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One of our defining beliefs at Wellness Garage is that when it comes to your health you have to consider ALL of the six pillars of health.  Over the years, we have provided the clinical evidence to support each lifestyle behaviour individually: In our coaching programs, we have always stressed that the power of these behaviours lie in the fact that they are interconnected. Our clinical health counsellor Noral recently created an internal guide for our team showing just how each behavior is impacted by, and impacts each other behaviour. Take a moment to go through this grid and assess yourself. (Apologies, but this grid needs to be viewed from a desktop or tablet - it's worth the effort!)
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When it comes to making positive changes for your health, the first habit is to block some time in your calendar to reflect and plan. Find 30 to 60 minutes one a week where you can take a moment, without distractions to think about your health. If you are a Wellness Garage member, use that time to log into myHealthJourney and review the new weekly content that has been added to your plan. Then take a moment to reflect:
If you had a good week - feel good and review why it was successful. If you had a poor week or a bad day - figure out what happened. Was it a one-off situation that could not be avoided or was it something that will likely happen again. If it was a one-off, don’t worry about it. If you think that the situation will recur - ask yourself what you will do next time to stay on plan. Now this is the important part - no recriminations, feel good that you have a plan for next time. Be gentle with yourself when you stumble. Be positive with yourself when you do better. Once you have a handle on the past week - take a moment to plan the coming week:
Over time, you will find that this planning takes less and less time. Defaults will emerge for meals, workouts, sleep and stress management. Those defaults will become habits and you will be leading the healthy life you desire, but remember it all starts from this first habit. So now take a moment and block your calendar for your weekly planning and reflection time. Last week, we detailed the process of insulin resistance and how Type II Diabetes develops. Diabetes is a disease of sustained energy overload that develops over many years. The body’s normal energy buffers gradually become overwhelmed, and stored energy in the form of fat disrupts the normal function of key organs. This disruption through a process called insulin resistance, creates a vicious cycle where energy once stored cannot be accessed, and the energy overload is perpetuated through hunger and increased appetite. Eventually, fat stored in the pancreas overwhelms the body’s ability to maintain normal blood sugars and the diagnosis of diabetes is made. On average it takes 10 to 15 years for this process to unfold.  So the logical question arises - can we reverse this process? The short answer is yes. The first line of evidence for this comes from bariatric surgery, where as long ago as 1992 studies showed that between 30 and 70% of diabetes can be reversed for over 10 years. In more recent years, Dr. Susan Hallberg and her team at Virta Health, have shown reversal of diabetes through a dietary therapeutic intervention. Their results with a ketogenic diet, show that 60% of diabetics are in remission at the end of one year. Impressively, the population consisted of many individuals with longstanding diabetes as well as many taking insulin. Of those, 94% decreased dosage or eliminated insulin entirely by one year. From my perspective the most powerful research has come out of the UK from Dr. Roy Taylor and his colleagues in Newcastle. Through a series of clinical trials, culminating in the DIRECT study. They systematically showed that insulin resistance correlates and is caused by fat in the liver in the liver, and the development of abnormal blood sugars and diabetes correlates and is caused by fat in the pancreas. Eliminating the fat in the pancreas can restore the body’s ability to release enough insulin after eating and eliminating the fat in the liver restores the body’s ability to maintain normal fasting blood sugars. So how much fat do you need to lose in order to reverse diabetes? If you had a magic wand and could eliminate fat directly from the pancreas and liver you would only need to eliminate less than 1 pound - as it is estimated that the amount of excess fat in the liver is approximately 400g with even less ectopic fat in the pancreas. Taylor’s group estimates that even as much as 1ml or 0.6g of fat reduction from the pancreas is enough to restore pancreatic insulin secretion in patients that respond to weight loss. Of course, the challenge is that we do not have a magic wand so we must seek to lose weight and trust that some of it will come from the fat stored in our liver and pancreas that is causing our insulin resistance and diabetes.  The DIRECT study was a randomized clinical trial (the highest source of clinical information) that demonstrated that 86% of patients that lost at least 15kg were able to put their diabetes into remission. The therapeutic intervention was a hypocaloric diet (830 calories per day) provided by meal replacements. Further research by Taylor has shown that patients that subsequently slipped back into diabetes regained pancreatic fat. Common to all three lines of evidence, the degree of diabetes reversal correlates directly with the amount of weight lost. So the evidence is clear that diabetes can be reversed provided you can lose enough weight and keep it off. It’s that last bit - and keep it off that is problematic. The challenge with using a diet to lose this weight is that diets do not work over the long term. Temporary restrictive approaches - whether it be of calories (DIRECT study) or carbohydrates (VIRTA Health) are prone to regression. The only way to get long term results is through a behavioral approach. Change habits in order to achieve sustainability.  The 4+2 Diabetes Reversal Strategy is built on this behavioral change model, incorporating an understanding of the physiology of insulin resistance and Type II Diabetes.
Step 1: Lower carbs to lower insulin Decrease insulin requirements by decreasing the intake of simple and refined carbohydrates. Replacing refined foods with whole foods with a special focus on fibre will result in less insulin required to maintain blood sugars. Pairing fibre rich, low glycemic, whole food carbohydrates with adequate protein and healthy fats helps normalize blood sugars after meals and provide steady glucose supply from food for hours. Step 2: Restore the Muscle as the Glucose SInk Recognizing the role of skeletal muscle as the key energy buffer for glucose; the next part of the 4+2 Diabetes Reversal Strategy is to leverage exercise and activity to increase the uptake of glucose from meals into muscle. This uptake in turn decreases the amount of glucose converted to fat by the liver. Step 3: Be Kind to the Liver The ability to maintain blood sugars while fasting is dependent on the liver making glucose from glycogen or other sources (gluconeogenesis). Fat in the liver causes insulin resistance and results in the liver over-producing glucose with a corresponding elevation in fasting blood sugar. Decreasing fat in the liver is necessary to reverse diabetes, therefore decreasing fructose and alcohol - two substances that are directly metabolized into fat in the liver is essential. In addition, focusing on gut health with adequate fibre intake has been shown to improve liver function. Step 4: Restore Fat Burning The first three steps create conditions that improve metabolic flexibility and allow the body to burn fat, but at the end of the day ‘less calories in, than calories out’ is necessary to lose weight. One of the most effective behavioral approaches to weight loss is time restricted eating starting at 12 hour of fasting and increasing to 14 to 16 hours as tolerated. Time restricted eating works because it eliminates nighttime snacking and results in fewer calories consumed making a deficit more likely. It also improves metabolic flexibility and the use of fat as fuel when fasting. When this is done after the first three steps, it is generally very easy to incorporate with minimal hunger symptoms. The +2 in the Diabetes Reversal Strategy involves decreasing the negative effects of cortisol on insulin sensitivity. Step 5: Learn to De-stress Finding ways to bring down cortisol without resorting to calories improves our ability to lose weight. Techniques as varied as meditating, yoga, time in nature and pursuing your hobbies have been shown to dissipate stress and bring cortisol levels down. Step 6: Sleep 7-8 hours per night Inadequate sleep elevates cortisol and appetite, often driving poor food choices (ie. comfort foods high in both fat and simple carbohydrates). Studies clearly show that adequate sleep can reset our stress mechanisms resulting in lower cortisol levels and improve appetite control. The 4+2 Diabetes Reversal Strategy works at the behavioral level to gradually and systematically shift to new healthy habits that are sustainable for the long run. Over time, blood sugars are better controlled, medications are reduced, weight is lost and diabetes is reversed. There is no magic to this - just sound evidence-based behaviours supported by science. At Wellness Garage we have developed a number of programs to support people who want to take control of their health and reverse diabetes: Our 4+2 Diabetes Reversal Group sessions are MSP funded group medical visits designed to provide you with all the information you need. Our 1:1 Coaching Program provides you with individualized nutrition, exercise and health coaching support to guide you to your own reversal path. “How did you go bankrupt?” Bill asked. “Two ways,” Mike said. “Gradually and then suddenly.” Ernest Hemingway, “The Sun Also Rises" Like Hemingway’s description of bankruptcy, Type II Diabetes develops gradually and then suddenly. Diabetes is a disease of sustained energy overload that develops over many years. The body’s normal energy buffers gradually become overwhelmed, and stored energy in the form of fat disrupts the normal function of key organs. This disruption through a process called insulin resistance, creates a vicious cycle where energy once stored cannot be accessed, and the energy overload is perpetuated through hunger and increased appetite. Eventually, fat stored in the pancreas overwhelms the body’s ability to maintain normal blood sugars and the diagnosis of diabetes is made. On average it takes 10 to 15 years for this process to unfold.  To understand diabetes we need to understand how our body is designed to manage energy. Energy comes from food. Specifically the fats, carbohydrates and proteins that make up the food we eat. Our bodies have two different and related ways to store energy from food: glucose and fat. Glucose is the preferred fuel for our brains and converts to energy faster in our muscles, but it has two major limitations:
Our brain’s consume 1 tsp of glucose per hour and at rest the rest of the body consumes 1 tsp per hour. In other words, our blood glucose is turned over twice per hour. This glucose is supplied directly from food when we are eating and absorbing meals and from stored glucose (glycogen) when we are fasting. Our livers can only store about 150g of glycogen - for perspective this represents only 15 hrs of basal glucose production (150g = 30 tsp = 15 tsp @ 2 tsp/hr). Fortunately our livers can also make glucose from fat, protein and lactate (broken down from muscle glycogen). So our livers are constantly trying to maintain blood sugar levels by either breaking down glycogen (glycogenolysis) into glucose or breaking other compounds (gluconeogenesis). These processes are both controlled by the pancreas through the release of two hormones:
Fat is our slow fuel and we have unlimited capacity for storage. Each gram of fat has 9 calories vs the 4 calories in a gram of glucose and fat can be stored as triglycerides (3 fatty acids linked to a glycerol backbone) without water. So for each day of stored energy we only need to carry 278g or 0.6 lbs. While fat is a slower fuel, in that it takes more time to liberate its energy, many cells with a steady basal energy requirement prefer fat as fuel - heart, intestines, muscles (at low levels of activity). When we eat food, the digestive process breaks it down into its basic components. Fat is broken down into fatty acids which are absorbed, reassembled as fats and distributed to cells that use fat for energy and stored in adipose (fat) tissue. Proteins are broken down into amino acids, distributed to cells that need them and then converted into fat or glucose by the liver depending on our energy needs. Carbohydrates are broken down into glucose, absorbed into the bloodstream triggering the release of insulin from the pancreas. 80-90% of glucose will be stored in the muscles as glycogen, 10% stored in the liver as glycogen with anything extra converted by the liver into fat. So when we eat, we use carbohydrates to top up our glycogen stores and store everything extra as fat. When we are not eating we break down fat into fatty acids providing fuel to the cells that prefer fat, and glycogen into glucose to maintain blood glucose at a steady state. This works well when we are in energy balance. Some days we store a bit more, some days we draw down a bit more. Both energy systems have buffers against overload. The glucose system has a small but immediate buffer through the storage of glucose as glycogen in muscle. The fat system has an immense capacity to buffer excess energy through the storage of fat in subcutaneous adipose tissue. And of course the fat system can buffer the glucose system. With prolonged periods of energy overload these buffers begin to break down. Muscle inactivity results in lower capacity to store glycogen in muscle resulting in more energy being converted into fat. Our ability to store fat in subcutaneous tissue eventually hits a limit. This limit differs greatly amongst different people and is known as the personal fat threshold. We have two ways to store extra fat - store more fat in existing fat cells or create more fat cells. By the time we are 2 years old the number of our subcutaneous fat cells is set. So once these cells are full we have to store fat elsewhere. We retain an ability to create new fat cells in our abdominal space around our intestines and other organs (viscera). This visceral fat is a further attempt to buffer energy overload but it is not without cost, as these fat cells send out inflammatory signals activating our immune system. Fat also begins to build up in other non-fat cells (ectopic fat). As fat builds up in these cells, their ability to respond to insulin decreases; they become insulin resistant. Ectopic fat in muscle results in insulin resistance and muscle takes up less of the glucose from dietary carbohydrates; causing more of this glucose to be converted to fat in the liver. Ectopic fat in the liver also results in insulin resistance. The pancreas initially responds to this insulin resistance by pumping out more insulin both in response to meals but also at baseline to control the liver’s production of glucose in order to maintain normal fasting blood sugars. This increased basal insulin level suppresses the body’s ability to utilize fat for energy as one of insulin’s effects is to inhibit fat oxidation. At this point, weight gain becomes inevitable further compounding the issue. Food is eaten, food is stored, but high levels of insulin prevent the utilization of that stored energy and hunger mechanisms are triggered resulting in more food intake. This extra food energy is in turn stored and the overloaded fat storage system continues to find new, but unhealthy places to store fat: visceral and ectopic fat. This vicious cycle repeats and the problem progresses. Eventually, ectopic fat finds its way into the pancreas and affects insulin production. At this point, insulin production plateaus and can no longer control blood glucose levels. By the time that blood sugars begin to rise - insulin levels are 2-3 times normal levels and 50% of pancreatic beta cells (cells that produce insulin) are dysfunctional. Once fasting blood sugars reach 7.0 mmol/L we call this Type II Diabetes and an estimated 80% of pancreatic beta cells are no longer secreting insulin.  The path to Type II Diabetes is the result of sustained energy overload systematically overwhelming our body’s buffers - muscle for glucose and subcutaneous adipose tissue for fat. Over time, excess energy becomes stored as fat in places that it should not be - visceral fat in the abdomen and ectopic fat in cells throughout the body. This fat worsens insulin resistance, resulting in higher insulin levels, and decreasing our ability to use the stored energy driving hunger that adds more energy to an overloaded body. Our individual propensity toward insulin resistance and its manifestation as Type II Diabetes is variable and dependent on such factors as age, genetics, obesity, especially visceral obesity, sedentary behavior, stress, poor sleep and of course poor nutrition.
Learn more about our Diabetes Reversal Programs Previous blog posts: Diabetes Reversal Part I Diabetes Reversal Part II Diabetes Reversal Part III Bessel van der Kolk, MD bestselling author of the Body Keeps The Score is a scientific researcher with a long history of measuring the effects of trauma on brain function, memory, and treatment outcomes, and an active therapist who keeps learning from his patients what benefits them most.  In his webcast, Dr. van der Kolk presents the conditions of trauma and describes how we are in a pre-traumatic state where life has become unpredictable and our sense of safety and control feel threatened. Drawing from his experience on working with people who have suffered from trauma- he outlines behaviours that we can do right now in order to protect ourselves from lasting traumatic effects. Trauma lacks predictability: Therefore it is important to create a sense of predictability in our day to day lives by creating structure and planning for experiences to look forward to- i.e. cooking and exercising at predictable times, planning to connect with friends online, etc. Trauma creates a sense of immobility: As humans we have a need to be mobile. Ensure that you are getting enough exercise, create a routine, try activities that involve mind-body connection such as yoga or thai chi. When people experience trauma they lose connection: Make sure you are staying connected with people. Have family dinners, or connect with friends and family online. When out, smile and say hello to strangers as we are all going through this together. You are not alone. Extreme trauma creates a numbing effect or dissociation: Be mindful of the present. Do not numb out the experience through overuse of alcohol or drugs. Go through your day with intention- i.e. plan to cook a new recipe or learn something new. During traumatic experiences we lose our sense of time and sequence: Increase your self awareness by noticing the small changes within yourself and your environment. Notice the present- how you are breathing, how your body feels. Looking outward may feed a sense of hopelessness as the situation is not changing fast enough, but when we look inwards we become aware of ourselves and realize that we are living organisms that are constantly changing. Trauma makes us feel unsafe: Create a sense of safety in your environment by listening to music, eating healthy food, engaging in activities you enjoy, connecting with loved ones if you are sharing your environment with them. Tell yourself that you are safe and that this will pass. Click here for his FREE 25 minute webcast- sign up Condensed version: That which does not kill us, makes us stronger - (Friedrich Nietzsche) ...provided we get enough recovery - (Wellness Garage) Chronic stress can play a central role in the development and progression chronic disease and ill health. But stress is not all bad Let’s consider the paradox of stress Protection and damage are the two contrasting sides of physiological processes that defend our bodies against the challenges of daily life, whether or not we call them “stressors.” We respond to stress in two ways:
 Our bodies are designed to respond to a challenge (or stress) by
This process is called allostasis – the ability to achieve stability through change. Your response to a stressor is determined by many factors:
ALL of which determine the extent of your physiological response.  Over time allostatic load can accumulate OR the individual can adapt. The immediate stress response is mediated by two systems:
 When a situation is perceived as stressful – the hypothalamus sends signals to activate both stress responses. The hypothalamus signals the inner part of the adrenal gland to release adrenaline and which activates the sympathetic nervous system, resulting in:
The effect is immediate and is experienced as the adrenaline rush. The hypothalamus also releases a hormone CRH which activates the pituitary gland to secrete adrenocorticotropic hormone (ACTH) the hormone that stimulates the outer part of the adrenal gland to produce cortisol. Cortisol enables the body to maintain steady supplies of blood sugar for a more prolonged stress. Adequate and steady blood sugar levels help person to cope with prolonged stressor, and helps the body to return to normal. Cortisol does this by:
Once the stress is over the body recovers by:
Every system of the body responds to acute challenge with allostasis leading to adaptation. When these acute responses are overused or inefficiently managed, allostatic overload results. There are 4 patterns to the accumulation of allostatic load:
 Remember, three factors largely determine individual responses to potentially stressful situations:
So the key to avoiding the damaging effects of stress is to:
This is why developing stress tolerance is one of our 6 pillars of health Strategies like meditation, yoga, mindfulness, hobbies and anything that brings you into flow can help both the recovery and the perception of stress. Other strategies like ‘stress audits’ can help you identify the areas of life within your control that are causing you stress. Decisions can then be made to alter or avoid these particular situations. Changing your perception of a stressful situation is one of the most powerful ways to develop stress tolerance. Katie Byron has a process called “The Work” in which she walks you through a process that has you answering 4 questions about the situation:  Developing a strategy to tolerate stress is a key part of maintaining health - what is your strategy?
When it comes to lifestyle and health, we sometimes over-index on exercise while ignoring the role of physical activity. We actively encourage 150 minutes a week as being the right starting dose for exercise but we often neglect to emphasize the importance of activity, or the deleterious effect of sedentary behaviors. From a health perspective, exercise and activity are different and complementary. They are the two sides of the MOVE pillar - each contributing different, synergistic benefits to your overall health.  But first, what’s the difference between movement and exercise? (as defined by the World Health Organization)
Independent of exercise, physical inactivity or sedentary behaviour is recognized as one of the leading risk factors for noncommunicable diseases and death worldwide. For individuals, the failure to enjoy adequate levels of physical activity increases the risk of cardiovascular disease (heart attack and stroke), cancer, and diabetes by 20–30% and shortens lifespan by 3–5 years. Sedentary behaviour, cardiovascular and metabolic health Sedentary behaviour negatively affects the way our bodies process the two major energy sources from our diets: fat and glucose. Even short periods of sedentary behaviour decreases our body’s ability to both use and store fat. Being inactive decreases levels of lipoprotein lipase (LPL) the enzyme that facilitates the uptake of fat into muscle and adipose tissue. Similarly, sedentary behaviour has been shown to decrease the expression and concentration of glucose receptors in muscle. These combined effects make lack of activity a particularly potent risk for both cardiovascular and metabolic risk. Hamburg et al. (2007) took 22 adult volunteers and had them remain in bed for 23.5 hrs per day for 5 days. At the end of the study - despite no change in weight they experience significant disruption of important cardio-metabolic biomarkers - increased cholesterol, increased triglycerides, higher glucose, and signs of insulin resistance, the process underlying Type II Diabetes. In fact when challenged with glucose their body’s had to release 67% more insulin in order to maintain normal blood sugar levels. In short - being sedentary rapidly increases your risk of cardiovascular disease and diabetes. Vascular Health Being sedentary, decreases vascular function independently of the effects on cardiometabolic risk factors with apparent effects on endothelial dysfunction. Cancer Multiple studies have shown links between sedentary lifestyle and increased cancer risk specifically for colon, endometrial, ovarian and breast.  Bone Health It has been well documented that lack of activity leads to decreased bone mineral density and the corresponding increase in the risk of fracture from the development of osteoporosis. In young healthy men, 12 weeks of bedrest can decrease bone density by 1-4% Mental Health & Psychosocial Well-being Physically active people have higher physical and mental quality of life as well as self esteem. Whether this is due to the increase of physical activity or the reduction of sedentary lifestyle is not entirely clear but it is safe to say that increasing physical activity and being less sedentary is associated with improved mental health and psychosocial well-being. All of these effects combine to create a dose-response relationship between time spent in sedentary behavior and mortality. Much of the research on sedentary behaviour has focused on TV viewing time and more recently screen time. Each 2 hour per day increase in TV time was associated with a 14-20% increase in the risk of diabetes independent of other physical activity. How can you be more physically active?  Planning is essential to make this part of your life. When planning your week be sure to block times to include both
 Both exercise and physical activity have independent and synergistic effects on your health, be smart and get both.
With the spread of COVID-19, our public health leaders have been very clear: The time is now to stay home, social distance and physically self-isolate to prevent the spread of this epidemic. It is important to remember that these sacrifices are not necessarily for you but will help the most vulnerable amongst us avoid this illness As we make such massive changes to our lives, we understand that these are extraordinary times and for many people the thought of making lifestyle changes may feel overwhelming. However, we at Wellness Garage believe that a healthy lifestyle is one of our best defenses we have against fighting off infections and disease. Now, as much as ever, is the time to make sure that you are taking care of yourself! And we want to be with you to support you on your health journey as we tackle these uncertain times together. Consider, we are here to support you so that you can continue to support those around you. Our staff has moved to work from home in order to follow social distancing recommendations from public health. And just like all of you, we are getting creative and finding resourceful ways to stay connected and stay healthy. 10 Things To Help You Stay Healthy (and sane) in a Time of COVID-19 Get outside (but remember social distancing): walk- bike- hike- whatever suits you! Nature is a powerful medicine and we are fortunate in BC to have an abundance of outdoor space. Social distancing recommendations are to stay 6 feet apart from each other- which isn’t hard to do when you consider how much green space there is all around us.  Try a new recipe: With many restaurants closed, it is a great time to try a new recipe. We have a number of favourites available through our meal planning resource. Reach out to us (recipes@wellnessgarage.ca) if there is something specific you are looking for. Learn to cook more plant-based: Check out Rouxbe, a Vancouver-based professional online cooking school offers courses for as little as $39. That is less than a meal for two at many restaurants. Now just may be the time to learn to cook! Try yoga from home: Glo Yoga- has a variety of different yoga and meditation options to try for for FREE. YYOGA- (Vancouver & Toronto) studios are also offering online options with free trial memberships. Check with your local studios as many are offering virtual options.  Image by Benjamin Balazs from Pixabay Learn to meditate - now you cannot say that you don't have the time! Start with 5 min a day. Download an app: Calm, Headspace, 10% Happier, Waking Up are a few of our favorites. Meditation has many proven health benefits, but one of the first that you will realize is a reduction in stress - something we all can use a dose of right now!  Develop a home workout routine and stick to it! - Whether you have equipment or not, we have developed a number of minimalist workouts that might be just the thing you need to develop a new routine that you can easily do at home. Email fitness@wellnessgarage.ca and we will send you a quick & easy resource to guide you. We recommend planning your workouts and. keeping track of how many you do a week. Try a challenge with a family member or. co-worker to help keep you accountable. We are exploring ways to deliver virtual work-outs to you- Stay Tuned! Challenge yourself to stay off your phone: As the news of COVID-19 keeps rolling in, it will become more and more challenging to keep from reading the news as quickly as it pops up on your news feed. Try limiting yourself to specific times of the day to check for updates. Avoid reading or watching the news before bed when it can stimulate stress hormones known to interfere with sleep. With all the time you save, you can make it through that much neglected novel on your bedstand!  Image by Wokandapix from Pixabay Plan a family games night: and another one, and another one,... Consider this time to hang low with family and take out the Yahtzee, scrabble board or puzzle that is hiding in the cupboard. Try reaching out to other friends and play a virtual card game through Facetime of Google Hangouts! Laugh, Share Uplifting Stories: Take note of the funny and inspiring things that are happening all around us. During challenging times, it is difficult to notice all of the good that we share. Life will return to normal and in the meantime, laughter helps to keep us connected and releases necessary endorphins that send positive messages to the brain! Watch a documentary about health: Take the extra time when you may be homebound to watch some of the health documentaries that we have been talking about at the Garage: Game Changers: Explores the benefits of plant based eating with a focus on how athletes are benefitting from a plant-based diet. Definitely controversial in some of it's claims but it has emerged as one of the most popular documentaries ever! Fed Up: Explores the prevalence of sugar in the standard North American diet and how it is driving an obesity epidemic. Embrace: Is a powerful movie about embracing your body for what it can “do” rather than how it looks. Cooked: Michael Pollan explores the connection between food and culture through this Netflix series. Supersize Me: The documentary to stop your fast food habit! Food As Medicine: Explores the role of food in healing. One last word - remember to take care of yourself. Give yourself space to rejuvenate, explore your (at home) hobbies, take a long bath, stretch, drink tea. Whatever ritual you find comforting, find time to work it into your day! By taking care of ourselves, we will have more to offer others in this challenging time.
Stay safe, stay connected and be well! (Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) There are multiple lines of evidence to support that getting a good night's sleep is important in order to be able to lose weight. From an evolutionary perspective sleep and energy management are intricately linked. Poor sleep dramatically alters the way the body responds to food.  When you do not get adequate sleep, your hunger hormones send signals to your brain to eat more.
As a result studies have shown that people who have inadequate sleep consume more calories. Compounding this, sleep deprived individuals have been shown to preferentially choose calorie dense foods rich in both fats and carbohydrates. Inadequate sleep also increases the release of the stress hormone cortisol, which in turn signals the brain to increase appetite via the release of another hormone orexin. High levels of cortisol may explain why sleep deprivation appears to lead to loss of muscle mass and increased abdominal (visceral) fat. Independent of its effect on appetite, cortisol also counters the actions of insulin, leading to insulin resistance the result of which can be high levels of insulin. Insulin is a storage hormone promoting the storage of prompt storage of glucose as glycogen and fats within adipose tissue. With high enough levels of insulin, fat will be quickly stored and lipolysis (the breakdown of fat for energy) will be suppressed, resulting in one-way storage in other words "a moment on the lips, forever on the hips" This cortisol induced insulin resistance can be demonstrated in as little as one week of sleep deprivation. Other studies have shown that a lack of sleep can
As a result of these effects it is not surprising that inadequate sleep is associated with weight gain. Large observational studies, like the Nurses Health Study, following 68,000 nurses, demonstrated that short sleep duration increased the likelihood of obesity by 15%. Of course, observational research can show associations it cannot prove causation, however shorter term sleep deprivation studies also show weight gain. The recent PREDIMED Plus study showed that lack of sleep affects weight loss during a trial of the Mediterranean Diet , as overweight people who did not sleep well lost less weight that those without sleep issues. Finally, sleep apnea one of the most devastating sleep disorders is both associated with and worsened by weight gain. This sets up a vicious cycle where poor sleep can lead to weight gain, and potentially sleep apnea and sleep apnea in turn leads to further weight gain. So we can see from this
The resulting vicious cycle can set up a progressive deterioration of sleep with a corresponding weight gain. The key to reversing this cycle is to prioritize sleep:
For more on this, see some of the previous blog posts on sleep
For other posts in our foundational behaviours for weight managemetn series:
On January 29th- we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. (Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) One of the best ways to improve your overall health is to exercise. Yet from a weight loss perspective, exercise on average yields modest results. The explanation for is captured eloquently by the saying “you can’t outrun a poor diet”. Increasing physical activity increases energy expenditure - the challenge is that it increases appetite. If you have not made changes to your nutrition (eating real food, hydrating without calories, going 12 hours without food and increasing your fibre), then by increasing exercise and your appetite, you run the risk of actually gaining weight as you eat more. Where exercise has it main role in weight management - is helping to prevent you from regaining weight. Once you have lost weight, exercise does a great job of maintaining or increasing your metabolic rate.  Beyond weight management, exercise has numerous health benefits and lack of physical activity has been identified as the fourth leading risk factor for global mortality and has been estimated as being the principal cause for approximately:
It has been estimated that for every hour you exercise you increase your longevity by 7 hours (up to a total benefit of an additional 3 years) and exercise can reduce premature death from all causes by 16% and from cardiovascular disease by about 25%. Simply put, exercise helps you to avoid premature death and live longer. Exercise also has many benefits for the here and now:
Despite these benefits, only 17% of Canadians meet the current guidelines of 150 minutes of “moderate-to-vigorous physical activity” per week. (2019 Canadian Health Measures Survey) This recommendation supported by the WHO reflects the amount of exercise necessary to get most of these benefits. It can be broken down into as little as 10 minute increments. Moderate intensity physical activities will cause adults to sweat a little and to breathe harder - up to the point that you could still have a conversation. Vigorous intensity activities will cause adults to sweat more and be ‘out of breath’. In our Wellness Garage Principles, we recommend:
Some ideas from Participaction: ;
Pick a time. Pick a place. Make a plan and move more. For other posts in this series:
On January 29th- we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. |
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