Dr. John Day, Cardiologist

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How a Baker Now Lives a Healthy Lifestyle

In this podcast, I interview LuAnn Lukenbach who is the owner of LuAnn’s Cupcakes in Park City, Utah.  Everyday she is in her bakery surrounded by countless temptations.  Despite these challenges, she has defied the odds and has been able to lose 50 pounds and maintain a healthy lifestyle!

In this podcast, LuAnn shares the following:

1. How she lost 50 pounds.

2. How she has converted her living room into a real “living room.”

3. How she has maintained a daily habit of taking 10,000 steps.

4. How she has overcome the temptation of all of the “BLT’s” (bites, licks, and tastes) in her bakery.

5. How intermittent fasting has helped her in maintaining a healthy weight.

6. How a diet high in fruits and vegetables has allowed her to feel her best.

7. How she has created healthy treats in her bakery.

How to Listen

To listen to this podcast you can click on the “sound” icon above.  Alternatively, you can subscribe to this podcast on iTunes or Stitcher Radio so that you never miss an episode.

What things have helped you in your healthy lifestyle?

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6 Ways to Stop Feeling Hungry All the Time

The holidays are the worst time of the year for Josie.  Josie is just 16 and all she can think about is food.  She is obsessed with food and is hungry all of the time.  Regardless of how much she eats, she is always hungry.

According to her mother, “Ever ingredient is meticulously measured and the calories counted.  When she was younger, screaming tantrums would begin if the clock ticked past the allotted serving time.”

To save her from overeating, her mother shares,  “We pile up the meal on a small dish so it looks fuller. We cut food in half and tell her it’s twice as much. We keep empty raisin boxes and fill them with half the number they’d normally contain so she can have an extra box.  We always keep back a bit of her meal so that if there’s a dropped spoon disaster, and three peas go on the floor, then three peas get replaced.”

Josie has a rare genetic condition, called Prader-Willi Syndrome, which causes her hunger hormone, ghrelin, to be extremely high.  Unless people suffering from this condition are physically restrained from eating, they will literally eat themselves to death.  If left unchecked, Prayer-Willi patients typically die young from obesity related complications.

Can the same thing happen to us?  Can our hunger hormones also get so far out of the normal range that we also feel hungry all the time?  In this article I will share with you 6 ways to stop feeling hungry all the time.

The Hunger Hormones

Before we discuss how to stop feeling hungry all the time, let me first introduce the “hunger hormones” and discuss the reasons why we feel hungry.  Below are the main hunger hormone players:

1. Ghrelin

Ghrelin, also called the “Ghrelin Gremlin,” is the one to fear the most.  Another easy way to remember the roles of ghrelin and leptin is that ghrelin “grows” your appetite whereas leptin “lowers” your appetite.  Ghrelin levels are extremely high with the Prader-Willi Syndrome.

When there is nothing in our stomachs, the hormone ghrelin is released.  On the other hand, when our stomachs are full then ghrelin secretion stops.  Once released, ghrelin acts on receptors in the brain to make us feel hungry.

The frustrating thing is that ghrelin not only makes us feel hungry but also activates the “reward center” of our brains.  Activating the reward center of our brains makes us crave the addictive or “comfort foods” like pizza or chocolate chip cookies.

Now that we understanding how ghrelin works, one obvious way to suppress ghrelin production is to fill our stomachs with water, fiber, or other low calorically dense foods at meal times.  If we can “stretch” our stomachs with a big salad and a tall glass of water then perhaps we can quickly shut down the body’s production of ghrelin.

2. Leptin

Leptin is another hunger hormone.  Leptin is released from the fat cells when they are “full” to signal to the brain to stop eating.

Leptin has the opposite effect of ghrelin.  Thus, for most people, letpin is a good thing if the goal is to stop feeling hungry all the time.  To help remember the effects of leptin just remember “lucky leptin.”

A young boy’s medical case, we’ll refer to him as “T,” was recently described in the most prestigious medical journal, The New England Journal of Medicine.  “T” is two years old and lives in the country of Turkey.  As with Josie, “T” is also hungry all of the time.  He ravenously devours any food he can get.  He never feels full.

“T” has a rare genetic condition where his brain cannot detect leptin.  While “T’s” height is just a litter bit taller than average, at the young age of just 2 he weighs 67 pounds!  Unlike Josie, T’s parents have not restrained him from eating.

“T’s” condition is something that has been well described in adults.  This condition is called “Leptin Resistance.”  With leptin resistance, even though leptin levels are high the brain cannot detect leptin.

The purpose of leptin is to prevent us from gaining weight.  The problem is that even though leptin levels are high in obese people, the brain never “registers” the leptin.  While leptin resistance in adults is not as severe as with “T,” leptin resistance may play a significant role in the worldwide obesity crisis.

Researchers are just starting to learn why obese people’s brains do not register the leptin signaling that they are “full.”  New research suggests that we can block the effects of leptin from eating a diet high in sugar and simple carbohydrates.  These simple carbs raise our triglyceride levels which has been shown to block leptin signaling to the brain.

Of course, the obvious way to help our brains to sense leptin and stop feeling hungry all the time is to minimize sugar and simple carbohydrates in our diets.

3. Insulin

Insulin is a hormone released by the pancreas.  Insulin is released when blood sugar levels rise.  The main effect of insulin is to cause us to store fat.

A diabetic patient recently told me, “as soon as I went on insulin I gained 10 pounds!”  This is not unusual.  If you talk with many people with diabetes they will often tell you the same thing.

A high sugar meal, like bread, pasta, or breakfast cereals, will cause a high spike in your blood sugar levels.  When this happens, the pancreas releases insulin causing the extra sugar to be stored as body fat.  Once the blood sugar drops you are hungry and the cycle begins all over again.

A simple way to prevent hypoglycemia from making you hungry is to eat foods that don’t spike your blood sugar.  Minimizing or avoiding sugar and simple carbohydrates will keep your blood sugar levels stabilized.

4. Cortisol

Have you or a loved one ever taken a short course of prednisone or another steroid?  Were you always hungry?  Did you gain 5 to 10 pounds from just a week of taking prednisone or another steroid?

Cortisol is the body’s steroid hormone.  Cortisol is released from our adrenal glands.  When we are sleep deprived or chronically stressed, cortisol levels are high.  As long as cortisol levels remain high our appetite will remain high as well.

5. Neuropeptide Y

Neuropeptide Y is a brain neurotransmitter and is also considered by many to also be a “hunger hormone.”  Neuropeptide Y is a powerful brain chemical that compels us to eat.

In a classic study, researchers in 1985 injected male rats with neuropeptide Y.  Within just minutes of the injection, male rats became obsessed with food and lost all interest in sex.  Even though a willing sexual mate was readily available, these male rats, under the influence of neuropeptide Y, craved rat chow more than sex.

Studies show that neuropeptide Y is released in response to stress as well as a high sugar, high fat diet.  Interestingly, intermittent fasting has been shown to lower neuropeptide Y levels.

Clearly, if we want to stop feeling hungry all the time, we also need to keep neuropeptide Y levels down.  The best way to do this is to minimize or avoid unhealthy fats and sugar, manage stress, and, under the direction of your physician, consider intermittent fasting.

I Have a “Double Dose” of the Fat Gene

I have had my genome analyzed and I have two copies of a variant of the FTO gene which is also known as the “Fat Gene.” Having two copies of the “Fat Gene” (one from my mother and one from my father) means that my ghrelin levels are genetically programmed to be high.

This means, that for those of us with two copies of this gene, we don’t feel full when we eat.  Studies show that most people in the U.S. with a “double dose” of the Fat Gene are obese.

While eating the Standard American Diet (SAD), I was overweight and yet was always hungry.  Since changing my lifestyle, my weight has dropped 30 pounds and I have maintained this weight loss now for more than 3 years.  While a healthy lifestyle has helped me to control my hunger and ghrelin levels, if I am not careful I can quickly become very hungry very fast.

Despite having genetically high levels of ghrelin, at least I can feel fortunate that I don’t have the same constant hunger pains that someone suffering from the Prader-Willi Syndrome might have.

6 Ways to Stop Feeling Hungry All the Time

Now that we understand the brain chemistry of hunger, we can now “hack” our hunger to keep ghrelin, cortisol, insulin, and neuropeptide Y levels low and allow our brains to shut down the hunger signals by being able to sense leptin.  Here are my 6 very best ways to stop feeling hungry all the time.

Ghrelin Release from the Stomach

1. Fill Your Stomach to Stop Ghrelin Release

If you want to keep the “ghrelin gremlins” at bay, stretch your stomach with low caloric density food.  In other words, drinking water with your meals, eating high fiber foods, or just filling your stomach with lots of vegetables can fill your stomach to suppress ghrelin and keep you at a healthy weight.

In contrast, very caloric dense food, like a piece of cake or a piece of candy, doesn’t fill your stomach.  Because the stomach is not stretched from these calorically dense foods, ghrelin levels remain high.  As long as ghrelin levels remain high, your brain will drive you to eat more.

When you feel hunger coming on, and it is not yet time to eat, reach for a bowl or bag of fresh vegetables and a glass of water to drive the “ghrelin gremlins” away.

2. Minimize Sugar and Simple Carbs

“Lucky leptin” is the signal that comes from our fat cells and tells our brains we have had enough food.  This is the hormone that is supposed to keep us at a healthy weight.

The problem is that most obese people are “leptin resistant.”  Unfortunately, studies show that sugar and simple carbs block the effect of leptin on our brains.  In addition, sugar and simple carbs increase insulin and neuropeptide Y release.

In order to prevent leptin resistance and keep insulin and neuropeptide Y levels down, minimize sugars and simple carbs.  I have found that for most of my patients, if they can just minimize or eliminate sugar and simple carbs, their weight quickly normalizes.

3. Get At Least 7 Hours of Restorative Sleep

Sleep is probably the most under appreciated weight loss strategy.  Besides the obvious that we are not eating when we are sleeping, getting enough sleep at night keeps ghrelin levels low and leptin levels high.  This is exactly the right combination which will help us to stop feeling hungry all the time.

In contrast, sleep deprivation increases cortisol and neuropeptide Y levels as well.  With all of these hunger hormones working against us, sleep deprivation makes it exceedingly difficult to maintain a healthy weight.

Don’t worry about going to bed hungry as sleep quickly raises leptin levels to prevent hunger from awakening you at night.  If hunger is waking you up at night then there is a good chance you are “leptin resistant.”

4. Practice Stress Management Each Day

Along with sleep, another under appreciated way to stop feeling hungry all the time is to manage stress.  When we are feeling stressed out, studies show that ghrelin, cortisol, and neuropeptide Y levels go up while leptin levels fall.  Once again, this is the perfect storm for feeling hungry all the time and gaining weight.

As chronic stress and weight gain go hand-in-hand, is it any wonder that yoga and meditation have both been shown to be possible weight loss options?  The key point here is to find what helps you to “de-stress” and do that each day.

5. Minimize or Avoid Unhealthy Fats

As a diet high in the unhealthy fats has been shown to induce neuropeptide Y, the goal is to minimize or avoid the unhealthy fats.  The main source of unhealthy fats in our diet is from processed foods, fast foods, and most restaurant foods.

6. Intermittent Fasting

It seems counter intuitive to fast in order to help control hunger.  However, if you are healthy, intermittent fasting for periods as short as 12 hours, has been shown to have beneficial effects.  For example, intermittent fasting may help with leptin resistance as it lowers triglyceride levels.  In addition, fasting lowers neuropeptide Y levels.  If you are interested in intermittent fasting, please discuss this with your physician first.

Are you always hungry?  What has helped you to stop feeling hungry all the time?

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Intermittent Fasting, Weight Loss, and Longevity

Could the secret to maintaining a normal weight, avoiding chronic medical diseases, and living a long life be as simple as intermittent fasting? Recent research suggests this is true.  Just what is intermittent fasting as is it something you should do?

Caloric Restriction and Longevity

Restricting calories while still getting the right nutrients for health has been shown to dramatically increase the lifespan of everything from the mouse to the monkey.  For example, caloric restriction, without malnutrition, in mice and rats has been shown to not only increase their lifespan by 30-40% but to also allow them to maintain a youthful appearance.

Caloric restriction appears to slow down the aging process through reduced oxidative stress while at the same time protect the heart and help to prevent cancer. Many repair mechanisms in the body are triggered during periods of reduced caloric intake.

Most of us would love to slow down the “sands of time” and maintain our youth and vitality until very late in life.  For me, I would love to be able to ski until well into my 100s.  However, like most of you, I love to eat and could never willingly practice caloric restriction.

These same life extending benefits of intermittent fasting have not yet been proven to occur in humans.  Also, caloric restriction in humans can be potentially dangerous as you have to ensure that you are getting the right nutrients for health or you could quickly undo any potential health benefits of caloric restriction.

The question naturally arises, is there a better way to achieve the same benefits of caloric restriction without all of the “pain” and potential risks? Fortunately, recent data suggest that intermittent fasting may offer the same benefits as caloric restriction.

Intermittent Fasting

Many different forms of intermittent fasting have been proposed and studied over the years.  These have ranged from reducing calories two days each week, popularized in the Fast Diet, to going without food for 12 to 24 hours.

Many different religions have also promoted fasting for spiritual reasons.  Christians, Jews, and Muslims have practiced intermittent fasting for millennia to gain greater spiritual awareness.

For me, growing up in a religious home I was taught from a young age to fast for 24 hours once each month as a means to gain greater spiritual awareness.  Unfortunately, the hunger pain of fasting for 24 hours was usually too intense for me to obtain much spiritual benefit.

Fortunately, recent data has suggested that fasting for shorting periods of time, such as even just 12 hours, could offer the same health benefits as a 24 hour fast.  A twelve hour fast is something that is relatively easy for most people to do and something you may already be doing without realizing it.

As part of my health turn around several years ago, I started intermittent fasting for 12 hours on most days.  This was not something that I specifically set out to do.

Rather, in efforts to lose weight, I told myself that I had to stop eating by 7 pm each night.  By shutting down the kitchen for me at 7 pm, I naturally fasted for about 12 hours each day.  This is now something that I recommend for my patients who are trying to lose weight and live a long and healthy life.

Intermittent Fasting in China’s Longevity Village

Over the last several years, my wife and I have led a research team studying the centenarians in China’s Longevity Village located in Southwest China near the Vietnam border.  Remarkably, this group of people have been able to avoid the chronic medical conditions that plague us in Western countries.  It was common in this rural Chinese village to see people still working full-time in the fields until well into their 80s, 90s, or even 100s free of disease and the need to take medications.

Of the many principles we learned from these people, which will be described in an upcoming book (here is a link to watch our book trailer), one important factor is that they practiced intermittent fasting every day of their lives.  These centenarians all ate an early and light dinner and then went 12+ hours before their next meal.  This was part of their culture and tradition.

Seven Reasons to Become an Intermittent Faster

1. Weight Loss

There have now been several well designed studies demonstrating that intermittent fasting can be a very effective weight loss strategy.  For example, in this study, women randomized to “relative” intermittent fasting two days a week as they were still permitted to eat on these “fast days,” were still able to lose just as much weight as those who cut their caloric intake every day.

From research performed at my hospital in 448 patients, we found that people who practiced intermittent fasting weighed much less than those who do not.  Even more interesting is that these intermittent fasters were not even trying to lose weight!

Personally, reducing calories for just two days a week sounds a lot better, and possibly even more effective, than trying to cut calories every day.  I suspect that the reason for this is that if you reduce calories every day your metabolism slows down so it is hard to gain any ground.  In contrast, with intermittent fasting you can keep your metabolism high while shedding the pounds.

2. Improved Brain Function

When we go without food for as little as 12 hours our body runs out of stored glucose to burn and starts burning fat.  This fat burning process is called ketosis.

By reducing our dependence on glucose for fuel we can protect our brains from the damaging effects of sugar.  Indeed, intermittent fasting has been shown to improve cognitive function and protect against age related degeneration of the neurons in our brains.  Other studies have shown that intermittent fasting boosts brain derived neurotrophic factor (BDNF) which allows us to create new brain connections, repair failing brain cells, and protect healthy brain cells from damage.

Perhaps this is why religious people for millennia have found spiritual enlightenment with intermittent fasting?

3. Prevent or Reverse Cancer

Intermittent fasting is well known to reduce the tumor inducing insulin-like growth factor 1 (IGF-1).  IGF-1 not only increases the risk of cancer but also allows children to grow big and adults to develop increased muscle mass.

Lower levels of IGF-1, from intermittent fasting, have been shown to prevent or even reverse cancer.  A study published this year showed that a drug which blocks IGF-1 can suppress cancer.

Interestingly, there is a rare genetic condition called Laron Syndrome.  People with Laron Syndrome cannot make IGF-1.  As a result, they tend to be dwarfs but yet live exceptionally long lives free of cancer.  Amazingly, if you give Laron Syndrome people IGF-1 during puberty they will grow to a normal height but yet will still be protected against cancer.

There may be other factors also at play which prevent against cancer with intermittent fasting.  One study even reported that intermittent fasting may be as effective as chemotherapy in fighting cancer.  Please note that I am not recommending intermittent fasting as a treatment for cancer.  If you are battling cancer right now or are just interested in trying intermittent fasting, be sure to talk with your physician first before considering intermittent fasting.

4. Prevent Diabetes

The most commonly reported benefit of intermittent fasting in the medical literature is the prevention or reversal of diabetes.  As mentioned above, going without food for 12 or more hours puts our bodies in a ketotic state.  During this period of ketosis, abnormalities in our glucose/insulin metabolism (insulin resistance) can be corrected so that when we resume eating again our body’s will respond appropriately to glucose and insulin.

An interesting study was published on the effect of Ramadan in people with diabetes.  During the month of Ramadan, Muslims fast from dawn to sunset every day.  An added benefit is that for many Muslims, during the month of Ramadan their diabetes may even go into remission.

5. Prevent Heart Disease

Dr. Ben Horne from my hospital has led a number of research studies looking at the role of intermittent fasting to prevent or reverse heart disease.  His studies have uniformly shown that plaque build up, or coronary artery disease, is less common in intermittent fasters.

In listening to my colleague, there are many potential reasons why intermittent fasting may protect the heart.  Foremost is the effect of intermittent fasting on protecting against diabetes and elevated triglycerides.  However, the most recent research from Ben suggests that other factors might also be involved like the reduction of TMAO which has been associated with coronary artery disease.

6. Restore a Healthy Gut Flora

Increasingly more research is emerging about the importance of maintaining a healthy gut flora and preventing leaky gut syndrome in disease prevention.  Intermittent fasting has been shown to promote a healthy gut flora and may be one additional reason why intermittent fasters enjoy better health.

7. Live a Long and Healthy Life

Many studies in animals show that intermittent fasting may confer the same life preserving effects as caloric restriction.  In addition to the above mentioned mechanisms, it is possible that one additional reason why intermittent fasting may allow for longevity is that intermittent fasting helps to put our bodies into the proper circadian rhythm.

This is certainly one factor we observed during our time in China’s Longevity Village.  These centenarians all had a healthy sleep-wake and feeding natural rhythm.  There is a natural rhythm to life that we need to honor to achieve health and longevity.

Do you intermittently fast?  Intermittent fasting may be as easy as just eliminated that before bed snack.