Chapter 1: Nine
Pillars of Successful Weight Loss ....................... 3
Chapter 2: Using
Blood Tests to Safely Induce Weight Loss ........ 13
Chapter 3: A
Multi-Modal Approach to Combat Obesity ….......... 35
Chapter 4: Insomnia
Protocol ….................................................
Chapter One
Nine Pillars of Successful
Weight Loss
When
it comes to weight loss, mainstream medicine has recommended “diet and
exercise” for so long, it has become more of a
cliché than a momentous scientific
communication.
The fact is that as people get older, they need
to do a lot more than reduce calorie intake
and increase physical activity to lose excess
body fat and keep it off.
In this chapter, we address the nine steps that
most overweight aging people should
follow to achieve optimal removal of surplus body
fat. This multi-step program is
comparable to the “drug cocktails” doctors now
use to control HIV infections (so
patients now live for decades instead of less
than a year, as was the case when the
disease first manifested).
The Nine Pillars of Successful Weight Loss are also analogous to what
progressive oncologists
are doing to cure cancer today by administering
multiple therapies designed to
neutralize the numerous survival mechanisms
cancer cells use to escape eradication.
In some respects, the uncontrolled proliferation
and enlargement of adipocytes (fat
cells) in the aging body is analogous to the
growth and spread of benign tumors in our
abdomens, buttocks, and other areas of the body.
Most people understand the need to correct
several vascular disease risk factors to
protect against heart attack and stroke. In the
same way, those seeking to lose weight
should consider making many of these Nine Pillars of
Successful Weight Loss a regular
part of their health-maintenance program.
Pillar Number 1: Restore Insulin Sensitivity
Normal aging causes a decline in sex hormones and
anabolic hormone production.
In addition, insulin receptors on cell membranes
lose their youthful sensitivity or
functionality. The result is a pathological
condition called “sarcopenia” that impairs
the ability of cells to efficiently take up
glucose and amino acids, and utilize these
fundamental building blocks for tissue growth and
repair. “Insulin resistance” is
characterized by the relative difficulty of
muscle cells and liver cells to take up glucose.
Hyperinsulinemia, a condition of high circulating
insulin levels, is the body’s response
to insulin resistance (the attempt to produce
more insulin to “drive” more glucose into
cells). However, an increased risk of heart
disease is well-known to be associated with
high circulating insulin levels. In fact, a
recent study showed that patients with heart
disease had significantly higher plasma levels of
blood sugar and circulating insulin.17
There are several ways to restore insulin
sensitivity to our cell membranes. For example,
nutrients such as chromium,18,19 magnesium,20 cocoa polyphenols,21
and fish oil 22,23
can help.
A low-cost prescription drug called metformin can also significantly
enhance insulin
sensitivity.24-26 It is approved only as a
treatment for Type 2 diabetes, but published
scientific studies indicate it can help reduce
body fat.27 The dose range for those seeking
4 | THE LIFE EXTENSION WEIGHT LOSS MANUAL
to enhance their insulin sensitivity and support
more youthful metabolic function
can vary from 250 mg three times daily with meals
up to 850 mg three times daily with
meals. Consult with your prescribing physician to
make sure that metformin is right for
you. As you will read later in this section,
restoring free testosterone to youthful ranges
can augment insulin sensitivity in aging men with
suboptimal testosterone levels.
The most effective way of restoring insulin
sensitivity is to reduce calorie intake.
Calorie reduction to 1,500–1,900 calories/day
significantly enhances insulin sensitivity,
as documented by dramatic lowering of fasting
glucose and insulin blood levels.27-32
Even a moderate cutback of excess calories can
markedly improve insulin sensitivity.
So the first pillar to successful long-term
weight loss should involve a moderate reduction
in calorie intake, at least long enough to
restore insulin receptor sensitivity to more youthful
ranges. The use of nutrients, hormones, and drugs
that enhance insulin sensitivity should
also be considered. As you probably know already,
a lot more than just eating less is needed
to lose weight.
Pillar Number 2: Restore Youthful Hormone Balance
Most overweight human beings have suffered the
agonies of calorie deprivation
(dieting), but have failed to achieve any kind of
sustained fat reduction. While eating
less addresses some of the underlying causes of
weight gain, the high failure rate of
dieting is partially attributable to the severe
alteration in hormone levels that occurs as
part of normal aging.
A large percentage of men today suffer from abdominal
obesity — the most dangerous
kind of body fat. It is often difficult, if not
impossible for aging men to lose inches off
their waistline if they are deficient in free testosterone, especially in the presence
of
excess estrogen.33-35 Low levels of dehydroepiandrosterone (DHEA) can also contribute
to
undesirable fat accumulation in men and women.36
A comprehensive blood test panel can reveal free
testosterone and estrogen (estradiol)
levels so that a physician can prescribe a
topical testosterone cream and an aromataseinhibiting
drug (if necessary) to restore a man’s sex
hormone profile to a youthful range.
The same blood test panel can also detect DHEA
blood levels to enable one to take the
proper dose of this over-the-counter dietary
supplement.
A comprehensive blood test panel should also
measure prostate-specific antigen
(PSA) in men (along with a digital rectal exam,
and prostate ultrasound with biopsy if
necessary) to help screen for occult prostate
cancer. Those with prostate cancer cannot
restore these hormones until the cancer is
completely eradicated. Some men are able
to reduce excess estrogen while simultaneously
boosting free testosterone by taking
nutrient formulas that contain plant extracts to
help inhibit the aromatase enzyme
(which converts testosterone into estrogen) and
decrease levels of sex hormone-binding
globulin (which binds free testosterone).
A substantial percentage of aging women (and many
aging men) have less-than-optimal
thyroid levels, thus predisposing them to weight
gain. Thyroid hormone is needed to
maintain healthy metabolic rates. Those who are
deficient in thyroid hormone should
be prescribed thyroid medication to maintain or
improve their overall health, as well
as to provide this hormone involved in the
regulation of body composition. Drugs to
consider are Armour® natural thyroid complex (containing both T4 and T3)
or Cytomel®
(containing T3). Trying to lose weight in the
face of thyroid hormone deficit can be
particularly challenging.
A common problem women experience during
menopause is an increase in belly fat
mass. Estrogen levels plummet during menopause
and some studies correlate this
estrogen deficiency with greater abdominal
adiposity in women. While treatment with
THE LIFE EXTENSION WEIGHT LOSS MANUAL | 5
high dosages of horse urine-derived estrogens and
progestin drugs may contribute to
increases in appetite and weight gain, evidence
suggests that individually dosed natural
estrogen replacement facilitates a reduction in
abdominal fat in women who are
estrogen deficient.37,38 Restoring hormone
balance in aging females requires the intervention
of a health care practitioner with specialized
expertise in prescribing bioidentical
hormone replacement therapy. Men are more fortunate in
that almost any doctor can
prescribe the proper dose of testosterone (and
aromatase-inhibiting drugs, if needed).
Pillar Number 3: Control Rate of Carbohydrate
Absorption
We already know that a rapid rise in blood
glucose (and the subsequent insulin spike)
associated with large meals predisposes people to
gain unwanted fat pounds by, in
addition to an overload of excess calories, a
rebound increase in appetite and hunger
when blood sugar levels plummet in response to
excess release of insulin. Research
suggests that by taking just five grams of
soluble fiber before or with each meal, one can
significantly blunt the glucose-insulin surge.39
Fiber may protect against unwanted weight gain
via several mechanisms that involve
both effects on satiety and glucose-insulin
responses.39-41 For example, research
has shown that vegetarians weigh significantly
less than non-vegetarians, whether
measured by body mass index or body weight.42 Some
experts believe that vegetarians’
lower average body weight is linked to one
factor: the high fiber content of the plant
foods consumed.43 Plant fiber fills you up
quickly, and studies indicate that this results
in less snacking and binging later in the day.
The Seven Countries Study provides additional evidence
linking a high-fiber diet with
lower body weight. Researchers found that people
living in countries with high fiber
intake weighed less than those living in
countries where fiber intake is low.44 Higher
fiber intake is also associated with lower
average body weight in the US. In the famous
Nurses’ Health Study, those who ingested more
dietary fiber consistently weighed less
than those who consumed less fiber.41
Finally, in the Coronary Artery Risk Development in Young
Adults Study,
which examined
how heart disease develops in adults, researchers
linked higher dietary fiber intake with
lower body weight and waist-to-hip ratios, along
with a reduction in markers of heart
disease risk. Higher fiber consumption predicted
less weight gain more strongly than
did total or saturated fat consumption.43
Not all fibers are created equal. Beta-glucans
(derived from oats and barley) are particularly
effective in slowing the absorption of
carbohydrates — enabling one to control
blood sugar levels and induce the satiety needed
to achieve healthy weight management.
Studies show that when taken with meals,
beta-glucan fibers markedly blunt
post-meal elevations in blood sugar and insulin
levels. Like other foods rich in soluble
fiber, beta-glucans help improve blood glucose
metabolism while also lowering serum
lipid levels.45,46
Getting into the routine of taking five grams of
a neutral-tasting beta-glucan fiber mix
before or with each meal would help provide
weight loss effects via this mechanism
(i.e., controlling rate of carbohydrate
absorption). Alternatively, taking fiber capsules
(containing the highly viscous fiber glucomannan,
which promotes healthy glycemic
status) before each carbohydrate-rich meal would
also help reduce the glucose-insulin
surge that contributes to obesity.
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