What’s New in Wellness? – Healthy Weight Loss!

September 17, 2013        Healthy Weight Loss

Healthy weight loss is fat loss. Though diet is important, it’s not as simple as diet alone. Losing fat while improving your individual nutritional needs is the key. Identifying your opportunities for muscle gain as you lose fat is critical to sustained change. It’s all possible.

A structured approach to losing weight begins with measuring fat and muscle, then establishing goals. Measuring fat loss while monitoring muscle gain helps guide progress. We monitor more than just your weight and we address much more than just your diet!

Weekly Wellness: June 27, 2013        Implementation: Getting Results

Implementation, getting the job done, reaching your goals.  Whatever name you give it, the bottom line is that all the planning and education, time and attention, research and discussion you devote to understanding something can’t bring you any success unless it’s applied.  How successful have you been in reaching your goals?  How many of your larger goals relate to your health goals?  Let’s get the ball rolling so you can…  Be Well.

In many ways we know what we need to do in order to achieve a certain goal, whether that is fat loss or getting our work done for the day.  So why do our best intentions so often fail to lead us to our goals?  At Physicians Total Wellness we answer this question in two ways.  The first has to do with reliability of information and the second has to do with depth of information.  But there is another dimension to our approach that is critical for implementation and this week we’ll take a look at that as well.

Reliability of information has to do with selecting information that you can depend upon to reach your goal.  For example, does decreasing cholesterol levels decrease the risk of heart attack for all individuals?  Is cholesterol level the most important factor in determining your risk for heart disease?  Is it the most important data for everyone or only for some people?  Which people and does that include you or not?

Depth of information relates to looking at an area with sufficient (but not excessive depth).  For example, why focus on overall cholesterol when what is really relevant is your HDL or LDL cholesterol?  Should your cholesterol be fractionated even more finely than this or is that a waste of money for you?  Will genetic testing help define whether you are more or less able to address your HDL or LDL with exercise or with diet?

Finally, emotional issues are critical.  We can put the ideal plan in place but it still needs to be acted upon.  A well thought-out plan is not a well-executed plan until your emotional impediments to success are addressed.  Too many plans fail because they sit on the shelf.  Success is about addressing all of the pieces of the puzzle and bringing dreams to reality.  Are you ready to act?  When you’re ready, we’re ready.

Be Well,
Bikram Dhillon, MD


Weekly Wellness: June 19, 2013   Depression and Vitamin D Deficiency 

Depression can be debilitating.  Even mild depression can be incredibly disruptive and disabling.  And it’s not just a problem for isolated individuals.  A Harvard School of Public Health study (Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study) projected depression to be the second leading cause of disability worldwide by 2020, second only to ischemic heart disease.  Of course, depression does not have a single cause but can be associated with many factors.  Increasingly, it seems that deficiencies may play a role in depression and addressing those deficiencies may be of great help.

Previous studies have suggested that Omega-3 supplementation can provide a significant benefit to some individuals suffering from major depressive episodes (MDE).  These results were noted with 8 weeks of treatment.  Vitamin B-12 deficiency has also been suggested to contribute to mood disorders and depression.  Now, evidence for the role of Vitamin D deficiency in depression is growing.  It may be worthwhile to take a closer look at this unique vitamin.

Vitamin D can be supplied by foods such as fish and eggs and is routinely added to milk (to make it fortified); Vitamin D is also produced by our skin when it’s exposed to sunlight, specifically the UVB (ultraviolet B) rays of sunlight.  There are two major forms of Vitamin D: D2 and D3 and it’s important to know which one you’re taking.

Vitamin D:

  • Vitamin D3 is the more biologically active form of Vitamin D,
  • D3 is the more stable form and is more likely to retain its activity in storage.
  • Vitamin D3 is the form that is most often used in studies
  • At certain latitudes, there is not enough direct sunlight (UVB) for sufficient Vitamin D production
  • Vitamin D deficiency has been associated with multiple sclerosis as well as several cancers
  • Obesity tends to lower vitamin D levels
  • Vitamin D plays a critical role in Calcium deposition and bone strength
  • Vitamin D may provide some protection from high blood pressure and from some autoimmune diseases

Preventive Medicine is concerned with creating situations of decreased risk of disease and Vitamin D can play an important role in that process.  Testing of initial levels is important and following blood levels as treatment progresses is important too.  You can get too much Vitamin D but the range is broad and with proper oversight you can enjoy many of the protective benefits of Vitamin D supplementation while reducing your risk of complications.

Be Well,
Bikram Dhillon, MD

Weekly Wellness: June 13, 2013   Keep What Matters

Getting to a healthy weight in early and mid-life is critical to living longer and healthier.  It’s never too early, or too late, to start.  Obesity used to be rare but has become quite common.  More than 30% of Americans are now obese.  The gains in longevity that modernity has brought about are now being threatened by our unintentional behavior and the systems that promote such behavior.  Youth is a time when we feel relatively sheltered from thoughts of aging but the damage we do in our youth and middle age can greatly shorten our lives.  It doesn’t need to happen, though, and a longer, healthier and more productive life is possible

Weight loss is a hot topic but as I often mention to my patients, we can only arrive at a goal if we can articulate it.  And the more specifically we can articulate it, the more focused we can be in our planning, oversight and management of the process.  So, let’s look at this topic of weight loss.

“Weight Loss” misses the mark.  At Physicians Total Wellness, we’re interested in fat loss, not weight loss.  That’s why we work on body composition.  Our goal is to help you lose fat while you gain muscle mass.  That’s what our patients experience when they put our program into practice.

Excess body fat can contribute to:

  • elevated blood pressure,
  • impaired blood sugar control,
  • elevated insulin levels and increased risk of diabetes,
  • increased risk of osteoarthritis,
  • inflammation and immune system imbalance,
  • fatigue and loss of energy
  • increased risk of cardiovascular disease,
  • and premature death

How much fat do you need to lose?  That depends on your current body composition and the goals you have for yourself.  But, losing just 10-20 pounds of fat for most individuals can have a significant impact on these risks for disease and can improve your chances of adding years of healthy life.  Monitoring your loss of fat and your increase in muscle is critical to attaining your goal of a healthy body composition.  The important thing to remember is that it’s never too early to address weight gain.  The earlier you act, for yourself or your family, the more you have to gain.  Start losing right away, but remember… keep what matters and lose the fat.

Be Well,
Bikram Dhillon, MD

Weekly Wellness: June 5, 2013   Cancer, Why Me?

June is Men’s Health Month and there’s a lot to talk about.  One of the strengths of an integrative approach is the ability to support your health in ways you may not even have considered.  This week we’ll look at cancer and what you can do about it beyond the usual advice.  The best time to beat cancer is before it occurs.  Are you doing what you can to avoid it?  You can do more than you think.

Cancer is not one disease.  Cancer is many diseases that share the common feature of demonstrating unregulated cell growth.  Each year, more than 1 million Americans are expected to be diagnosed with cancer, yet only 5-10% of these cases are thought to be due to genetic causes.  The vast majority of cancer, 90-95% has its roots in lifestyle and environmental factors.  This means that the vast majority of cancer is preventable!

Preventing cancer is not simply about avoiding tobacco, though that’s a good start.  Many factors play a role, including diet, toxins and environmental pollutants, hormone imbalance, stress, levels of physical activity, gut health, infection, immune function, inflammation and obesity.  Which of these are more relevant for you, has to do with your particular habits, metabolism, diet, genetics and so much more.

From identical twins studies to studies that track cancer rates in immigrant populations, environment and behavior have repeatedly been shown to be the primary risk factors for the development of cancer.  Cancer shortens lives but it does not need to shorten your life.  Cancer disrupts live and destroys savings but it doesn’t need to occur to you because it is largely preventable.

The good news is that many of the measure that you can take to prevent cancer also help to prevent heart disease, diabetes and stroke.   Our Comprehensive Wellness Program is designed to provide you with the tools to put distance between you and cancer today, so that it becomes the bad memory you never had.  Some of these tools involve new actions, some of them involve changing old habits and some of them are meant to be slept on.  In fact, sleeping on them is the subject of this week’s Recent Research.  I hope you find it useful.

Be Well,
Bikram Dhillon, MD

Weekly Wellness: May 30, 2013   Lose the Weight and Keep it Off.  How?

Weight loss is a goal for many of my patients at Physicians Total Wellness. Almost everyone has tried to lose weight at some point in their life. They may even have succeeded for a time. Then the weight comes back, often quite quickly and often that weight regain is more than the amount they lost to begin with. There are several reasons why this happens but the question is how to avoid this problem.

So how do you lose weight and keep it off? We begin by redefining our goal. Do you really want to lose weight or do you really want to lose fat? Is it more important to lose that fat quickly or to have a sustained fat loss… or are both equally important? There are many questions that need to be answered in order to clarify your goal. Then we begin testing.

What is your percent body fat? What is your muscle mass? Do you have a balance of muscle on both sides of your body? Do you have a genetic tendency to fat regain or dietary deficiencies? Are there intestinal, hormonal or inflammatory factors contributing to your weight gain? As we gather data, a customized plan takes shape for you and weight loss becomes body composition change.

But plans need to be implemented and having access to the tools that can get you to your goal is critical. Monitoring that progress becomes equally important because you live in the real world and any plan needs to be flexible enough to match your changing needs and your unique circumstances. Monitoring your progress doesn’t mean weigh-ins. It means body composition checks with specific percent body fat goals you’ve selected as well as supplemental and hormonal adjustment as needed.

The goal is to help you get that harmful and unwanted fat off and to keep it off without surgery and without potentially harmful drugs. After all, the ultimate goal is a healthier, longer, more energetic life. My goal is to help you get there. We’ve all heard the advice about diet and exercise. Basically, modifying your diet and exercising regularly are important for your health. But, as usual, the general advice doesn’t often get us very far. Why? Because we are all unique in the ways that we process food and in the exercise that is best suited for us. Specific advice allows planning to meet your determination for the best chance at success.

Planning helps because it looks at specifics. Which diet best suits you genetically? Are there certain foods to which you’re allergic? Are those foods making it harder for you to lose weight? Are they causing you to get fatigued and give up your exercise? What about timing of food during the day? How about your post work-out meal? Should it be adjusted?

Planning for exercise can be just as nuanced. Do you have current joint, back or other limitations? How do you work around these? How do you integrate resistance training with aerobics, conditioning, balance and flexibility? How do you fit all this into your life? How do you change this balance as you make progress? Can exercise help you control your cholesterol more than most people? Are you genetically predisposed to Achilles tendon injury? Do you have an undiagnosed joint impairment that could predispose you to arthritis or make it wise to switch to another type of exercise? What is your experience with exercise? Have you tried yoga or had experience with resistance training?

The list goes on but the more precisely we can plan, the more likely you are to succeed. This week’s Recent Research takes a look at the intersection between diet and exercise and answers the question: Which do I do first, modify my diet or start exercising?

Be Well,
Bikram Dhillon, MD

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