Burnout Part 3: Diagnosis Tips

Hello everyone: This blog is longer than normal because the information is so important. If you have been following my blog posts, then you know that I have stated many times that inflammation causes, perpetuates, and/or aggravates every known human chronic health problem. Here is a simply stunning paper that says it superbly by highlighting the positive healthy aging effects you can generate for yourself with a whole-foods, unprocessed, plant-based food plan along with fasting and the subsequent gut improvement with fiber and plants…you should read this paper and look at the diagrams…but here are some of the important highlights: “The lifestyle adopted by most people in Western societies has an important impact on the propensity to metabolic disorders (e.g., diabetes, cancer, cardiovascular disease, neurodegenerative diseases). This is often accompanied by chronic low-grade inflammation, driven by the activation of various molecular pathways. Chronic inflammation is a central process involved in a high number of metabolic disorders (e.g., obesity, metabolic syndrome, diabetes, dyslipidemia, etc.), including neurodegenerative (Alzheimer), malignant diseases, and autoimmune diseases. In most if not all chronic inflammatory conditions, there is an extensively failed resolution of inflammation with high influx of leukocytes, which in their effort to resolve inflammation stimulate the synthesis of pro-inflammatory molecules and establish a highly inflammatory micro-environment, leading to extensive fibrosis and tissue damage. Chronic low-grade inflammation has been shown to either induce or aggravate metabolic disturbances, including insulin resistance and dyslipidemia, which contributes to the development of other complications. There is accumulating evidence that, in the case of autoimmune diseases, when the immune system loses self-tolerance and attacks the body’s cells and tissues, metabolic disturbances are key contributors to disease progression. Many chronic inflammatory diseases originate or have their development promoted by an unbalanced diet. Lifestyle and nutrition are modifiable factors that interact with genetics in regulating chronic inflammation, leading to aforementioned complications. The changes in nutritional patterns in Western societies—caused by a high intake of fat and energy-dense, processed foods, as well as a low intake of fibers, fruits, and vegetables—are associated with a rising prevalence of asthma, allergies, and autoimmune diseases involving inflammatory mechanisms. High fat diets determine, among other things: intestinal inflammation, favoring lipopolysaccharides (LPS) absorption from gram-negative gut bacteria, and increasing lipoperoxidation that induces insulin resistance and inflammation. Saturated fatty acids and LPS activate toll-like receptor 4 (TLR4) signaling pathways further contribute to promoting systemic inflammation and consequent metabolic disorders. Lifestyle- and diet-induced inflammation affects several cellular pathways, which stimulates the synthesis and secretion of various pro-inflammatory molecules. This ultimately maintains the low-grade inflammation state…. Interestingly, populations that consume a diet rich in fruits, vegetables, and fibers have lower incidences of inflammatory diseases compared to Western populations. The Mediterranean diet—based on olive oil, fish, vegetables, and fruits, in addition to incorporating myriad beneficial phytochemicals—discourages cardiovascular diseases (and pretty much all chronic conditions [Dr Smith]). Given that a large part of the global population suffers from various metabolic disorders, it is important to look for non-pharmacological ways to deal with these conditions. Targeted changes in lifestyle and especially diet can be economical tools to mitigate the development of metabolic disorders when they are at an early stage. These changes include increased fiber and polyphenol intake compared to the current western diets, but also well-structured, personalized fasting protocols, which can reduce the risk of metabolic disorders.”[By the way, metabolic disorders are the leading causes of death and disability…Dr. Smith comment.] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312944/ Bottom Line: Experience with thousands of patients has revealed that without an excellent, nutrient-dense, whole food, clean (organic whenever possible), primarily plant-based food plan, even the best functional medicine supplement protocols and chiropractic care are not effective or only help a little. Food is so foundational that when it comes to either preventing or treating any chronic health condition, dietary optimization is where almost all of us need to start. Only the plants have the necessary ingredients to optimize health, that is, the majority of our food should be plant-based, unprocessed, whole foods. Start there and never stop. I can say that the people who consult me and commit 100% to an optimal food plan are the ones that absolutely do the best. When it comes to fasting, what appears to work the best is eTRF (early Time Restricted Feeding). In eTRF, you consume a breakfast before 10 AM, and 80% of your total daily calories by 2 PM, and then dinner is 20% of your daily calories. Additionally, you consume all of your daily food within a 10-to-12-hour window and finishing your light dinner as early as possible (say before 6 PM) is crucial for success. It is sort of like this: breakfast like a prince/princess, lunch like a king/queen, and dinner like a pauper. Put it all together (figure 3 in the paper) shows how you can lower your inflammation and promote healthy aging…and that means an expanded health-span with a longer lifespan with less disability and increased vibrancy and resilience. What this paper means to you is that now you absolutely know that you can optimize your health and safeguard your future by an upgrade to your lifestyle: Eat right; Move Right; Think Right. Start with eating right and see how it goes!!

Hello again everyone: The Standard American Diet (S.A.D.) is considered a high fat food plan that is associated with obesity and altered mood and brain function. Any food plan that is more than around 20% fat could be considered high fat, and the typical American diet has been measured to be at or above 35% for both men and women. Not only that, it is not good fat but fried, oxidized, and otherwise adulterated fat and too much of it. The U.S.D.A. estimates that 32% of our calories come from animal foods, 57% from processed foods, and only 11% from whole, unprocessed grains, beans, fruits, vegetables, and nuts. Reverse those numbers and you have a much healthier approach. A new report issued these findings: · A high-fat diet can disrupt the gut microbiome, leading to an imbalance in gut bacteria. · An altered gut microbiome can influence brain chemicals, potentially increasing anxiety-like behaviors. · Healthy fats, like those found in fish, olive oil, and nuts, are beneficial for the brain and may counteract the negative effects of a high-fat diet. https://www.cdc.gov/nchs/fastats/diet.htm https://neurosciencenews.com/anxiety-diet-microbiome-26331/ Bottom Line: While this is a study on rats, there are similar articles on humans with the same results, such as these: “Analysis revealed an association between less anxiety and more fruits and vegetables, omega-3 fatty acids, “healthy” dietary patterns, caloric restriction, breakfast consumption, ketogenic diet, broad-spectrum micronutrient supplementation, zinc, magnesium and selenium, probiotics, and a range of phytochemicals. Analysis revealed an association between higher levels of anxiety and high-fat diet, inadequate tryptophan and dietary protein, high intake of sugar and refined carbohydrates, and “unhealthy” dietary patterns.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8706568/ So, what do the researchers advise?  “Eat as many different kinds of fruits and vegetables as possible, add fermented foods to your diet to support a healthy microbiome and lay off the pizza and fries. Also, if you do have a hamburger, add a slice of avocado. Some research shows that good fat can counteract some of the bad.” Sounds a lot like the Mediterranean diet to me. Respect yourself and eat right, please.

Hello again everyone: Here is a very interesting study that reveals that not only do plant-based diets lower inflammation, it also shows that poorly chosen plant-based food patterns raise inflammation. As you know, inflammation causes, aggravates, and/or perpetuates every known chronic health condition…you cannot name one health condition in which inflammation is not a key player. Food consumption patterns are the leading cause of inflammation as well as being recognized as the leading cause of death and disability in our country. Currently, there is enormous interest in plant-based dietary models that reveal significant health benefits. As the science progresses, they are now teasing out the differences between healthy and not-so-healthy food choices. And guess what? The healthier plant-based food choices lowered inflammation while the unhealthy choices did not. Conclusion: Higher scores of HEI-2015 (Healthy Eating Index) and increased intake of a healthy plant-based diet were associated with lower inflammation, while an unhealthy plant-based diet was associated with higher inflammation. A greater adherence to the 2015 dietary guidelines may reduce the risk of mortality associated with inflammation and may also benefit individuals with obesity who had low and moderate inflammation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468921/pdf/394_2023_Article_3191.pdf Bottom Line: So, what is a healthy plant-based food plan? It was a Mediterranean style diet. This is simply the healthiest way to go as it lowers inflammation and protects and lowers your risk of all-cause mortality. Enjoy!! A Mediterranean-style diet typically includes: plenty of fruits, vegetables, whole grains, potatoes, beans, nuts and seeds. olive oil as a primary fat source; and dairy products, eggs, fish and poultry in low to moderate amounts. Fish and poultry are more common than red meat in this diet. It also centers on minimally processed, plant-based foods. Wine may be consumed in low to moderate amounts, usually with meals. Fruit is a common dessert instead of sweets. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet PS: I strongly disagree with the wine statement. Read more here: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/alcohol/art-20044551

Hey there everyone: Here is a new study that reveals the ability to slow the progress of dementia with lifestyle upgrades. Here are the essentials: Conclusions “In summary, in persons with mild cognitive impairment or early dementia due to Alzheimer’s disease, comprehensive lifestyle changes may improve cognition and function in several standard measures after 20 weeks. In contrast, patients in the randomized control group showed overall worsening in all four measures of cognition and function during this time. The validity of these findings was supported by the observed changes in plasma biomarkers and microbiome; the dose-response correlation of the degree of lifestyle changes with the degree of improvement in all four measures of cognition and function; and the correlation between the degree of lifestyle change and the degree of changes in the Amyloid Beta 42/40 ratio and the changes in some other relevant biomarkers in a beneficial direction. The point of sharing this information is summarized in the highlighted section below. Our findings also have implications for helping to prevent AD. Newer technologies, some aided by artificial intelligence, enable the probable diagnosis of AD years before it becomes clinically apparent. However, many people do not want to know if they are likely to get AD if they do not believe they can do anything about it. If intensive lifestyle changes may cause improvement in cognition and function in MCI or early dementia due to AD, then it is reasonable to think that these lifestyle changes may also help to prevent MCI or early dementia due to AD. Also, it may take less-extensive lifestyle changes to help prevent AD than to treat it. Other studies cited earlier on the effects of these lifestyle changes on diseases such as coronary heart disease support this conclusion. Clearly, intensive lifestyle changes rather than moderate ones seem to be required to improve cognition and function in those suffering from early-stage AD.” https://alzres.biomedcentral.com/articles/10.1186/s13195-024-01482-z So, what exactly were these intensive lifestyle interventions? “The intervention program had four components: a whole-food, minimally processed, plant-based diet of predominantly fruits, vegetables, whole grains, legumes, and selected supplements; moderate aerobic exercise (such as walking) and strength training for at least 30 minutes a day; stress management including meditation, stretching, breathing, and imagery for 1 hour a day; and online support groups for participants and spouses or study partners for 1-hour sessions three times a week. The diet had approximately 14% to 18% of its calories as total fat, 16% to 18% as protein, and 63% to 68% as mostly complex carbohydrates. Calories were unrestricted. All meals were sent to each participant's home twice a week.” https://www.medpagetoday.com/neurology/alzheimersdisease/110596?xid=nl_mpt_DHE_2024-06-15&eun=g1207968d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Weekly%20Review%202024-06-15&utm_term=NL_DHE_Weekly_Active Bottom Line: Why not start right now to upgrade your lifestyle to avoid dementia in the first place. Today, dementia/Alzheimer’s is the 5 th leading cause of death in those over 65. Personally, I do not want to be part of those statistics and I have easily and gradually implemented all of those lifestyle upgrade strategies outlined above. I hope you will join up with this worthwhile cause. Think and plan ahead, while you still can.

Hey there everyone: You may wonder why I am so positive about the evolving understanding about plant-based food plans and our environment, so here is a recent paper to add to your knowledge base: “Conclusions: In 3 large United States-based prospective cohorts of males and females with up to 34 y of follow-up, a higher PHDI (Planetary Health Dietary Index) was associated with lower risk of total and cause-specific mortality and environment impacts.” https://ajcn.nutrition.org/article/S0002-9165(24)00389-7/abstract Closely following a planet-friendly diet of mostly fruits, vegetables and whole grains reduces the risk of premature death by nearly one-third in people, while also dramatically cutting the release of greenhouse gases devastating the planet, a new study found. “Eating more whole plant foods, less animal foods, and less highly processed foods is better for people and planet alike,” said Dr. David Katz, a specialist in preventive and lifestyle medicine who was not involved in the study. “In this paper, we see that same message amplified: adhering to a dietary pattern conducive to the health of the planet and sustainability is associated with meaningful reductions in all-cause mortality,” he said in an email. https://www.cnn.com/2024/06/10/health/planetary-diet-longevity-study-wellness Bottom Line: The evidence is mounting up and the conclusions are becoming more and more focused: whole food, unprocessed, plant-based food plans are good for you and the planet. Shifting your meal focus away from all types of processed foods and animal products and moving towards a plants predominant food plan has significant benefits for one and all. To put it another way, I have never seen a chronic illness get better without a dietary upgrade. Take all the functional medicine approaches and nutritional supplements you want, but without a clean, whole foods, low inflammatory potential predominantly plant-based food plan, I have yet to see someone reach their health goals adequately. Food is simply foundational, and quality matters significantly!! Check this out: “ Conclusion : Higher scores of HEI-2015 (Healthy Eating Index) and increased intake of a healthy plant-based diet were associated with lower inflammation, while an unhealthy plant-based diet was associated with higher inflammation.” Wang YB, Page AJ, Gill TK, et al. The association between diet quality, plant-based diets, systemic inflammation, and mortality risk: findings from NHANES. Eur J Nutr. 2023. doi:10.1007/s00394-023-03191-z: https://pubmed.ncbi.nlm.nih.gov/37347305/

Hello once again everyone: If you are curious about how Intermittent Fasting works, this paper should help explain things once I explain things: Highlights Throughout observational time, prolonged intermittent fasting affected dynamical changes in autophagy, senescence and inflammasome activities. These include: · Prolonged intermittent fasting significantly induced ATG5 and ULK1 expression but reduced the other autophagy gene, BCN1. · Prolonged intermittent fasting significantly induced the expression of inflammasome gene NLRP3 and IL-1b but not it’s active component, ASC. · Prolonged intermittent fasting could significantly reduce p21, p16 and p53 expression at a later point in time. Taken together, this manuscript combines novelty and clinical relevance to help our understanding of fasting, especially intermittent fasting. Furthermore, it can be implemented as a non-pharmacological and low-cost therapy to promote rejuvenation. https://www.sciencedirect.com/science/article/pii/S2666149723000063?via%3Dihub Bottom Line: Ok…so what does all that stuff actually mean? · The first bullet point related to intermittent fasting upregulating autophagy in a good way. Briefly, autophagy is the self-cleaning custodial work that our body (mostly immune cells) do on a daily basis, and most of it is at night in the absence of calories. This is why intermittent fasting improves autophagy and helps to maintain an internally clean environment and adequate surveillance against infection and tumor induction. To quote the paper: “dysregulation of autophagy is associated with many diseases, such as diabetes, cancer, vascular diseases, and many others.” This is an incredibly important essential benefit! · The second bullet point reveals that intermittent fasting significantly lowers inflammation, and as you know, inflammation causes, perpetuates, and/or aggravates every known human condition. Thus, lowering inflammasome expression will lower our total non-purposeful background inflammation, thus promoting a longer health span and lifespan with less illness and disability. Another amazing benefit. It is also shown to lower autoimmune diseases! · The last bullet point reveals that markers of immune senescence are reduced. Immune senescence is the same as immune senility…certain aspects of the immune system begin to become ineffective and act old. Recent research revealed that those without immune senescence live the longest with the greatest health span. The best form of intermittent fasting (at least this is what the current literature states…but that can change) is called early time restricted feeding, or eTRF. Basically, it works like this: you have breakfast before 10 AM and lunch before 2 PM and consume 80% of your total daily calories in that early time. Your dinner is as early as you can and is very light with only 20% of your total daily caloric intake. You then fast for at least 12 hours without any calories…up to 14 hours is a bit better but longer than that does not seem to bring more benefit. A helpful hint to get started with this is to prepare your normal dinner, but only eat about 1/3 of it and have the rest for breakfast…this is actually a lot better than it sounds. Give this a try and let me know how it works for you. I do recommend that before you attempt eTRF you should consult your health care provider, especially those that are pregnant or breastfeeding, have a history of eating disorder, or are diabetic.

Hello everyone: As you know from reading these blogs, inflammation will cause, perpetuate, and/or aggravate every known chronic condition. Science has long known that immune activation and the subsequent inflammatory response caused by food choices leads to atherogenesis, or what we all know as cardio-vascular disease…heart attacks, strokes, high blood pressure, vascular diseases and more. But did you know that your food choices can also reduce your risk? “ Conclusions : Med-Diets supplemented with VOO or nuts down-regulate cellular and circulating inflammatory biomarkers related to atherogenesis in subjects at high risk of CVD (Cardio-Vascular Disease). The results support the recommendation of the Med-Diet as a useful tool against CVD.” https://pubmed.ncbi.nlm.nih.gov/19056596/ Bottom Line: Upgrading your food plan to a plant-based Mediterranean style is not only delicious, but it is highly anti-inflammatory and immune modulating. This important because not only does it reduce your risk for non-communicable diseases (which are the leading causes of death and disability in our country today), it can substantially improve both your health-span and your lifespan as well. You may have heard about how aging is now called ‘inflammaging’ because science has revealed that it is inflammation from multiple sources that drives pre-mature and/or unhealthy aging as well as cardio-vascular disease, cancer, diabetes, dementia, anxiety, depression, autoimmunity, fatigue, arthritis, headaches, and more. Research has also revealed that the primary driver of inflammation in our country is our food choices. You can easily do an online search for a list of anti-inflammatory foods to include in your diet, and you can just as easily find many lists of what are considered pro-inflammatory foods. I would recommend that you spend a few minutes online and look up anti-inflammatory diets…there you will find an enormous amount of information, and you will soon see that most of those food plans agree on the basics of what to avoid and what to eat. If you have any chronic conditions of any type, just give an anti-inflammatory diet a try for 4 months and see if it changes your life. It is for reasons such as this that Hippocrates is famously quoted as saying: “Let thy food be thy medicine, and thy medicine be thy food.” PS: Being overweight promotes a chronic inflammatory chemistry that slowly erodes health and is a great reason to get into anti-inflammatory dietary upgrades.

Hello everyone: A new study revealed that Vitamin D supplementation was beneficial in supporting brain health and lowering depression symptoms. Now scientists know that there are Vitamin D receptors in the brain suggesting that Vit. D is important in helping to regulate neurological immune processes and lower inflammation. “For the study, the researchers examined 41 RCTs including 53, 235 people in their analysis…The researchers also noted that while doses up to 2,000 IU daily had a small to moderate effect, those who took over 4,000 IU daily had a larger effect…vitamin D supplementation appeared to have a larger effect when taken for less than 12 weeks compared to longer periods of time. Overall, the researchers found that vitamin D supplementation had a small to moderate effect on depressive symptoms .” https://www.medicalnewstoday.com/articles/vitamin-d-supplementation-seems-to-alleviate-depressive-symptoms-in-adults?utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=dedicated&utm_content=2022-08-21&apid=32362300&rvid=24561ae4b347411c6ae1874dad579a0aedec4a5e471e9b3b5a21dc0826faa6b9 (Medical news Today report) https://www.tandfonline.com/doi/full/10.1080/10408398.2022.2096560 (full study) Bottom Line: As a component of a comprehensive brain health treatment plan, it is important to consider Vitamin D status. The researchers noted that the size of the effect of Vitamin D supplementation was larger in those with initial baseline Vit. D levels less than 50 nmol/L than those with Vit. D levels above this baseline. In other words, get your Vit. D levels tested and start to supplement as indicated by your labs and your condition. Since Vit. D can become toxic at high levels, make sure you monitor your Vit. D levels with lab testing at least every 6 months. A significant omission from this study which can help explain the findings is that in order for Vit. D to work, the Vitamin D Receptor (VDR) must function optimally. Background elevated levels of some viruses and other infections can block the VDR from working properly. This means that even if you have normal Vit. D levels on your lab test, it may not be working nearly as much as it should if your Vit. D receptors are blocked by a background infection or a genetic polymorphism. The best way to figure out if your VDR’s are working right is that if they are working well, and you take a high dose of Vit. D, your calcium should go up to a high normal and your parathyroid hormone should go down to a low normal. If that does not happen, your VDR is probably blocked, and you may need higher dosages. To figure this out, coordinate with your health care provider to get the right labs done and figure out the right dosage for your Vit. D. We find this issue is very common and important for many conditions.

Hey there everyone: In this study, the researchers were looking to review evidence regarding dietary patterns, their effect on the gut and microbiome, and how this may impact the increase of chronic health conditions that we are not witnessing. Here is what they were looking at: “…a Western diet (WD), as described, features excessive amounts of saturated fat, refined grains, sugar, alcohol, processed and red meat, conventionally raised animal products, high-fat dairy products, and salt. High amounts of ultra-processed foods and drinks are also characteristic of the Western diet, according to the review authors. For the current research, they compared and contrasted this to a Mediterranean diet , which they stated as having lower levels of processed food and higher levels of fruits, vegetables, and plant-based proteins, among other nutrient-rich plant-based foods. Here is what they found: “An increasing body of evidence supports the association between the diffusion of WD and the rising prevalence of NCDs (Non-Communicable Diseases). WD also negatively affects both gut microbiota and the immune system by driving to microbial alterations, gut barrier dysfunction, increased intestinal permeability, and leakage of harmful bacterial metabolites into the bloodstream, with consequent contribution to the development of systemic low-grade inflammation.” Bottom Line: As you know, inflammation causes, perpetuates, and/or aggravates every known human chronic illness or condition…including aging! Thus, the traditional standard American diet predisposes you to developing chronic low-grade inflammation which leads to diseases, suffering, inflammaging, and a reduced health span and lifespan. The article goes into how diet causes adverse effects in the gut, microbiome, immune system and more, and it is a fairly easy read if you care to dig into it. For now, start making the move to a plant-based food pattern and enjoy the benefits of better health and a longer, happier life. https://www.sciencedirect.com/science/article/pii/S1521691824000489