Our 4 Step Process

Getting The Academy at your place of business



Below we describe the typical process of how a company gets The Academy implemented with their employees.

This is important for a few reasons but one of these is most important.

It is likely that our approach to this is very different than what you are used to seeing. Some explanation can be helpful.

Step 1: Discuss The Academy

This is a simple but necessary step. Everyone involved, from those enrolled to those making the decisions should understand how this works. We cover all of this during Step 1.

For example, The Academy is geared to helping specific groups of people: Those at risk or diagnosed with any combination of the following:

  • Type 2 diabetes
  • High blood pressure
  • High cholesterol

The “at risk” includes those with a family history of these conditions or those diagnosed as “pre-“, pre-diabetic or pre-hypertensive.

We also discuss the 12 Modules and how they are delivered – in-person (best outcomes), online or some combination.

Our preferred method of doing Step 1 is a 30-minute meeting/presentation, with key people in attendance, including: Someone from the executive leadership team, preferably a person involved with the financial aspects of the company (CFO, Controller); someone in a leadership position within HR and the person in charge of benefits. Additionally, anyone else involved in the decision-making or implementation process is also helpful.

Step 2: Is there a good fit?

Once we’ve completed the above, the next step is to determine if there is a good fit.

This is a simple process and involves us looking at some of your current healthcare spending. The most important things for us to evaluate include:

  • Rates of the above mentioned conditions within your employee population.
  • The number of prescriptions for these conditions.
  • Dollars spent on these conditions.

We evaluate aggregate information, so the total percentage of those with diabetes, high blood pressure or high cholesterol is perfect. As for the last two bullet points, the typical Top 25 table of prescription drugs will usually suffice.

So how do we determine fit?

This part is simple.

We take your information, apply our typical results and tell you what to expect in outcomes.

It is simple because we give you two numbers: 1) how much our services would cost and 2) how much we expect to save your company. You compare and then make a decision.

See? Simple!

Step 3: Implementation

If we have all determined there is a good fit, the next step involves working out the details for implementation.

The very first decision that needs to be made is this: “How many people do you want to enroll in The Academy?”

Some companies are little hesitant to implement a company-wide strategy like The Academy right off the bat. We understand. So we offer a Pilot Program, where The Academy gets implemented with a defined number of employees. We refer to this as the “Target Enrollment” and once identified, we then start with phase 2 of implementation.

This involves the following: deposit, dates and recruitment.

The deposit is typically 15% of the total invoice. This allows us to get started on the backend. It also allows you to reserve certain dates/times for the sessions, if you’d like.

There are several dates that need to be identified: information sessions, measurement sessions, start date, etc…

Recruitment is done mainly through emails (which we provide) and the information sessions. We also need to define who is allowed to enroll. The best approach we have seen is allowing anyone to enroll.

There are more details, for sure. But this covers the gist.

Step 4: Off and running

Once all of the above is complete – everyone enrolled, measured and entered into our system, we start with Module 1.

At the time of Module 1, we also submit the final invoice, which is adjusted for the deposit and any discrepancy from the Target Number.

Somewhere around Module 2, we give you a summary report of those enrolled. This report is descriptive and includes aggregate information on height, weight, body composition, health status, targeted medications and more.

That’s our process

It gives you some idea of how it typically works.

If you are interested in learning more or would like to know if The Academy might be a good fit for your company, reach out to us. We are be more than happy to talk with you.

Reading List 2016: Part 2

The list below contains books that we use on a very frequent basis.

Here is Brian’s personal reading list for 2016. He most recently reviewed Talk Like TED by Carmine Gallo.

Reference Resources

Eating on the Wild Side by Jo Robinson

There is so much to learn from this book, it’s hard to pick where to start. If learning about foods, preparing them yourself and doing little things to improve the health impact of a food are important, this book is for you.

Charcuterie by Ruhlman and Polcyn

The fine art and science of curing just about any meat in any way imaginable!

Bones by Jennifer McLagan

Your grandparents can probably relate to many things in this book. And there is a reason they didn’t get sick. Bones are healthy. In this book, there are many ways to prepare bones to extract the goodness from them.

Ruhlman’s Twenty by Ruhlman

The 20 refers to 20 1-word techniques, like think or butter or sauté or sauce. With these 20 techniques, there are 100 recipes.

Odd Bits by Jennifer McLagan

From McLagan about this book: “Most of the meat we eat – the tenderloins, racks, steaks, legs and chops – is only a small percentage of the animal carcass.”

Well, I’m not interested in these cuts and you won’t find them here. This book is about the rest of the animal: The pieces we once enjoyed and relished but no longer bother with.

Textbook of Medical Physiology by Guyton

At one point, this was the number one selling textbook on human physiology in the country. I didn’t know a single graduate student that didn’t have a copy! Whether or not it is still the number one seller, I don’t know. But this book is invaluable as a reference. Plainly written, thorough and easy to understand.

Books on Sports / Exercise Physiology (several of them)

This is the “in motion” or “during exercise” equivalent to the Guyton textbook above.

Countless articles through medical/science/research journals

There is always a stack of these to go through, highlight and either write about or decide if we should make changes to our recommendations.

2015 Member of the Year: Kathryn

Meet Kathryn!

To be the HPI Academy Member of the Year, you have to exhibit more than just results. Kathryn did that in a big way!

Kathryn did not miss a single session. She was always there. Smiling. Happy. Ready to listen and ask questions. And she asked great questions, which meant she was paying attention!

Her excitement and enthusiasm rubbed off on the others.

It was all of this that made her an easy selection for Member of the Year.

Congratulations, Kathryn! This is well-deserved.

Her Results

While this is about more than results, here are hers.

Before and after pics.

That smile never disappears.

Some of the details!

In 6 months she:

  • Lost 30 pounds
  • Lost a total of 13.75 inches
  • Saw her blood pressure drop nearly 20 points
  • And most importantly, nearly 100% of the weight she lost was fat weight

Great numbers but there is more!

The Interview

We ask each of our members of the year a series of questions. Here are some of the questions we asked Kathryn and her responses.

What did you like about The Academy?

My experience with the Academy was a delightful experience. I was a skeptic at first because I am very self-conscious when it comes to my weight. But I must tell you that all of that dissipated after the first Module.

Do you have suggestions on how we can make The Academy better?

I have no complaints about he Academy at all. It is very easy to follow if you have the intent in your mind to make constructive changes in your life style.

The literature presented in each module was informative and easy to understand. The facilitator was “excellent”. He has been deemed my “five flavor lifesaver for life”. I will continue to work on my health initiative.

It’s a life saver.

Where do you have your plaque displayed?

At the present time, my plaque is proudly displayed here in my office. I want to rub it in on my coworkers. I have them bow when I enter the room, and have been called “Ms. HPI” on several occasions. I wear the title proudly.

Special shout out to Dr. Brian Sekula.

He’s my hero!!!

Excellent Stuff!

To have someone say what we did was a “life saver” doesn’t get much better.

We don’t take any of this lightly. It is very gratifying that we were able to play a role in guiding Kathryn to this outcome.

So we said there was more than just numbers. There was. We could not be more happy for Kathryn or proud to have her as our Member of the Year.

The last thing we will leave you with is Kathryn receiving her plaque. We did this in front of her co-workers. They were also very happy for her!

Congratulations Kathryn on a job well-done and an award well-deserved!

image1

Dinner with the husband, the shakes and metabolic flexibility

Dinner with the husband, the shakes and metabolic flexibility


Thumbs Up

Have you ever experienced your hands starting to shake a little when you are hungry? When that happens, it’s time to get something to eat. Right?

Maybe.

Maybe not. This post is about that exact issue.

We had a great question this week from a member of The Academy.

About 3-4 hours after eating a meal, she can feel hunger setting in and her hands start to shake a little.

For her, this typically happens late afternoon / early evening. One option she has is to eat something (more on this later). But she doesn’t really want to do that. She likes having dinner with her husband and doesn’t want to mess that up!

She was following our recommendations and wondered if there was anything she could do.

Access and Metabolic Flexibility

There are many aspects to how and why your body gets hungry but since she was following our recommendations and experiencing less hunger overall, it didn’t sound like it was a food related issue. It sounded like an access and metabolic flexibility issue.

Here is a textbook definition of metabolic flexibility? In verbiage you might not find in an endocrinology journal, metabolic flexibility is defined as the ease in which your body can switch between burning carbohydrates and/or fats to produce energy. The less flexible your metabolism is, the harder it is to switch. Most people with poor metabolic flexibility are good at burning carbohydrates, which means burning fat is hard. This means that losing weight (specifically fat tissue) can be difficult.

When we eat a meal, the food provides a rush of energy that comes from the macronnutrients (carbohydrates, fats and proteins) and micronutrients (vitamins, minerals, etc…). Over time, this rush decreases and eventually returns to pre-meal levels. During this period of time, our body has access to a lot of potential energy. So we don’t feel hungry. But as the access to potential energy diminishes, we get closer to being hungry.

This is why metabolic flexibility and access to energy are tied together. Here is the situation for most adults: Your body has a lot of fat to lose but because your metabolic flexibility is poor, you can’t access it. This is the “access problem” we discuss in The Academy. When that rush of energy from the food you’ve eaten is gone, your body needs more. And if it can’t access fat stores, it sends hunger signals. Then you get hungry. Then you eat.

(This cycle starts with weight gain as a result of decreasing insulin sensitivity. As insulin sensitivity continues to decrease, pre-diabetes and then full-blown diabetes are on the horizon.)

Can we fix this problem?

Let’s return to our question. She was following our recommendations. In general, her hunger levels were better. This signals an improving metabolic flexibility. But, it wasn’t improved enough to keep her from getting the shakes or allowing her the ability to wait and have dinner with her husband.

To answer her question directly, the response was “Yes” there is something she can do!

At the beginning of this post, one of the things we mentioned that she could do was eat something. This would solve the problem because the “food rush” would provide a lot of potential energy, which would mean her body would stop trying to “access” the fat tissue. So eating food would fix it and eliminate the shakes.

Not practical for two reasons:

  1. The first is personal. She wants to have dinner with her husband. Eating would spoil that. So it’s not a good option.
  2. This one is from our perspective. Eating food when access is low only fixes the “lack of energy” problem and does nothing to address the access to energy problem. It just “kicks the can down the road.” She will eat. The shakes will stop. But as soon as the “rush” is over, she will be hungry again. Not a practical long term solution.

Ok, so what to do?

We have diagnosed this as an access and metabolic flexibility issue. From above, we noted these two things were tied together. If our diagnoses is accurate, then improving one should improve the other.

Earlier we defined poor metabolic flexibility. Optimal metabolic flexibility, conversely, means our body can easily switch between burning fats and carbohydrates to produce energy. If our metabolic flexibility is optimal, we can “access” the fat stores. This can eliminate the access problem and decrease hunger (and in this case, the shakes too!).

The prescription

We told her the following:

When the shakes set in and you are not ready to eat, take a walk.

Walking forces your body to burn fat, improving metabolic flexibility. In turn, this will help eliminate the access problem.

We suggested a 10-15 minute walk.

She went above and beyond.

She walked until the shakes disappeared.

It took 22 minutes!

Problem solved.

The shakes went away.

The access problem was gone.*

Most importantly, she was able to have dinner with her husband!

We are happy for her and glad to play a small role in her finding success!

 

*The access problem isn’t gone completely. But it is better. Most importantly, it’s better enough for her not to be so hungry that it might mess up dinner with her husband!

Calm.com a tutorial

calm-homepage

Click here to visit the calm.com website.

UPDATE – July 2017
Calm.com has made some changes to their website. It is still free but you need to create an account to use the website. You can log in with your Facebook account or create a separate one.

Many of the features discussed below are still available (and still free) once you create an account. However, they also offer a membership (with different options) for additional relaxation tools and sounds. Once you create your account, you can easily see what is available free and what requires a membership.

What is Calm dot com?

To begin with, it is one of our favorites!

As you might gather from its name, it can help you calm down, relax or de-stress.

It does this by playing relaxing sounds through your computer. There are 25 different sounds, ranging from the sound of the ocean, to rain, nature sounds and more. Also…each of the sounds has an animated image that compliments the sound.

In this post we will give you some pointers on how to take full advantage of it.

Visiting the website

As soon as you visit the website, the default sound and image are loaded. The default sound seems to be a combination of wind, birds, rain and other nature sounds. The image shows tree-covered mountains in the foreground and snow-capped mountains in the background. There is a slow moving river between the mountains in the foreground. Outstanding!

The image at the top of this post shows what you see when the site is loaded. The image below focuses on the left-hand side of the page. There are two things to point out here. First, you can download the app to any Apple or Google portable device. Second, you can take a meditation break! Just click one of the icons for however long your meditation break needs to be.

calm-app

If/When you need a meditation break and after you select a time option, you are then given two options for type of meditation (see image below): Guided (on the left) or Timer Only (on the right). What’s the difference? In the guided meditation, narration takes you through the process. In the timer only, you take yourself through the process. If you are new to meditation, we suggest the guided one to get started.

calm-meditations

Once you’ve made your choice, you are ready to begin! Click “I’m ready” to get started. Note: We highly recommend the headphones, particularly if you are at the office. It limits your distractions.

calm-start-meditation

Using it daily

While we think the meditations are excellent, the real benefit of calm.com comes from daily use. Just load the site, select your sound, adjust the volume and let it play in the background all day long. Use the meditations when things are stressful or during your busy times, so you can relax, focus and get more done.

There are 25 different sounds it can play. To play something different, move your mouse to the bottom-right of the screen, click the icon that looks like a mountain (right next to the volume icon) and select from the pop-up. See the image below.


calm-sounds

Our favorite one at the moment is rain – right in the middle of the top row. The image below is what is loaded when this sound plays. The animation in this image shows the tree limb moving slightly and slowly from the rain, you can watch rain drops falling off the limbs and leaves and you can see the rain falling in the background.

Just sitting, staring and listening for even 2 minutes will calm you down!

calm-rain

One of our favorite tools

It should be clear by now why this is one of our favorite tools for managing stress.

We suggest you start loading this site on your computer at work before doing anything – before coffee, before checking email, voice mail, etc… Watch the reaction of people when they walk into your office: “It sounds like it’s raining in here!” and you can excitedly spread the good news to them.

Give this a shot, load it on your phone or tablet too, and let us know how it works for you.

3 tips on dealing with food cravings

3 Tips on Dealing with Food Cravings


Are You Hungry

You’ve probably experienced it frequently. Maybe daily. The mid-afternoon urge to go find a snack. The late night craving for something sweet or salty and crunchy.

We talk quite a bit about cravings in Module 2: Why the body gets hungry (the psychological aspects).

One thing we emphasize, endorsed by many that have gone through The Academy, is the intensity of cravings seems to be related to how well you have eaten throughout the day. For example, most of our users report the mid-afternoon urge to visit the vending machine (or break room ) is harder to deal with after a lunch of Chicken Alfredo versus a grilled chicken breast salad.

This makes sense and we discuss why in Module 1: How the body gets hungry.

But if you know this and still eat the Chicken Alfredo, how should you deal with the cravings? In no particular order, here are three tips you can try:

Tip #1: Do something different!

If it’s the middle of the afternoon and you’ve been sitting at your desk since lunch, that’s too long to be sitting. Start doing something else. Follow up on phone calls. Do some filing. Get out of the chair and do something different.

Tip #2: Take a 10 minute walk!

If you ate the Chicken Alfredo for lunch, make it a 20 minute walk! As we discuss at several points in The Academy, walking does an excellent job of temporarily reducing hunger (for a bunch of metabolic reasons). Think you can’t afford a 10 minute walk? Think again. Nothing is so important that it can’t wait 10 minutes.

Tip #3: Drink some water!

You may be thirsty. You may not be thirsty. But get up and get a big glass of water. And drink it.

Sometimes you might have cravings because you are bored. That’s when you try something different. Sometimes you might really be thirsty, so drink some water.

No matter the craving, a good walk around the office building will be helpful.

And please…stop eating Chicken Alfredo for lunch!

Try any of these the next time you feel cravings coming on. Then let us know how they work for you.

PS. We are partial to the 10-minute walk!

Type 2 Diabetics and the Disposition Index

When most of us think about type 2 diabetes, we think about several things: problems with blood sugar control, insulin sensitivity, difficulty in losing weight, struggling with exercise, etc… Most of us, however, rarely, if ever, think about an obscure term known as the disposition index.

It is so obscure, it doesn’t even have its own Wikipedia page!

While most of the things we think about regarding type 2 diabetes are part of the condition, the reality is they are just individual pieces of the same puzzle.

That one thing that encapsulates all of this is the disposition index.

Why Type 2 Diabetes Occurs

The typical progression from normal blood glucose control to type 2 diabetic goes something like this:

Over time, our insulin begins to lose sensitivity. This can be due to a number of factors but is typically the result of chronically elevated blood sugar (glucose) as a result of our diet. As our insulin loses sensitivity, our pancreas starts to secrete more insulin to deal with the elevated blood sugar. Somewhere during this progression, most people start gaining weight, typically when insulin first starts losing sensitivity.

Eventually, insulin struggles to reduce blood sugar so the pancreas secretes more insulin. At some point, our pancreas is unable to continue secreting more insulin. This is when people get diagnosed as type 2 diabetic. They go to the doctor, get a blood test and find their blood glucose is too high. They then go through an OGTT (Oral Glucose Tolerance Test) and get diagnosed as a type 2 diabetic because blood sugars are not reduced appropriately.

In the two paragraphs above, insulin and blood glucose were mentioned frequently. So it it understandable when these things are mentioned as part of the Type 2 Diabetes condition. Notice that we haven’t even mentioned disposition index.

There is a good reason for that because the disposition index encompasses something else we haven’t mentioned: the pancreatic beta cells.

Pancreatic Beta Cells and Insulin

Insulin is released from the pancreas; more specifically, it is released from the beta cells of the pancreas. When your blood sugar is under control and insulin sensitivity is high, everything functions normally.

You eat a meal or a snack, your blood sugar elevates, your pancreas senses this, the beta cells secrete insulin, insulin does its job by reducing blood sugar and then insulin goes back to normal levels.

This entire relationship can be described with a mathematical function in both normal blood glucose control and type 2 diabetics. This function is known as the disposition index. See figure below.


Source: Bergman et all, Diabetes, 2002, Figure 1, page S213.
Note: Red lines added.

The horizontal axis is insulin sensitivity and the vertical access is insulin secretion. What we can note from this figure is that as insulin sensitivity increases, insulin release decreases. We also note the opposite: As insulin sensitivity decreases, insulin release increases.

Based on research, we know the following: The work required by the pancreatic beta cells changes as insulin sensitivity changes – this can be seen by in the graph above by noting the increase in insulin release as we move left along the horizontal axis (insulin sensitivity).

As noted above (2nd italicized paragraph), at some point the pancreatic beta cells are unable to secrete more insulin in response to elevated blood sugar as insulin sensitivity decreases.

Note the two boxes in the graph above. We have zoomed in on them in the figure below. The two bottom numbers in the figure below in each of the boxes is 800 and represented by DI, which is the disposition index. So both have a disposition index of 800 but occupy different places on the function. How can this be?

The other numbers in the boxes give us the answer. “S” refers to insulin sensitivity and “AIR” refers to insulin release. The insulin release value in the left box is 2,000 pmol/l while it is 400 pmol/l in the right box. This means, for all practical purposes, that to achieve an optimal level of blood sugar control, when insulin sensitivity is 2.0 pmol/l (right box) we have to release 400 pmol/l of insulin. If insulin sensitivity decreases to 0.4 pmol/l, we have to release 2,000 pmol/l of insulin – a fivefold increase in insulin release.

What this means is that as insulin sensitivity decreases, the pancreatic beta cells have to do more work by secreting additional insulin to deal with the elevated blood sugar. The beta cells adapt to this additional work and over time, they reach an “insulin secretion limit.” This results in chronically elevated insulin and blood sugar, also known as type 2 diabetes.

But it is clear the dysfunction in pancreatic beta cells is the first domino to fall in this string of events.

So the main question is, what causes the beta cells to reach their limit? Why and/or how do they reach a point where they can no longer secrete insulin (or enough insulin)?

This is an active area of research, with new answers frequently. While there are answers to many questions, the precise mechanism has not been identified. And it may just be there are several factors that lead to this pancreatic beta cell dysfunction.

In our next post, we will cover some of the more promising areas of research. Included will be things you can do to increase the health of your pancreatic beta calls.

By implementing some of these suggestions, your insulin sensitivity will certainly change. This will also lead to an improvement in insulin release. Overall, this will lead to an improvement in your control of type 2 diabetes.

That’s something all of us want.

Libra Scale from Runtastic

More than just a scale!

Our next product recommendation is the The Libra Scale from Runtastic.

Why we recommend

From the website:

Runtastic Libra – the scale that speaks with your smartphone/tablet!

Analyze important body metrics including weight, body fat and water percentages, muscle and bone mass, BMI, BMR and AMR (calories burned).

Using bioelectrical impedance analysis (BIA), the Libra scale can calculate the data noted above. With Bluetooth technology and the app, the scale can communicate with your phone (or tablet) and keep track of your progress.

How to use

Could not be more simple:

  • Enter your profile.
  • Step on the scale.
  • View your report on your phone or tablet.

It will keep track of your progress, so you can monitor how close you are getting to your goals.

While it measures and keeps track of a lot of information, we think body composition is most important. Testing body composition with BIA has improved but it still lacks accuracy. However, one of the main improvements is in reliability. So while the reading it has for your body composition may be off a little bit, the reliability means it will accurately identify changes in your body composition.

One other thing to mention: To increase reliability, do your best to step on the scale at approximately the same time every day and under the same circumstances. For example, right after you get out of bed. If you really want to throw it off, get on the scale right after a hard, sweat workout!

Cost: $129.99 from their website.

Final Thoughts

If you like technology and gadgets, particularly as they relate to your health, this is for you!

If you have used this product or plan to purchase and use it, let us know your thoughts in the comments below.

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Can losing fat from the pancreas reverse type 2 diabetes?

Maybe!

This summary says it can.

The summary comes from this article, which paints a slightly different picture, but important nonetheless.

So what is going on?

Well, it is part truth and part sensational, attention-grabbing headlines.

Gastric Bypass, Insulin sensitivity and Type 2 Diabetes

In the actual study, the authors evaluated both type 2 diabetics and non-diabetics, matched for age, sex and weight, before and 8 weeks after gastric bypass surgery (laproscopic RYGB).

The results were interesting.

Both groups lost weight after surgery (not surprising) and both groups lost a significant amount of body fat (also not surprising). However, the type 2 diabetic group also lost a significant amount of pancreatic fat, which did not happen in the non-diabetic group. See figure below.

This led to significant improvements in all measures of insulin sensitivity for the type 2 diabetic group, which means a significant improvement in controlling type 2 diabetes. In other words, they improved.

It’s also likely why the authors of the summary had such a sensational headline.

Can you spot reduce visceral fat?

So what happened here?

The type 2 diabetic group had a higher level of pancreatic fat before surgery. This is internal fat, known as visceral fat. Subcutaneous fat is the fat right underneath your skin. It’s the fat you can pinch. Studies have repeatedly shown that visceral fat is more detrimental to your health than subcutaneous fat.

If you are type 2 diabetic, you might wonder if you can specifically reduce visceral fat and improve your insulin sensitivity. And based on the questions I’ve had, many of you are wondering this.

The answer is kind of.

You can do this through diet and exercise and probably by sleeping better and managing stress.

We will focus on exercise and diet.

Exercise, Type 2 Diabetics and Visceral Fat

Higher intensity exercise has repeatedly been shown to decrease visceral fat, whether type 2 diabetic or not. And, while both low and high-intensity exercise have been shown to also reduce subcutaneous fat, it is high intensity exercise that can do so more preferentially.

Given that the type 2 diabetics had higher amounts of visceral fat at the beginning of the study, exercise might be a plausible explanation for the significant reduction in pancreatic fat after surgery. It’s unlikely, though, since surgery can be rough and assessment was only 8 weeks after surgery.

Diet, Type 2 Diabetics and Visceral Fat

It is likely the significantly reduced caloric intake after surgery was the main reason for reduction in pancreatic fat. Prior to the surgery, the average weight of the type 2 diabetics was 266 pounds. Eight weeks after surgery it was 230 pounds. This is an average weight loss of 36 pounds or 4.5 pounds per week. And…of those 36 pounds of weight loss, 30 of them were fat, which means they were losing 3.75 pounds of fat per week.

To lose 4.5 pounds per week, you need a daily caloric deficit of 2,250 calories per day (going by the 3,500 calories per pound, which is questionable). That’s a HUGE caloric deficit!

Which brings us back to diet and visceral fat. A caloric deficit this large will lead to significant visceral fat reduction. And without surgery, I’m not sure anyone can subject themselves to a caloric deficit of this magnitude.

Outside of gastric bypass surgery, what can you do, at least nutritionally, to decrease visceral fat? The research is fairly clear on this. A diet that severely limits processed foods – particularly processed carbohydrates will help. A low-carb, high-fat diet (which may be the same thing) will also do the trick.

But it won’t work as fast as surgery.

So what does is all mean?

Well, the diabetes wasn’t reversed in this population but it was significantly improved. And it corresponded to a decrease in pancreatic fat. This most likely happened because of a massive reduction in caloric intake after gastric bypass surgery.

Outside of surgery, are there things you can do to preferentially target pancreatic or visceral fat? Yes!

If you are a type 2 diabetic you should consider two things: 1) a diet lower in processed carbohydrates and 2) work to improve your fitness level. Diets lower in processed carbohydrates (or low-carb, high-fat diets) have repeatedly been shown to reduce visceral fat (and subcutaneous fat too). Improving your fitness level through any means of physical activity so that you can perform higher intensity activity is also important. And at some point, you probably need to make sure you are getting enough sleep and managing stress.

These two things will accomplish the same as the surgery, just not as quickly or severe.

Reading List 2016: Part 1

Each year I make a list of the books I want to read or reread. I have typically kept this in my notebook or email system – somewhere handy. This year, I’m posting it here on the blog.

This is Part 1 and includes books on my list to read. In Part 2, I list books and other sources that I use daily (or almost daily) as references.

Books to read in 2016

Bad Science by Ben Goldacre

How can you NOT be intrigued by the subtitle alone? I read a lot of research. A lot. And while it can be frustrating to find well-done studies, it is nice to know someone is calling them out.

I first learned of Ben Goldacre through a TEDx talk. This one will give you an idea of what this book is all about.

I’ve read many of his articles, have seen several presentations and have scanned through this book – I’ve had it for four years! So I’m looking forward to reading this book in its entirety.

The Checklist Manifesto by Atul Gawande

Why do I want to read this book? From the inside cover:

The modern world has given us stupendous know-how. Yet avoidable failures continue to plague us… And the reason is simple: the volume and complexity of knowledge today has exceeded our ability as individuals to properly deliver it to people. We train longer, specialize more, use ever advancing technologies and still we fail.

Doing things where failure is not an option, a simple checklist can make all the difference.

Margin by Richard Swenson

Are you busy? Good! Make time to read this book. You can make time by increasing your margin – the space between you and your limits.

Influence by Robert Cialdini

Why and how do people make the decisions they make? How do they justify those decisions? Can any of this be used in our personal or professional lives?

The answer to the last question is yes!

As someone who leads a group, whether it be the team at work, your family or like-minded individuals, knowing the information in this book will help you lead or take them where you want them to go.

Secret Service by John Dijulius III

Customers are the life-line of any business. Happy customers can make a business thrive! One way to get happy customers is by delivering unforgettable customer service.

This is the first sentence from Chapter 4: What are We Really Selling?

The experience is remembered long after the price is forgotten.

What experience do you want people to remember?

Unlimited Power by Anthony Robbins

The copyright on this book? 1985!

No fancy pictures or diagrams. Just 400+ pages of Tony Robbins awesomeness!

This will be my 3rd time through.

Meateater by Steven Rinella

The first chapter in the book:

This book has a hell of a lot going for it, simply because it’s a hunting story. That’s because hunting stories are the oldest and most wide-spread form of story on earth. The genre has been around so long, and has such dep roots, that it extends beyond humans. When two wolves meet up, they’ll often go through a routine of smelling each other’s breath. For a wolf to put his nose to another wolf’s mouth is to pose a question: “What happened while you were hunting?” To exhale is to answer: “You can still smell the blood.”

If that’s not enough to make you want to read the book, I’m not sure there is any help for you! 🙂

Good to Great by Jim Collins

This will be the second or third time to read this book. No explanation needed. Always makes any list of best business books of all time.

The Man Who Swam the Amazon by Martin Strel

Second time to read this book.

People that do things of super-human nature are fascinating. Swimming 3,274 miles on the world’s deadliest river in 66 days qualifies.

The Five Dysfunctions of a Team by Patrick Lencioni

Whether you know it or not, you are the leader of a team. The quicker you learn that, the better.

And if you are struggling or wondering why your team is going nowhere, then you need to identify why.