I am calling this post activity instead of exercise because exercise somehow implies lycra, gyms and gushing sweat. I am in favor of lycra, gyms and gushing sweat but let’s start with just getting up and moving. One of my favorite memories and greatest inspirations was our mom saying out loud “Keep on moving Nancy”.  She kept on moving and she retained the ability to function at a high level until her late 80s. Activity can be something that is undeniably and unmistakably exercise like Kim going to Orange Theory for a workout. I went with her once and had a blast and also got a thorough, whole body workout. Activity can also be yard work involving lifting bending hauling twisting and turning. Pruning our palm trees with a pole saw reduces me to a quivering mass in about two hours. During our first retirement when we rented a house in Fairhope Suz and I spent 15 hours a week at the YMCA taking spinning, yoga, kickboxing, water aerobics and weightlifting. We got in excellent shape that way but the best shape I have ever been in was when we renovated the barn and built the cottage and I put in 10 hour days as a construction worker in the Alabama Summer.

Whatever activity you choose, the key is actually doing it on a regular basis. Fun stuff like tennis or playing with the kids is easy to adopt. A full program of stretching, strengthening, and conditioning is harder to stick with but well worth it.

Activity is a way of telling your body what you want it to do. If you lift heavy weights, you are telling your body that you want more muscle and strength. If you do yoga you are telling your body you want more flexibility, suppleness and core strength. When you do high-intensity interval training, you are telling your body that you want more energy and endurance. If you do all three you are telling your body that you want to function at a high-level without disease or injury.

All activity produces a “hormetic effect” which is a fancy term for anything that does damage in the short run that makes you better in the long run. To benefit from an activity you need sufficient rest and recovery to allow your body to repair itself and then to improve itself. You need excellent nutrition, rest, relaxation, and sleep to provide your body with the resources needed for repair and recovery.

Professional tennis players are examples of too much activity and not enough rest. They engage in exercise that is both too intense and too extreme in duration and frequency for their bodies to heal. By the time they reach 30 most have had multiple surgeries and they have chronic conditions despite having personal chefs, physiotherapists, and coaches. They look older than their years and are forced to retire.

Roger Federer and Serena Williams perhaps the greatest male and female tennis players of all time are able to continue to play because they limit their schedules. Federer also has a fluid style of play that does less damage. his arch-rival Rafael Nadal, by contrast, is constantly injured due to his extreme style of play.

Overtraining also wears out joints. We had dinner last night with a group of runners. One of them began running after coronary bypass surgery. He got so hooked he started training daily for 5 and 10 K weekend races and then half marathons and marathons. He is now shopping for a set of artificial knees.

One of the fittest men I ever knew was a friend, colleague and Ironman triathlete. I say was because atrial fibrillation now has him parking in handicapped spots and slowly walking to his office. Long-term high endurance athletes get atrial fib in record numbers.

Some people exercise like crazy so they can eat whatever they want. Exercise will boost metabolism and provide some margin but it is impossible to outrun a bad diet.

The bottom line is to find activities you can and will do. Do them while slowly, gradually increasing in intensity and duration. Provide your body with the rest, nutrition and sleep needed for healing and building to do their thing and you will enjoy the ability to function at a high level for far more years of your life.

Food is one of life’s great pleasures. Suz and I often plan or next meal while we are eating our current meal. we seek out new cuisines and restaurants and we are constantly experimenting in our kitchen. So why would I stop eating anything at all for five days at a time?

I have completed two, five-day water fasts this year and I plan on doing more because they have huge benefits. Here they are:

In five days I lose 12 pounds and when I resume eating I only put on 4. Nothing else I have tried is more effective in carving off body fat. When you stop eating, your body turns to stored energy. Most of us McDs have plenty of that. In the first 48 hours of a fast, your body becomes a “butter burner”. The ketones generated by fat metabolism kill your appetite and boost your energy level. I do hard physical labor when fasting and I have more energy than I do when eating. Ketones are brain-friendly. The mind becomes clear and the act of fasting may even counteract some of the effects of age on the brain.

When you fast your body does housecleaning. There are cells called senescent cells that are like zombie cells. They reached the end of their life and should die to allow new cells to proliferate but instead they just hang around. When fasting your body rounds these cells up and gets rid of them. Cancer cells thrive in a high glucose environment but they die or struggle in a low glucose environment. Dr. Valter Longo head of a research project on fasting at USC San Diego believes that three rounds of five-day fasts might be a strategy for cancer prevention. Fasting in conjunction with conventional cancer treatment is proving to be much more effective than conventional treatment alone.

Fasting also resets your glucose metabolism and improves insulin sensitivity. If this were all it did it would be worth it.

But wait! Don’t start fasting yet. There is a bonus. When you start eating again your growth hormone production goes through the roof so you can build muscle like a teenager.

I also like the feeling of control it gives me. I ate nothing for five days and was not even hungry. Wow!

By way of fairness and full disclosure, I must admit that I have cream in my morning coffee and I use exogenous ketones in the form of Betahydroxybuterate that I drink twice a day to kick me into high ketosis without having to go through the normal adaptation process. I also replace electrolytes to prevent lightheadedness. I am told that nobody should do a fast without consulting their doctor. I did my first one without consultation and I did my second one after I told him the first one went well. You should consult a good doc before doing one yourself.

Dr. Longo has also developed a “Fast Mimicking Diet” (FMD) that consists of 600 calories a day for those unwilling to go with water alone. His research suggests that you can get all of the benefits from the FMD that I get from the water diet. I plan to try it and report back.

Other forms of fasting that are gaining traction for health and fat loss are “Time Restricted Eating” which involves confining all calorie consumption to an eight-hour window or shorter fasts like the 5/2 diet that involves a fast two days every week.

One additional plus for fasting is that it does not drop your metabolic rate the way dieting does. For five days your metabolism is ripping right along and when you start eating again it stays robust. Long term calorie restricted diets by contrast cause a drop in metabolic rate.

Part 5 describes an approach to eating that I believe best fits McDonald genes while providing delicious, interesting varied food. Nothing is completely off limits with this approach unless you have a severe reaction to it and need to avoid it for that reason. The foods we avoid in general, we will have for a fun splurge occasion. For example when in Canada you must try Poutine which is french fries smothered in brown gravy and cheese curds. What you eat 80% of the time is what counts.

If you do start eating as described in Part 5, you will probably lose body fat, decrease inflammation, increase energy, improve gut health and in general feel better. When you have medical tests done I would not be surprised if all of your numbers moved in a desirable direction.

The cost of this is more meal planning, more cooking from scratch and a steep initial learning curve. Once you get into the routine however it gets easy. It should also be noted that decades of damage do not go away overnight. Some damage is irreversible and some will reverse slowly. The turnover of cells in your body does mean that in time there will be a new you.

One of the results of this way of eating will be a reduction in the amount of insulin your body needs to produce because of the elimination of simple sugars and the reduction in carbs in general.

Insulin is important because it does two things. First, it removes sugar from your blood to try to keep it in the desirable range ( In the case of diabetes it fails in this effort). Your brain requires a narrow range of blood glucose levels. Too high or low and your brain cannot function and death follows rapidly. The second thing insulin does is to signal fat cells when to store fat and when to release it. High insulin tells your body to store fat and not release it. Low insulin tells your body to release fat for energy and burn it. Loss of insulin sensitivity means that your pancreas has to produce more and more insulin to regulate blood sugar and therefore your blood levels of insulin are high which tells your body to store fat and to hang onto it tightly.

Bodyfat reduction requires lower insulin and improved insulin sensitivity. Diet, exercise, good sleep, reduced inflammation, and relaxation can do both of these things. the degree of effort and time required depends on how far “McDonald Syndrome” has already progressed. Prevention is easy so the youngest among us should start now and never have a problem. Oldsters like me need to be very disciplined and make every effort every day. If you are already being treated for diabetes, high blood pressure, chronic inflammation and bad lipids like high triglyceride, low HDL and high LDL, you may need the combination of every possible diet, exercise and lifestyle intervention combined with a supplement and prescription meds. Prescription meds only control symptoms somewhat they do not cure the underlying disease.

“Eat Real Food, Mostly Vegetables, Not too much”

The above phrase is from Michael Polan’s book In Defense of Food. I highly recommend everything Michael Polan writes as well as his documentary. He has a great way with words. He entertains and informs at the same time.

The diet my genes like best is a Mediterranean diet that follows Polan’s simple instructions. The diet starts with lots and lots of non-starchy vegetables. Green leafy vegetables are the base along with anything from the cole family which includes broccoli, cauliflower, cabbage of any kind, brussels sprouts. It also includes lots of onions, garlic and shallots. Peppers cucumbers and tomatoes are also on the shopping list whenever they run low. We also use lots of mushrooms, squash and sweet potatoes. The goal is to eat a pound of non-starchy vegetables per day, per person. The effect of this is amazing. You get lots of delicious food to eat that fills you up. These veggies are loaded with phytonutrients as well as vitamins and minerals. Vegetables also are a great way to incorporate lots of olives, olive oil and grass-fed butter into the diet. Our diet is not a low-fat diet. Olive oil, in particular, is great for lowering triglycerides and inflammation. We also use lots of fresh herbs, spices avocados, and vinegars. Vinegars are a great way to add flavor and interest to food. They come in a wide variety from apple cider vinegar with live cultures to mission fig balsamic. We keep a variety of high-quality vinegars on hand to make vinaigrettes. We tailor the vinaigrette to the meal by changing the vinegar. A simple vinaigrette consists of equal parts olive oil to vinegar with salt and pepper. we usually add chopped shallots and a dash of mustard. A small dash of honey can also be used.

We eat huge salads dressed with either vinaigrette or just lemon and olive oil. We top them with a small portion of nuts and seeds for crunch. We also incorporate fruit and cheese depending on our whim. Apples, pears, figs and oranges are some of the usual suspects. Figs and goat cheese on arugula with a simple vinaigrette is a gourmet delight.

We eat nuts seeds and fruit regularly but in small portions. Two ounces by weight of nuts and seeds packs a lot of nutrition in a small package but they are high calorie also so keep the portions small. Fruits are loaded with sugar but eaten whole they contain fiber also. So again keep portions small. Berries especially blueberries are a nutrition powerhouse low in sugar. A half cup a day is great. We keep a big bag of frozen blueberries on hand at all times.

Portions of protein are moderate. Fish is on the menu a lot. The best fish for health are wild caught fatty fish. Olive oil packed sardines, for example, are wonderful but some people do not like them. Oil packed tuna and wild caught salmon are also excellent. We eat a wide variety of seafood. I tend to buy whatever is fresh. Oysters, clams and mussels, by the way, are nutrient powerhouses. Beef Pork and Chicken and Duck are also in the rotation. Free range, grass fed etc. is preferred but hard to get. Our butcher shop always carries duck and we love it. A seared duck breast with crispy skin is better than filet mignon. A crispy roasted duck is a treat and the fat it yields is the best frying medium ever. When we have crispy duck we splurge on duck fat fried potatoes.

Some people tolerate legumes and others do not. We both tolerate them well. the fiber they provide is an excellent prebiotic and they slow the absorption of carbs which is great for satiety and insulin sensitivity. A small portion any kind of bean with every meal can be extremely helpful. Just be sure to rinse cooked beans thoroughly.

Starchy vegetables and grains are not eliminated but they are treats we rarely eat. Both of us react badly to gluten eaten in this country. When we travel in Europe, we eat bread at every meal with no negative reaction except for a few pounds extra at the end of the trip. We cannot explain this unless it is the GMO wheat in this country or the wide use of glyphosphates (Roundup) in grain growing in this country. We love rice in sushi, paella and risottos as well as part of an Indian meal or Asian breakfast bowl. Once again we eat small portions and not that often. Corn whether on the cob or as cornmeal in polenta, cheesy grits or tortillas is not excluded, just limited.

High-quality cheese is a gourmet treat we adore. It is hard to think of a world without parmesan, cheddar, gorgonzola, brie, mozzarella, etc. Imported cheeses tend to be made from grass-fed milk. We prefer all dairy to come from grass-fed animals. The color, flavor, and texture is just so much better. the animals are healthier and they make healthful products.

Eggs are a staple. we pay extra for free-range organic eggs. The color, flavor and nutritional value are worth it. Nellies are our favorite brand.

Lacto fermented foods are great tasting, long-lasting in the fridge and loaded with probiotics. These include kombucha ( I brew our own), yogurt (full fat unpasteurized), kimchee, sauerkraut, pickled vegetables (with live cultures). these foods add a funky “umami” to food that enriches any meal.

Thank god, research has shown that the consumption of high-quality chocolate, coffee, and red wine confers significant health benefits, so we dutifully indulge in all three. Small portions once again applies.

What we do not consume (there are rare exceptions) is processed seed oils (Corn, safflower, soybean etc) We use coconut oil and some peanut oil. A small container of sugar lasts years in our house. We eat almost nothing made in a factory. Almost everything is made from scratch in our kitchen. Desserts are special occasion treats only. We usually save a bit of red wine from dinner and enjoy it with a square of excellent chocolate instead.

We love wine and an after dinner bourbon. In moderation, the science says this is either beneficial or neutral. the science is clear that excess on a regular basis is detrimental.

This is a day of meals we ate recently following these guidelines:

Breakfast

Coffee with half and half

Spinach and feta omelet. Lots of spinach a few red pepper flakes and some olive oil, eggs, and crumbled feta.

Lunch

Big salad with romaine, sliced peppers, tomatoes, avocado, toasted pumpkin seeds and chunks of rotisserie chicken. Dressed in olive oil and lemon.

Iced tea or water with lemon

Dinner

Crispy medium rare duck breast. ( Gordon Ramsay shows you how to cook this on youtube)

Mushroom risotto loaded with powdered dried mushrooms and lots of baby bellas.

Arugula salad with orange supremes and toasted pistachios in a balsamic vinaigrette.

Red wine and a square of chocolate for dessert.

While you are waiting for your first appointment with your Functional medicine practitioner, the results of your 23 and Me genetic test and the lab results that will be ordered after your first visit, there are a few things you can start to do right away.

The first is to listen to our podcasts. We spent hundreds of hours putting together the podcasts that were based on thousands of hours we spent developing the three-day stress and wellness seminar we delivered hundreds of times to groups in several companies. Merck hired us to do the seminar for years (Thank You, Laurie). The Merck groups often contained Md. Ph.D. medical researchers who would have shut us down if we did not present solid information that was well researched and documented.

I have no intention of recreating all of the material in the podcasts in print form in this blog. I will assume knowledge of the podcasts in what I write. For a thorough grounding please start with podcast one. Skip those that do not contain information that interests you. The podcasts are easily accessed from any podcast app you have on an iPad, phone or any computer. Reply on Facebook if you have any trouble finding and playing the podcasts. Start with Podcast One. The Podcasts build upon each other so listening in order is important.

I hope you get hooked on podcasts. I find them to be a great free and fun way to fill your ears and mind with great information while doing other things like yard work, exercising or driving. I listen to about 12 hours of podcasts a week.

What I am about to describe is a cluster of disorders that are highly interrelated. The problem is common among many Americans but I am of the opinion McDonald’s have increased risk and prevalence and therefore we have to be more vigilant and more aggressive in prevention and treatment.

1. Metabolic syndrome: Large waist circumference, high triglyceride levels, low HDL cholesterol increased blood pressure and elevated fasting blood sugar.
2. Pre-diabetes/diabetes
3. Chronic inflammation.
4. MTHFR genetic defect ad determined by genetic sequencing such as 23 and me ancestry and health.

Each of the above exacerbates the others and thereby worsens and accelerates the damage caused.

These conditions can be treated and perhaps cured ( meaning that all values can be brought into the normal healthy range with changes in behavior and lifestyle and some special supplements if caught early and addressed aggressively. At more advanced stages the behavior and lifestyle and supplement changes may need some help from prescription medications.

The damage from the disorders above is cumulative and ultimately they result in severe illness that includes heart disease, stroke, peripheral nerve damage, chronic joint problems, cancer and cognitive decline.

Successful efforts to cure or minimize these disorders significantly enhances quality of life and “health span”. Health span refers to what Suz and I call the number of “good years”, that is years during which your ability to function allows you to enjoy life in whatever way you choose.

During your first visit with your Functional Medicine practitioner, you should discuss tests that will allow you to determine if you suffer from the list above. If you already know you have some of the conditions above you might want to discuss a game plan for behavior, lifestyle and supplement approaches you can add to whatever medical treatment you are now employing.

Some tests to discuss:

High sensitivity CRP test for inflammation (HSCRP)

Many doctors stop with A1C testing for diabetes/pre-diabetes. A two-hour glucose tolerance test with insulin measurements will provide much more useful information.

Cholesterol testing by itself is close to meaningless. A more thorough lipid panel with particle size and count is more meaningful.

An ultrasound of your carotid arteries (CIMT) can detect blood vessel damage that is predictive of blood vessel damage elsewhere in your body.

A liver ultrasound for fatty liver and cirrhosis.

An abdominal ultrasound for abdominal aortic aneurysm.

Blood testing for B12 is close to useless. Gut bacteria can produce a counterfeit form of B12 that confounds the blood test.

Vitamin D levels are extremely important. you probably need to supplement but to get the dose right and consequently the blood level right you need to know your starting point.

Body composition testing to establish a baseline and yearly follow-ups to track progress.

While you are waiting for your 23 and Me kit and results, you need to get started on the next step which is finding a Functional Medicine Doctor. The institute for functional medicine defines the practice this way:

Disclaimer

I am not a doctor and I do not even play one on TV. The recommendations I make in this section are based on my own research and my own choices. When possible I will include source documents you can use to do a deeper dive as you make your own choices. Every person is different. What works for me may or may not work for you. The more closely we are related, the more likely you will have some of the genetic strengths and weaknesses I have. Something else you should keep in mind is that science is evolving rapidly. What the scientific community believed forty years ago about fat and cholesterol has been proven to be absolutely false. I cannot promise that the science I share with you may not be overturned by advances in research tomorrow.

Something also to keep in mind is that genes can exist but not be expressed. For example you could have an oncogene, that is, one that predisposes you to a type of cancer and yet you might live your entire life cancer free because the epigenome never caused that gene to be expressed. A doctor I have followed for years describes it this way. The genome loads the gun but the epigenome pulls the trigger. If the trigger is never pulled the gun never fires. the epigenome is composed of all of your environmental and lifestyle factors over a lifetime.

Whole Person Approach

Convention medicine is focused on body parts and disease. Disease treatment in this model consists of searching for the “silver bullet” drug that will “cure” the disease. This approach is failing with diabetes, cancer, heart disease, dementia, skin problems, joint problems etc. I will share the supplements and prescription drugs I take and why I take them but you should realize that taking these things without dealing with other matters such as diet, exercise, relaxation relationships etc. is like putting lipstick on a pig. For this reason I will address some details on diet, exercise, relationships, relaxation and sleep etc.

Personalized Medicine

Until recently medicine has used a one size fits all approach. Genetics and the field of functional medicine is creating a body of knowledge that now more than ever allows for a personalized approach. Your genetic makeup may make you a great candidate for some treatments and drugs and a terrible candidate for others. This approach is in its infancy but it still makes sense to use the little information available to your advantage. New information is emerging every day. If you have your genome sequenced by 23 and Me, you will get updates as new research is published. you can also volunteer to fill out questionnaires that will contribute to knowledge of the effect of genetics on health.

Step One

In order to personalize your approach to health, you need data. One good place to start is your genome. To do this google 23 and Me. Go to the site and order the ancestry and health kit. Please order it directly from 23 and me. I know that works because Suz and I both did it that way and we were pleased with the outcome.