Blood Sugar & Your Internal Clock


You’ve heard it before, “Late dinners are bad for your health,” but do you actually know why? Recent research has strengthened the link between blood sugar and your internal clock, helping to explain why late dinners are potentially detrimental to your overall health.

A few definitions to consider first:

  • Glucose Tolerance: The ability to regulate blood-sugar levels 
  • Diabetes: A metabolic disease in which the body’s inability to produce any or enough insulin causes elevation levels of glucose in the blood

In a study led by researchers from Harvard-affiliated Brigham and Women’s Hospital (BWH), 14 healthy individuals were closely monitored with the ultimate goal of explaining why glucose tolerance is lower at dinner than at breakfast. Researchers measured the independent influences that behavioral factors (mealtimes, sleep), the body’s internal clock (circadian rhythm) and misalignment between these two components had on a person’s ability to control blood-sugar levels. To put things in real-world perspective, the team reported its findings with implications for shift workers and for the general public.

Frank Scheer of Harvard Medical School explains, “Our study underscores that it’s not just WHAT you eat but also WHEN you eat that greatly influences blood-sugar regulation, and that has important health consequences.”

The Study:

Participants took part in two protocols: The first, the participants had their first meal (breakfast) at 8am and their last meal (dinner) at 8pm. In the second, their schedules were reversed so breakfast was at 8pm and dinner at 8am. In this version, they were scheduled to sleep during the day. Researchers measured levels of glucose and insulin at 10-minute intervals after each meal and hourly throughout the full sleep/wake cycle.

The Results:

They found that glucose levels (lower glucose tolerance) were 17% higher in the evening than in the morning, independent of when a participant spelt or had their meals. They also found that simulated night work (sleeping during the day) lowered glucose tolerance throughout multiple days. The researchers believe that conflicting signals from the body’s internal clock may contribute to these effects of misalignment on glucose control.

The Next Step:

The goal with studies such as this is to develop and improve strategies for controlling glucose levels in day-active people and night workers. Scheer explains, “By better understanding the key factors that contribute to changes in glucose tolerance, we may be able to find better strategies to help mitigate the risk of diabetes for shift workers.

Ultimately, when food is consumed late at night, when our glucose tolerance is lower, the body is more likely to store those calories as fat rather than burn it as energy. Repeatedly eating late will ultimately lead to weight gain. Researchers are still reviewing WHY exactly there is a difference between how we process food in the morning and in the evening.

At Medical Metabolic Specialists, we take your lifestyle into consideration from the very beginning. We work with you to determine the best diet and exercise plan to help you achieve your goals. For more information or to get started on your weight-loss journey, contact us today!

Source: Harzard Gazette

read more
On January 15, 2016, posted in: Healthy Tips, Recent research by

Tips For Avoiding Workday Snacking

Maybe it’s stress eating, sheer boredom or even just the fact your co-worker brings in killer homemade baked goods seemingly every day, but it feels like opportunities for unhealthy grazing abound in most office environments. If you consistently start your work day vowing to make balanced choices yet find yourself reaching for that second doughnut by noon, don’t lose hope! Keep your nibbling impulses and workday snacking  in check with these simple tips:

workday snacking

1. Stash your own munchies
If the woman down the hall keeps a bowl permanently stocked with fancy dark chocolate, slay that dragon by keeping a small stockpile of healthier bites in your own desk drawer. That way, your healthier option will be ready when you’re in the mood for a little pick-me-up. Be sure to ration them out by serving size. Almonds are a great choice since they are a wholesome snack that help fight cravings.

2. Brown bag it
Picking the right mix of food for your daytime meal can help fortify you against an afternoon attack of the snacks. Include a fruit, vegetable and a lean protein to help you stay fuller longer and have more energy throughout the day. Make your lunch the night before, instead of in the morning when you’re rushing out the door and may not have time to think through a balanced meal.

3. Keep crave-worthy foods out of sight 
If you can’t easily spy the contents of that co-worker’s candy dish, it’s less likely to entice you. Researchers at Cornell University found that people ate an average of 2.2 more candies a day when they were visible compared to when they weren’t in view. If your co-workers are candy stashers, offer them a dark, lidded bowl for their goodies. A simple swap from a clear container to a beautiful ceramic jar could save you thousands of calories a year.

4. And keep them out of reach
Resist the urge to slip into the conference room after lunch to snag a leftover slice of pizza. Take a few deep breaths when you walk by to bring you back to the present and remember you’re not even hungry. Each time you resist a craving you normally would’ve given in to, you’re building good habits, rather than repeating a negative pattern!

5. Go for a walk
It’s a great way to relieve work stress, even if you only have 10 minutes. It’s also a way to help you work through a challenging work project. Researchers at Stanford University found that creative thinking increases by 60 percent when you’re taking a stroll. If you can’t get outside, walking up and down the hallway or climbing a few stairs will help too!

read more
On October 14, 2015, posted in: Healthy Tips by

Mediterranean Diet May Have Additional Positive Side Effects

“Now, researchers say that eating a Mediterranean diet supplemented with four tablespoons per day of extra-virgin olive oil reduces the risk of breast cancer.”

By now, you’ve certainly heard of the Mediterranean diet – a pattern of eating that mostly emphasizes fish, nuts, legumes, fruits, vegetables and olive oil. Over the last few years, the evidence of its [the Mediterranean diet] benefits has been piling up. In 2013, a study in the New England Journal of Medicine showed that the diet can help protect against heart disease and a study published earlier this year revealed that the diet can help fight against memory loss.

Breast cancer is in fact the leading cause of female cancer burden and its incidence has increased by more than 20% worldwide since 2008. In a limited yet promising study, researchers at the University of Navarra in Spain have found a strong reduction in the risk of breast cancer as a result of adhering to the Mediterranean diet.

For this study, which was published in JAMA: Internal Medicine, Martinez Gonzales conducted a randomized, single-blind, controlled field trial at a primary health center in Spain from 2003 to 2009. He assigned about 4,282 women between the ages of 60-80 at high cardiovascular disease risk to follow either the Mediterranean diet plus olive oil, the Mediterranean diet supplemented with mixed nuts or a control low-fat diet.

Researches found that women following the Mediterranean diet (olive oil and mixed nuts combined) had a 68% lower relative risk of developing breast cancer compared to the control group. This was the first randomized trial finding an effect of a long- term dietary intervention on breast cancer incidence. The results suggest a beneficial effect of a Mediterranean diet supplemented with extra-virgin olive oil in the primary prevention of breast cancer.

Of course, no study is perfect. While there are certainly limitations to this study, most notably the fact that this was a non-diverse group of women, the Mediterranean diet has been shown to reduce the risk of cardiovascular disease and may also very well help prevent breast cancer. If anything, this study is a stepping stone for further research and a strong reminder that the Mediterranean diet can be implemented as a means to help reduce cardiovascular disease and improve general well-being.

As far as research, the next step is determining which compound or compounds in the Mediterranean diet could be most beneficial. Given that the group of women with the lowest rate of breast cancer consumed about four tablespoons of olive oil in their diet each day, researchers are contemplating whether it’s something in the extra-virgin olive oil. According to a study published in 2011, extra-virgin olive oil is essentially the fresh-squeezed juice of an olive or, fruit juice. Inside the juice is a range of potentially beneficial compounds known as polyphenols, which possess similar anti-inflammatory properties to ibuprofen. Though promising, these results still need confirmation by long-term studies with a higher number of incident cases.

At Medical Metabolic Specialists, we fully embrace and endorse the many health benefits of a Mediterranean diet. As shown in this study though, improving overall well-being requires time, patience and dedication to lifestyle change. To learn more about our approach to lifestyle intervention and the Mediterranean diet, stop by or give us a call today.

Source: NPR

read more
On September 22, 2015, posted in: Healthy Tips, News, Recent research by

‘Obesity Gene’ May Hold the Key to Eradicating Obesity

For the first time, a direct link between a gene and fat production has been discovered. The results of recent research could reduce obesity altogether. The research was published in Nature Communications and brings an end to a four-year study and provides the perfect catalyst for further research.

Did you know it is now estimated more than two-thirds of Americans are overweight or obese? Well, new genetic-based findings could help develop drug therapies that diminish the obesity percentage. While scientists already know that there are many reasons why two people with the same diets and exercise regimens can gain different amounts of weight and why fat becomes stored in different parts of their bodies there had been no significant evidence of genes playing a role in this. Recently, an international collaboration of scientists helped researchers hone in on genetic reasons for the crippling epidemic of obesity.

Using the largest set of genetic samples for the study of body fat distribution and body mass, the Genetic Investigation of Anthropometric Traits (GIANT) group of researchers analyzed more than 300,000 genetic samples and found 89 new genetic locations across the genome that play roles in obesity. These include body mass index (BMI) and where fat is stored in the body.

While tedious, the results of this research are groundbreaking. Finding these locations is a necessary step towards pinpointing individual genes that play major roles in traits related to obesity. Ultimately, finding specific genetic variations can help structure therapeutic interventions. Scientists theorize that by suppressing the gene or blocking a specific protein, excess fat accumulation in people who are at risk of obesity can be prevented.

Kari North, PhD, a key researcher in this study explains, “Obesity is a worldwide public health burden with no safe and long-term treatments available. Our development of new therapy is limited by our lack of knowledge of the underlying pathophysiology of obesity. One novel and exciting way to identify new biology is through the study of human genetics.”

James Johnson, author of the study, believes the results can contribute to new drug therapies for weight loss, “Until now, we did not know how this gene affected obesity. This study shows how fundamental research can address major health problems and open up new avenues for effective treatment.”

Even though current drug therapy is an option for obesity, Medical Metabolic Research stresses the importance of lifestyle intervention, regular exercise and comprehensive weight management for tackling obesity. To find out more about our programs, click here or stop in to the office to speak with one of our team members.

Source: Medical News Today & UNC Health Care

read more
On August 18, 2015, posted in: News, Recent research by

The Effect of Alcohol on Brain Response to Food in Women

Have you ever noticed a change in your eating habits after consuming alcohol? Well, in the first study of its kind, researchers from the Indiana University School of Medicine have found ties to the hypothalamus, the gut and the aperitif phenomenon.

The study aimed to measure the brain’s role in mediating caloric intake after consuming alcohol, specifically among women. Ultimately, researches uncovered that alcohol exposure sensitizes the brain’s response to food aromas and increases caloric intake. Led by William J. A. Eiler II, PhD, this research adds to the current knowledge that alcohol increases food intake.

Understandably so, the brain can play a vital role in regulating food intake. The study shows that alcohol exposure can both increase the brain’s sensitivity to external food cues (smell, sight) and result in greater consumption. Since most alcoholic beverages already include empty calories, an increase in food consumption can lead to energy imbalance and possibly weight gain.

The study included 35 non-vegetarian, non-smoking women at a healthy weight. Researchers circumvented the digestive system by exposing each participant to intravenously administered alcohol at one visit and then to a placebo at the next visit, prior to eating. Subsequently, brain responses to food and non-food scents were measured using an fMRI scan. After this imaging, participants were offered a lunch choice between pasta with Italian meat sauce or beef and noodles.

The results showed that when participants received intravenous alcohol, they ate more food at lunch (on average) compared to when they were given the placebo. Still, there were individual differences, with one-third of participants eating less after alcohol exposure.

It is very interesting to note that in addition to food consumption, the hypothalamus (area of the brain responsible for certain metabolic processes) also responded more to food odors after alcohol infusion. Researchers concluded that the hypothalamus might therefore play a role in mediating the impact of alcohol exposure on our sensitivity to external food cues.

While this study did yield interesting results, researchers agree that further research into the mechanism by which the hypothalamus affects food reward must be conducted. Dr. Binks of Texas Tech University explains, “today, nearly two-thirds of adults in the U.S. consume alcohol, with wine consumption rising, which reinforces the need to better understand how alcohol can contribute to overeating.”

Original article: Obesity

read more
On August 11, 2015, posted in: News, Recent research by

A Strategy For Weight Loss Based on Healthy Dietary Habits & Control of Emotional Response to Food

Research has shown that emotions have a powerful effect on eating behavior and that there is a connection between food choices, emotions and increased energy intake.

In June 2015, researchers from the University of Compultense of Madrid published the results of their study looking into the “emotional behavior of individuals as a function of the relation between food intake and emotions to facilitate the establishment of personalized dietary guidelines based on healthy eating habits and increase the patient fidelity until the desired weight.”

The results of the study showed that the studied population was sedentary, consumed an unhealthy diet and eating behavior was greatly affected by emotions. The majority of participants were classified as emotional eaters. During the treatment program, eating habits and lifestyle subjects were modified and reduced at least 10% of their body weight. Ultimately, knowing the relation between food intake and emotions allows individuals to personalize their dietary strategy for weight loss.

At Medical Metabolic Specialists, we always begin with individualized assessments. We work with our new clients to determine what kinds of lifestyle modifications related to nutrition, medical issues, physical activity and emotional wellbeing would best combine to provide you with the healthiest and most effective weight loss. Please give us a call to discuss our Comprehensive Program and to learn how to get started!

Source: PubMed

read more
On July 14, 2015, posted in: News, Recent research by

Innovative Research to Improve Maintenance of Weight Loss

Recently published, the National Institutes of Health, led by the National Heart, Lung & Blood Institute, organized a working group of experts to discuss the problem of weight regain after weight loss.

Experts included integrative physiologists and behavioral psychologists, all with the goal of merging their perspectives regarding the barriers to scientific progress and the development of novel ways to improve long-term outcomes in obesity therapeutics. The ultimate goals of this panel were to:

  1. Identify the challenges that make maintaining a reduced weight so difficult
  2. Review strategies that have been used to improve success in previous studies
  3. Recommend novel solutions that could be examined in future studies of long-term weight control

The major limitation to this type of research is an attempt to avoid extensive discussions delving into policy changes and the built environment.

One resounding recommendation from the group was that to produce more effective weight loss maintenance therapies, we must improve our understanding of the mechanistic interactions between these pressures (biology, environment, behavior) resulting from weight loss.

Suggestions From Panel For Advancing Science to Develop More Effective Weight Loss Therapies:

  • Countering biology to reduce the gap between appetite and expenditure
  • Deeping our understanding of exercise
  • Innovations with diet
  • Innovations in behavioral strategies
  • Innovations in pharmacotherapy
  • Mechanisms of weight loss and weight regain following bariatric surgery
  • Advances in technology, constructs and definitions
  • Measuring components of energy balance and related parameters
  • Individualized and targeted strategies to maximize effectiveness
  • Constructs and mechanisms underlying “motivation”
  • Information technology and social networking
  • Novel research designs

The overwhelming conclusion from this discussion was that greater collaboration and cross-talk between physiological and behavioral researchers is needed. Training in both areas for early-stage obesity researchers may lead to a more sophisticated understanding of factors that influence relapse and development of methods to enhance long-term maintenance.

How Can You Apply This Research To Your Weight Loss Goals?

At Medical Metabolic Specialists, teaching patients about weight loss is our primary goal. We firmly believe that lifestyle, psychological and medical interventions all work together to help our patients learn about weight loss in the healthiest way possible. A commitment to lifestyle change, rather than a flash diet, teaches our patients how to lose weight & keep it off.

Visit our philosophy page or give us a call to learn more!

Source: NIH & PubMed

read more
On June 23, 2015, posted in: News, Recent research by

Years of Obesity Increase Aortic Stiffness & Worsen Middle-Age Memory

A recent study has shown that being overweight or obese beginning in early adulthood is associated with increased aortic stiffness and decreased performance in a memory test around age 60. Similar to the impact of cigarette “pack-years” on health, the number of “obesity-years” has an impact on later memory as well.

Researchers investigated this in a 30-year follow up of participants in the United Kingdom Medical Research Council’s National Survey of Health and Development birth cohort study. They analyzed data from 1233 participants in the cohort study. Participants had complete data for BMI, aortic pulse-wave velocity, aortic calcification score and carotid IMT, which was determined at age 36,43,53 and 60 to 64. Participants were divided into seven groups based on their BMIs.

The most significant negative effect on later memory was seen in the participants that become obese at the youngest age, around their late 30s. Higher BMI was associated with worse performance in the word-recall test, even after adjustment for sex, heart rate, education and systolic blood pressure. The findings of this study were recently presented at the European Society of Hypertension’s.

Dr. Stefano Masi of University College London explains, “The main message is that cumulative exposure to obesity since age 36 is associated with later memory dysfunction and this impact seems to be independent of the acquisition of cardiovascular disease.” Still, this research also suggests that dropping one body-mass-index (BMI) category and maintaining this weight loss might reverse these negative effects to memory. Ultimately, the study shows that individuals can make a difference on their cognition by controlling their body weight. Masi emphasizes, “It’s [maintaining a healthy weight] an investment for the future.”

Masi speculated, “We know insulin resistance is a strong risk factor for Alzheimer’s disease, and when you have a period of weight loss and regain, that is a strong risk factor for insulin resistance.” Researchers plan to explore this further.

Original article: Medscape


read more
On June 16, 2015, posted in: News, Recent research by

Effects of Weight Loss on Airway Responsiveness In Obese Asthmatics

Obesity and asthma are major public health concerns in the United States. The links between asthma and obesity are widely studied and well known; however, the effects of weight loss on asthma severity are not as evident. The following study aimed to examine whether weight reduction reduces asthma severity in adult obese-asthmatics especially by measuring airway hyper-responsiveness.

Researchers followed 22 obese-asthmatic subjects ranging in age from 18 to 75 years. Each individual had a body mass index (BMI) of >32.5kg along with airway hyper-responsiveness. Sixteen of the subjects followed a behavioral weight reduction program from 3 months and the remaining 6 subjects were the control group. The primary outcome was change in airway hyper-responsiveness over the course of 3 months. Secondary outcomes included changes in lung function, asthma control and overall quality of life.

After 3 months, the weight loss (intervention) group lost an average of 16.5kg while the control group gained an average of 0.6kg. There were significant improvements in asthma-control and asthma quality of life in the intervention group while these parameters remained unchanged in the control group. Finally, physical activity levels significantly increased in the intervention group but not the control group.

While small, the study shows that weight loss in obese asthmatics can improve asthma severity and result in improvements in airway hyper-responsiveness, asthma control, lung function and quality of life. These findings further support the need to actively pursue healthy weight loss measures.

Original Article: CHEST Journal

read more
On May 27, 2015, posted in: News, Recent research by

Importance of Weight Loss and Physical Function For Older Cancer Survivors

The main question: Do lifestyle interventions (weight loss and physical function) have a beneficial impact on older, sicker cancer survivors?

Researchers understand that cancer is most often a disease of aging, and frequently, a disease for which obesity is actually a high risk factor. As a result, many cancer survivors are older, overweight or obese, with higher risk of illness and comorbidities. The following study examined how overweight long-term survivors’ symptom severity prior to a diet and exercise intervention is associated with post-intervention function. The study also looked to determine symptoms’ effects on function through change in physical activity, diet quality and weight status.

The study included 514 breast, prostate and colorectal cancer survivors. They participated in the one-year home-based diet and exercise intervention program. Researchers looked at both pre-intervention and post-intervention data including: pre-intervention symptoms, changes in weight, physical activity, diet quality and post-intervention overall physical health. Finally, researched looked at advanced lower extremity function.

The results showed that weight loss and increased physical activity were significantly associated with higher physical function and advanced lower extremity function. Ultimately, symptom severity of older, overweight cancer survivors negatively affects physical function. However, greater weight loss and increased physical activity lead to higher physical function scores. The study highlights the importance of weight loss as a factor in maintaining function in older cancer survivors.

Original article: AACR

read more
On May 11, 2015, posted in: Healthy Tips, News, Recent research by