Sleep patterns in the absence of electricity

The focus of our discussion in the Sleep Module is to improve sleep quality so that we are well-rested. Most of “How to do this” is targeted at the last 1-2 hours before going to bed, what we refer to as transition time. While there are several aspects to this, particularly with what we have at our disposal, a major part of what we discuss is light exposure.

So we were glad to see this: A recent study in Current Biology looked at sleep patterns of three pre-industrial societies, one each in Tanzania, Namibia and Bolivia. Some key observations include the following:

  • The groups lived absent of electricity – no lights or external temperature controlling systems. So they were exposed to seasonal variations in weather, temperature and sunlight. Perfect groups for studying sleep patterns!
  • Not a single person had a BMI greater than 30. Not one. Obesity was non-existent!
  • On average, the three groups spent 7.0-8.5 hours in bed with 6-7 of those hours spent sleeping. So for the most part, they don’t sleep through the night.
  • Two of the three groups lived far enough south of the equator to experience significant changes in darkness and light exposure depending on the season. During the time of year when darkness was longer, these groups slept, on average, nearly one hour longer than when days were shorter.
  • They don’t take naps! Sensors used to determine whether they were awake or asleep recorded 10 naps over 574 days. Additionally, all of these were during the summer, when days were longer. This could be related to shorter nights and tiredness or maybe a rest period during the hottest times of the summer days. But one nap every two months doesn’t show much of a pattern.
  • Less than 3% have trouble falling asleep and staying asleep (1.5% for the former and 2.5% for the latter). This is very different than industrialized societies, where it can be as high as 30%.

As we discuss in our seminars, the transition time is important. It prepares our body to fall asleep and enter a normal sleep pattern throughout the night. Given the statistics on sleep deprivation and the fact that so many are tired all the time, it’s safe to say that most of us don’t do a good job of “transitioning” our body for sleep.

Takeways and things at our disposal.

There were a lot of important observations in this study, but a couple stand out. The first is that obesity is non-existent!

While there are certainly differences in physical activity, given that their primary mode of transportation is on foot. Other “things” are probably more important. For example, the absence of electricity means no lights, which means no TV, cell phone, tablet, computer or even lights. When it is dark and they are tired, they go to sleep. In industrialized societies, when it is dark and people are tired, they have cake, chips, ice cream, etc… at their disposal. So they plop on the sofa, eat and stare at the TV or other technology device. This light exposure (and snacking) is not a good mix for our transition time.

Another important observation: For the most part, they don’t sleep throughout the night! In every seminar we do on sleep, we are guaranteed to get a question like this:

I wake up and sometimes don’t fall back asleep for 15, 30, 45 minutes or even an hour. Why?

The conventional wisdom is that we are supposed to fall asleep and stay asleep. This is clearly not the case, as shown in this study (and countless others). But it is apparent, based on how frequently we get this question, the message isn’t being conveyed. So as health professionals, we need to do a better job of letting people know this is normal. And this is important. When you make a statement like this and ask why, there is clearly some concern. Concern leads to worry, worry leads to stress and stress makes it harder to fall back asleep.

So we clearly need to do a better job at letting people know, that for the most part, this is a normal occurrence.

2 things to do right now and improve your sleep transition time!

Sleep better tonight by:

  • Start limiting your exposure to light about one hour before bed time. Turn off the bright lights and turn on softer ones so you you can see. This includes the television and all of your electronic gadgets. If you can’t do without your computer, download this and install it on your computer. It blocks the most offensive lights.
  • If you think you are hungry and not tired, think again. And if you are hungry, eat a little something that is not processed (In other words, skip the stuff mentioned earlier).

Overall, sleep is important to your health – a lack of quality sleep is associated with nearly every chronic condition you can imagine. The fact that obesity was non-existent in these groups provides further support. To improve your health, you must sleep better. To sleep better, you need to be better during the transition time. These two tips will help you do that.

After a few days of better sleep, you won’t believe how good you feel.

Webinar: Why Wellness Fails April 2016

Below is the recording from our webinar on Why Wellness Fails to control medical costs, recorded on April 13, 2016.

To stay up-to-date with the latest news and offerings from us, we encourage you to sign up for our newsletter, which you can do at the bottom of this page.

Note You are already subscribed to our list if:

  • You are or were enrolled in The Academy, the HPI Diabetes Academy or one of our Preview Accounts.
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If you are not sure, submit the form and if you get a notice that your email address already exists in the database, you are subscribed

Please share across all of your social networks!

The information included in this webinar is important. We know the drill – healthcare costs are crippling all of us. However, with the right approach to wellness and by implementing the right programs, we can have a significant impact!

Unfortunately, the standard, run-of-the-mill “Wellness Programs” are unable to accomplish this!

If you have questions or need help, download the vCard for Brian Sekula (below) and reach out. We are glad to help!

 

A pdf version of the slides.


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Links for further reading

One slide in the webinar had links to additional articles on our website(s). Here the links:

Additional Readings
Type 2 Diabetes is killing your company.
Is exercise more difficult with type 2 diabetes?
RPE and determining exercise intensity.
Dinner with the husband, the shakes and metabolic flexibility.
2015 Member of the Year: Kathryn.
The IARC: Red Meat and Cancer.

 

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You’re doing eggs all wrong!

Image from bostonmagazine.com.

 

You’ve heard it before, maybe even believe it yourself:

Eat the egg whites and trash the yolks!

Egg yolks are full of saturated fat and cholesterol – they are bad for you!”

The list goes on…

It’s hard not to get caught up in this line of thinking because it seems to be everywhere. After all, nearly every restaurant that serves breakfast has a “healthy breakfast option” that removes the yolks from the eggs.

Thinking this way is doing eggs all wrong. It’s time to stop the egg-yolk-phobia!

Yolk is the healthiest part of the egg!

Look at the image below. From a single egg yolk (17 grams), it’s easy to see yolks are loaded with micronutrients!

These restaurants and their healthy egg options are getting rid of the healthiest part of an egg. Compare the nutrient density of the egg white from a single egg below.

Not much of a comparison. In fact, there are bunch of zeros when it comes to nutrient density of the egg white.

Beyond the direct comparison, the protein in egg whites is more difficult to digest when the fats from the egg yolks are not available to help your body digest them.

But, but saturated fat and cholesterol!

Yes, we all know the drill. Eating saturated fat raises cholesterol, which increases heart attack risk. This is simply not true. Although eating a “saturated” fat like Crisco certainly increases your risk, it’s not really a saturated fat.

Further, study after study after study has repeatedly shown that dietary cholesterol and saturated fat has little impact on your cholesterol levels. Cholesterol levels are internally regulated, when you consume more, your body makes less. And vice-versa.

Finally, studies show that consuming whole eggs improves cholesterol profile, increases HDL and improves metabolic syndrome here, here and here.

Beyond all of that, high cholesterol is (supposedly) a risk factor indicating an increased risk for cardiovascular disease. Some would argue against that.

See? Eggs aren’t so bad!

In fact, they are one of the best foods you can eat. Their awesome micronutrient profile means they go a long way to filling your satiety bucket, which means your body will stay full longer.

What about the calories?

What about them? A single, large boiled egg contains 70-80 calories, depending on size. So if you eat two boiled eggs for breakfast, you are consuming 150-160 calories. Compare that to a medium, plain bagel at nearly 300 calories! And the nutrient density in the whole egg completely blows away the bagel. So you are eating fewer calories and doing a better job of feeding your body.

Not much of a comparison!

Tell’em they’re doing eggs all wrong!

The next time someone tells you the egg yolk should be thrown out, tell them they are doing eggs all wrong. Then proceed to recite everything in this article.

And the next time you have breakfast at a restaurant, tell your waiter you want the healthy eggs, those WITH the yolk!

Wild Fermentation

Wild Fermentation by Sandor Ellix Katz is one of our favorite books!

Why? Because fermented foods are good for you.

From the foreword, written by Sally Fallon of the Weston A Price Foundation:

Unfortunately, fermented foods have largely disappeared from the Western diet, much to the detriment of our health and economy. Fermented foods are a powerful aid to digestion and a protection against disease. And because fermentation is, by nature, an artisanal process, the disappearance of fermented foods has hastened the centralization and industrialization of our food supply, to the detriment of small farms and local economies.

There are many things you can learn to ferment from this book, like making beer, wine or vinegar. There are also the standard recipes, like sauerkraut, dill pickles, yogurt, kimchi and kombucha. But the real benefit of this book is learning the technique of fermenting.

For example, it is rather simple to make sauerkraut. You need cabbage, salt and a couple of kitchen tools. That’s pretty much it. Katz takes three pages to explain and discuss this topic. Reading this book, you feel how much he enjoys preparing foods this way.

And if you take the time to read and absorb what he has written, you appreciate it more.

It’s why this is one of our favorite books!

Is Exercise More Difficult with Type 2 Diabetes?

Is Exercise More Difficult with Type 2 Diabetes?

We will answer this question shortly.

But first, when talking about whether exercise is more “difficult” for type 2 diabetics, the question is really referencing exercise intensity. There are a number of ways to measure/monitor exercise intensity. We prefer to use Ratings of Perceived Exertion (RPE).

The question refers to a scenario like this:

Given two individuals where everything is the same (age, gender, height, weight, etc…) when performing the same type of exercise, is it more difficult for the type 2 diabetic?

The answer to this question: Yes (in general)1

To illustrate, let’s say the exercise we referred to above is walking at 3 mph. The typical non-diabetic might rate the intensity of this activity at a 3 or 4 on a 10-point RPE scale, while the typical type 2 diabetic might rate it a 5 or 6 on the same scale.

Since RPE is a measure of intensity and 5 or 6 is higher than 3 or 4, we would have to say that, in general, type 2 diabetics have more difficulty with the same activity than non-diabetics.

Why is exercise harder for Type 2 Diabetics?

Look no further than resting metabolism. Metabolically unhealthy (which is what type 2 diabetics are) have a higher respiratory quotient at rest when compared to metabolically healthy individuals. This means type 2 diabetics are using a larger proportion of carbohydrates as a substrate to produce energy. Further, substrate utilization predicts intensity: The more carbohydrates, the higher the intensity.

For type 2 diabetics, this means that even at rest they are producing energy differently than non-type 2 diabetics. And when we change the intensity, like walking at 3 mph for example, this relationship holds true. So they continue to operate at a higher intensity, which is what makes exercise more difficult for type 2 diabetics.

If this is the case, how should we approach exercise and exercise intensity for type 2 diabetics?

Type 2 Diabetics and Exercise

From a metabolic perspective, type 2 diabetics operate at a higher intensity level in comparable exercise because their ability to use fat as a substrate to produce energy has been compromised. (See this for an example). In other words, the average type 2 diabetic has difficulty in using fat to produce energy.

This difficulty in using fat to produce energy makes it harder for type 2 diabetics to lose weight.

This should be addressed first.

Improving metabolic flexibility in type 2 diabetics

In the literature and even within both The Academy and the HPI Diabetes Academy, we refer to this as metabolic flexibility: The ability of the metabolism to switch between substrates (carbohydrates or fats) to produce energy. For someone lacking metabolic flexibility, their ability to switch is compromised. Since type 2 diabetics have difficulty in using fat to produce energy, their metabolic flexibility is compromised.

So the first objective should be to “un-compromise” them by improving metabolic flexibility.

The two best approaches to fixing this are with food and exercise. Since this article is about exercise, we will omit the food part.

We only have two recommendations for exercise: low-intensity and/or high-intensity. Both are effective for different reasons.

Low intensity is effective because it forces the body to get better at using/burning fat during the exercise session. There are a couple of caveats, however:

  1. The intensity must be lower than normal, due to the compromised ability to burn fat.

  2. To be most effective, duration must be longer than 30 minutes – the longer the better. As it takes time for the body to fully get into a fat burning mode, shorter duration activities are not as helpful.

High-intensity exercise is effective because it helps improve the body’s ability to burn fat outside of the session. Earlier, we mentioned that type 2 diabetics have a higher respiratory quotient at rest, which means they are using a higher proportion of carbohydrates to produce energy. As the body adapts to high-intensity exercise, it starts fixing this problem. The end result is a lower respiratory quotient, which means the body is using a larger percentage of fat to produce energy at rest.

On a related note, this is why we aren’t big fans of jogging for most people until they get to a point where metabolic flexibility has improved.

Yes, exercise is more difficult for type 2 diabetics

But this problem can be fixed with an appropriate exercise prescription, one that improves the body’s ability to burn fat during exercise and at rest.

This will result in the increased ability to perform comparable exercise at a lower intensity.

Endnotes

1We say in general, because there are always exceptions and this refers to the average.

RPE and Determining Exercise Intensity

While heart rate (HR) is a popular way to measure exercise intensity, we prefer Ratings of Perceived Exertion (RPE) and will explain why in this post.

When using HR, you workout at some percentage of Max HR; for example between 50-60% or 70-80% of Max HR. The usual way to determine Max HR is by subtracting your age from 220 (Max HR = 220 – age). Once you know Max HR, the upper and lower ends of your HR range can easily be determined.

This seems simple and straightforward but technology doesn’t always get it right. For example, there is a class action lawsuit against Fitbit, claiming their technology and/or algorithms are inaccurate. This can have serious consequences for the user, particularly at the higher end of intensity.

We prefer RPE

RPE stands for Ratings of Perceived Exertion and the key word here is “perceived.”

The “perception” of how hard you are exercising is important for evaluating the overall intensity of the workout. And it is probably more accurate than measuring heart rate only. For example, let’s say you were working out hard – near your maximum capacity. You would certainly “feel” like you were working hard, but if you were using a HR monitor to determine intensity and this HR monitor consistently under-reported your HR, you might think you weren’t working hard enough. This would be in spite of how you “feel” and might compel you to try or push yourself harder. This could lead to a dangerous situation.

The RPE scale takes this into account.

Using numbers on a scale and descriptors for how you should feel at various levels of intensity, a user can accurately identify exercise intensity.

This is probably the most popular RPE scale. If you’ve ever taken a treadmill test – either for a research project in college (or graduate school) or at the cardiologist office, you probably saw something like this.



Notice on the left there are numbers for rating the intensity of exercise and descriptors on the right for helping you pick the most appropriate rating. This is the perception part we refer to and think is important.

While the ratings correlate with HR, they are not 100% accurate.

In both The Academy and HPI Diabetes Academy, we use a slightly different RPE scale – the CR-10 Scale.



We use this version for a couple of reasons:

One, it starts at zero. Notice the scale above starts at 6. We prefer a scale that starts at zero so we have a better anchor point for a resting intensity.

Second, it is much more convenient than any type of HR monitor.

Once a person is comfortable with using the scale, nothing else is needed.

To finish this up, the green areas indicate how we prescribe exercise for those in our programs. We recommend either “light” or “hard” exercise and prescribe intensity using this scale. For example, light workouts should have an RPE of 2-5 while hard workouts should have an RPE of 7+. We skip “6” on purpose and it’s not because there is no descriptor. There is a metabolic reason.

Beyond the two points mentioned above, this also allows our users a lot of flexibility. They can do any activity they’d like, as long as it meets the RPE criteria. This means they aren’t restricted to walking, jogging, cycling or any activity where measuring HR might be problematic (like swimming).

This is why we like to use RPE for measuring exercise intensity.

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!