Using the Glycemic Index more effectively

There is (and always has been) a lot of controversy regarding the glycemic index (GI), which is a measure that is used to see how quickly a certain food can raise your blood sugar. Since a persistently high blood sugar can really wreak havoc on your health, it seems like the GI would be a useful tool for many people.

But many practitioners and patients don't like to use it in the context of diets and weight loss programs because (a) it doesn't always make intuitive sense  and (b) patients make the wrong assumptions about it and thus, use it improperly.

If you base your diet on glycemic index alone, it is true that you will not have much success in either losing weight or controlling your blood sugar. There are plenty of low-glycemic index foods like ice cream, which would not count as health foods in ANY diet. Likewise, trying to adjust glycemic index by adding fat and fiber to your meals (which generally reduced the GI or most foods) can lead you to thinking that a chocolate milkshake with extra flax seed is a health food. It really isn't.

But if you understand how the glycemic index works in context with the basic of good eating, I still think GI can be a valuable adjunct in helping you make informed choices regarding what foods to eat and not to eat.

But here's the thing: you have to be able to use your brain.

This means you have to understand the GI as a general guideline, to help you manage your food choices, so you can identify foods that you have trouble with (raise your blood sugar, leave you hungry 2 hours later, and make you gain weight) so you can avoid them. 

It sometimes has exceptions and works counter-intuitively (eg ice cream). So, instead of being a GPS it acts more  like a compass, in a sense. It will show the general direction of where you might want to go, but if there is a river or a deep gorge, you might have to alter your path a bit. Ultimately, the GI  won't tell you exactly where you are, you will need other information to help you do that so that you will be able to incorporate foods that you do like safely into your diet.

And if you really want to understand the GI--I mean REALLY understand it--then get a glucometer and check it yourself. That's right.  If you are serious about knowing about your GI, then know your GI! 

These are the 8 supplements I regularly take in addition to a multivitamin.

Supplements are confusing. I know. The best I can do here is simply tell you the best that I know about them, and explain to you how I buy them and use them.

What I usually do is go to the Amazon store and start reading about the supplements, and then buy one. simple enough -- as it should be. I don't get too fancy either. I stick with stuff I know and don't get too exotic.

I usually  end up using the Metagenics brand, which I like, and have taken for many year ever since my aunt, who is a doctor, started taking them about 30 years ago. 

I like a great deal of their products, and am thinking about setting up a store on the website for these products because it is nice to get all your supplements in one stop shopping.  But the fact is, there are several good vitamins and multivitamins out there.

My recommendation is that you find one that you like, and more importantly, find a regimen that is working for you. And make sure you TEST!  It's always a good thing to experiment and individualize with different supplements to find the regiment that works for you, but get the data.  That is why I test for all the things I can, like EPA/DHA, B12, Vitamin D, and Magnesium levels in my office. These are simple blood tests I do in the office that are usually covered by most insurance plans. 

Of course, you must remember that supplements can be dangerous as well. Use caution, and if you have any doubts, always check with your doctor, especially if you have any medical conditions or are taking medications.

Here is the list:

1. Sublingual Vitamin B 12/B Vitamins. I think B vitamins are very important for your energy levels, and trying to achieve optimal neuronal health.

2. Coenzyme Q10: If you are not eating liver, then you you should consider supplementing with this important vitamin/nutrient

3. L-Carnitine: It helps. I like to use these when I am lifting weights and exercising strenuously. 

4. Vitamin D3. Good for everything, it seems. 

5. Kelp: For those of you who don't like to eat seaweed, but you need to get your iodine. Men too. Hypothyroidism is a huge problem.

6. Omega 3: There are many brands out there, but Nordic Naturals is generally the popular one. Once again, I take the Metagenics brand because (a) they are good and (b) I like to get everything in one place. 

7. Glutathione (aka 'The mother of all antioxidants'). I do recommend taking vitamin C, for sure, but really, vitamin C is just about everywhere. Many supplements have vitamin C in them, plus, even if they are labelled otherwise (such a B Complex). But glutathione is a great antioxidant that most people simply just don't get enough of, or it is depleted in the course of our stressful and hectic lives! I take this supplement myself, and I prefer sublingual dosing, which can help ensure better absorption.

8. Probiotics: I don't always take these, but I know many of my patients like this brand, especially when the include a gluten free diet along with these probiotics. 

9. Magnesium supplements (oral)

What to snack on with a low-carbohydrate diet.

That is a question I get asked a lot because, well, people are hungry.

There are a few things that are important to note before I give you a list. 

(1) Chronic severe calorie restriction 1200-1500 calories that leaves you constantly hungry simply does not work over the long term, and actually works against you if you are trying to lose weight. Your body will respond to this 'mini-starvation' state not by giving up fat, but greedily keeping it and  instead, give up lean body tissue, ie muscle and organ tissue. You can't trick your body, so it's actually good to snack when you are hungry, especially initially, and especially on foods that are not sweet. But keep in mind, like all things in life, it's a balancing act, and you have to still use some common sense (ie have a reasonable snack portion, not a meal, that acts a bridge to your next meal). You don't have to be a monk, but don't engorge on snacks either. 

(2) Always to keep yourself hydrated when you have a snack. That is have a big glass of water or tea before you eat. That is a trick that seems to mitigate the hunger pangs for many people so they don't end up eating a pound of peanuts. At work, we have a coffee/tea machine in the doctor's lounge that makes really nice jasmine green tea, which I think tastes great without sugar. You should experiment and try to find your particular drink. You will find you will eat less, and be less predisposed to engorge yourself as a result in most cases.

 (3) Although fruit can be a good choice for a snack, try to avoid it initially and focus on low-carb/low sugar snacks. I want to be clear, though.  Fruit is healthy. I like fruit. It is okay to eat fruit. Fruit is not evil. But the fact is fruit really isn't as necessary as you think. I think it's always a mistake to lump fruits and vegetables together, even though I do it all the time, but they are different.  There are fruits, especially things like bananas and dried fruit, which are basically like having a potato and table sugar because that is how your body processes them, basically. This is not to say you can never have things like bananas, dates, and figs, but once again, it is not an either-or proposition. Most diets fail because they are static things that tell you that this food is bad, and you can never eat this food again. This is no way to succeed over the long term, and this is why, I think, most diets fail. 

Most foods are just fine, but the are not all equivalent. Some can be a staple  in your diet, and some can't. You can have figs, but you probably won't have a lot of success if you base your diet in them as you probably have only just shifted your sugar cravings to something else. An example of this is when a person stops drinking coffee, but ends up drinking a ton of ice tea. 

So here is the list (It's not exhaustive, and if you have one to add, share it with us!):

• Plain yogurts, and plain yogurt drinks like kefir
• Raw nuts (one of the best places to go for these is Trader Joes's. Try nuts you have never had like filberts. You might like them!)
• Seeds (pumpkin and sunflower seeds--mix them with the nuts)
• Jerky (once again, Trader Joe's rocks, but you can make your own pretty easily)
• Nut butters (peanut and almond are great on things like celery sticks and lower-carb fruit like apples)
• Sardines (I love King Oscar sardines in olive oil with some hot sauce and a few low-carb crackers like Mary's Gone Crackers)
• A can of tuna, mackeral, or other fish, like kippered herring
• A few slices of ham and cheese rolled up together, or whatever you like, eg salami, mortadella, etc.
• Olives, pickles, pickled vegetables (asparagus is a pretty good one I like!)
• Cottage cheese (If you have chives in your backyard, use them! Mix them in the cottage cheese and you will have a great snack)
• Boiled eggs (make a bunch in the morning and put a little butter/cream cheese and salt on for snack)
• Make your own whip cream (no sugar) and put it on some berries, or mix it with some peanut butter for a smooth apple dip.

A few tips so you don't get bored:

• You can be creative and mix and match a lot. Say you don't like plain yogurt, then put a few berries and nuts in the mix to ramp up the taste.
• Get good at using spices! Cinnamon and vanilla can make plain yogurt taste better than anything you can buy at a store.
• Try not to indulge you sweet tooth when you are hungry or stressed. Have something that has a tinge of sweetness, if you must, but not that intense sugar rush--things like plain coconut milk, a few cashews, and some herbal tea. Or heavy cream on some berries, or perhaps you can get a flavored coffee, like hazelnut, and place a little heavy cream in it. Sugar is very addictive, and it is doubly addictive it seems when you eat it in extreme hunger or stress.
• Try to portion out your snack. Once again, you can grab a few generous handfuls, and another if you are still hungry after 15 minutes. That's totally okay, but don't eat out of the bag or the jar.

These are a few tips for snacking. I hope it helps, and if you have any suggestions for awesome low-carb snacks, then let me know. I'd be glad to hear from you!    

Coenzyme Q10 for Great Health AND Great Skin!

Background Information on Coenzyme Q10

Coenzyme Q10 (CoQ10) is a very popular supplement nowadays and rightly so. It has several important functions in the body.  Most notably it participates in the production of energy in our bodies. Specifically, CoQ10 helps in the production of ATP in your mitochondria (which are the energy factories of you cells). It also is an antioxidant/free radical scavenger that is good for among other things, skin health. So, I tend to recommend this supplement frequently both as a topical and as an oral supplement that can help optimize skin metabolism.

Coenzyme Q10 also shares a biosynthetic pathway with cholesterol. This means that many of the same steps are necessary to help utilize coenzyme Q 10 as well as cholesterol. So, take a statin to helps reduce your cholesterol, this tends to deplete your levels of coenzyme Q 10. In fact,  there are many case reports of people with memory loss, extremity pain and fatigue, and other symptoms. These folks should check with their doctor if they have these symptoms.

Remember also that the nervous system requires a large amount of energy to function. As a result, it also requires active coenzyme Q10 to help in this process. If you are suffering from the symptoms of cramps, paresthesias (nerve tingling), and even numbness and you are on a statin, you may want to consider supplementing with coenzyme Q10, or talking with your doctor about whether the statin you are on is truly necessary.

Coenzyme Q10 also helps increase the efficacy of other antioxidant vitamins such as vitamin E and vitamin C by helping convert them into their reduced form, which is their active form.

Some studies have suggested that CoQ10 supplementation can extend lifespan, and it can be used to treat things like hypertension and heart failure.

In regards to skin health, in particular, CoQ10 can be a very important supplement to include in both oral and topical forms to help promote overall skin health and fight against the aging process.

The ability to convert energy efficiently and the aging process are intimately interconnected, and it seems that coenzyme Q 10 plays a vital role in this process particularly in the skin.

Coenzyme Q10 and the skin

Remember, the skin is a highly active organ in terms of its metabolism and turnover. Rather than being a static organ, and skin cells are constantly turning over. Likewise, the collagen and elastin, which forms the central "skeleton" of the skin in the dermal layer, is also turning itself over and repairing itself. This also takes a great deal of energy, and so coenzyme Q 10 plays an important role in this process. In addition, by virtue of the fact that coenzyme Q 10 is a powerful antioxidant, it helps prevent free radical damage to the skin. Free radical damage to the skin is one of the causes of aging.

Ubiquinol is the reduced form of coenzyme Q 10, that means it's not oxidized (active form), and as a result, it can participate in the production of energy effectively while also acting as an antioxidant, and helping other antioxidants do their job as well like vitamin C and vitamin E. Look for this form when you are buying your supplements, or look at my supplement list if you want to know what I personally take and recommend to my patients.

What are the best dietary sources of CoQ10?

Some of the best dietary sources of coenzyme Q10 are meats and fish, particularly organ meats such as beef liver, while herbs like parsley and nuts are also excellent sources of coenzyme Q10. 

Of note soybean oil is an excellent source of coenzyme Q10, but there is a significant caveat in this regard, because soybean oil is very high in omega six fatty acids, which are generally inflammatory.

In addition, when soybean oil and other vegetable oils (which are also high in CoQ10) are used in high heat frying, this tends to deactivate a significant portion of the coenzyme Q10.