, lima beans, potatoes, avocados, broccoli, and most fruits). Salt restriction may be indicated for some types of hypertension, but not all types. I recommend salting food to taste after cooking, and use only natural sea salt. A diet rich in garlic and onion is as important as any other supplements, so be prepared to smell like an Italian restaurant!

Life-style Changes
Weight loss -- The United States is in the midst of an epidemic of obesity involving more than one-third of the adult population. Weight gain is very high risk in determination of hypertension. It is very critical to lose weight in a slow fashion to control hypertension. Rapid weight loss is not advised. Many studies have shown those overweight-hypertensive patients can reduce their medication with weight loss.

Exercise -- Sedentary people have a 35% greater risk of developing hypertension than athletes do. Keep in mind that people with hypertension should always consult with their physician (ie Dr. Horvitz or a cardiologist) before starting a new exercise program.

Good Sleep Habits -- Insufficient sleep can contribute to high blood pressure in hypertensive people. Are you getting your 8-10 hours each night?

Stress reduction - Stress management and relaxation techniques such as meditation can help in controlling high blood pressure. I feel that hypertension is similar to a pressure cooker- but a pressure cooker always has a valve to let off steam. If we don’t have a valve to "let off steam" or a way to prevent the pressure from rising, then our internal blood pressure goes up!

Specific Supplements
Supplements that have been clinically studied and shown to reduce blood pressure include: Magnesium, Potassium, Coenzyme Q10, Omega-3 Oils, Vitamins C and E; amino acids L-arginine and Taurine; herbs such as Hawthorn, Arjuna, Olive leaf, and Garlic.

You are advised to consult with a naturopathic physician to check for interactions between supplements and medication before embarking on any supplement plan that may reduce blood pressure, especially if you are currently taking medication. In my own practice I have helped many patients reduce or eliminate medication through natural means. The changes also help to reduce other cardiovascular disease risk factors, so the benefit is not just limited to blood pressure.
Jennifer Phillips, ND

If you would like to consult with Dr. Jennifer Phillips, she evaluates patients at my office on Thursdays.

For more information about Dr. Jenn.
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Have you ever had a massage and felt rejuvenated after? Julie Fischer, our massage therapist has the following thoughts on the benefits of massage on high blood pressure.

The lasting health benefits of massage are many, and yet it is often thought of as a luxury. In fact, studies have confirmed that one of the most effective ways of lowering high blood pressure is through receiving massage on a consistent basis. After a few weeks of regular massage, profound effects are found in groups of people who had been struggling to improve their heart's health. Blood Pressure levels are significantly lowered, levels of stress hormones decrease, and feelings of general well being return. As is the intent with all massage programs, the ultimate goal lies in a pain free and relaxing lifestyle. Controlling blood pressure is just one of the many benefits of massage therapy.

As a way to introduce Julie's massage skills, and hopefully bring or keep your blood pressure to a healthier level, she is now offering the following promotions:

Mini Massage! No time for a full session? Come by for a 15 or 30 minute refresher for your back, neck and shoulders! Feel the tension and stress release during your lunch break or between appointments in your busy day. Return to your schedule energized and renewed after this fully clothed, oil free mini massage. Be sure to call ahead to check time availability.

$20 - 15 minutes
$40 - 30 minutes

Relax Packages:
5 massage package 10% off
10 massage package 15% off
*must be used within 6 months

Healthy glow plan:
1 hour session per week - $250 monthly rate

Referral special:
Refer a friend for a first time visit, and receive $5 off of your next massage!
*Make sure your friend lets us know you are the referral source so that we can thank you!

Mothers Day Gift Certificates available!
What better way to show your appreciation than with a gift of renewal! Whether she chooses Thai, Hot Stone, Deep Tissue or Swedish, she will receive a healing treatment that will feel like absolute pampering.

Lockheed Martin employees -
Show your corporate ID and receive $5 off a 1 hour massage and $10 off a 2 hour massage!

For more information about Julie's sevices.
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Proper exercise can also play a key roll in controlling blood pressure. Andy Dick of Optimum Fitness has prepared the following:

Regular exercise is a great way to naturally lower your blood pressure and keep it regulated and nearly any form of regular exercise is proven to help. Both cardiovascular (running, biking, etc…) and strength training has been proven effective in controlling blood pressure. While diet alone can accomplish this, exercise has the added advantage of getting your heart involved in the work. Plus, while you are burning calories, your are also maintaining and/or improving your muscle tone. Regular exercise improves your circulation and allows your body to more efficiently use oxygen in the bloodstream. Sweating out excess amounts of stored water and sodium in the body during exercise can help regulate some of the important components in the body that contribute to high blood pressure. Exercise forces the body to release insulin, which lowers sodium, which helps to lower blood pressure naturally. Any exercise is good, so my advice would be start on any program that you will enjoy and that fits your lifestyle and personality.

Andy Dick

Please feel free to take advantage of a special offer available only to patients in Dr. Horvitz's Wellness Programs at The Institute for Medical Wellness: Enjoy a free initial consultation that will include body composition analysis, goal setting, program planning, and a comprehensive question and answer session to go over all of your concerns. After this, members of Dr. Horvitz’ Wellness Program are able to take advantage of an introductory 2 for 1 training package to get started. This is a $120 value for only $60 to get you on your way to a better, more rounded lifestyle.

For more information on Andy's services.
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High Blood Pressure has many different causes, and many different treatments. You should never feel forced or coerced into any one treatment plan. At The Institute For Medical Wellness, we will work with you to find the treatment plan that meets the following criteria:

It is Safe, Healthy, and will make you Happy!!

Steven Horvitz, D.O.
Board Certified Family Medicine
Founder of The Institute for Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone: 856-231-0590
Fax: 856-294-0311

For more information about Dr. Horvitz and The Institute for Medical Wellness.

To view upcoming Wellness Network Events.

For previous newsletters.

www.DrHorvitz.com

Institute For Medical Wellness Vision

April 27, 2009

I have often been asked how and why I developed The Institute For Medical Wellness.

So here goes.

It all came down to following my vision of what makes a true Family Physician and developing a practice with this mission. This vision has been shaped and reshaped over the past 18 years. Upon graduation from medical school in 1991, and completing an internship and residency in Family Practice in 1994, I felt very well trained to begin my career. My first four years were spent working for another family physician with two offices. One was based in Cherry Hill and the other in North Camden. During those years I matured alot as an individual and as a physician. I learned that being a physician is not just about diagnosis and treatments. It is about building relationships based on trust and mutual respect.

My goal since childhood has always been to have a private practice. So in 1998 I started my own solo private practice in Moorestown. At the time I was told by a majority of physicians that I would never succeed. The prevailing thought in 1998 was that independent medical practices were too risky. In 1998, hospitals were buying up independent practices and physicians became employees of large hospital orgaizations. Well, if you do not know me well yet, I have my own views, many of them contrarian. I do not believe that the majority opinion is always correct. I also do not always play well with others, so an independent practice was my best career decision and I have never looked back and never regretted it.

Now starting a practice from scratch was not easy, but it was the right thing for me. It was slow the first year, but by the second and third year, things were moving along nicely. I was busy enough to be happy, but not so busy that I couldn't take the time necessary for each patient, as well as have enough time for my own family. Health insurance companies were strong, but they were not yet planting themselves between me and my patient's. But year after year insurance companies started requiring more and more bureaucratic nonsense in order for the proper delivery of care. Back in 2004-5 I stopped participating with 2 health plans due to their nonsense. My practice grew nonetheless. But again, each year brought more bureaucratic and governmental regulations that hindered the proper delivery of care. Referalls, preauthorizations, precertifications, electronic billing, HIPPA, and many others were not part of running an efficient and effective medical office when I started medical school. But this is what happens when Big Business and Big Government takes control of your healthcare.

In 2007, I was at a crossroads. My career goal was not to be the richest or poorest physician, but to be the best physician I could be. I explored two opportunities. One would have meant joining a large group practice that would deal with all the bureaucratic nonsense for me. The other was to convert my practice to a Concierge model. Both had many advantages, but also came with one big disadvantage, that being loss of control of how my practice is run. And as I stated before, I do not play well with others. So I needed another direction. I needed a practice model that fit my views of proper patient care and yet still remain viable in the community. So I brainstormed and put together the vision of The Institute For Medical Wellness. Special thanks to my wife, my daughter Nori, and great friend Ivy for all your help with bringing a name to my vision.

So in January 2008, The Institute For Medical Wellness was born and has been growing and evolving every day. It has not been all smooth sailing, and I have hit some bumps along the way, but overall I am moving in the right direction. Being in practice for 18 years, I have become more realistic in my views on medical care. I have learned that traditional medical care does not have all the answers. So while I received a traditional medical school education, my views now also include holistic approaches. In the treatment or prevention of illness, we need first to do it safely and effectively. I do not like to order tests just to order tests. I do not prescribe medications just for the sake of medications or expediency. I do not like calling in a prescription over the phone without a proper evaluation. That is not the best care I can provide. When I do prescribe medications or order tests, it will be the least amount necessary to do the job right. More is not necessarily better when it comes to medical treatment. My views are also that most disease can be classified as mild, moderate or severe. A holistic approach may work very well for prevention of disease as well as for mild disease. But when we get to moderate to severe disease, a traditional approach may be necessary. That being said, nothing makes me happier than lowering medication use by way of a healthier and more holistic lifestyle. Treatment without medications is always the number one goal.

So it is now the Spring of 2009. The Institute For Medical Wellness is 16 months old and is still in its infancy. But like all infants learning to walk, our legs are getting stronger each day. We are learning what our patients want and expect and are doing our best to accomodate in the safest and most effective way possible. The most frequent question has been about offering a closer integration of holistic approaches to treatment. So in future newsletters I will be introducing some holistic integrations available to improve your overall health and wellness. Many of our affiliates listed on my wellness network page will become more visible and available for your care.

So please stay tuned and be certain that The Institute For Medical Wellness is focused not on Big Business or Big Government, but instead on each and every individual who steps through our door. Our focus has always and will always be focused on you!

Steven Horvitz, D.O.
Board Certified Family Medicine
Founder of The Institute for Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone: 856-231-0590
Fax: 856-294-0311

For more information about Dr. Horvitz and The Institute for Medical Wellness, please click here.

To view upcoming Wellness Network Events, please click here.

Your Metabolism and You- Part Two

April 8, 2009

Dr. Steven Horvitz- Reading between the Lines:
Bringing you healthcare information you can trust!

Your Metabolism and You- Part Two

As mentioned in my previous newsletter, You and Your Metabolism - Part One, your weight is a result of a balance between anabolism-the storing of energy, and catabolism- the burning of energy. If you are overweight you tend to store more energy than you burn. If you are underweight, you tend to burn more energy than you store. During your yearly wellness exam, I take the time to review your diet and food choices. It also tends to be the time when my patient's eye contact starts drifting away. But back to your metabolism. The most common discussion if you are overweight is about becoming more of a burner than a storer of energy. While we all know that exercise increases the burning of energy, all the exercise in the world will not make you lose a whole lot of weight if you still store too much energy as fat. So how can you tip the balance towards becoming a burner as opposed to a storer?

Let me explain by bringing insulin into the equation via carbohydrates and sugar.

When you eat carbohydrates, and that includes both simple and complex carbohydrates, they are digested and broken down into glucose which enters your bloodstream. Elevated concentrations of glucose in blood stimulate the release of insulin, and insulin acts on cells thoughout your body to stimulate uptake, utilization and storage of glucose. When glucose is overabundant, it gets converted into triglycerides and stored as fat.

See the diagram below:

Excess carbohydrates---> increased glucose (sugar) ---> increased insulin---> increased storage of fat ---> increase in bad cholesterol ---> increase in weight.

So if you want to lose weight, and have that weight loss come from loss of fat, then by decreasing your carbohydrates the following occurs:

Low carbohydrates---> normal glucose---> normal to low insulin---> decrease in storage of fat---> decrease in bad cholesterol --->burning of fat for energy--->decrease in weight.

Let us look at this another way. When we need energy to burn, our body first uses glycogen (liver glucose store), followed by glucose available from our bloodstream. When these are used up, the next most available energy source is from our fat cells. So if we keep our carbohydrates low, thereby lowering the amount of glucose available for use, our bodies become better at burning our fat cells for fuel. Our metabolism shifts to burning more fat than we store, and weight loss comes predominantly from our fat stores. In men this is usually a decrease of weight around the abdomen. In women the weight loss occurs from the hip, legs and buttocks.

Now, if we want to build muscle, insulin as an anabolic hormone helps. When we eat abundant protein, this is digested into amino acids. Insulin acts upon the amino acids to form proteins. Proteins are the building blocks of muscle. To increase your muscle tone, start a good exercise program, to stimulate insulin to build muscle. This is why body builders can eat a whole lot of calories, put on a lot of muscle, but keep their body fat low. This is opposite to sumo wrestlers. Sumo wrestlers eat a high carbohydrate diet, thereby increasing their fat storage, and thus increasing their weight.

So take your pick.

Low carbohydrate diet with moderate exercise:

Or,

High carbohydrate with minimal exercise:

Any questions???

If you have any suggestions about topics for future newsletters, or how to make the newsletter better, please send me an email at DrHorvitz@DrHorvitz.com.

To Good Health!!

Steven Horvitz, D.O.

Board Certified Family Medicine

Founder of The Institute for Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone: 856-231-0590
Fax: 856-294-0311

To view previous newsletters, please click here.

For more information about Dr. Horvitz and The Institute for Medical Wellness, please click here.

To view upcoming Wellness Network Events, please click here.

http://www.drhorvitz.com/

Your Metabolism and You- Part One

April 4, 2009

Your Metabolism and You- Part One

The most common health complaint I hear in my practice deals with weight management. Upon visiting my office. my patient's often get grumpy when asked to step on the evil scale.

When the evil, vile scale is read, I often hear the phrase, "It must be that I have a slow metabolism". But we should all remember that evil spelled backwards is live, so a scale is not always such a bad thing, but a necessary part of my job, and helps to keep you a-live!

Overall, metabolism is not just about being overweight, but is also responsible for being underweight. How can this be? Let us take a look at metabolism, and its definition.

Metabolism is the set of chemical reactions that occur in living organisms in order to maintain life. These "metabolic" processes allow us to grow and reproduce, maintain our organs, and respond to our environments. Metabolism is actually a balance between anabolism-the storing of energy, and catabolism- the burning of energy.

If you store more energy than you burn, you gain weight and may look like the figure on the right in the above cartoon. If you burn more energy than you store, you lose weight, and may look like the figure on the left.

How we maintain balance to get to a healthy weight is where the fun, or pain begins, and has been the subject of numerous diet books, of which, I have read a great many. Some have made me laugh out loud, while others have changed the way I eat and the way I practice. The first book I read was Protein Power, by Dr Eades. This book went over the metabolic processes of how we store and burn energy. It advocated we lower carbohydrates in our diet along while increasing both proteins and fats. It went against most of the lessons I was taught in medical school, yet it made tremendous sense. But I was not yet convinced and was not about to change my views based on one book. So I continued to research. Dr Atkins diet revolution, The Schwarzbein Principle, and Life Without Bread were all books that had similar concepts to Protein Power, but with their own distinct flavor. These books all based their theories on real human physiology. But just like life and politics, theories are one thing and reality can be another.

Would the theory of eating a low carbohydrate diet help the overweight and obese to lose weight? The only true way to know would be to test it out. But try convincing anyone to go against what all the so called experts on television and radio say about a healthy diet.

Well, the stars must have all been aligned, as a patient came to my office who had recently read Protein Power and wanted to try out the diet. I agreed to help and to monitor their progress by watching their weight, blood pressure, cholesterol and sugar levels. The low carbohydrate diet was a huge success. Weight loss with normal sugars and a much improved cholesterol profile. Blood pressure dropped so much that we had to stop blood pressure medications, and energy levels rose. How did this happen while eating more protein and fat, and less carbohydrates? Could all I was taught in medical school, and all the "media pundits" be wrong? More on this later. But if you want a sneek peek, check out the books mentioned above. It may open your eyes, slim your waistline, improve energy levels and balance out your metabolism!

If you have any suggestions about topics for future newsletters, or how to make the newsletter better, please send me an email at DrHorvitz@DrHorvitz.com.

To Good Health!!

Steven Horvitz, D.O.

Board Certified Family Medicine

Founder of The Institute for Medical Wellness

128 Borton Landing Road, Suite Two

Moorestown, NJ 08057

Phone: 856-231-0590

Fax: 856-294-0311

Please visit http://www.drhorvitz.com/ for more information about Dr. Horvitz and The Institute for Medical Wellness.

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