Will Bitter Orange Help You Burn More Fat?

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When it comes to weight loss and exercise, we’re always looking for an edge such as burning more fat at rest or during exercise. Bitter orange is an herb that contains p-synephrine, a reputed booster of fat metabolism while you’re at rest. A small study tested p-synephrine, caffeine, and both together to see the effects during exercise when compared with a placebo; the researchers wanted to find which was more effective in increasing fat metabolism during exercise.

The researchers used 13 young, healthy volunteers for the experiment. They tested each of the subjects on four separate days with three to five days between tests. In random order, subjects were tested taking a placebo, three mg/kg body weight caffeine, three mg/kg body weight p-synephrine, and three mg/kg body weight of a combination caffeine and p-synephrine.

They found that caffeine raised systolic BP by eight mm Hg and diastolic mm Hg at rest; statistically different but nothing extraordinary. During the exercise phase, subjects began at 40% of max capacity and increased effort by 10% every three minutes until they reached 90% of capacity Caffeine raised fat use during exercise more than p-synephrine or the combination of caffeine and p-synephrine. Overall energy use and carbohydrate metabolism did not change.

What does that mean for us? It could mean that a strong cup of coffee or an energy drink would help us burn more fat during exercise better than some exotic plant. Why waste money buying an herbal product with long-standing safety concerns?

What we don’t know is whether that effect would remain after the body adapted to the caffeine intake. Here’s what does work: training your body to use fat as a fuel at rest and during exercise. That’s what the Optimal Performance program is all about. Check it out.

What are you prepared to do today?

        Dr. Chet

Reference: MSSE 2018. 50(9):1899-1906.

Will Flaxseeds Help with PCOS?

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In this week’s Memos, I’ll review several studies—not large clinical trials, but studies that make you think about possibilities and direction. The first update is a case study on polycystic ovary system (PCOS) and ground flaxseed. A registered nurse attending a conference I addressed last weekend called it to my attention.

Ground flaxseed is something I recommend to men with an enlarged prostate or prostate cancer. It contains lignans that bind to testosterone. PCOS is usually found in women who are overweight and affects the ability to conceive. Abnormal hormone levels are also a characteristic of PCOS including high testosterone levels. The subject of the study had read about a clinical trial on men with prostate cancer that used ground flaxseed to reduce testosterone levels. She discussed using flaxseed to treat her PCOS. The physician tracked a number of hormone levels, and after four months, she had reduced her free testosterone levels by half and was back into the normal range for women.

Ground flaxseed might be something for women to consider if they have PCOS. It’s a great source of omega-3s and fiber as well as lignans, so ground flaxseed is good for you whether it helps PCOS or not. The critical thing is to buy the flaxseeds whole and grind them in a coffee grinder. Store them in the refrigerator and use two tablespoons per day in oatmeal, smoothies, or any other way you want to eat them. Remember, this was a case study with a single subject. It’s not certain that flaxseeds will help PCOS in every case, but it may help some. It may also help with facial hair growth and hair loss in post-menopausal women. What are you prepared to do today?

        Dr. Chet

Reference: Curr Top Nutraceutical Res. 2007; 5(4): 177–181.

My Weight Loss Experience and Goals for 2019

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As the author of the Optimal Performance program, I want to tell you about my experience with the Weight Loss Cycle. I had used the Basic Program to train my body to use fat as a fuel. I use the strategy in Energy on Demand when I need to be at my best whether for a time of day, an entire day, or for an event that lasts a week. I’ve used the approach in the Fat-Burning Plan for years. Here’s my experience on the Weight Loss Cycle.

My goal was to lose 16 pounds in six weeks; normally I recommend no more than two pounds a week. I determined my caloric intake based on my exercise program and activity level. When I didn’t meet my weekly weight loss goal, I decreased calories for the next week. In those six weeks, I lost 12 pounds and almost three inches off my waist. I missed my overall goal, but because I began after already losing over 30 pounds and maintaining it for a couple of years, it was unrealistic to lose the remaining weight in that short a time; don’t make the same mistake if you choose to use the Weight Loss Cycle.

The Weight Loss Cycle explains how to maintain the lost weight and what to do until you decide to do another cycle. I chose to ignore it and went back to my typical caloric intake just to see what would happen. It took eight months to gain back the 12 pounds. The reason I did that was to show that if you’re going to lose weight and maintain it, you have to defend the weight you lose by adjusting your calories to maintain that weight.

The Optimal Performance program isn’t based only on my personal experience. In addition to keeping up on the science on weight, metabolism, and physical training, I have over 30 years experience in the field of weight loss and physical performance. This isn’t one of those “do as I say but not as I do” situations; I’ve lived it, I know it’s possible, and you can do it, too.

My Goals for 2019

I’m going to limit my goals to physical changes; my blood pressure, blood lipids, and other metrics have stayed in the excellent range.

My goal is to lose 18 pounds by April 15th—15 weeks. I’m going to break it into two six-week cycles with three weeks of maintenance between cycles. The reason for that weight loss goal is that it will put my BMI into the normal-weight category. I’ve never been there in my entire adult life.

At that point, I’m going to spend the next six months adding seven pounds of muscle while losing the remaining fat around my waist to get it to an actual 34 inches. I’ll use the Fat Burning Plan in a three-day cycle every week. That takes me to October 15th.

If I can accomplish those goals, I’m going to maintain the weight, muscularity, and body fat to the end of the year.

Those are my goals and I’ll write about my progress. But while this Memo was about me, the real question is what are your weight loss or weight gain goals and how are you going to achieve them? Remember, you can use any diet you want with the Weight Loss Cycle. It’s the process that will make you successful to get to the weight you always wanted and to maintain it.

Join me for the journey.

What are you prepared to do today?

        Dr. Chet

The Science Behind the Weight Loss Cycle

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One of the tenacious problems with weight loss is that people don’t lose all the weight they want to lose and then don’t keep it off. In trying to find out why that happens, I narrowed it to two studies that pointed the way to a solution.

The first was a study that attempted to develop an app for people to provide help exactly when they needed it. In reviewing studies to create the app, they used data from four studies on weight loss and weight gain. While they couldn’t identify the precise point for every individual, they could identify a time frame in general where people start to hit a plateau: about week 11 of any diet. That’s the point where people begin to stop paying attention to their meal plan as closely as they did when they began, and their weight gets stuck.

Another study used was the Minnesota Starvation Experiment from World War II in which lead investigator Ancel Keys severely limited calories for a group of conscientious objectors who volunteered to be starved; much of what we know about calorie restriction and helping famine victims comes from that study. It’s the only study ever in which every subject lost weight in a linear fashion. How? Researchers adjusted the subjects’ calories the following week to keep weight loss on track.

Using those two studies, I developed the Weight Loss Cycle, a way to responsibly get to your ultimate weight loss goal and then maintain it, and as far as I know, this approach is unique. What makes the Weight Loss Cycle different is that it’s not a diet with good foods and bad foods, no meal plans or recipes. You can use whatever eating plan you want; the Weight Loss Cycle shows you how to use it to achieve your goals and stay there.

If you’ve hit plateaus in the past or gained back the weight you’ve lost, the Weight Loss Cycle in the Optimal Performance program could be your key to success.

What are you prepared to do today?

        Dr. Chet

References:

1. Am J Clin Nutr 2014;100:787–95.

2. Keys A. The biology of human starvation. University of Minnesota Press, 1950.

2018’s Worst Most-Read Paper

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In March of last year, the Journal of the American Medical Association published a viewpoint written by two experts in public health titled “Vitamin and Mineral Supplements. What Clinicians Need to Know”; it was one of the nutrition papers most read and most shared last year. The only problem is that clinicians really won’t find out much by reading it.

I’m going to pick one recommendation because everything after it won’t matter. The authors recommend that all clinicians recommend that patients get their nutrients from food. I absolutely agree with that. They go on to advise clinicians to tell their patients there’s no need to take any dietary supplements if they eat a healthy diet. That’s plain wrong.

We already know that over 90% of all adults do not get enough servings of vegetables, fruit, and whole grains every day—and it’s proven that food contains less nutrition than in the past—yet the authors did not recommend doing a nutrition analysis for the patient. With little to no information about the patient’s diet, clinicians are to tell their patients to eat a healthy diet, don’t take any supplements, and go on their way.

These are exceptional researchers; they know how poor the American diet is because they’ve done much of that research. To publish this opinion was incomplete in my opinion and thus it ranks as one of the worst papers of 2018. With almost a quarter million reads and shares passed along through social media and news feeds, millions read what they wrote, and it will influence millions. My opinion is that millions will be less healthy because they accepted these recommendations and dropped their nutrition insurance: their multivitamin and omega 3s and so on.

That doesn’t mean you take every dietary supplement that comes along. The rule is simple: know what supplements you take and more important, exactly why you’re taking them. And work on eating a healthier diet in 2019 as well.

What are you prepared to do today?

        Dr. Chet

It’s Time to Take Inventory

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The New Year is here. For many businesses, it’s time to take inventory. Companies have to know what products and assets they have in order to plan for the upcoming year. If you’ve started or will begin a health improvement program, it’s a good time to take inventory on yourself. You have to know where you begin to track progress. Here are a few areas to consider, depending on your health improvement goals:

Body Mass

Weight is obvious. It’s also important to take some measurements such as waist, hips, chest, neck, arms, thighs, and calves. Tracking inches lost or gained allows you to know where you’re losing fat or gaining muscle. Not sure what you should weigh? Check out the body mass index chart on the Health Info page.

Fitness

There are at least three areas of fitness you can test for yourself or working with a trainer: cardiovascular fitness, strength, and flexibility. There are both simple and complicated tests for each that goes beyond the scope of this memo. The type of testing depends on the priority of each element in your health improvement program. I want to add some muscle mass, so I’m going to test for strength in my arms, shoulders, chest, and legs now and periodically throughout the year.

Medical Metrics

Resting heart rate and blood pressure are easy to test. If you’re working on pre-diabetes or cholesterol levels, you’ll have to get those tested by the pros. However, if you’ve made these a priority, you probably already know where you began at your last physical.

Finally, if you haven’t had a physical to check the medical metrics, get it scheduled. You can still begin your health improvement program without a specific goal in medical metrics, but do it ASAP. If you don’t know where you’re beginning, you have no idea where you’re supposed to go.

What are you prepared to do today?

        Dr. Chet

Did Probiotics Help Preschoolers with Gastroenteritis?

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The use of probiotics to stop diarrhea and vomiting for preschoolers with gastroenteritis (GE) was studied in two major studies published in the New England Journal of Medicine. In the U.S. study, 55 of the 468 subjects who got the probiotics had scores of nine or greater on the scale while 60 of 475 in the placebo group has scores of nine or greater for the two weeks after the study began. This was a 20-point scale and the higher the score, the worse the GE symptoms. No significant differences.

In the Canadian study, 108 of the 414 subjects in the probiotics group and 102 of the 413 subjects in the placebo group had scores of nine or greater for the two weeks after the study began. Again no significant differences were found.

This led both research groups to conclude that the probiotics used in the studies were ineffective in preventing negative GE outcomes compared to those who received the placebo.

The press releases and follow-up interviews were much harsher in their criticism of probiotics. One of the study leaders concluded that “These two probiotics did not work. They should not be used for GE.” I would emphasize “period!” was implied. But is that true? If you’re a regular Memo reader, I’ll bet you have an idea where this is going; I’ll explain on Saturday.

What are you prepared to do today?

Dr. Chet

 

References:
1. N Engl J Med 2018; 379:2015-2026. DOI: 10.1056/NEJMoa1802597.
2. N Engl J Med 2018; 379:2002-2014. DOI: 10.1056/NEJMoa1802598.

 

Preschoolers, Probiotics, and Gastroenteritis

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Estimates are that close to two million preschool children will be taken to the emergency room for vomiting and diarrhea every year; the term generally used is gastroenteritis (GE). Two research groups, one from the U.S. and one from Canada, conducted studies to see if probiotics would have any impact on the course of GE from the time of the ER visit for at least two weeks after. Here’s what they did.

Researchers in Canada recruited close to 900 children and researchers in the U.S. had close to a thousand; all the children had symptoms of GE. The subjects were randomly assigned to a placebo or experimental group. The subjects in the experimental groups were given a five-day course of probiotics; the Canadian group used two strains and the U.S. used one strain. The subjects were then tracked to see whether there was a difference in the severity of the GE between those kids getting the placebo and the ones getting probiotics. Both research groups used the same GE symptom scale to monitor the severity of the GE.

Did the probiotics have any impact on the severity of the GE? We’ll check out the results on Thursday.

What are you prepared to do today?

Dr. Chet

 

References:
1. N Engl J Med 2018; 379:2015-2026. DOI: 10.1056/NEJMoa1802597.
2. N Engl J Med 2018; 379:2002-2014. DOI: 10.1056/NEJMoa1802598.

 

Winterize Yourself

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The official start to winter is quickly approaching, but for most of us the cold, wet, snowy, rainy weather has already begun. Today’s Memo contains some tips on how to winterize your body by focusing on basic nutritional supplementation.

Water: Make sure you increase fluid intake during the winter. The humidity is lower because the heat is on in your home, work, and school. You breathe out more water as a result. You have to replace those fluids. Every day drink one-half your body weight in ounces of water or any other fluid; if you weigh 150 pounds, drink 75 ounces of water daily.

Multivitamin-mineral (MVMM): If you haven’t been consistent in taking your MVMM, this is a good time to begin. Your immune system needs some basic nutrients and a MVMM is a good place to start, especially if it’s one that contains plant concentrates and extracts.

Probiotics: The immune system starts in the gut. Taking a probiotic every day can help your immune system function better. In addition, taking fiber with the probiotic can help feed all the good bacteria in your digestive system.

Vitamin D: Consider adding vitamin D to your regimen because we get a lot less sun during the winter. Ask your physician to test your vitamin D levels; if it’s below 30 ng/ml, add 2,000 IU vitamin D to your supplementation. There’s no real danger in taking vitamin D, so make sure you’re getting some even without a test.

Antioxidants: Help your immune system; add additional vitamins C, E, and beta-carotene to your supplementation.

Supplementation may or may not help you avoid getting a cold or the flu, but it may help reduce the severity and duration of a respiratory infection if you do get one. That’s worth the small expense of the supplements in my opinion.

 

Happy Thanksgiving!

Paula and I wish you all a Happy Thanksgiving. We are grateful for your support throughout the year. This week is one to spend with family and friends, so this will be the only Memo of the week. Thanks for being a member of the Dr. Chet family.

What are you prepared to do today?

Dr. Chet

 

The Bottom Line on the 2018 Cholesterol Guidelines

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In Thursday’s Memo, I talked about the 2018 Cholesterol Guidelines and evidence-based medicine, focusing on the physician side of the treatment discussion. But I believe that’s not the most important part of the discussion; I think the critical part is the patient side. Here’s why.

The Cholesterol Guidelines focus on lifestyle changes first: a healthier diet, exercise, quitting smoking, and weight loss. That’s supposed to be the initial part of the potential treatment plan—lifestyle first. In other words, what will the patients do for themselves before the discussion leads to medications, especially statins?

The guidelines aggressively focus on the use of statins and other medications to get the LDL-cholesterol to desirable levels, so we have a dilemma during the discussion of a treatment plan. Do the physicians assume, based on experience, that the patients won’t do what they’re supposed to do to lower their risk of CVD and immediately prescribe medications? Or do the patients take the lifestyle route seriously and do what’s necessary to change their health?

To be blunt, we patients haven’t done our part. We lose weight and gain it back. We start to eat healthier and don’t sustain it. We start to exercise, but we let life get in the way and stop, or we push too hard and get injured and stop, or the weather turns colder or hotter and we stop. When we agree to change our health habits and then don’t follow through, we make our health issues worse—they’re still in there eating away at our lifespan and not being treated.

Don’t make promises you know you won’t keep; notice I didn’t say can’t keep, I said won’t keep. If you know in your heart you’ll never change your diet or keep up with exercise, the best thing you can do for your health is don’t delay: start taking the meds and start taking care of the problem.

Although I disagree with it, I get why physicians jump to meds. There’s only one way to change that: we have to prove them wrong when they assume we won’t stick to a healthier lifestyle.

The Bottom Line

The 2018 Cholesterol Guidelines put the responsibility for lowering the risk of CVD without medications in our hands—the patients. Work out a timeline with some concrete goals for each lifestyle area with your physician. It won’t be easy: regular exercise for life, eating better from now on, quitting smoking, plus getting to a normal weight and staying there will all take time and consistent effort. That’s okay because even if your risk of CVD is high, it doesn’t mean you drop dead tomorrow. Even if you fall into an at-risk scenario, I know you can do it. There are many tools to help you keep at it: an app, a workout buddy, a Facebook group, and more.

Instead of looking at your health challenge as an obstacle, look at it as an opportunity for better health. If you say you don’t want to take medications, this is your chance to prove whether you really mean it. I can’t guarantee you’ll never need the meds, but you can work your way down to a smaller dosage with fewer side effects.

It all depends on your answer to one question: what are you prepared to do today?

Dr. Chet

 

Reference: www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000625.