Background
Brian was a retired 60 year old who came to see me to lose weight and lower his cholesterol and triglycerides. He was on medication for high triglycerides and blood pressure. His starting weight was 240 in a 6’2” frame. His body mass index was about 31, which put him just in the obese range.
During the first few appointments I analyzed Brian’s diet and found he was eating too many refined carbohydrates like pretzels and cookies as snacks throughout the day to keep his energy up. He was starting the day with a sugary low-fiber cereal that was setting him up to be hungry and tired in about an hour. Sugary foods (considered high glycemic) cause a quick rise in blood sugar followed by a surge in insulin which drives the blood sugar down fast. It is much healthier to eat low glycemic, high fiber carbohydrates, which create a gradual rise in blood sugar and insulin and a gradual fall. That way energy is balanced and food cravings and hunger are managed.
Brian was eating sandwiches for lunch, usually followed by pretzels and cookies and an occasional fruit. For dinner he consumed large portions of protein and starch with a small side of vegetables. Sometimes there were a few more cookies after dinner or another dessert.
Over the years Brian’s exercise level had decreased since he had experienced some knee and shoulder injuries.
Treatment
Diet
I educated Brian about eating the right carbohydrates – low glycemic, high fiber – and healthy snacks with a balance of some protein and fiber. Examples are a handful of almonds, low-fat cheese with whole grain crackers or apple slices with natural peanut butter. We also discussed portion control with his dinner meal.
In addition, I asked Brian to switch to egg white omelettes with vegetables a couple of mornings a week and salads with fish, turkey, chicken or low-fat cheese for lunch instead of sandwiches, to cut down on the amount of carbohydrates he consumed. While farmed salmon and albacore tuna are high in the good omega-3 fatty acids, they also tend to be high in health-threatening toxins. These should be limited to no more than once or twice a month. Sole, cod, flounder, wild salmon, haddock, red snapper, halibut and bluefish might have half as many essential fatty acids, but they have much lower toxin levels.
Supplements
I also introduced several supplements to help bring down Brian’s cholesterol and triglyceride levels which also helped him to continue to lose weight without hitting a plateau.
I recommended a fiber supplement made of psyllium husk and other soluble fiber* to help pull cholesterol out of his body and to aid in weight loss. Taking fiber with a large glass of water before meals helps the person fill up so they are less starved during the meal. I also added fish oil (EPA/DHA)* which helps to lower cholesterol and triglycerides, keeps the blood clean with less arterial plaque, and L-Carnitine, a natural fat burner – good for cholesterol and triglyceride management, overall cellular energy, and heart health. Other supplements for general health and energy metabolism were a multi-vitamin and mineral complex, B-complex, and Calcium/Magnesium for the aches and pains he was experiencing. Brian later added glucosamine sulfate* and manganese to help with his joint problems.
Exercise
With a little help from the chiropractor that I referred him to, who worked on his knee and shoulder injuries, Brian was able to start an exercise program. It consisted of walking with his dogs one to two miles, three times per week. He also added light weight lifting, which helped his knee and shoulder.
Results
After the first 6 weeks on the diet Brian lost 15 lbs. He felt much better than he had in years. His energy was higher throughout the day, and he was more alert, with better concentration.
After another few weeks Brian had his blood lipid panel checked. He was amazed at how much his numbers had improved. His total cholesterol went from 260 to 205, his HDL went from 39 to 49, and his LDL from 165 to 135. The most impressive change was his triglycerides, which went from 279 to 105. Brian stated that in 25 years his triglycerides were never normal. His walking was now increased to 1 mile a day with some light running mixed in. At our last meeting, about 8 months after he started his program, Brian was down to 200, with his goal weight of 195, and BMI of 25 in sight.
Summary
What worked for Brian was slow steady progress in weight loss and quick improvements in how he felt. With more energy and fewer joint problems, Brian was able to greatly increase his exercise, which helped with his lipid profile, weight management and sense of well-being. He didn’t feel that he was really giving up much in his diet. Once in awhile he can eat an occasional snack food without any trouble. He no longer cares to eat the quick fix carbohydrates because he feels much better without them. In fact, he doesn’t find himself craving foods nearly as much.
Brian’s case illustrates that with the right program begun early enough, many of the characteristics of syndrome X can be reversed, and disorders like heart disease and osteoarthritis can be avoided. Unlike rheumatoid arthritis, an autoimmune disease that can affect people of all ages, osteoarthritis is a common degenerative disease resulting from years of joint usage that can be improved with proper nutrition, weight loss and supplements.
Brian’s Makeover: Before
Diet:Lot’s of refined carbohydrates including white bread, pretzels, sugary cereals, and cookies. Portions of pasta and protein were too high. Not enough fruits, whole grain, legumes and vegetables.
Weight/Cholesterol: Brian’s starting weight was 240, height 6’2, BMI =31.
Cholesterol: 260.
Triglycerides: Triglycerides: 279.
Supplements: Brian was not taking any to start.
Exercise: Brian was limited by osteoarthritis in his knee and shoulder. He walked a little but was not able to sustain a balanced exercise program.
Stress Mgt. & Self-Care: This was not really something Brian thought about. He was semi-retired and did not think he was under a lot of stress. He didn’t really understand the mind-body connection and the effect of stress on obesity.
Brian’s Makeover: After
Diet: Balanced diet using 40/30/30 principles. All carbohydrates consumed are low glycemic and high fiber. Portion sizes are moderate for grains and protein. Fruits, vegetables, whole grain, and legumes as well as healthy fats and quality protein now make up the majority of Brian’s diet.
Weight/Cholesterol: Brian’s weight was reduced to 200 after 6 months, height 6’2, BMI =25.7.
Cholesterol: 205.
Triglycerides: Triglycerides: 105.
Supplements: Brian started taking a fiber supplement to help with his cholesterol. He also added fish oil, L-Carnitine, a multi-vitamin, B-complex, calcium/magnesium and glucosamine sulfate and manganese for his osteoarthritis.
Exercise: Once his arthritis improved, Brian was able to walk one to two miles every day and add in some light running. He also started a weight lifting program to continue to improve his knee and shoulder.
Stress Mgt. & Self-Care: Although it is hard to teach an old dog new tricks, Brian realized that his daily stresses did impact his health and outlook on life. Even though he wasn’t interested in taking up yoga or learning how to meditate, he was open to listening more to his body and making sure to spend quality time every day doing one or two activities he enjoyed.
