4 Root Causes of Low Mood & Depression

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Low mood and depression are increasingly at an alarming rate in today's modern society. The Center for Disease Control shows 10% of people suffer from depression, but in clinical practice people struggle with low mood at much higher rates in today's constantly connected world seemingly fuelled by processed foods. The World Health Organization has estimated that by the year 2050, one-third of the global population will suffer from either anxiety or depression. This is a moind-boggling statistic. How is this possible? Why are we more prone to depression today than in generations past? As with any complex condition, multiple underlying factors conspire to create an environment where low mood and depression can thrive. Let’s look at a few common root causes to better understand how things go wrong at a cellular and hormonal level. 

#1 BLOOD SUGAR AND INSULIN DYSFUNCTION

Today, 75% of the North American population are classified as overweight or obese. While the annual consumption of processed and simple sugars has dropped a little over the past few years, it's still incredibly high at 100-140 lb. of sugar per person. Combined with the over-consumption of processed carbs and alcohol and you've got five of the top six foods in the American diet; desserts (grain-based), breads, processed chicken, soda pop and energy drink, alcohol and pizza. This leads to an excessive caloric intake, which is further exacerbated by these hyper-palatable foods, meaning the cycle continues over and over again. When your cells are constantly flooded with excess energy, they eventually say "enough is enough" and refuse to take in more energy. This is the state of insulin resistance and further down the road diabetes (type-2). 

How does this relate to mood? Research from Scandinavia has uncovered a clear association between elevated HbA1c - a three-month average of you blood sugar levels - and insulin levels with increased risk of depression. They found that young men with insulin resistance were three times more likely to suffer from severe depression.(1) Another study in Diabetes Care of over 4,000 people showed depressive symptoms were highly associated with higher fasting and 30-minute insulin levels.(2) The authors specifically noted that antidepressant medications did not alter this association because the medications target neurotransmitters (e.g. serotonin, dopamine) and do not address blood sugar and insulin dysfunction. Improving blood sugars and insulin control is an important first step for reducing your risk for low mood and depression.

#2 CHRONIC & SYSTEMIC INFLAMMATION

Inflammation is another potential root cause of low mood. Low-grade systemic inflammation leads to the over-production of pro-inflammatory cytokines that are also associated with depression.(3) The prestigious New England Journal of Medicine recently published a review of the growing connection between chronic inflammation and the development of today’s most common chronic diseases, including depression.(4) The current medical literature tells us that if you are overweight or obese, you likely have low-grade systemic inflammation.(5) This shouldn't be a surprise, as inflammation is "upstream" of blood sugar and insulin dysfunction. A diet rooted in traditional foods - rich in animal protein, healthy fats and antioxidants - will help to cool inflammation and reduce the damaging effects of reactive oxygen species (ROS) produced during the inflammatory response. Polyphenols found in coffee, dark chocolate (even red wine!), as well as vegetables are great sources of anti-inflammatory polyphenols. Extra-long chain omega-3 fats DHA and EPA also exert powerful anti-inflammatory effects and a poor omega-3 to omega-6 fats ratio is also associated with a chronic stress state and increased risk of depression.(6)

#3 GUT DYSFUNCTION & DYSBIOSIS

The gut microbiota - commonly referred to as your microbiome - plays a key role in your mental health through its constant communication with the brain via the vagus nerve. Key neurotransmitters targeted by medications for improving symptoms of depression – serotonin and dopamine – are actually produced in the greatest concentrations in the gut (not the brain). This gut:axis is highlighted by research showing that if you are overweight, you're at much greater risk of poor zonulin function, a key molecule that regulates gut permeability.(7) Poor zonulin function leads to symptoms of a leaky gut, leading to a pro-inflammatory environment that creates the cytokine storm that contributes to low mood and depression. You don’t need to be overweight to suffer from leaky gut. If you travel across multiple time zones, consume alcohol excessively, or chronically rely on NSAIDs – non-steroidal anti-inflammatory drugs – like ibuprofen and naproxen you'll be much more prone to leaky gut and chronic worsen inflammation.(8,9) A dietary approach rooted in traditional foods - animal protein, healthy fats, vegetables and unprocessed carbohydrates - will help to keep blood sugar levels balanced and support a healthy gut microbiota, thus keeping systemic inflammation and low mood at bay.  

#4 A SEDENTARY LIFESTYLE

Movement is a critical component of mental health and wellbeing. Long, busy workdays make it difficult to find time to exercise, however it should be a foundation of every mental health plan. A recent meta-analysis of 92 studies on more than 4,310 people showed that light to moderate exercise significantly reduced the incidence of depression.(10) Try adding 15-20 minute walks at lunch or the end of your day to increase your activity level.

Strength training can also play a key role in mental health. Basic movements like squatting, lunging, bending, pushing, and pulling are deeply engrained in our DNA and exert tremendous positive benefit on multiple systems of the body: improving blood sugars and insulin, reducing inflammation, boosting testosterone (low levels have been associated with depression), and supporting healthy gut flora. If you’re not active, start slowly with 10-20 minutes of strength training 2-3 times weekly and focus on bodyweight type movements.

There is no “magic bullet” to fix depression. It’s a complex multi-factorial condition that is impacted by numerous systems of the body. From a biochemistry and physiology standpoint,  addressing root causes like blood sugar and insulin dysfunction, chronic inflammation, dysbiosis and leaky gut and maintaining an active lifestyle are great places to start so you can raise the playing field. (It's also important to consult a qualified mental health professional to address the underlying emotional root-causes). Take control of your mental health by making the small changes to your nutrition, movement and lifestyle so you can get back to feeling your best. Many people and athletes alike experience low mood and depression, you're not alone.

Dr. Marc Bubbs ND, CISSN, CSCS

Want to learn more? High blood sugar and insulin levels are strongly associated with depression. Listen to diabetes expert Dr. Jason Fung MD in Episode #15.

 

 

REFERENCES

1. Timonen. M et al. Insulin resistance and depressive symptoms in young adult males: Findings from Finnish military conscripts. Psychosom Med 69(8):723-28.

2. Pyykkonen AJ et al. Depressive symptoms, antidepressant medication use, and insulin resistance: the PPP-Botnia Study. Diabetes Care. 2011 Dec;34(12):2545-7.

3. Felger J, Lotrich FE. Inflammatory cytokines in depression: neurobiological mechanisms and therapeutic implications. Neuroscience. 2013 Aug 29;246:199-229.

4. Emerging Risk Factors Collaboration. Diabetes mellitus, fasting glucose, and risk of cause-specific death. New England Journal Medicine, Mar 2011;364;9:328-341.

5. G. S. Hotamisligil, N. S. Shargill, and B. M. Spiegelman, “Adipose expression of tumor necrosis factor-α: direct role in obesity-linked insulin resistance,” Science, vol. 259, no. 5091, pp. 87–91, 1993.

6. Larrieu T, et al. Nutritional omega-3 modulates neuronal morphology in the prefrontal cortex along with depression-related behaviour through corticosterone secretion. Transl Psychiatry. 2014 Sep 9;4:e437.

7. Moreno-Navarrete JM et al. Circulating zonulin, a marker of intestinal permeability, is increased in association with obesity-associated insulin resistance.. PLos One 2012;7(5):e37160.

8. VanWijck K et al. Aggravation of exercise-induced intestinal injury by Ibroprofen in athletes. Med Sci Sports Exerc. 2012 Dec;44(12):2257-62.

9. Matsui H et al. The pathophysiology of non-steroidal anti-inflammatory drug (NSAID)-induced mucosal injuries in stomach and small intestine. J Clin Biochem Nutr. 2011 Mar;48(2):107-11.

10. Rebar A, et al. A Meta-Meta-Analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health Psychol Rev. 2015 Mar 5:1-78.

Does Red Wine Make You Healthier? 11 Factors To Consider

Does Red Wine Make You Healthier? 11 Factors To Consider

Red wine has been consumed for centuries, dating all the way back to 7,000 BC in China and 4,500 BC in Greece, and when Rome conquered Greece it became embedded into Roman culture. Not surprisingly, it became a huge part of the Southern European lifestyle in countries along the mediterranean, whom still typically consume wine with meals. More recently, in the 1980s the term "French Paradox" attempted to explain why the French had the lowest incidences of cardiovascular disease despite a high-fat diet (see Nina's Teicholz expert podcast for the full story) and regular intake of antioxidant-rich red wine was thought to be a factor.

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Salt - Evil Additive or Essential Nutrient?

Salt - Evil Additive or Essential Nutrient?

Salt has been a highly valuable commodity throughout the history of mankind — so revered that terms like “worth their salt” are used widely to describe a person’s integrity. Yet today, every newspaper, magazine, and blog seems to be telling us to avoid salt like the plague!

With all the conflicting information, it’s no wonder one of the most common questions I get asked by patients and athletes...

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Late-Night Eating: The Modern Circadian Mismatch

Late-Night Eating: The Modern Circadian Mismatch

Renowned evolutionary biologist Theodosius Dobzhansky said “nothing in biology makes sense except in the light of evolution.”[1] Throughout our evolution, we have lived in daily cycles of light and dark. These cycles have led to the development of natural circadian rhythms that impact many aspects of our health and vitality.

Circadian rhythms are triggered by the bright light stimulus in the morning and darkness in the evening. The hypothalamus area of the brain – specifically the suprachiasmatic nucleus (SCN) – is the master regulator, synchronising the body’s circadian clock based on information it receives from photoreceptors in the eyes in response to light [2]. The impacts of circadian rhythm are wide-reaching:

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3 Ways Gut Bacteria Can Harm Your Thyroid

3 Ways Gut Bacteria Can Harm Your Thyroid

Today, approximately 30 million people are struggling with a thyroid problem and many more are undiagnosed. Women are much more affected by thyroid problems, compared to men, with one out of eight impacted in their lifetime and the likelihood increases as you age. Alarmingly, while most cancer diagnoses are on the decline over the past decade, thyroid cancer rates have been increasing. The obvious question to ask is why are thyroid conditions becoming so commonplace? Like most chronic and degenerative conditions it's multi-factorial, and one key factor affecting your thyroid health is your gut bacteria, also known as the microbiome.

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3 Ways Camping Can Reboot Your Circadian Rhythms

3 Ways Camping Can Reboot Your Circadian Rhythms

Sleep problems seem to be the “new normal” these days. Most of the clients I see in clinical practice complain of difficulty falling asleep or staying asleep regularly throughout the week. Sleep quality isn’t the only problem. The average person gets a mere 6.5 hours of sleep per night (a far cry from the 8 hours our grandparents slept two generations ago) and over 33% of the population get less than 6 hours per night. New research shows lack of sleep is also a major factor contributing to blood sugar, insulin imbalances and chronic disease (not to mention poor athletic performance), so rebooting your sleep and recovery are critical. It seems late nights watching iPads, working on your laptop, or scrolling social media is dramatically changing our modern sleep patterns.

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6 Winter Foods That Boost Your Health

 6 Winter Foods That Boost Your Health

This time of year, it seems like every time you turn on the TV or open up Facebook, someone is talking about tips and tricks for staying healthy during the winter months. And while being a stickler about hand washing, disinfecting your workspace, and getting plenty of rest is excellent advice for avoiding seasonal colds, one area you cannot—I repeat, cannot—neglect is your diet.

If a strong, high-functioning immune system is your goal, then consuming quality, nutrient-dense foods needs to be a keystone in your game plan.

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What To Do If You Have Seasonal Affective Disorder (SAD)?

What To Do If You Have Seasonal Affective Disorder (SAD)?

It’s that time of year again. The darkest and shortest days of the year don’t just bring about cold weather; they can also bring about significant changes in your mood and how you feel. 

Seasonal affective disorder (SAD) is a real thing that affects over 10 million Americans, with another 10-20 million said to struggle with mild symptoms.

If you live in a city with a true winter climate – like New York, Toronto, or London – you’re up to 10 times more likely to struggle with mild to moderate SAD. Also, adolescents and young adults are more likely to be affected.

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Reduce Omega-6s (and Increase Omega-3s) for Better Health & Performance

If there’s one area where the nutrition media seems to sing a different and more confusing tune every week, it’s with their messages about fats.

Low fat was good for us, now it’s not. Saturated fats may not be the heart-clogging poison we thought. And what exactly are trans fats? It’s enough to make us throw our hands in the air and reach for the nearest burger.

Fortunately, one message has been consistent: omega-3 essential fatty acids (EFAs) are extremely beneficial for your overall health.  

The problem is, not all sources of omega-3 fatty acids are created equal.

In fact, the most common plant source of Omega-3s, called DHA, is converted to the form that we use, called EPA. It’s EPA which exerts the majority of the potent benefits of omega-3 fats.

But that’s only half of the story. While omega-3’s benefit our health, too much consumption of its counterpart, omega-6 EFAs, increases circulating levels of inflammatory arachidonic acid (AA) which can promote heart disease, cancer and most chronic diseases. 1

Unfortunately, our bodies can more readily convert omega-6 fatty acids to AA. Especially among some multi-generational vegetarians. That’s why, for optimal health, it’s not enough to just increase your variety of DHA and EPA-rich foods. You need to reduce your intake of pro-inflammatory omega-6 fats as well.  

Decrease Your Omega-6 Intake

The balance of omega-6 to omega-3 is critically important and unfortunately today’s modern diet is loaded with omega-6 fats. The omega-6 to omega-3 ratio of ancestral hunter-gatherer diets was approximately 2:1-3:1, whereas today’s ratio is around 10:1 to 20:1 (and higher among vegetarians). 2

Many people aren’t even aware they consume as much Omega-6 fatty acid as they do. It’s hidden in processed and convenience foods, used in most restaurants (even the expensive ones!) and in your favorite midday treat.

Vegetable and cooking oils are the most common sources. The following is a list of common omega-6 rich oils:

Oil - Omega-6 (%):Omega-3 (%)

Safflower- 75:0%

Sunflower- 65:0%

Corn - 54:0%

Cottonseed50%0%

Sesame - 42:0%

Peanut - 32:0%

Soybean - 51:7%

Canola - 20-9%

Fish Oil - 0:100%


Most of us will benefit from cutting out these pro-inflammatory oils in favor of animal fats like beef tallow and duck fat (best for high-heat cooking) as well as coconut, avocado, walnut, macadamia or extra-virgin olive oil (best for moderate-heat cooking).

Increase Omega-3 Intake (EPA/DHA)

Now that you’ve cleared your kitchen of pro-inflammatory omega-6 fats, it’s time to ramp up your dietary intake of the extra-long chain omega-3 fats; DHA and EPA.

A daily intake of just 1g of combined EPA and DHA can have many positive effects. If you’re overweight or struggling with poor health, increasing your intake of omega-3 fats can improve blood sugar and insulin control, help fight off low mood and depression, and protect you from coronary heart disease. 3,4,5

If you’re exercising regularly (or just getting active), the University of Florida found consuming DHA post-training was able to significantly reduce exercise induced pro-inflammatory markers IL-6 and CRP over a two-week period. 6 In the UK, researchers at Cardiff University found that EPA and DHA were able to reduce key proteins that trigger the disease progression in osteoarthritis. 7

Fish: A Great Source of EPA

Terrific sources of extra-long chain omega-3 fats include Atlantic mackerel (2.6g per 3.5 oz. serving), herring (1.8g), tuna (1.6g), and salmon (1.5g per 3.5 oz.). If you like shell fish, blue mussels (0.5g per 3.5oz serving), oysters (0.6g), and squid (0.4g) are nice options as well.

Lean Meats: A Less Known Sources of Omega-3s

While most people naturally associate feedlot beef with saturated fats, and look to fish and seafood to get their omega-3s, grass-fed beef is actually a good source of EPA and DHA (0.3g per 3.5oz. serving).  Ancestral staples like wild game meats – elk, bison, venison, etc. – are also good options as they’re naturally low in pro-inflammatory omega-6 with some omega-3s.

Omega-3 Eggs

Pasture-raised eggs are far more nutrient dense than conventional eggs and provide 0.3g of omega-3s per two large eggs.8

If there’s a lesson to be learned, it’s that the balance of omega-3 to omega-6 is what’s crucial for optimal health, as well as mental and physical performance.9,10,11 Focus on both reducing your intake of pro-inflammatory omega-6 fats and increase your intake of extra-long chain omega-3 fats to reverse chronic degenerative conditions and restore health and vitality.

Dr. Marc Bubbs ND, CISSN, CSCS

 

References

[1]  ResearchGate. (March 29, 2016). Human genome shaped by vegetarian diet increases risk of cancer and heart disease. Retrieved from https://www.researchgate.net/blog/post/human-genome-shaped-by-vegetarian-diet-increases-risk-of-cancer-and-heart-disease

[2]  Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005;81(2):341-54.

[3] Delarue J et al.Interaction of fish oil and a glucocorticoid on metabolic responses to an oral glucose load in healthy human subjects.Br J Nutr.2006 Feb;95(2):267-72.

[4] Su K, et al.Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial.Eur Neuropsychopharmacol 2003;13(4):267-271

[5] Okuyama H et al. ω3 Fatty Acids Effectively Prevent Coronary Heart Disease and Other Late-Onset Diseases – The Excessive Linoleic Acid Syndrome. World Review of Nutrition and Dietetics (Karger) 2007, 96 (Prevention of Coronary Heart Disease):83-103. Retrieved From – https://www.researchgate.net/publication/232471505_o3_Fatty_Acids_Effectively_Prevent_Coronary_Heart_Disease_and_Other_Late-Onset_Diseases_-_The_Excessive_Linoleic_Acid_Syndrome

[6] Phillips T et al.A dietary supplement attenuates IL-6 and CRP after eccentric exercise in untrained males.Med Sci Sports Exerc 2003;35(12):2032-2037.

[7] Zainal, Z et al. Relative efficacies of omega-3 polyunsaturated fatty acids in reducing expression of key proteins in a model system for studying osteoarthritis. Osteoarthritis Cartilage. 2009 Jul;17(7):896-905.

[8] Karsten H et al. Vitamins A, E and fatty acid composition of the eggs of caged hens and pastured hens. Renewable Agriculture and Food Systems. Volume 25/ Special Issue 01 / March 2010, pp45-54. Retrieved From – http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=7219036

[9] Sheppard, K.W. and C.L. Cheatham, Omega-6 to omega-3 fatty acid ratio and higher-order cognitive functions in 7- to 9-y-olds: a cross-sectional study. Am J Clin Nutr, 2013. 98(3): p. 659-67.

[10] Simopoulos, A.P., An Increase in the Omega-6/Omega-3 Fatty Acid Ratio Increases the Risk for Obesity. Nutrients, 2016. 8(3): p. 128.

[11] Simopoulos, A.P., The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother, 2002. 56(8): p. 365-79.

 

Why Avoiding The Sun Is As Dangerous As Smoking

For almost three decades, we’ve been told by doctors and health practitioners to limit our sun exposure. Just like eggs yolks and cholesterol, a fear of too much sun and the risk of skin cancer was instilled in the general population. Unfortunately, more sunscreen and less sunshine hasn’t improved our health. In fact, it’s gotten worse.

Something that likely started with good intentions eventually morphed into a completely excessive use of sunscreens to protect ourselves from skin cancer.

New research is highlighting that NOT getting enough sun exposure can be just as bad for you as smoking! (1) That’s a powerful statement, so let’s take a closer look at the studies and find out what the right dose of sunshine is for you.

Doesn’t the Sun Cause Skin Cancer?

There is no doubt that if you continually and significantly overexpose yourself to the sun (think sunburns), then you increase your risk of melanoma and skin cancer. However, the skin cancer scare of the 1990s was a little misleading.

Recently, the British Journal of Dermatology concluded that the marked rise in cases of skin cancer in the 1990s had less to do with sun exposure—and more to do with changes in the diagnosis of skin cancer. Researchers call it “diagnostic drift,” which is a fancy term that describes how doctors in the 1990s started lumping in noncancerous (i.e. benign) lesions with cancerous ones. (Previously, they were separated.) (2) In fact, sun exposure may actually help you prevent skin cancer and heal more quickly if you already have skin cancer. (Yes, really!)

How is that possible? Well, the original research was done in northern Australia, an area that provides constant, strong sun exposure throughout the year. A group of individuals live there who ancestrally migrated from northern Europe.

What we know now is that extrapolating that information and then applying it to countries that only get a few months of strong sun exposure every year (e.g., Canada, England, and Sweden) is faulty logic. Similarly, using the original research of populations with predominantly fewer melanocytes (cells that produce melanin), and applying it to other populations with more pigmentation is also poor logic.

In short, they got it wrong. The good news is that new research is uncovering just how important the sun is for your overall health and vitality.

The New ‘Light’ on Sunshine Research

Just this spring, the prestigious Journal of Internal Medicine made a discovery unlike any other. If you AVOID the sun, it increases your risk of death to the same degree as smoking! (3) It’s hard to believe, but the evidence is very compelling.

Between 1990 and 1992, Dr. Pelle Lindqvist, MD, of Karolinska University in Sweden had his research team recruit almost 30,000 women between the ages of 25-64. They tracked their health status over the next 2.5 decades. They found that women who got the most sun had a lower risk of cardiovascular disease (CVD), diabetes, multiple sclerosis, and lung disease—compared to those who avoided the sun.

They concluded that avoiding the sun could subtract 0.6-2.1 years of your life expectancy. How’s that for turning the “sunshine” argument on its head?

The researchers also found the benefits were dose-specific: The more sun you get, the more the benefits increase. However, it’s important to remember that it’s an observational study, so it highlights an association between lack of sun exposure and disease, not causation. (There could be a number of different factors that lead to this improvement; people who get more sun tend to eat more healthily and exercise more regularly.)

Some confusion was added to the list of their findings because skin cancer rates did in fact increase, but those patients exposing themselves to sun had much better survival rates. Studies in Ireland confirm that a Vitamin D deficiency makes skin cancer more dangerous. (4) How is that possible? The answer likely lies the dosage.

More Benefits of Sun Exposure

Here is a quick list of benefits from exposure to regular sunshine and Vitamin D:

Cancer Prevention
Sunlight is your body’s best source of Vitamin D, which has been shown to be protective against more than a dozen cancers. In fact, the Canadian Cancer Society performed a large, randomized, placebo-controlled study, and they found that it may help cut the risk of cancer by 60%. (5) (6)

Better Blood Pressure
If you live in colder, darker climates (e.g., northern cities in the United States, Canada, or England), then the research shows you’re more likely to suffer from hypertension than people who live in warmer, sunnier climates closer to the equator. (7)

Lowers Inflammation
Inflammation is a common root of many chronic diseases. Therefore, cooling inflammation should be a high priority for anyone trying to improve their health. Exposure to sunlight has been shown to reduce the effects of cardiovascular disease (CVD), and experts think that Vitamin D’s impact on lowering inflammation may play a key role. (8)

Sets Your Circadian Patterns
Exposure to first morning light is a signal to your nervous system to wake up and get ready for the day. Recent research on modern-day hunter-gatherer tribes (e.g., the San in southern Africa, the Tsimane in Bolivia, and the Hadza in Tanzania) has highlighted the powerful impact of waking with the rising sun and going to sleep not long after sunset. (9)

Despite these tribes averaging only 5.7-7.1 hours of sleep per night, they sleep deeply and have superior overall health. (In fact, they have no words to describe "insomnia"; it does not exist in these groups.) Disrupted circadian patterns have been shown to leave you more prone to fatigue and inflammation, and they can even change the balance of bacteria in your gut from “good” to “bad”. (10)

What Is The Right Amount of Sun?

The right amount of sun for you involves the approach that maximizes the benefits of additional sun exposure, while limiting the potential harms. The following is a short list of tips to help you find the right dose:

  • Never let your skin burn.
  • If you have fair skin, aim for approximately 10-15 minutes of sun exposure—enough to make your skin very light pink (but never red or burned).
  • If you have darker skin, you need more sunlight. Aim for anywhere from 20 minutes to 2 hours, depending on the individual. (Again, never let your skin burn.)
  • Get exposed to morning sunlight daily.
  • Get outside! Sunlight is the purest form of vitamin D.
  • If you know you’re going to be outside all day, then cover your face and nose with sunscreen during the hottest parts of the day.

Getting outside in the fresh air and sun could be the most Paleo of all lifestyle factors. It should be a staple in your life. Enjoy!

(This article first appeared @Paleohacks.com)

Dr. Marc Bubbs ND, CISSN, CSCS

7 Reasons Exercise Is "The Best Pill" For Chronic Disease

The idea that exercise is the best ‘pill’ you’ll ever take to promote a healthy heart and blood vessels is consequently gathering steam in the medical community.  World leaders in cardiovascular medicine gathered at the 2010 European Society of Cardiology Congress Conference in Stockholm, Sweden.  The main topic of discussion was the impact that moderate exercise can have on not only preventing cardiovascular disease (CVD) but reversing CVD in patients with existing damage.  This is a profound statement as according to the American Heart Association we currently spend 475 million dollars annually treating CVD. The scientific data presented supports the notion of exercise as a ‘first line’ therapeutic medical intervention - not just a token preventative option - for patients with cardiovascular disease.

Interval Training Improves 5 Markers of Disease

A very interesting study at the Conference entitled “Exercise: from leisure activity to therapeutic option,” was presented by Dr. Denis Clement, highlighting the relationship between low peak VO2 and poor prognosis in post-myocardial infarction – or post-heart attack – patient outcomes.  These results outline the relationship between poor aerobic fitness and poor outcomes after heart attacks.  His investigative group concluded that aerobic exercise should be a ‘first line’ therapeutic option when treating CVD patients.  That is to say Dr Clement’s medical team view exercise as the most important treatment option for cardiovascular patients due to its overwhelming positive impact on cardiovascular health.   His team has also seen benefits using interval aerobic training on Metabolic Syndrome or Syndrome X, a growing epidemic in North America.  Metabolic syndrome is defined as a combination of elevated triglycerides, elevated blood pressure, elevated blood sugar or insulin levels, decreased HDL or ‘good’ cholesterol, and increased body fat levels or body mass index (BMI).  Dr. Clement’s preliminary work shows the power that one single intervention – interval aerobic training – can have on changing all five disease-markers!  Not even the best drug in the world can have this wide reaching beneficial impact.

Increasing Strength Improves Heart Health

Another study presented in Stockholm, by Dr Francois Carre, discussed the beneficial impact that weight training can have on cardiovascular health.  Dr Carre, an expert anesthesiologist, believes that properly executed weight training targeting large muscle groups has a multitude of profound heart healthy benefits.  His team’s research observed positive correlations between increased strength and improved cardiovascular health. This is incredible evidence that weight training can prevent cardiovascular degeneration and drastically reduce the incidence of CVD. Dr Carre’s research demonstrates that the benefits of exercise far outweigh the risks for CVD patients, however he does suggests patients be evaluated by a physician first before starting a new exercise regime and be given a personalized program to maximize their results.

Resistance Training Improves Blood Pressure

We often think if we are not losing weight after hours of training at the gym that we are not getting results, that our efforts are inconsequential.  The studies presented at the Cardiology Conference in Stockholm tell a different story.  They provide gold-standard scientific evidence that exercise is improving the structure and function of your heart and blood vessels, setting up the foundation for optimal health.   Dr Rainer Rauramaa of the Finish Institute of Exercise further supports the use of resistance training as a therapeutic tool.  He has stated "moderate resistance training exercise should be considered the ‘cornerstone in the treatment of hypertension’. He made this conclusion after presenting research highlighting the positive impact of moderate resistance training on blood pressure and vascular disease.  His investigative team discovered “a clear anti-atherosclerotic effect” - or plaque reducing effect - in blood vessels due to strength training, regardless of whether or not the patient lost weight. This point is especially important. Even if you don’t lose any weight in the gym, you are improving your cardiovascaular health tremendously, and fighting off degeneration and disease.  Best of all, there are no negative side-effects! Actually, one could say the side-effects of resistance training are increased energy, vitality, immune and digestive function, and better sleep! Sounds like something we all could use a little bit more of.

The overwhelming message from the Cardiology Conference was that traditional drug therapy is really only a ‘palliative’ or ‘band-aid’ therapy and did not address the underlying causes of the disease.  Dr Rainer Hambrecht of Germany was so impressed with the results of his study that he concluded, "I would be happy if I could convince everybody with coronary artery disease to participate in a moderate exercise program." He presented material highlighting the positive impact that 12 months of exercise had on myocardial perfusion – or blood supply to heart muscles – and the symptom relief it gives patients suffering from angina or chest pain.  His data showed that exercise was just as good as the leading cardiovascular drug on patient outcomes.  However, exercise was the only thing that improved endothelial function and slowed the progression of disease, due to its holistic and overall impact on the body.  This is a profound testimonial to the powerful positive impact of exercise on heart health.

Get started on an individualized heart healthy protocol of exercise, diet and supplementation. 

Dr Marc Bubbs ND, CISSN, CSCS

Want to learn more? Listen to Dr. Charlie Weingroff PhD talk exercise, health and performance on the Dr. Bubbs Performance Podcast...

 

References:

1)     Clement DL. Treatment of hypertension in patients with peripheral arterial disease: an update. Curr Hypertens Rep. 2009 Aug;11(4):271-6. Review.

2)     American Heart Associtation, [www.americanheart.org/presenter.jhtml?identifier=4475] Jan 2010

3)     Corra U, Carre F et al.  Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. Eur Heart J. 2010 Aug;31(16):1967-74. Epub 2010 Jul 19.

4)     Laukkanen JA, Mäkikallio TH, Rauramaa R, Kurl S.  Asymptomatic ST-segment depression during exercise testing and the risk of sudden cardiac death in middle-aged men: a population-based follow-up study. Eur Heart J. 2009 Mar;30(5):558-65. Epub 2009 Jan 23.

5)     Clement, DL. “Hypertension and Peripheral Disease”.  2010 European Society of Cardiology Congress in Stockholm, Sweden.

6)     Carre, DL. “Exercise Modalities for Cardiovascular Patients”.  2010 European Society of Cardiology Congress in Stockholm, Sweden.

7)     Hambrecht, R. “Training Away Angina”. 2010 European Society of Cardiology Congress in Stockholm, Sweden.

8)     Rauramaa, R. “ Exercise As Treatment Option for Hypertension.” 2010 European Society of Cardiology Congress in Stockholm, Sweden.

9)     Gielen S, Hambrecht R, Schuler GC.  Commentary on Viewpoint: Exercise and cardiovascular risk reduction: time to update the rationale for exercise? J Appl Physiol. 2008 Aug;105(2):771.