We’ve had some requests for an “Ask Dr. Miranda” feature, so here is the first question we’ve been sent:
Q — I’m trying to lose weight and my biggest issue is my stomach. How do I get it down? Any suggestions?
A – – First, you are not alone! Many people tend to accumulate weight below the belly button far easier than above, it is inherent to our general fat distribution and certain hormones. In fact, very often abdominal weight isn’t just fat under the skin, but rather includes the more dangerous visceral fat that you’ve read about, so it is important to address. For the record, any male with a waist circumference of 40+ inches, or a female with 35+ inches, is considered to have dangerous levels of abdominal fat. So given that, there are several proven ways to target abdominal fat: Let’s take a minute to look at the major ones.
1) Kick sugar to the curb! Sugar in ALL of its incarnations, including High Fructose Corn Syrup (HCFS) is probably your number one trigger for abdominal fat. Now, remember, to your body, a carb is a carb to a great extent. White bread, potatoes, pasta, sodas, etc. all get broken down into glucose, and what you don’t immediately use up for energy expenditures, you store – and your gut is the numero uno place the body starts to store fat! I am going to go out there on a limb and say that added sugar in general is a no-no! It is unhealthy, and has strong, negative effects on your metabolism. Now, sugar is composed of half glucose and half fructose, it can ONLY be broken down in the liver in any significant quantity. So, if you are exposing your system to sugar daily, your liver gets overworked. Your pancreas gets overworked. Your body has no choice but to start storing as much as it can as fat. Listen up fruit eaters – you don’t get off scot-free, fruit contains a large percentage of fructose, and large amounts of fructose were never meant to be eaten by us. Most wild fruits are small and were only eaten in small amounts seasonally. Our ancestors rarely got the opportunity to chow down on a giant bowl of fruit salad every day for breakfast. Fructose is also directed into fat storage! That is why I have specific guidelines on how much fruit you should eat for optimal fat burning AND specific times you should eat it. Large amounts of fructose also tend to make the gut leaky, and cause digestive imbalances with your good bacteria, which leads to GI discomfort and the development of allergies. Very often, the health benefits of fruit are not outweighed by their sugar content. You have to really educate yourself and look at the difference between whole fruit (and its beneficial fiber content) and fruit derivatives, concentrates, and parts. Keeping this in mind, the top way most people intake sugar, is by drinking it. Don’t drink your calories is one of our important Lifestyle List tips for that very reason. If you audit your daily sugar intake – most people fall short here. Your brain doesn’t recognize liquid caloric intake in the same way it recognized calories that were chewed, and sugar-sweetened drinks are associated with a 60% increased risk of obesity. So, a simple solution is to just avoid it as much as possible. Now, if you are sitting there at home telling me you don’t drink soda – this also applies to sweetened teas, sports drinks, coffee drinks, and fruit juice.
- Count grams of protein, not calories! Protein is the best fuel for your metabolism, and getting in enough high quality grams of protein per day is absolutely crucial for optimal fat burning. No, this doesn’t mean that you need to eat an 18oz porterhouse steak 3 times a day, but you need to be cognizant of how much protein you are consuming. For most people, 80-100g per day is a good range to shoot for. If you are over 60 lbs overweight, you should be in the 100-120 g per day range. If you’ve followed me for any length of time, you know that I’m a huge advocate of protein for breakfast. it is my belief that having a high protein, low carb breakfast is the most important thing you can do for your metabolism and insulin levels. Your first meal of the day literally sets the stage for how your metabolism responds for the rest of the day – so make good choices. So, lets say you are trying to keep the 80-100 g of protein in mind, divide this up into the number of meals you consume daily to get your average per meal. Most people eat 3 meals per day, so if you aim for a protein intake of 30g per meal, you fall exactly in the middle of the range! Furthermore, protein provides key amino acids that reduce cravings by upwards fo 60%, and boost the amount of calories you burn by 80 or more calories per day. Studies have shown a link between the quality and quantity of protein consumes and a reduction of abdominal fat. People consuming enough grams of protein typically decrease their caloric intake by over 400 calories total per day, and if you’ve already lost your weight, eating enough protein helps you from putting the pounds back on — so it’s a win-win food choice!
- Tell carbs to take a hike ! Carb reduction is one of the most studied and most consistently successful ways to lose weight. Now, no one is saying ALL carbs are bad, because carbs found in whole vegetables are just fine, but the starchy, sugary carbs head straight for your midline. There are literally dozens of studies that show that low-carb diets lead to 2-3 times more weight loss than low-fat diets. Low carb diets are difficult for some people however because they are addicted to carbs and the serotonin rush they get from eating their comfort foods, so you have to either make drastic cuts or gradual cuts based on what suits your personality best. Low carb diet specifically target abdominal fat, so if you need to lose belly weight – cutting carbs is crucial. Men should look at keeping carbs below 50 g per day, women should aim for 45 g per day, however this number will vary. Some women tell me they have done low carb but a review of their food journals show they are still getting in 60-80g of carbs per day, and the weight doesn’t start falling off until they hit 40g. YMMV, but the above guidelines are a good place to start! And please – keep your servings of carbs for lunch and dinner – we want breakfast to have as few carbs as possible.
- Poop. Is one meal coming out for every meal that goes in? We have become the constipated generation. I guess it wouldn’t take much to convince you that your friends and coworkers are full of it! Unfortunately it is true – most people consume a Standard American Diet (SAD) and it is SAD — it is nutritionally devoid of protein, nutrients, and fiber. It is a hot mess. The result is that they estimate that ~70% of the population deals with regularity issues. To be blunt – for every meal that goes in, one should come out. If you eat 3 meals a day, you should be having 3 bowel movements per day. If you are not, that is your sign that you need to clean up your diet, add more fiber and fiber rich veggies, add magnesium, and drink more water. Now, many of you are familiar with fiber associated with grains, and while that can be true, fiber is indigestible plant matter. So, if you are reading a box of flax seed toasts – and it says 18 g of carbs per serving, 11 g of fiber. You can subtract the g of fiber from the total amount of carbs to get your NET carbs. In this case – 18g – 11g = 7 NET g carbs! That makes that piece of flax toast a lot healthier looking, doesn’t it? Now, not only does fiber help fill you up and satisfy certain cravings, but it keeps you full and satisfied longer. It helps to hold water in your bowel, so your stools are not dry little bullets that need chemical laxatives (or dynamite) to dislodge. One study showed that adding an additional 14 g of fiber per day to the diet increased weight loss by 4.5 lbs over 4 months doing nothing else! The best sources of fiber include seeds, vegetables, legumes, oats, etc. There are also plenty of fiber supplements on the market that make it relatively easy to increase your fiber intake without adding additional calories.
- If you want to lose it, you’ve got to move it! It has been often repeated that you cannot out-exercise a bad diet, and that is true, however that doesn’t negate the importance being active is to your overall health. There is no such thing as spot fat reduction when it comes to exercise – that is entirely a myth, but — when you consistently exercise, you lose weight from everywhere you’ve stored it, and since bellies often have a greater percentage of stored fat, you should notice fat loss there first. Aerobic exercise has long been found to reduce abdominal fat. It is also good for increasing your basic metabolic rate, reducing inflammation , normalizing blood glucose levels, and increasing energy levels.
- Write it down or it didn’t happen! One of the top predictors of whether people will be successful in losing weight is whether they are consistent about documenting everything they consume. Food journalers are typically FAR more successful at achieving and maintaining their weight goals. Most people will tell you they eat a good diet, but an inspection of their food journal will reveal otherwise! Many people have no clue of what they are truly consuming in the course of a day. Most over-estimate or underestimate what they are eating. Now, I love a plain old paper food journal, but tracking apps like MyFitness Pal are a wonderful addition to your program. Log everything, no matter how insignificant you think it is. You don’t have to do it forever, but until you achieve your weight goals – it is a good idea, and it is a barometer of your success. Food journalers find it easier to stick to their diet. They find it easier to turn down snacks and impulse food consumption. It is an easy way to hold yourself accountable.
- You’ve got to consume (healthy) fats in order to lose fat! Yep – that low-fat diet you’ve been told to follow is bad for your waist line. Your body is a fat-burning machine. Certain nutrients are fat soluble, and other faty are essential to your health, so when you avoid adding healthy fats to your diet, you create a deficiency state that leads to your body going into conservation mode – where it tries to hoard fat instead of burning it. Hoarding is bad – don’t be a hoarder – sneak small amounts of healthy fats into your meals. Not only do they help you assimilate more nutrients out of your diet, but they increase satiety, and are crucial for your health. If you have IBD or you are missing your gallbladder and fat digestion is difficult for you – use an appropriate digestive aid to facilitate the process.
My Plateau Busting protocol is a work in progress, as we discover new information in the literature – we tweak things accordingly. By popular demand, I have enclosed the updated protocol here so people can refer to it, but please know that this protocol is the “Cliff Notes” version, and the full program will be outlined in detail in my upcoming book.
One of my most popular videos on Youtube is “What To Do When You Hit a Weight Loss Plateau”, and due to it, and the popularity of my Facebook group www.facebook.com/WeightLossResources, I hear from many women from around the country (and around the world) that are immensely frustrated with their inability to lose weight. Often these women are seemingly doing everything right – they are eating a decent diet, they are exercising, they are making a concerted effort to live healthier – unfortunately, their bodies are rebelling, and eschewing all of their efforts to shed the pounds. This is disheartening and demoralizing, and it creates a vicious cycle of trying the next new diet, failing, getting bigger, trying the next new diet, failing etc.
I want to make it clear – you are not a failure! There is so much erroneous and misinformation in the diet world – you can’t help but be confused. Furthermore, not every diet is a good match for every person. Some people are able to thrive on a vegetarian diet, others fail miserably as their quest to avoid meat brings a plethora of low quality processed foods into their diet. There is always a HUGE difference between how a diet looks on paper and how it is brought to live in a real world setting. So let me say this; weight loss is never linear. It always comes off in stair steps. Our goal is to minimize those stair treads and maximize the risers! I would love to equip you with simple, easy to implement tools which empower you to make lifestyle changes that result in a happier, healthier YOU!
First off, let’s throw the notion out the door that everyone needs to be a size 2. It isn’t reasonable, it isn’t healthy, it isn’t practical. Maybe you have always struggled with your weight, maybe the hormone changes from multiple pregnancies put you on your current course, maybe you have other underlying health challenges… when you set your goal weight, don’t pick one from a statistician’s magic graph, pick one that is reasonable and doable for you! Make the first step in setting yourself up for success!
So, I am going to outline the key steps in helping you blast through those plateaus in 7 simple steps:
- Protein for Breakfast! Our aim is to follow a ketogenic/”Death to Diabetes®”/ Paleo style breakfast. Your ideal breakfast will be a ‘bulletproof’ coffee (coffee containing a spoonful of melted grass-fed butter and/or coconut oil), at least 35 grams of high quality protein (eggs, meat, fish), and unlimited steamed vegetables (if so desired). Keep your carbohydrates, yogurts, smoothies, etc for later in the day.
- Snacking – If you must snack between meals – limit your snacks to protein, or 1-2 oz of healthy seeds or nuts. When you snack on fruit, dairy, or carbohydrates – you create a bigger spike in your blood glucose levels (and subsequently your insulin), which lends you towards eating more and being hungrier. It also stimulates you to release hormones which make weight loss more difficult.
- Inflammation – reducing your systemic load of inflammation is KEY to getting the pounds off permanently. You can do this by ensuring that you are getting at least 8 hours of uninterrupted sleep per night. Getting your carbohydrates from vegetables and fruits as opposed to pastas, breads, and sweets will also help. Supplements including fish oil, turmeric, boswellia, ginger, or proteolytic enzyme blends will go a long way to reduce your total inflammatory load. Intenzyme Forte from Biotics Research is one proteolytic enzyme blend that I frequently use with my patients and clients.
- Tea time – instead of loading up on sodas, make a concerted effort to drink tea ( hot or cold work equally well) – at least twice a day. Make a point however to mix up the types of tea that you drink so that you do not consume too much of any particular nutrient that may be found in certain teas (such as fluoride in green tea) . Black tea, white tea, green tea, roobios tea, dandelion tea, yarrow, rosehip, cornsilk, pu-ehr, matcha, and ginger all have known anti-inflammatory and diuretic properties. Lemon water or lime water will also work, and they have the added benefit of containing bioflavonoids – which also aid in the process. TruVision’s Heart & Hydration is another acceptable substitute for any of your daily cups of tea.
- Protein centered meals – While nutritionists vary on what they consider to be the ‘ideal’ daily intake of protein, I find it a good rule of thumb to use HALF OF YOUR IDEAL WEIGHT (LBS) IN GRAMS (PRO) , so if you currently weigh 225 lbs, but your goal weight is 150 lbs, you need to take 150 divided by 2 = 75. Therefore, you should strive to consume at least 75 grams of high quality protein per day. I tell my clients to quit worrying about counting calories, and count grams of protein instead!
- Probiotics before bed – more and more studies are demonstrating that gut bacteria play a definitive role in whether you carry extra pounds. Obese people and average weight people have very different ratios of gut bacteria. Take 1-2 capsules of a probiotic from my approved list before bedtime, and rotate brands so that you can introduce multiple strains into your gastrointestinal tract.
- Move IT or Lose IT – You don’t need to take up decathlons or bench press 300 pounds, but you need to move those joints. Chiropractors are always fond of the saying “move it or lose it”, and that plays true with your joints and your muscles. Get out and walk, and if you can’t walk – get a stationary bike. Most thrift stores have a ton of stationary bikes for just a few dollars! Your quadriceps are the largest lymphatic pump in your body, you need to start working those on a regular basis and you will flush away the metabolites from breaking down fat.
Want to kickstart the weight loss process?
8. The TruCombo’s (TruFix/TruWeight&Energy, both Gen 1 and Gen2) are one of my secret weight loss weapons. They both help reduce your appetite, make you feel full quicker, balance glucose fluctuations, reduce cravings, and increase your metabolism. The cornerstone of either combo is TruFix, and it is a body balancing supplement. An imbalanced body stores fat, a balanced body will release fat! TruVision can be an incredible tool in your arsenal to decrease those cravings that make it so hard for you to stick to a program. It is literally “willpower in a box!”
So now you know the basic steps, but you need to understand the science and rationale behind the recommendations:
Rationale 1 : The breakfast needs to be essentially carb-free. Do not ask me if you can have fruit, or yogurt, or cereal, or pancakes, or donuts, or oatmeal, or cheese, or anything else. We want ONLY protein so we are starting off the day by leveling glucose and insulin. Those other foods, even if they are ‘healthy’ choices, will spike your glucose and insulin, and then your TruFix has to work twice as hard to be effective. This is, in effect, a ketogenic or paleo-style breakfast. This type of meal “shifts the body’s metabolic engine from burning carbohydrates to burning fats”2 and improves insulin sensitivity and leptin resistance3. Consuming carbohydrates, even in healthy forms such as those from fruit (fructose) or dairy (lactose) causes surges in blood glucose levels which in turn initiate the release of insulin. People with excess weight have been shown to be insulin resistant4 and therefore if we by pass this, we set the stage for less severe glucose and insulin fluctuations throughout the day. In fact, in his book Death to Diabetes™, researcher DeWayne McCauley postulates that eating a paleo or ketogenic breakfast is the most important factor in modulating glucose levels throughout the day.5 If protein alone doesn’t fill you up, feel free to add 2 cups of any steamed green vegetable. You can season it with olive oil, vinegar, and Mrs. Dash seasoning.
Rationale 2 : Snacking should not stimulate the appetite, spike glucose levels, raise leptin levels, or be a major source of calories. Most people grossly underestimate how many calories are contained in their daily ‘snacks’ and instead of being 100-200 calorie tide-me-overs, snacks have become 700 calorie crappucino’s, milkshakes, yogurt-covered extravaganzas. If you stop drinking your calories, it is much easier to stick to your daily dietary recommendations.
Rationale 3 : Where do we start? There are so many! First, let’s take a look at how inflammation makes you fat : Inflammation begins within the fat cells themselves. Most people think of inflammation and assume that means joint pain, but inflammation is so much more. At its very core a fat cell is an inflamed cell. “As glucose is moved into fat cells, they produce an excess of Reactive Oxygen Species (ROS) which in turn initiates an inflammatory cascade within the cell”7. As the percentage of body fat increases, the rate of inflammation increases exponentially. This inflammation causes insulin resistance, and can be noted with C-Reactive Protein testing. The inflammatory cascade eventually makes its way to the brain, specifically the hypothalamus, where it causes leptin resistance.8 Leptin is your ‘hunger’ hormone and is noted for controlling your appetite and regulating your metabolism. The more fat you have the greater potential you have for leptin resistance, which affects your glucose regulation, and slows your metabolism which results in more weight gain and insulin resistance. It is a vicious cycle that keeps getting progressively worse. Inflammation within the gut itself, where 80% of immune function resides, further causes both leptin and insulin resistance. An imbalance in the gram-negative bacteria in the gut has been shown to produce an endotoxin called lipopolysaccharide (LPS) and a cytokine cascade which causes inflammation, insulin resistance, and weight gain.9 But I digress, we will get into how bacteria are related to obesity in the step 6. Obesity makes fat cells act like they are infected.10 The stimulation of fat cells by excess calories causes the cells to make Major Histocompatibility Complex II (MHCII), which in turn sends your immune system into over-drive, mimicking autoimmune dysfunction.11 This breakthrough in understanding the fat cell may prove to be crucial future weight loss and aging studies.
Intenzyme Forte™ is a proteolytic enzyme formula. When taken on an empty stomach, it can be absorbed intact into the bloodstream12 where it can be directed towards breaking down those inflammatory products in the body. Proteolytic enzymes have been demonstrated to reduce Tumor Necrosis Factor alpha (TNF-a), a cytokine protein that signals inflammatory responses along with other pro-inflammatory mediators such as Prostaglandin E2 and Thromboxanes.13 Autoimmune dysfunction is associated with increased levels of TNF-a.14
In addition to the overwhelming capacity of proteolytic enzymes to interrupt this fat-inflammation cycle, certain ones, including bromelain, have a secondary action of helping the body to utilize insulin more efficiently which in turn helps to keep blood glucose fluctuations less dramatic. 15
To summarize all of this technical jargon : fat cells are inflamed cells. Think of each fat cell like a little water balloon filled with fat. The fat creates chemicals which not only irritate the body, but stimulate the body to keep making more and more fat cells. This is very stressful on the body which finds the inflammatory chemicals hugely irritating, so the body tries to dilute those irritants by sending more water to the area (bloating and swelling) to flush those chemicals away. This not only sends the body down the pathway to blood sugar dysregulation and even diabetes, but can result in premature aging and even autoimmune-type degeneration. Once you have made a fat cell, you can never get rid of them (barring surgery like liposuction) but you can deflate those ‘balloons’ of fat, and turn off the inflammation production. That is what we are trying to achieve with this step.
Mid-morning and mid-afternoon take Intenzyme Forte™ . The protocol recommends 1-2 capsule(s) of Intenzyme Forte mid-morning, and 1-2 capsules mid-afternoon on an empty stomach. Empty stomach usually means 30 minutes+ prior to eating or a minimum of 90 minutes after eating. *This HAS to be taken on an empty stomach or IT WILL NOT WORK! Please note, if you have significant levels of inflammation, you can take additional capsules twice a day, but for simplicity and to curtail costs, I suggest starting with 1 capsule twice daily.
If you choose to use one of the other anti inflammatory supplements that are listed above, then change the dosing accordingly.
Rationale 4 : All of these teas have a known mild diuretic effect and by keeping them in rotation our body will not accommodate to it- thereby it maintains its effectiveness. As we already discussed, the body likes to flood inflamed tissues with excess water, so if we drink tea, it’s mild, natural diuretic properties help us flush those inflammatory by-products from the body, and that will support healthy weight loss. Please note: many of the teas listed, particularly the herbal teas are naturally caffeine-free. Should you choose to use green tea or black tea however, it is the caffeine portion of it which acts like a diuretic, so make sure to purchase regular versions and not decaffeinated ones.
Rationale 5 : Protein intake speeds metabolic rate. You need to be consuming enough high quality protein in order to trigger your body to release the fat that it has accumulated. Dieters that fail to consume enough protein will get muscle wasting – so it is in your best interest to make sure that you are consuming enough high quality, non-soy protein.
Rationale 6 : An increasing body of evidence suggests that obesity is directly linked to the bacteria in your gut. In fact the bacteria in thin people differs from the bacteria in overweight people. 16 Thin people and overweight people have entirely different strains and ratios of intestinal flora.17 Researchers at Laval University in Canada, found that female test subjects receiving probiotics lost twice as many pounds as those in the placebo group over the course of a twelve week period.18 Furthermore, probiotics may normalize intestinal pH, making it more difficult for candida albicans to thrive, and may crowd out pathogenic bacteria species.19 There are variations of professional opinion on the best way to consume probiotics, but heat and acid are enemies of bacteria, so if you can get the probiotics through the stomach acid as quickly as possible, then you have created optimal conditions for the greatest number of probiotics to survive. Hence the need to take them on an empty stomach. Taking them at night coincides with the greatest period of bowel rest for most individuals, which allows for longer periods of contact between the probiotics and the intestinal mucosa, which may improve the rate of colonization. When you take probiotics with food, they stay in the acidic stomach for much longer, which kills off a greater percentage of the bacteria. Again you want to take your probiotics on an empty stomach so it gets passed through your stomach acid quickly and so it can colonize in your large intestine while you have your longest period of bowel rest. If you take magnesium, this is an ideal time to take it too.
Rationale 7 : You can not out-exercise a bad diet, and similarly, a clean diet alone will not compensate for a deficit of physical activity. After blood, lymph is the largest fluid which circulates in the body and it is very important to maintaining overall health. Walking is the #1 exercise to encourage lymphatic flow, and moderate to fast paced walking is excellent aerobic activity. It is a lifestyle modification that is easy to implement and that provides both immediate and long-term benefits.
Rationale 8 : There are several. First, we want to regulate glucose and insulin spikes. Even as little of five extra pounds of body weight indicates some degree of insulin resistance. One, we are consuming the TruFix at or near the same time as protein. Protein takes longer to digest than carbohydrates and the stomach retains protein containing meals for longer periods of time before it is sent through to the small intestine. This enhances absorption of the TruFix ingredients. Two, for those drinking tea or drinking the TruHeart & Hydration drink mix, there is a well established neural-lingual connection between your taste buds and the brain. Primary gustatory fibers synapse centrally in the medulla, so upon consuming sweet substances, the sweet taste receptors in the mouth stimulates the release of dopamine in the brain. We can use this signaling to turn down the body’s desire for carbohydrate-rich or sweet substances; “…sweet taste is modified by circulating hormones. Recently, the effect of leptin on sweet-responding taste cells has generated much interest. Leptin, a protein hormone secreted mainly by adipocytes regulates body mass and suppresses insulin secretion by the activation of ATP-sensitive KCn . Its inhibitory effect on TRCs also involves the activation of a K+ conductance and membrane hyper polarization. Thereby the hormone partially blunts nerve signals indicating sweet taste, which, presumably, makes food less attractive.”6 If you hold the sweetened (stevia) tea or Heart & Hydration mix in the mouth for several seconds before swallowing it extends the contact time between the taste buds and the sweet taste – thus fooling the brain into believing that it has consumed a significant amount of carbohydrates, which results in a down regulation of your appetite and sweet cravings.
Other Helpful Pointers:
- Meals – Make healthy choices when you can. If you can eat lower amounts of carbohydrates, you should see results faster. Try to eat GOD made foods and avoid as many Man-made foods as possible. *Perfect meals are meat & veggies*
- If you drink alcohol, limit yourself to one (1) oz of hard liquor or 1 6(oz) glass of wine per day. If you drink more than this, it increases the difficulty you will have losing weight tremendously.
- Avoid artificial sweeteners
- Keep your fruits and yogurts as side dishes to your meals – like dessert.
- If you are having a smoothie – have it with lunch or dinner.
- If you already exercise, keep continuing what you are doing. Please don’t start a new program at the same time you initiate a new diet. You want to know what is working for you and what isn’t.
- If you are consuming the beverages as described, please make sure that you are drinking your water. These cups of tea do count towards your daily quota.
- Please do not skip meals.
Troubleshooting for SPECIAL CASES:
1) Autoimmune patients have difficulty losing weight. They usually have elevated levels of inflammation and hormonal imbalances – both of which impact fat burning. Before starting any diet program, it behooves you to see your physician and get a complete blood workup. C-Reactive protein and Thyroid panels are well worth getting. If you are symptomatic for any autoimmune condition, now is the perfect time to have your endocrinologist review and balance your medications. I will explore more options for autoimmune patients in future blog posts.
2) Gallbladder surgery can make weight loss incredibly difficult. I have two very popular blog posts on what post cholecystectomy patients need to do to lose weight. Supplementation is absolutely KEY to helping them balance the nutritional deficits caused by their surgery. I have very specific recommendations for anyone who has had their gallbladder removed.
3) Bariatric Surgery is a double edged sword – it can be a life saver, or it can leave people feeling more frustrated than ever. Bariatric patients all have altered digestion and at some point or another they all experience nutritional deficits. An optimal body is a balanced body, therefore, bariatric patients need to be much more diligent about their diet and they should strive to supplement their diet with liquid-based dietary supplements whenever possible to ensure optimal absorption.
4) Consider getting ELISA (blood test) to determine your allergies and sensitivities. Then you can take the guess work out of what substances are causing you inflammation and you will know exactly which ones to remove or limit from your diet. ALCAT or ALLETESS are two that I use in my office.
- Start by taking before pictures – take a face view and a full body view. Clothed is just fine because that is how the world sees you!
- Take your measurements, write them down and stick them aside.
- Write down your goals! This is important — remember the adage, “Write it down & make it happen”? People that write down their goals are significantly MORE likely to achieve them than those who just dream about them.
- Don’t let a bad day get you down. A momentary lapse doesn’t mean you have to abandon your diet and health goals. It isn’t about being PERFECT, it is about doing the BEST YOU CAN!
- When you weigh yourself, weigh yourself first thing in the morning after going to the bathroom. As a rule, I do not recommend weighing every day, but rather every week. It is completely normal for women’s weight to fluctuate by 1-4 pounds per day. What you eat, drink, and your physical activity all contribute towards this. it is not uncommon for some people, particularly those with autoimmune conditions like Rheumatoid Arthritis or Hypothyroidism to fluctuate by more than 5 pounds a day when they are particularly inflamed.
- Focus on how your clothes fit and how you feel – that is a better indicator of your momentum and success than a number on the scale.
- visit https://www.facebook.com/groups/Weightlossresources for help and support.
1. McCulley, DeWayne. Death to Diabetes. North Charleston: BookSurge LLC.© 2005
2. Ketogenic Diet Improves Insulin Sensitivity and Numerous Aging Markers. Retrieved April 26, 2014 from: http://articles.mercola.com/sites/articles/archive/2014/02/02/ketogenic-diet-health-benefits.aspx
4. Hyman, Mark. The Blood Sugar Solution. NY: Little, Brown and Company. ©2012
5. McCulley, DeWayne. Death to Diabetes.
6. Sweet taste signaling. Retrieved April 26, 2014: http://www.qiagen.com/products/genes%20and%20pathways/pathway%20details.aspx?pwid=425
7. How inflammation makes you fat and diabetic (and vice versa).
10. Obesity makes fat cells act like they are infected. Retrieved April 26, 2014: http://www.sciencedaily.com/releases/2013/03/130305145145.
12. Proteolytic enzymes among top 10 ways to help decrease inflammation. Retrieved April 26, 2014: http://www.enzymesinc.com/index.php?id=
13. Quell the fire of Inflammation the immense power of proteolytic enzyme therapy. Retrieved April 26, 2014: http://metabolichealing.com/quell-the-fire-of-inflammation-the-immense-power-of-proteolytic-enzyme-therapy/
15. Bromelain. Retrieved April 26, 2014 : http://www.webmd.com/vitamins-supplements/ingredientmono-1089-BROMELAIN.aspx?activeIngredientId=1089&activeIngredientName=BROMELAIN
16. The Microbes in Your Gut May be Making You Fat. Retrieved April 29, 2014: http://www.livescience.com/41954-gut-microbes-make-you-fat.html
18. Certain probiotics could help women lose weight, study finds. Retrieved April 30, 2014:
19. Why Use Probiotics For Candida? Retrieved Apriil 30, 2014: http://www.thecandidadiet.com/probiotics.htm
*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease. Disclaimer: Consult your physician before beginning any diet or exercise program. Dr. Miranda’s protocol is offered as generalized information and should not be construed as medical advice.
Copyright (c) 2014, 2015 Miranda Jorgenson. All rights reserved. This material may not be published, broadcast, rewritten or redistributed in whole or part without the express written permission of the author
It has been a long time since I have done a product specific post, but I am so excited about the release of this product next week, that I just had to tell you about it…
TruElevate – The latest creation from TruVision Health, TruElevate is a synergistic blend of ingredients known to promote healthy weight loss. In fact, TruElevate was designed to help individuals with resistant fat break through their weight loss plateaus. Furthermore, it comes in two unique versions – a delicious chocolate smoothie, or as easy-to-swallow capsules. So how does it work? In a nutshell, TruElevate acts to decrease appetite, balance glucose and insulin levels, burn fat (with an emphasis on stubborn abdominal fat), and provide you with gentle, sustained energy so that you can get out and enjoy life more! While it aids in fat loss, it doesn’t do so at the cost of losing muscle. It helps you to maintain your muscle mass and feel good while doing it. It contains several ingredients that have balancing or reparative properties to ensure you have ‘healthy’ weight loss. If you’ve been stuck in a rut – then give TruElevate a try!
Here is how each ingredient works:
Ribose – Is a pentose monosaccharide (simple sugar) which forms the backbone of RNA and plays roles in metabolism and energy (ATP) production. Early research indicates that taking ribose supplements orally may improve energy, sleep, the sense of well-being. Studies also show that it supports healthy heart function, a reduction in fatigue, restless leg syndrome, and may lessen symptoms associated with fibromyalgia . Ribose may lower blood sugar levels, so people taking insulin or other diabetic medications should monitor their blood sugar and consult with their physician.1
Inulin – A polysaccharide and functional fiber which acts as a prebiotic. Prebiotics are substances which support the growth of healthy intestinal flora and probiotics (good bacteria) in the gut. In dietary supplements, inulin is most commonly derived from the chicory plant. Studies have demonstrated that inulin is beneficial in supporting healthy blood lipid levels, including cholesterol and triglyceride levels. It promotes bowel regularity, weight loss, and can also be used as a food additive to improve taste.2
Caffeine – is a natural CNS stimulant which is found in tea, coffee, chocolate, colas, and many other products. It is commonly used to reduce fatigue and increase mental alertness. Used in moderation, caffeine can enhance the action of other medications and supplements, and is widely recognized as being safe when used as directed.3
Yerba Mate – a tea derived from the evergreen bush ilex paraguariensis, and has been used for centuries to provide energy and improve concentration. It has been demonstrated to promote normal blood levels of glucose and cholesterol. Studies also indicate it may be beneficial for urinary tract health, colon health, bone density, healthy mood, and weight loss. Consumers of Yerba mate report that it provides them with the energy and alertness of caffeine without any ‘jitters’ or sleep disturbances.4,5
N-Acetyl Tyrosine – An amino acid that may be difficult for the body to make in optimal concentrations. It is used as a building block to make new proteins and cells, and to aid the recovery and repair of muscles and other systems. One of its key roles is that it aids in the synthesis of dopamine – one of our main neurotransmitters. Dopamine is directly correlated to your emotional responses, behavioral responses, and addictions. Dopamine levels are also associated with norepinephrine – a neurotransmitte related to adrenalin. Maintaining healthy dopamine levels results in stress alleviation, enhanced mood, and improved energy and concentration.6
Taurine – A sulphur-bearing amino acid that is a required building block for proteins. Certain tissues of the body have higher concentrations and requirements including the heart, brain, muscles, and blood cells. It has been used to support healthy cardiovascular function, blood pressure, blood lipid profiles, and as an agent of repair for those with oxidative damage from diabetes and alcoholism.7,8 It also helps the body respond to mental and physical forms of stress.
Phenylethylamine – is a natural chemical found in the body which boosts mood, mental drive, concentration, productivity, and aids in fat burning. It is also one of the components in chocolate that makes it so appealing.9
Green Tea – Used for centuries a daily tonic and all-purpose beverage, green tea is an extract form the Camellia sinensis plant. Studies have demonstrated that green tea extracts have thermogenic properties, and can reduce body mass index (BMI) and obesity levels (particularly abdominal fat).10,11
Evodiamine – An Asian plant extract that has been demonstrated in laboratory studies to reduce both fat uptake, act as a thermogenic, and stimulate metabolism.12,13
Trimethylglycine – An organic compound found in many plants, but commonly isolated from beets. Trimethylglycine is required for methylation, and for the synthesis of neurotransmitters. It also plays a key role in energy production, and is beneficial for optimal digestion, liver health, and certain detoxification pathways.14,15
Theacrine – is a natural plant extract which structurally resembles caffeine but appears to have fewer side effects, making it known as an acceptable alternative to caffeine. It is noted to increase energy levels, and has stimulatory effects. It may boost physical activity, motivation, concentration, and levels of alertness. Anecdotal reports suggest it may be useful in reducing fatigue, and have anti-aging and immune boosting properties.16,17
Glucomannan – Often found in the cell walls of certain plants, Glucomannan is a polysaccharide/dietary fiber. It has been used as a food additive to emulsify fats and act as a thickening agent. As a dietary supplement, it can decrease appetite and it slows the absorption of sugars and fats in the gut; which can help to balance glucose levels, and result in weight loss. As the fiber passes through the intestinal tract, it absorbs water, which also helps glucomannan improve bowel health and regularity. 18,19
Huperzine – purified extract from Chinese Club Moss. It is associates with improved memory, mental focus and clarity, muscle function, energy use, and sleep.20
DHEA – Is a hormone (dehydroepiandrosterone) naturally produced in the body, however both stress and age decrease its production and many people turn to dietary supplementation to maintain optimal levels. DHEA has been associated with enhancing immune function, energy production, normalizing hormones, building and maintaining muscle, bone health, and balanced mood. It is believed to have anti-aging benefits and plays a role in weight loss; particularly in the reduction of abdominal fat and insulin sensitivity. Lower levels of DHEA are found in people with chronic health conditions, including diabetics, and those with cardiovascular dysfunction, inflammatory disorders, immune disorders, and with those taking certain medications – including corticosteroids and hormonal birth control.21,22,23
Xylitol – a natural sugar alcohol commonly extracted from birch trees for the dietary supplement market. It is used in lieu of sugar in “sugar-free” products, and is believed to prevent dental cavities and ear infections when taken orally. It is considered a ‘diabetic friendly’ sweetener.24
Available soon: You will be able to get TruElevate as part of our convenient Combo-Packs
**A note on resources – while I had the option to use any of a variety of available sources for the information contained above, I chose to stick to popular and widely accepted sites such as WebMD and the MayoClinic. Whenever possible, I did not use sites associated with the manufacture or sale of dietary supplements so there would be no accusations of ulterior motivation. These resources are not all encompassing, but are user friendly, and I encourage you to be your own informed consumer and do your own fact checking.
©2015, Miranda Jorgenson. May not be used in whole or in part without the expressed written permission of the author.
These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.
In post #2 of Hidden Reasons You Can’t Lose Weight series, I am going to explore protein: one of the most common nutritional deficiencies I see among dieters.
Full disclosure: I am a dedicated omnivore. My first course of study was anthropology. For that reason, I tend to look at things from both an anthropological and a physiological perspective. All of that firmly points me to the assertion that we are protein driven creatures – that is why we have the brains we currently have. That is why we have mixed dentition, and our current collection of digestive acids and enzymes. That is why we have one stomach and 23 feet of small intestine and 6 feet of large intestine. If you are a dedicated vegetarian, you are not going to like what I have to say. I don’t have the inclination or the time to argue with you, so just take this as a forewarning that you might want to skip this post! We will have to agree to disagree.
When you think of protein, you might think of juicy steaks and succulent chicken thighs. You probably don’t really give it much thought. You certainly don’t think it is something that you could be deficient in. If you are a habitual dieter, or if you have unsuccessfully been trying to lose weight, you may be completely wrong. One of the key deficiencies that I identify when I am doing my ‘Plateau Buster’ consultations, is an overwhelming need for increased protein intake.
Protein is an essential macronutrient. It is comprised of varying combinations of amino acids and those amino acids make up every tissue and substance in our body. They truly are the building blocks of life. There are two key types of protein: complete, and incomplete. Complete proteins contain the full complement of essential amino acids and they are associated with animal sources. Incomplete proteins, contain a partial array of essential amino acids and are typically associated with plant sources. You need to have ALL of the essential amino acids for optimal health, and that means consuming adequate supplies of complete protein. When you consume foods, whether plant or animal in origin, your body breaks those foods down into those amino acid building blocks. Now, it can’t store amino acids for a rainy day — it is a ‘use it’ or ‘lose it’ system. Complete proteins must be consumed on a very regular basis to fulfill your body’s daily requirements. If you do not intake enough protein, your body pays the price!
So, could you be protein deficient?
If you are a current or former dieter, if you don’t eat high quality meat sources 4+ times a week, if you are a vegetarian, if you are over 55 year old, if you have had recent surgeries, or if you tend to consume a considerable amount of processed foods – chances are good that you are protein deficient. If you have been dieting and your weight has hit a plateau – then it is most definitely one of the factors that you need to consider.
SIGNS OF PROTEIN DEFICIENCY
|· craving sweets and carbohydrates
||· fatigue, especially after activity
|· joint pain, muscle pain
||· get sick frequently
|· feeling hungry soon after you eat
||· slow wound healing
|· brain fogginess
||· various scents make you nauseous
|· hair shedding
|· fragile hair: breakage, split ends
||· depression/ anxiety
|· ridges on fingernails and/or toenails
||· tendency towards constipation
|· dry skin or frequent rashes, flaky patches
||· poor muscle tone
||· sleep issues
Let’s have a look at some of the larger signs and symptoms:
1) Chronic muscle and/or joint pain. As a chiropractor, we see this musculoskeletal sign frequently. This is partly to blame on the Standard American Diet (SAD) which is heavy in junk. We can also see a huge shift in our diet since World War II. Prior to that, most parts of an animal were utilized. We ate organ meat on a regular basis. We made soups with the bones and joints of the animal carcass – and this rich bone broth supplied us with an incredibly supply of protein, gelatin, glycine, proline, and amino acids that supplied our own muscles and joints with premium building blocks so they could maintain optimal function. Families used to cook more meat on the bone, and people would fight over who got the gristle! Now, our diets are ‘sanitized’. Our kids have not grown up helping us prepare anything. To them, meat consists of hotdogs and hamburgers (often the worst cuts of meat on the animal). Our soups are completely processed and come in convenient red and white striped cans. We find eating with our fingers distasteful, so if you can’t eat it with a knife and fork – we don’t bother. Many of us don’t consume any meat that is not processed or prepackaged, and then we wonder why we hurt all of the time. We hurt because we are putting hollow building bricks into our bodies. You can’t build your temple with wet cardboard! I would also like to add that your daily protein requirements increase significantly after surgery or during periods of elevated stress, so if either of those things affect you — adjust your diet accordingly. Also, as we pass 40 years of age, our ability to produce stomach acid and digestive enzymes decrease (it declines much faster after age 55), so your ability to assimilate protein decreases as the years tick by.
2) Constant Cravings. Not all cravings are caused by protein deficiency, but many are. If you have a tendency to crave sweets and carbohydrates, then you could very well be protein deficient. If you feel hungry frequently, or if you feel hungry shortly after you eat ( see Satiety Index), then you are probably not getting in enough protein. Instabilities in blood sugar lead the body to want to correct itself, this means that one of the first things the body does in response to blood sugar instability or fluctuations is to cause you to crave sweets or carbohydrates (for you bread lovers). This is a stop-gap or a band-aid approach, but your body senses an issue and aims to correct it with as little effort as possible. If you have a secret stash of candy, if you are someone that has to snack between meals, if you are vegetarian (or just don’t eat much meat), and if you get absolutely ravenous if you skip a meal — you have strong indications that you don’t consume enough high quality complete protein.
3) Your hair, skin, or nails are a wreck. This is a trickier sign, because you might do a bunch of things to abuse your hair, skin, or nails – like flat iron your hair three times a day, or slather yourself in the latest & greatest skin acid lotion in the hopes of warding off wrinkles. As a general rule though, if you find yourself shedding hair often or if your hair grows slowly, or is fragile – it breaks or splits easily, then that is a clear indication that you need more protein. Similarly, if your skin is thin or dry, if you get frequent skin irritations or blemishes, and if you take a long time to heal – then you certainly need more protein. You will notice that people with protein-poor diets tend to get premature aging, their skin thins in places, and they get lines and creases on their face before they probably should. Their nails are thin, or they contain ridges, and they tend to peel or break. Again — all of these things are signs that your body has run out of building blocks. Think of it this way: when you don’t consume enough of the complete protein your body needs, it has to break down YOU to get the necessary building blocks to support life. It doesn’t target your love handles, it goes after your muscles, your energy reserves, you hair, skin, and immune system.
4) The inability to lose weight. Is protein deficiency the main reason why people stop losing weight? No, but it is in the top 10, and it is one of the most common nutritional deficiencies I see among dieters. As part of what I do when I put on my “Plateau Buster’ hat when I work with someone to figure out why they are having such a hard time losing weight — I have them complete a multiple-day food journal. More times than not, I see people starting off the day with fruit and dairy products, they might have a sandwich at lunch, and maybe a burger or nachos for supper. They usually snack on more fruit or granola bars. They are eating meal after meal that spikes their blood glucose and they are not getting in near enough protein! This results in maintaining elevated insulin, and leads to insulin resistance — which we know is associated with weight gain. In fact, some healthcare practitioners believe that as few as 5 extra pounds is a sign of insulin resistance. There are several different ways to calculate protein need, but for otherwise healthy individuals looking to lose weight, I use the formula :
IDEAL WEIGHT divided by 2 = # of grams of protein you should consume daily
So, if you currently weight 200 lbs, but your ideal weight is 160, you take the 160, divide that by two to get 80, and use that as your guideline for protein intake. I have seen many people move out of their weight loss plateau simply by adding 20 more grams of protein to their daily intake. Sometimes it is the simple fixes that work the best! Following this, I am a HUGE advocate of starting your day off with protein. I have other blog posts which go into considerable on the science behind WHY I find this necessary, but suffice to say – I believe that a protein rich breakfast starts you out on the best footing to have the protein requirements you have to initiate fat loss, it minimizes the cravings that can sabotage your diet, and it helps you to maintain steady blood glucose levels that are necessary for burning fat.
You can consider your body as being lazy, or as a highly tuned machine: either way, it attempts to maintain a steady state – or equilibrium, at all times. It wants to get the most work done for the least amount of effort, and it likes to prepare for those inevitable rainy days. If your body is in a deficiency state, it goes into self-preservation mode, or ‘conservation mode’. It realizes it doesn’t have everything it needs and so it saves itself for later. This is why it is so darn hard to lose weight sometimes. This is why you can be eating like a bird but the scale refuses to budge.
So, how do you correct protein deficiency? Quite simply, you need to consume more protein. Let me correct that, more high quality complete protein! Beans, legume, lentils, etc are fine for some of your protein needs, but they are incomplete, and they contain fiber – which binds to the protein, making it less available to you. You should be adding fresh, high quality meat to your diet, at the least – every other day. Organ meats and bone broths are one of the best things you can do for your health. A study published in the British Journal of Nutrition found that soup eaters tended to weigh less and have smaller waists than non-soup eaters1. Compared to muscle meat, organ meat is much more densely packed in just about every nutrient, especially B12, B6, B1, B1, folic acid, and the fat soluble vitamins A, D, E, and K. Grass-fed animals provide an even better source of these nutrients over their commercially raised counterparts. Now I am not suggesting that you need to eat an 18-oz porterhouse steak every day, but it behooves you to keep a food journal and use one of the popular fitness apps to track your dietary intake. You may be shocked to see what you actually consume. I will add a caveat here – many of the fitness apps I have seen grossly underestimate the amount of calories you consume, so please don’t go by that alone. This is partly due to user input errors; people guestimate their portion size to the lesser degree, and completely omit certain food items, like the cheese on their sandwich, or the three packets of mayo they used. I advise my clients that aim to lose weight that they need to consume at least 20 g of protein with every meal. Eggs, fish, nuts, aged cheese, etc. are all great sources of protein as well.
The cornerstone of my Plateau Buster program is achieving balance, because when your body is out of balance – health issues result. Where weight loss is concerned, there are several key factors I look at:
What does the diet look like?
How much physical activity is occurring? (you can’t out exercise a bad diet)
Does the person have a gallbladder or not?
Is there evidence of thyroid dysfunction?
Is there evidence of adrenal dysfunction?
How is their digestive system working?
Is there evidence of gross nutritional deficiencies?
Are they on medications know to inhibit weight loss?
Do they have other health conditions associated with weight gain?
What diets have worked well for them in the past, and which ones haven’t?
What emotional factors are weighting them down?
In essence, there can be so many different factors that cause excess weight, and you are not restricted to only having one issue on the list. Many of these things, including protein deficiency, are things you can trouble shoot yourself. If you are sitting there reading this, thinking, “meat irritates my stomach” – then you need to read my blog post on gallbladder dysfunction, and look into digestive enzymes. For more information, please join my community on facebook – Weight Loss Resources with Dr. Miranda.
Did you know that calcium absorption is a major issue for bariatric patients? Approximately 85% of all calcium supplements sold in the United States contain calcium carbonate (also known as limestone, or chalk) – and this form of calcium is rarely recommended for bariatric patients because of several key features: 1) it acts as a functional antacid, 2) it requires a highly acid environment to be absorbed, and 3) as a direct result of surgical alteration of stomach size – most people will no longer have the physical capability to absorb any of the elemental calcium from it.
The two forms of calcium that bariatric patients hear bantered about most frequently are CALCIUM CITRATE and CALCIUM LACTATE. Both of these are excellent sources of calcium, however, one has a distinct advantage over the other. If we are speaking about the best form of tableted calcium for people who have not had surgical alteration of their GI tract – then I would agree that calcium citrate pills are ideal. However, when you take into account how bariatric surgery affects the stomach and/or small intestine, and knowing that a large percentage of bypass surgeries involve bypassing at least part of the duodenum (which is where calcium is normally absorbed) – then calcium lactate becomes the winner.
Furthermore, calcium is a bulky mineral. You have to take a lot of it to be able to absorb the percentage you actually need. That is why calcium tablets are usually fairly big. Knowing this, vitamin manufacturers have two choices when they configure their supplements – they can either divide the dose into multiple tablets or capsules, or they can compress it into one or two giant ‘horse’ pills and compress them to the point that they are veritable cement bullets. This leaves bariatric patients in a catch-22, — they usually do not want to feel full and bloated from taking a lot of pills, but they also know if they take one of the highly compressed tablets, that they will likely absorb very little from it.
The solution is to take powdered calcium, and the ideal form of powdered calcium is calcium lactate. Calcium lactate is considered to be one of the most neutral forms of calcium. It is not chalky or soapy like calcium carbonate, and it lacks the bitterness of calcium citrate. If you need a calcium that is readily absorbed, and has a high solubility factor, which means that you can easily mix it into any beverage you so choose — then calcium lactate is the one to choose. It is significantly more soluble over other forms so you can fit a larger dose in a smaller serving size. Naturally gentle on the stomach, powdered calcium lactate provides the most available surface area for absorption once it passes into the small intestine.
That isn’t to say that you can’t get calcium citrate in powdered form. There are a few commercial preparations that use it, but powdered citrate does not mix readily into beverages. If you put a spoonful of it into a glass of water, you would have to stir and guzzle the contents very quickly or you would lose a significant amount as it would settle to the bottom of the glass or stick to the sides. Having to chug a big glass of bitter, gritty calcium, 2-3 times a day may not be appealing to many people.
That said, it is my belief that most Americans do not have a calcium issue. Per capita, American’s has one of the highest calcium consumption rates in the world yet they have one of the highest rates of osteoporosis. This tells me that we don’t have a calcium issue, but a magnesium and co-factor issue. We know that 80% of women are magnesium deficient. If you are going to supplement with calcium, please speak to your physician about adding a magnesium supplement to your regimen. Vitamin C enhances the absorption of both calcium and magnesium, so they are good nutrients to pair together. My office carries a supplement which contains a balanced ratio of calcium, magnesium, and vitamin C. Please contact us for details.
If you’ve never had gallstones, you’ve probably never thought about your gallbladder. However, if you have had gallstones, chances are good that you have had your gallbladder removed. Either situation has its own inherent issues, and one thing that healthcare providers rarely tell gallbladder patients is that surgery will forever impair their digestion and may make losing weight very, very difficult.
The gallbladder is a small, pear-shaped organ under your liver that concentrates and stores the bile that your liver produces to aid fat digestion. Most people don’t give it a second thought until it starts to trouble them, and unfortunately, for many years, the medical establishment didn’t realize the full importance of healthy gallbladder function. They felt its removal had few, if any consequences. I am of the opinion that we were not designed with unnecessary parts, and the gallbladder is no exception. In fact, science is just beginning to understand the true importance of healthy gallbladder function and the detrimental consequences of its dysfunction or removal.
Each day, your liver produces ~27-34 ounces of greenish-brownish-yellow bile, which is concentrated anywhere from 5-18 times, and then 1-3 oz is stored in the gallbladder awaiting your next meal. When you consume foods containing dietary fats, your gallbladder is triggered to release this concentrated bile into the first part of the small intestine, the duodenum, where it acts as an emulsifier to break down those fats and aids in the absorption of the fat soluble vitamins, A,D,E, & K, and any essential fatty acids. If you have ever vomited until a bitter, yellow substance came up — that was bile, and while you may not have thought so at the time – bile itself is an amazing substance. Comprised of bile acids, bile salts, cholesterol, phospholipids, pigments, water, electrolytes, and amino acids, bile is a bitter, acidic substance that breaks down fats into components that the body can use. Healthy fat absorption is crucial to our health. In fact, we were designed to eat fats rich in healthy fats. Our brains, our hormones, and even our very cell walls are dependent on a steady and healthy supply of fat soluble vitamins and essential fatty acids.1 Vitamin A is an important antioxidant that plays a crucial role in cell division, cell differentiation, reproduction, immune function, growth, and vision. Vitamin D is a prohormone which not only regulates calcium metabolism, but is essential for the functioning of the nervous system, for bone health, for muscle strength, for immune function, regulating blood pressure, hormone production and for cell differentiation. Vitamin E is a blanket term for eight different nutrients (4 types of tocopherols and 4 types of tocotrienols) that have string antioxidant properties and also play a role in immune function, healing, repair, and cardiovascular functioning. Vitamin K is a nutrient that scientists are just starting to devote research time to. It is known to play a key role in bone health, blood clotting, and heart disease, but studies are showing that it may have many more far-reaching effects. Essential fatty acids (EFA’s), such as omega-3 fatty acids, are ESSENTIAL to human functioning. Long recognized for its powerful anti-inflammatory benefits, EFA’s are required to make the cell walls of every cell in your body and they play a key role in immune functioning, musculoskeletal health, cognitive function, and heart disease. Considering the overwhelming importance of fatty acids and fat soluble nutrients to general health, it makes no sense to willingly cut out gallbladders with no plan of action to compensate for the deficit caused by its dysfunction or removal. Whether you have a gallbladder that isn’t doing its job or you have already lost yours – there is a solution.
So, how does all of this apply to lack of weight loss — or worse, weight gain?
In simplistic terms, the body is a finely tuned organism. We need 17 nutrients in specific quantities just to make adequate levels of stomach acid and other digestive substances. When gallbladders dysfunction, two things can happen: First, the bile gets too thick and stagnant, which creates an ideal situation for gallstone formation. Second, when gallstones impair or block the emptying of the gallbladder, fat digestion decreases dramatically, which in turn, puts your body into starvation mode. The body requires the absorption of those fat soluble vitamins and essential fatty acids, but it recognizes it is in a chronically deficient state – so it hangs on to the fat it has (which unfortunately may be that stomach pooch) for dear life. You in turn want to lose that stored fat, and may erroneously take on a low-fat diet at the advice of your healthcare provider, which only makes the matter worse.
Causes/Risk of Gallbladder Dysfunction
- hypochlorhydria (low stomach acid)
- low fat diets
- high fat diets
- food allergies and sensitivities
- gluten intolerance
- being overweight
- dieting, rapid weight loss
- sedentary lifestyle
- birth control pills or hormone replacement therapy
- use of antacids and Proton Pump Inhibitors (PPIs)
- 40+ years of age
- females are at greater risk in the United States (in other countries, males can be at higher risk – it is thought that alcohol consumption plays a causative factor there). Women that have birthed children also have a greater risk of developing gallbladder dysfunction
- alcohol use (the more you drink, the greater your risk)
- bariatric surgery
- ethnicity (more prevalent in Native American populations and Hispanics)
- family history of gallbladder issues
- extreme diets which eliminate any key food group
- elevated cholesterol, especially high triglycerides or LDL
- consumption of statin medication or immunosuppressive medication
- medical conditions including hypothyroidism, diabetes, insulin resistance, inflammatory bowel disease, PCOS, hemolytic anemia, etc.
- western diets, diets high in refined carbohydrates and sugars
That’s a long list of risk factors – it’s a miracle that anyone has a normal functioning gallbladder given our Standard American Diet (SAD) and reliance on fried and processed foods. In fact, gallbladder dysfunction is so common that clinicians refer to it as the 4-F syndrome: Female, Fat, Forty+, Flatulent. However, most people with gallbladder dysfunction are asymptomatic. Studies estimate that anywhere from 67-80% of people with gallstones have no symptoms. That said, many people discount gallbladder symptoms as being related to poor digestion or other factors. Everyone with gallstones started off with thick or stagnant bile. You have to have one to lead to the other. The pattern of symptoms associated with gallbladder dysfunction is so varied that many people without digestive pain may not associate their muscle pain, dry skin, poor wound healing, dry (or shedding) hair, headaches, heel calluses, or inability to lose weight despite doing everything right with a gallbladder that is not operating at par.
Symptoms of gallbladder dysfunction: Most commonly: pain or discomfort after eating. This can include gas, bloating, belching, heartburn, nausea, queasiness abdominal discomfort, extreme fatigue, pain under the ribs, particularly on the right side, or shoulder pain. Additional symptoms include headaches over the right eye, constipation or diarrhea, light colored or ‘floating’ stools, dark urine, offensive body odor or breath. People with gallbladder dysfunction tend to have bowel extremes — they experience diarrhea (up to 10 bowel movements per day) or constipation (often having days between bowel movements) and rarely have normal bathroom habits.
Have you had your gallbladder removed? You are not alone. Over half a million gallbladders are removed every year in the US. It is one of the most commonly performed surgical procedures. Symptoms of postcholecystectomy syndrome (PCS): gas, bloating, belching, heartburn, nausea, queasiness abdominal discomfort, extreme fatigue, pain under the ribs, particularly on the right side, or shoulder pain. The need to run to the bathroom immediately after eating is fairly common. Additional symptoms include headaches over the right eye, constipation or diarrhea. Notice the symptoms are almost exactly the same for people with NO gallbladder as for those with a dysfunctional one? Researchers estimate that at least 40% of people who have had gallbladder removal continue to experience significant abdominal pain.2 It is estimated that 5-40% of people who have had a cholecystectomy experience long term symptoms from it . 3 One British study looking at the after-effects of gallbladder surgery found that 87% of men and 68% of women experienced weight gain after cholecystectomy and urged physicians to caution patients about this ‘side-effect.4 I can easily say that in my 12 years of practice, I have NEVER had a gallbladder patient tell me that they were informed of the likelihood of weight gain prior to their surgery!
Where Weight Gain & Weight Loss Issues Come into Play
Having a dysfunctioning gallbladder or having no gallbladder are both associated not only with difficulty losing weight, but with weight gain. Anecdotal reports are abound of women having few issues maintaining their healthy weight until they had gallbladder removal surgery. On a functional level, we know that nutritional deficiencies are associated with difficulty losing weight, and by drastically impairing fat digestion through having stagnant bile or by surgical removal of the gallbladder – we create the foundation for broad-spectrum health disorders. Our bodies are designed to maintain an equilibrium, or steady state. It craves balance. So when we have gross nutritional deficiencies, our bodies inherently want to hang on to its stores of fat and nutrients. It doesn’t want to exacerbate its deficient status by losing more of anything – and that includes your love handles.
So, what can you do about it?
1) First and foremost, you need to concentrate on eliminating the nutritional deficiencies. This is imperative if you want to get your body out of starvation mode. I suggest that you take a high-quality, highly absorbable multivitamin. Look for a high potency multivitamin that contains more than the 100% RDA amounts. Those amounts were designed to keep a person out of gross deficiency status, they are not amounts your body needs for optimal functioning.
2) The second thing I recommend is supplementing with pancrealipase and organic beet extract. I carry two different formulas – one for people with gallbladders who need to thin their bile so their digestion works better and another for people who no longer have a gallbladder and who need to add ox bile extract in addition to the pancrealipase and organic beet extract so they can start breaking down those dietary fats , get themselves out of a deficient status, and start losing weight. Either formula can be ordered directly from me (message me through facebook), or through the manufacturer. These supplements are only sold through licensed healthcare providers, and I am prohibited from publishing prices publicly, but if you visit my facebook group https://www.facebook.com/groups/weightlossresources/ and check the FILES section. I have included complete ordering information along with a discount code for my clients.
3) Limit your intake of refined carbohydrates. Not only are these typically ’empty’ calories, but they rob you of minerals like magnesium and chromium, and your b-vitamins. They also induce insulin spikes which further stress your liver and gallbladder.
4) Increase your magnesium intake. Whether you take oral magnesium preparations, or you use epsom salt baths – magnesium has been shown to prevent gallstone formation. It is also required for making appropriate levels of stomach acid.
5) Increase your intake of taurine-rich foods. Taurine is one of the major amino acids found in bile. Healthy digestion depends on getting adequate supplies of taurine. Meat, eggs, seafood, certain dairy products, and brewers years are all good sources of dietary taurine.
6) Eat healthy fats! Your body needs fat in order to lose fat. If fat digestion troubles you, start slowly with small amounts of unrefined organic coconut oil and slowly add other healthy oils into your diet. Let your body accommodate to them. Healthy fats include grass-fed butter (which is a source of vitamins A,D,E,K, as well as selenium, and CLA), ghee, lard, egg yolks, organ meat, palm oil, olive oil, most nut oils, etc. Bad fats include corn oil, soy oil, canola oil, sunflower oil, safflower oil, cottonseed oil, margarine, and anything listed as ‘hydrogenated’. These refined oils are a source of omega-6 fatty acids which not only contribute to obesity but cause inflammation within the body, and that includes liver and gallbladder inflammation.
In short, having gallbladder problems or no gallbladder whatsoever need not cause you issues. There are simple solutions that allow your body to work the way it was intended to. You can get the weight off and avoid the bizarre food cravings that come along with those nutrient deficiencies. You can feel normal after meals. You can have normal bowel movements, and you can get rid of the fatigue that overwhelms you. If you combine healthy food choices along with the simple supplements I suggest, you will see results. If you are able to combine the two with lifestyle improvements you will see results that much faster. I sincerely wish that more medical providers educated their patients on the detriments of gallbladder surgery before they submitted to it, so they could take preemptive action, however, in the words of Mick Jagger, “you can’t always get what you want, but if you try sometime, you just might end up with what you need”. So, in closing, I hope this information is what you need. Please visit me on facebook at Weight Loss Resources with Dr. Miranda. If abdominal pain persists, you may have a problem caused by something other than the gallbladder. Other possible causes of abdominal pain include irritable bowel syndrome, inflammatory bowel disease, stomach ulcers, or pancreatitis. Please seek the advice of your licensed healthcare provider to rule out serious health conditions.
♥♥♥Other posts of mine that you may find helpful (click on any of the blue text below to open) :
2) Hearing, L Thomas, K Heaton, L Hunt
Post-cholecystectomy diarrhoea: a running commentary Copyright © 1999 BMJ Publishing Group Ltd & British Society of Gastroenterology.
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