As an Ob/Gynecologist, the transition to using bio-identical hormones was a natural one. I started using progesterone first and slowly added the estrogens, testosterone, thyroid, melatonin, DHEA and growth hormone. A few years into the process of mastering hormone therapies, I realized that specific nutrients are critical to activate hormones. I learned that iodine was critical for thyroid and that chromium was critical for insulin. As I researched the subject it became clear that, although our knowledge in this area is in its infancy, thyroid hormone needs iodine, selenium, zinc, Vitamin A and several others for optimal activity 1,2,3,4. Insulin needs chromium, vanadium and Vitamin B3 5,6,7,8. These specific factors must be present at therapeutic levels to be effective. This information led to the evolution of a nutrition program with an emphasis on superfoods, plants and a few essential supplements.
This nutrition program is the crux of our 5-point restorative approach towards disease which includes optimizing 1) hormones, 2) nutrition, 3) toxin removal, 4) mind balance, 5) body balance. In this article, I share, through 2 cases, the nutritional interventions which have become integral to the success of this program. I will cover our three main programs: 1) Metabolic Balance, 2) Plant-Based and 3) Superfoods.
Metabolic Balance Program
The Metabolic Balance Program, which has been used by over 2,000 patients, is based on the goal of reducing insulin resistance through 1) specific dietary ratios, 2) bowel and liver cleanse and 3) supplements. The aim is to increase body pH and encourage a transition from dramatic sugar highs and sugar lows to moderate swings. Referring to graph 1, the aim is to bring the metabolism from the red line (insulin resistance which leads to storage of fat in the lower abdomen and thighs) to the blue line (insulin sensitivity). This program is appropriate for anyone desiring optimal health, weight loss, lower cholesterol and lower sugar.
The Metabolic Balance Program is a basic, restorative approach which can be enhanced with the use of HCG, phenteramine, glucophage and calorie restriction as appropriate, especially for rapid or profound weight loss. The average weight loss in this basic program is 10 pounds/10 inches in the first six weeks, 20 pounds/15 inches in the first twelve weeks, without the use of HCG, phenteramine or calorie restriction. After the program, we encourage our patients to stay on a dietary ratio at every meal of 50% vegetables, 25% lean protein and 25% complex carbohydrates.
GRAPH 1. Insulin resistance presents with highs and lows of sugar and insulin
Bonnie is a 41 year old woman who presented complaining of weight gain of 28 pounds in 5 years. Her weight had been unresponsive to the diet and exercise programs that she had tried. On further questioning, she also had anxiety, panic attacks, insomnia, low energy and high stress. Although the Metabolic Balance Program was perfect for her, the first step was to get Bonnie feeling better by correcting her progesterone and thyroid. She was also placed on basic supplementation with hormone-activating, antioxidant doses of essential vitamins, minerals and omega-39. She was coached in stress management and breathing techniques to reduce the impact of stress on metabolism. By week 8, her energy, sleep and anxiety were corrected and she entered the Metabolic Balance Program with a HgbA1C of 6.1% mg/dl, FBS of 103 mg/dl and a fasting insulin of 15 uIU/ml. She followed the 12 week program as outlined in Table 1 and 2.
|Table 1: Metabolic Balance Program Instructions Week 1|
|One week of vegetables only (cooked or raw) no calorie restriction||Increases pH: As the pH increases, the tissue metabolism normalizes and allows fat to mobilize from the peripheral deposits. The ideal tissue pH is above 7.0 and the ideal morning urine ph is 6.4 to 7.2|
|Use herb and fiber supplements to move the bowels 3 times a day||As the bowel moves more often, the toxins dumped into the bowel by the liver exit the body without absorption into the system.
Herb formula includes: alfalfa, dandelion, fennel, yarrow, green tea, elutherococcus, hawthorn, horsetail, licorice, peppermint, red clover, red raspberry and many more.
Fiber formulaincludes: cascara, fennel, psyllium, ginger, acacia, apple pectin, beet, glucomannan, slippery elm, lemon peel, oat bran and many more.
|Avoid meat, fish, dairy, eggs, grains and starchy vegetables||decreases pH|
|Avoid coffee, tea, alcohol||decreases pH|
|Avoid processed, refined, canned and boxed||preservatives decrease pH and increase toxins|
At the end of week 1, Bonnie was having 3 bowel movements a day, her sugar cravings were down by over 50% and she had lost 5 pounds. At this point, she entered the Weeks 2-12 phase (see Table 2 below) by meeting with a coach every 2 weeks. She was also started on a moderate aerobic exercise program (40 minutes, 4 days a week). We asked her to focus on breathe and to keep her heart rate in the oxygenated, aerobic range where she could converse. The higher heart rates are to be avoided, since they stimulate anaerobic respiration and tissue acidity through the formation of lactic acid.
|Table 2. Metabolic Balance Program Instructions week 12-12|
|Every meal should be 50% vegetables, 25% lean protein, 25% complex carbohydrates no calorie restriction||Vegetables should include 8 different colors per day
Lean protein includes fish, chicken, beef, and plant-based proteins
Complex carbohydrates include sweet potato, steel cut oats, spaghetti squash,
A breakfast example: veggie smoothie: eggs: steel cut oats in ratio of 2:1:1
|Add Insulin Modulators||Insulin modulators include: chromium, vanadium, fenugreek, bitter melon, gymnema sylvestre, garcinia cambogia, cinnamon, alpha lipoic acid, 7-keto DHEA etc|
|Add Leptin Modulator||Leptin modulator includes: Irvingia|
|Add Liver Support||Liver support includes: artichoke leaf, alpha lipoic acid, NAC, milk thistle, MSM, calcium D-glucarate, ellagic acid etc|
|Individualized instruction included:
At the end of 12 weeks, Bonnie had lost a total of 16 pounds. Her repeat labs showed a HgbA1c of 5.7% mg/dl, a FBS of 93 mg/dl and a fasting insulin of 5uIU/ ml. Her triglycerides had also come down from 174mg/dl to 110 mg/dl. Bonnie was asked to repeat the vegetables-only diet (of the week 1) and then continue to maintain a plate ratio of 50% vegetables, 25% lean protein and 25% complex carbohydrate. Over the next 12 weeks, she lost another 10 pounds to total 26 pounds. Her 6 month labs showed a HgbA1c of 5.5% mg/dl, a FBS 87 mg/dl and a fasting insulin of 5 uIU/ml. She has maintained her new weight over the past year by optimizing thyroid and progesterone function, staying on basic supplementation with hormone-activating, antioxidant doses of essential vitamins, minerals and omega-3. She repeats the week 1 vegetables-only routine 1-2 times per year. Her success is attributable to restoring optimal function in 5 main areas namely: 1) hormones, 2) nutrition, 3) bowel and liver through toxin removal, 4) mind and 5) body (see Figure 1).
Plant-based Nutrition Program
Scientific data from the last 2 decades is showing that the best way to prevent and correct degenerative disease is to aim for the highest level of raw plant proteins possible, which raises the pH of the body. The most compelling data has been reported from a 27-year comprehensive study, known as “The China Study” by Dr. T. Colin Campbell11. They reported that animal proteins, including the casein in milk, significantly increase the risk of cancer, heart attacks, neurological diseases and all inflammatory diseases. This effect is thought to be partially due to the acidifying effect of animal proteins. The evidence for reversal and prevention of all inflammatory conditions (in the heart, brain, vascular system, bones, muscles, neurological system, skin) is compelling enough that major institutions like Cornell University and Cleveland Clinic are emphasizing plant-based nutrition.
Our experience has been that when people adopt a predominately plant-based diet (raw or cooked) their health improves in general. We have seen dramatic improvement in conditions such as rheumatoid arthritis, fibromyalgia, diabetes, hypertension, osteoporosis, eczema, psoriasis and cancer. The purpose of this program is to educate patients to successfully integrate plant-based proteins into their nutritional program. With the knowledge comes the power to choose a better diet.
What does the program consist of?
The program focuses on reducing meat, fish, dairy, eggs, processed and refined foods (which increase acidity) and replacing them with vegetables, whole grains, beans, nuts, seeds, sprouts and sea vegetables. The general philosophy is “if men made it don’t eat it”. This program focuses on all the foods a patient canhave rather than what they cannot have. The aim is to balance the body’s pH level so cellular energy and repair is optimized. An acidic internal environment contributes to internal inflammation, which leads to diseases and cancers. Patients are instructed on:
- The best sources of plant-based protein (i.e. hemp, sprouted legumes, brown rice) and where you get them
- Recipes that will allow you to maintain your essential amino acids and are delicious
- Recipes bursting with anti-oxidant/anti-inflammatory value based on data
Who is a good candidate for this program?
This program is ideal for anyone interested in improving their quality of life, detoxifying the body, alkalizing the body and especially those with inflammatory conditions such as:
- skin conditions (psoriasis, eczema, rashes)
- heart, vascular conditions, neurological (hypertension, atherosclerosis, stroke risk)
- intestinal conditions (colitis, irritable bowel syndrome)
- cancer and other immune dysfunction
- musculoskeletal conditions ( fibromyalgia, lupus, Sjogren’s, rheumatoid arthritis, osteoporosis )
Super Food Program
“Superfoods” are those vegetables, fruits, seeds and nuts which contain a dense abundance of phytonutrients and anti-oxidants greatly exceeding the values in common vegetables and fruits. These are best described in the book “Superfoods” by David Wolfe 12 examples of powerful superfoods include aloe, maca, cacao, goji, bee pollen, spirulina, blue-algae, hempseed, marine phytoplankton and coconut. These foods are best eaten raw. They generally contain proteins and essential nutrients that cannot be obtained from a traditional diet. With a well chosen, organic-based diet containing raw, plant-based fresh materials provided by superfoods, we stand a chance to improve our health in a way that has never been available in the past. The aim of this program is to educate and facilitate education about the successful incorporation of superfoods into the current diet.
Although, everyone should incorporate as many superfoods as possible into their diet for optimal vitality and health; however anyone with chronic degenerative disease such as hypertension, arthritis, osteoporosis, heart disease, cancer will benefit from the regenerative capacities of superfoods.
Stephen is a 51 year old male who desired help with controlling his Ulcerative colitis exacerbations and subsequent arthritis and eczema from the inflammatory reaction in his intestines. He additionally had a very low sex drive, severe fatigue and loss of motivation. He had a family history of early heart attacks. Stephen’s labs revealed suboptimal testosterone and thyroid levels and a high c- reactive protein of 8.7mg.dl. A functional intracellular nutritional analysis revealed an antioxidant function in the 34th percentile and significant nutritional deficiencies in B-vitamins and magnesium. It was clear that the low-grade inflammatory condition in his gut was the source of generalized body inflammation and arthritis. However, before embarking on a nutrition program we addressed his other complaints with testosterone, thyroid, omega-3, B-12 injections (with 10,000 mcg methylated cobalamin weekly) and a complete vitamin and mineral formula. In choosing such a formula, attention was paid to: 1) vegetable capsule with the absence of preservatives, fillers, binders 2) biologically active forms and hormone-supportive doses of B-vitamins, selenium, zinc, iodine, chromium etc.
Stephen’s sex drive, motivation and fatigue improved dramatically within 8 weeks, at which point he was started on the Plant-based nutrition program with Superfoods. Stephen’s Ulcerative Colitis exacerbations diminished by 30% within the first 4 weeks and by week 12, he had been free of any episodes for 8 weeks. His arthritic pains diminished steadily. His 6 month lab values were notable for a c-reactive protein of 2.2 mg/dl, an antioxidant function in the 63rd percentile, correction of all hormone deficiencies and a 20 point drop in LDL cholesterol. Both clinical and lab parameters supported an overall lowering of inflammatory status with this diet. While all patients are encouraged to maintain as much plant-based nutrition as possible; patients with serious inflammatory conditions are asked to maintain a greater than a 90% plant-based diet. Stephen has been free of exacerbations for 16 months with almost a 100% plant-based diet with occasional animal protein from time to time.
The nutritional programs form the crux of a successful practice in the area of restorative medicine and hormone therapies. The main components of a successful program include:
- Maintain a diet of whole, natural foods at a plate ratio of 50% vegetables, 25% lean protein (plant or animal sourced) and 25% complex carbohydrates, at every meal.
- Vegetables should be of 8 different colors every day
- Raw and lightly cooked vegetables are a superior source of active phytonutrients and enzymes
- Avoid packaged, canned, boxed, refined and processed foods
- Based on recommendations from AMA9 and studies from Harvard10 everyone should be on a supplementation of essential vitamins, minerals and omega-3.
- We aim for preservative-free formulas with anti-oxidant and hormone activating doses
- Measure the nutritional status and anti-oxidant function annually
- Maintain regular bowel movements
- Ertek,S., Cicero, A.F., Caglar, O., Erdogan, G., Realtionship between serum zinc levels, thyroid hormones and thyroid volume following successful iodine supplementation. Ufuk University medical Faculty, Department of Endocrinology and Metabolic diseases, Ankara, Turkey.
- Kohrle, J., Oertel M., Gross, M, Selenium supply regulates thyroid function, thyroid homone synthesis, and metabolism by altering the expression of the selenoenzymes Type 15′- deiodinase and glutathione peroxidase. Abteilung Klinishche Endokrinologie, Medizinische Horchschule Honnover, Germany. Thyroid, 2005 Aug; 15 (8): 841-53.
- Yoshida, K., Kiso, Y. Watanabe, T.K., Kaise, K. Kaise, N. Itagaki Y., Yamamoto, M. Sakurada, T., Yoshinaga, K., Erythrocyte zinc in hyperthyroidism; reflection of integrated thyroid hormone levels over the previous few months. Deep Folia Biol (Praha). 2007; 53 (5); 183-8.
- Maarques, L.F., Donagelo, C.M., Franco, J.G., Pires, L., Luna, A.S., Casmiro-Lopes, G., Lisboa, P.C., Koury, J.C. Plasma zinc, copper and serum thyroid hormones and insulin levels after zing supplementation followed by placebo in competitive athletes. Instituto de Quimica, Universidade Federal do Rio de Janeiro, Rio De Jeniero RJ, Brazil. Hormones (Athens), 2010 Jul-Sep; 9(3); 263-8.
- Singer, G.M., & Geohas, J., The effect of chromium picolinate and biotin supplementation on flycemic control in poorly controlled patients with type 2 diabetes mellitus; a placebo-controlled, double-blined, randomized trial. Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut 06520-8017, USA. Gregory.firstname.lastname@example.org. Diabetes Metab Res Rev. 2008 Jan-Feb; 24 (1): 41-51.
- Albarracin, C.A., Fuqua, B.C., Evans, J.L., Goldfine, I.D., Chromium picolinate and biotin combination improves glucose metabolism in treated, uncontrolled overweight to obese patients with type 2 diabetes. Arch Biochem Biophys. 2005 Aug 15; 440 (2): 158-64.
- Mehdi, M.Z., Srivastava, A.K., Organo-vanadium compounds are potent activators of the protein kinase B signaling pathway and protein tyrosine phosphorylation: mechanism of insulinomimesis. Laboratory of Cell Signaling, Research Centre, Centre Hospitlaier de l’University de Montreal (CHUM) – Hotel-Dieu, Canada. Met Ions Biol Syst. 1995; 31:575-94
- Orvig, C., Thompson, K.H., Battell, M., McNeill, J.H., Vanadium compounds as insulin mimics. Hormones (Athens), 2010 Jul-Sep; 9 (3): 263-8.
- Fletcher, R., Fairfield, K., Vitamins for chronic disease prevention in adults. JAMA 2002; 287: 3127-3129. Diabetes. 1997 Nov.; 46 (11) 1786-91.
- Electronic reference PDF
- Colin Campbell, T., Campbell, T.M., The China Study. BenBella. Dallas, TX. 2006.
- Wolfe, D. Superfoods. North Atlantic Books, Berkley, California. 2009.