PaleoHikerMD

Join me as I do a quick solo overnight backpacking adventure on the North Sylemore Creek Trail in Arkansas’ Ozark National Forest. This is my first overnight trip using a hammock, in this case my new Warbonnet Outdoors Blackbird XLC. You also get a peek at my Mamajamba tarp, as well as top and bottom quilts by Hammock Gear. I hike it later in the day, find a great creek side campsite to set up my hammock. The following day I do some challenging uphill hiking before meeting up with my family for a ride home. Hope everyone enjoys!

Aside from being a practicing Internal Medicine Physician, I am also board certified in Sleep Medicine and it comprises around 20-25% of my office based practice.  The importance of sleep is very much lost to America as a whole, and I have said in previous posts that sleeping too much is almost seen as a “sign of weakness.”  On a day-to-day basis I see people who accumulate endless amounts of “sleep debt.”  This is the amount of sleep you should get but don’t, and in the end your body keeps a ledger and knows what it is missing.  The question is, does accumulating sleep debt hurt you?  Is it dangerous to burn the midnight oil?  Let’s do a little research and find out.

What got me thinking about doing this post was a link I saw on Drudge Report this week to this article.  Now the headline claims “BEATING diabetes may be as simple as getting a good night’s sleep…”  Well, I think we all know that is a bit of a simplification, but what was found in this study is important.  Diet and exercise have always been seen as lifestyle modifications vital to treating diabetes (although the American way is certainly give me a pill and pass the cheesecake!), but this study sees sleep as the third piece to the lifestyle puzzle, and “It could be on reason why some other lifestyle interventions are not working.”  The study followed 522 people for a year and found that missing 30 minutes of sleep on a “regular basis” increased one’s risk of obesity 17% and insulin resistance 39%.  If you don’t know, insulin resistance is where you body slowly becomes resistant to its own insulin over time secondary to overconsumption of highly processed carbohydrates.  This in turn is the major pathway to the development of Type II diabetes.  The scientists lastly warn that our “arrogance” in cutting sleep is leading to “serious health problems.”

So, how does losing sleep lead to higher blood sugars?  Well, I can easily see two pathways for this to happen, and they both have to do with CORTISOL.  Cortisol is your body’s major stress hormone and is produced by the adrenal glands.  It’s release is brought about by stress and low blood sugars, and its main function is to increase blood sugar by stimulating gluconeogenesis in the liver.  Although good, cortisol also has harmful effects if in excess such as suppression of the immune system, a decrease in bone mineral density and formation, and the afore-mentioned insulin resistance.

Let’s go back a minute and look at that word stress.  Now none of us live stressful lives right?!  Stress is just part of our culture and basically inevitable.  Eliminating as much stress as possible is vital to long-term health not just for your sanity, but also for your blood sugar!  Chronic stress leads to chronic cortisol elevation…you do the math.

One other interesting tidbit on cortisol.  Viewing yourself as the animal that you are, starvation is a pretty basic form of stress for the human body.  If you are starving cortisol rises to cause a compensatory elevation in blood sugar via gluconeogenesis to provide your power-hungry brain the energy it needs!  So, what happens when you starve yourself on some crazy 1200 calorie a day diet?  Yep!  Your body goes into stress mode, energy conservation mode, elevated cortisol mode.  You starve yourself, stress yourself, and defeat the purpose all together!

Now, back to sleep and blood sugars.  Take a look HERE for a study on how sleep loss elevates cortisol levels.  The authors conclude that “Sleep loss could thus affect the resiliency of the stress response and may accelerate the development of metabolic and cognitive consequences of glucocorticoid excess.”  It’s pretty simple really; chronic sleep debt leads to elevated cortisol levels, and elevated cortisol levels promote insulin resistant and subsequent obesity and diabetes.  It’s like 2 + 2 = 4…

Ok lets give cortisol a break, it can’t be the only hormone causing problems with sleep deprivation can it?  Of course not…let’s discuss leptin.  I tell people leptin is your friend because it triggers the sensation of satiety (being full).  Leptin is produced by fat cells in response to adequate nutrition resulting in the inhibition of hunger; it is essentially an energy regulator.  Take a look HERE to see a study showing short sleep duration is related to reduced leptin levels and increased BMI.  These authors conclude “In Western societies, where chronic sleep restriction is common and food is widely available, changes in appetite regulatory hormones with sleep curtailment may contribute to obesity.”

So think about it!  We live stressed out lives, we starve ourselves to look “good”, we sleep way less than we should…as Dallas Hartwig has said to me we “reek of cortisol”.  So well said!  We do all we can to disrupt your body’s normal way of managing weight and energy by eating the wrong things.  Why did I bold and italic “adequate nutrition” in the prior paragraph?  Well, you cannot fool your body into thinking a bag of Cheetos is good nutrition.  You may fill your stomach with “physical” satiety, but you will not actually satiate your body nutritionally.  So what happens?  You eat food that is poor nutritionally, your body digests it but it fails to elevate leptin levels, and you remain hungry despite having eaten!  Talk about throwing a wrench into God’s design!

So there you have it, a direct link between short sleep, elevated cortisol levels, and rising obesity and diabetes around the world.  By the way, how many times are you out at a movie late, or a restaurant and notice kid after kid with their parents out later than they should be?  Statistically kids are sleeping less and less as the decades pass.  Adults want to continue to live their lives, have their fun, despite having kids so they just drag their poor kids along.  So what does that mean for the cortisol levels in kids these days?  Wow, and obesity and diabetes in kids is on the rise in epic proportions!  Who would have thunk it…

All that from a link I saw on Drudge LOL  This is my life, I see people every day developing diabetes, suffering the consequences of diabetes, and dying from diabetes.  I also see patient after patient with ISS, a technical diagnosis, Insufficient Sleep Syndrome.  Most don’t see the connection, I hope I have helped you clearly see what I see.

Sleep is vital, it is absolutely vital to good health and longevity.  More sleep is almost always the answer, not less.  If you keep your sleep short, you will make your life short.  Every year study after study is published showing us the dangers of not sleeping enough.  There is no end in sight for this flood of research in my opinion.

One last thing, and I’m talking to all you CrossFitters out there!  Those striving to be “elite athletes” through hard work and dedication in what you eat and how you train.  You are being foolhardy to EVER miss sleep to train harder.  Sleep is necessary for adequate recovery, and you will NEVER reach your maximum protection without adequate sleep.  It’s just not physiologically possible.

Many see the Paleo lifestyle as recreating the diet of the first humans to optimize human performance.  I take it even a step farther, quite a few steps actually.  In my humble opinion, in your body, God created the perfect animal.  The tolerances that your body keeps for blood chemistries for example put the efficiency of NASA to shame.  Everything works in perfect harmony until you go and screw it up 🙂  Following a Paleo Lifestyle allows your body to function the way God intended it to!  You fuel it correctly so that it runs correctly.  You also need a certain amount of sleep, and if you don’t get it, you don’t run correctly.

So, are you sleeping enough?  Do you regularly trade in sleep to train more? Work more? Party more?  What is that doing to your health?  Remember, your health is like an investment plan…you sacrifice now so that you win in the end.  Eating right is like depositing into your health, sleeping right is depositing in your health.  If you deposit enough into your health, it will take care of you for a long, long time!

I’m off to BED!

-Ernie

Looking for some good Paleo Cookbooks? I’m starting a series where I cook a recipe from my favorite Paleo cookbooks!

Today’s video is from Simone Miller’s Zenbelly Cookbook and it’s an AMAZING dish Pan-Roasted Chicken with Bacon and Apples. This book is beautiful in every way from the layout to the pictures, and the recipes are spot on every time I make them.  This dish is by far the favorite in our family!  I look forward to showing you more of my favorite books in weeks and months to come.

Instead of filming the cooking action, I chose to do somewhat of a slide show to easily show you the steps and process involved in the recipe. I would love to know ya’lls feedback on whether you find this effective or not?

Anyway, enjoy, and visit Simone at http://www.ZenBellyBlog.com, and of course, buy her book for other amazing recipes!

Recipe used with Author’s Permission

Did you know every state, and FEMA recommend every home have a disaster plan in place? What does that include? Watch this video to find out!

We all live busy lives, and it’s easy to forget how quickly things can change to the point that our family could be in danger.  We take simple things like running water, plumbing that works, readily available food to eat, sufficient shelter over our heads.  This is NOT a doomsday prepper video, this is a simple plan that I believe EVERY family in America should address.  I look back on hurricane Katrina and the lessons we learned from it.  The government cannot stop all emergencies, and they cannot protect you from them either.  If Katrina taught us one thing, its that we should not expect the government to make everything smooth in such a disaster.  Are YOU willing to depend 100% on the government to protect YOUR family?

I tried to make this video as short as I could, but the information is VITAL to prepare your family for an emergency. There are so many scenarios for potential disaster for your family; some far fetched, some very real.

In this video you will see how easily you can get your family ready for most any disaster to give you a fighting chance to make it through all right. Don’t leave things to chance. Get your family ready TODAY!!

If you will, please share the link to anyone you know who you feel could utilize the information!  Better to be ALL prepared!

-Ernie

So what’s the worse idea you’ve ever had? Did you actually follow through with it? Well, I had a bad one, and I followed through with it, and it stunk!

For years I’ve tried to find the right “diet” for me and my family. I always tried to weigh the health benefits of what we ate and since I am the cook in the house, it falls primarily on my shoulders. Plus, being a doctor, my wife tends to go with what I say on nutrition since I “should” know best right?

Physicians receive about as much training in med school on nutrition as my 6 year old got about the Ming Dynasty in Kindergarten. We learn all kinds of things in and around the physiology of the human body, including the complex interaction between insulin, fat, and weight. We learn the details that is, but nothing that is the least practical in day to day life. As an internist your primary goal in training is to learn to keep people alive, but mainly when they are ACUTELY dying. Ho hum day to day primary care is covered, but not as well as more serious hospital care. So what we learn falls in line with the standard “calories in-calories out” teaching that I of coarse now reject. We learn about protein, carbs, and fat, and how fat contains twice as many calories as proteins and carbs, so they must be what make you fat!

It’s important for everyone to know that their doctors (most likely) preach this information because that is the little that they were taught, and it’s hard enough to keep up to date with all the new information when it comes to everyday practice. New drugs, new clinical trials; they all take precedent most of the time over relearning old topics. Especially when the “data” that has always been emphasized falls in line with the above train of thought. How can fat not make you fat? It just doesn’t make sense if you stick to the knowledge we are presented in our training.

So, how did I end up putting the time in to learning about Paleo? Well, that goes back to my big mistake! Around 4 years ago I read a book called the China Study just around the time my daughter was turning 2 years old. I was bound and determined to live a healthy life, avoid the chronic diseases my patients lived with everyday, and I knew my diet was the key. So, I became a Vegan. For a year…yes, a year. I bought all kinds of new cookbooks, swore bacon back to the fithly swine it came from, and became one with tofu. I’m nauseated just thinking about it.

I told everyone around me I was going to try it for a year and then re-evaluate. I knew two months in I should just quit, but I’m too darn stubborn to not go the whole year. I…FELT…TERRIBLE all the time. I was hungry, cranky, slept terribly, missed food, and even gained a little weight to boot. As a veggie all I did was try to find ways to make things taste like meat. Tempah, faux chicken stock…and the worst idea ever TO-freaking-FURKY. For the record, I never ate Tofurky, but the thought crossed my mind. It was obvious I craved meat, I was gaining weight, and I felt exhausted all the time. Come to think of it, how often do you run into a fit and energetic looking vegan? I will confess to all here, I did not make it a full year. Around 6 days before the year mark my wife and I were visiting friends in Manhattan and we booked reservations to a wonderful place called Del Frisco’s Double Eagle Steakhouse on 6th Avenue. The original Del Frisco’s is in Fort Worth,Tx, and we have been there many times. I ordered the biggest New York Strip on the menu and sat in awe as the blazing hot dry aged beef fat burst into my mouth on first bit. Meat was back, thank goodness!

I kind of gave up trying to even figure out what is best to eat. I stopped cooking as much, gave in to the kids desires to turn into a miniature chicken nugget, and took the easy way out for a year or more. Eventually I started cooking again, but never with much purpose other than to make tasty things. Now I can cook, and it was fun throwing together tons of classics, mastering homemade gnocchi, building a wood burning pizza oven, making artisan bread at home…all the foodie things you can think of! Still, my wife and I were just living. We didnt’ feel good, we didn’t feel bad; we didnt’ gain weight, we didn’t lose weight…you get the picture.

Around a year and a half ago our neighbor’s started eating Paleo. My initial thought was no way, I’m not trying another fad diet because they don’t work. Why give so much up for so little gain. So we just kept up with the status quo. In the fall of last year my wife was outside talking to our neighbor, and when she came in she said “I think we should go Paleo.” Secretly I was dying to do SOMETHING, I just hated feeling defeated and controlled by food. In typical fashion in our house, we decided I would read the book, and I would give her the short version in less than 10 minutes!

I bought Robb Wolf’s book on my iPad Kindle app, and away I went. I read the whole thing by the end of the weekend and I got energized in a way I have never been before. Why? Rob MADE SENSE, and he included all the science and data my medical mind needed. If you have not read his book, please do so you know why Paleo is important and correct. He gives you the option to skip the “why” of Paleo and just read the “how.” I urge you not to do this as I feel strongly that if you know why you will be more motivated to stay with it. That night I downloaded Why We Get Fat by Gary Taubes and I polished it off in two days (long nights rather). How could I change my mind so fast? This was completely against all I had been taught.

The reason is simple, my patients. I see patients all the time who come in, either have not lost weight, gained weight, or are the same; take your pick. All the while they swear they are counting calories, trying hard, and exercising where they can. I hear this story countless times a day. So there are two options: they are either all complete bold faced LIARS!, or what they are doing is not working. With Paleo, I found the answer… It’s not working.

From that day I have been very strict in my Paleo eating, and have eaten as clean as possible. Have I been perfect?; no I have not. But I can honestly say I have been 95% compliant in my eating and as you all know I am 13 days into my Whole 30 at the moment. My personal results are all the “data” I need to change the way I talk to my patients. I feel good, have lost 25 pounds or more without trying, I am NEVER hungry anymore, and I sleep like a log. Most importantly like I have mentioned on other posts, I am finally in control of my diet. Food no longer controls me and that is the most rewarding part of my journey. Will this lifestyle fizzle out in me? Guess you should never say never, but I just don’t know how I could ever go back to eating non-Paleo. Even now when I “cheat” there are certain absolute no-no’s like wheat, dairy, and soy.

All this has led to this blog, and I have plans for more Paleo projects in the future. I am a very lonely voice in the world of Internal Medicine when it comes to Paleo, but there are many years to come. I am not convinced that the government will, republican or democrat, ever change their views on nutrition and flip the food pyramid over the way it should be. It’s just so sticky, complicated, and political; but that should not stop me or all of you from trying to help others. Over the next few months I will be laying out several projects aimed at bringing Paleo more into the conversation in mainstream medicine. I’m most excited about an observational trial I am hoping to start soon with the help of the Hartwig’s over at Whole 9 Life looking at Paleolithic Nutrition in Diabetics. Exciting things to come!

I am most amazed by the quality, passion, and intelligence of the leaders of the Paleo community. This is not a fad movement, but rather a well educated, scientifically based, and compassionate group of people who want to help people get healthier with simple food choices. I humbly add myself to the mix in hopes of adding to the knowledge base and hopefully…changing the course of history. Together we can do it!

If you are a Vegan out of choice, or a vegetarian for religious reasons I certainly understand. I am simply sharing my experiences and personal frustrations in my life. Medically, I do have questions about how healthy a meat-free diet is, just as I have questions about the health of people following a traditional “heart-healthy” low fat diet. Thanks

-E

This video gives a short photo tour of our recent vacation to Yellowstone and Grand Teton National Parks. See the views, examples of the wildlife seen, and get excited to plan your own trip. They are truly amazing places well worth the effort to get there!

In the final part of this series on my keys to Paleo success we will talk about consciousness; not being awake, but being alert!  Together with cooking, understanding, and patience this will conclude the series on keys to success.  How conscious you are on a day to day basis may ultimately determine just how successful the Paleo lifestyle will be for you.

Eating: It’s fairly obvious that you must be supremely aware of what you are eating to be successful.  There are certain areas though that I think are more important as they are the most likely to make you slip up.

Although I don’t encourage calorie counting to my patients, I do ask my patients to be conscious overall of how much food they are eating.  Eat slowly and enjoy your food that way you give it time to settle and for your natural sense of satiety to kick in.  It is not uncommon to overeat even while eating clean.  There is a sense at times that since the food is clean, you can eat as much as you want.  Although technically true, try to be aware of what your body really needs and not just what you think it wants.

When you are shopping at the grocery always be aware of this; even when you have multiple food choices, there is almost always one that is better than the other.  For example choosing a leaner cut of meat will be better than a fattier cut.  By all means, eat a ribeye at times, but fit in some leaner meats as well.  I want you to also read every label you can in the grocery.  Even when you think that you know what is in there, check again.  Are there nitrate free choices for some of your meat choices?  If so, try to get them as often as you can.

Also take the time to ask your grocer, or preferably a butcher or meat farmer where the meat you are buying is from, what it is fed,  and how it is raised.  Do not feel obligated to eat only grass fed meat; although optimal, it is not possible or practical for many people out there, even myself at times.  Lastly, look at anything that is processed in any way with skepticism.  As my goal is 90% compliance with my Paleo diet, I very rarely blatantly eat what I know is not good for me.  I look at what I consume that is processed, or not prepared by me as being unclean, and it accounts for my 10% fudge factor.

Eating is an absolute joy for me, and it should be for you as well.  When you do it consciously, ALL the time, it can be fun and enjoyable instead of the dread it has become for many.

Feelings:  I want you to be completely aware of how you are feeling at all times.  Before you eat make yourself aware of just how hungry you are.  While eating, enjoy how the food makes you feel, and eat slowly enough to feel how full your meal is making you before you overeat.  Tie your feelings together with eating in every way that you can and it will really help you be more successful.

One key are of feelings I want you to be aware of is how certain foods make you feel, especially pay attention when you cheat.  Everybody reacts differently to foods, and even to non-Paleo foods.  I have learned over time what kinds of foods I can and can’t cheat with if I expect to feel well.  Keeping a food diary early in your journey will really help with this are of your lifestyle.  You want to be able to look back and say “I feel really sluggish, what could I have eating in the last few days to cause this?”  Is your stomach more unsettled than usual?  It’s probably something you ate!

Another thing to really pay attention to when you cheat is WHY did you cheat?  If you are like me, emotional eating can be a problem.  Don’t just look back at cheats and see how they made you feel, but look at what emotions led to you cheating.  Over time you can analyze what circumstances or emotions trigger cheating so you can control them.  You want cheating to make you feel GOOD when you do it because there is no guilt involved, but that will take time and patience to achieve.

Are you hurting somewhere that you normally don’t day to day, or after a workout?  I’m not talking about typical soreness post workout; you know when something is not right. People come in to the office all the time and complain to me about something.  I talk to them about it, and come up with a plan to figure out what could be causing it.  Commonly the patient then says something along the lines of “It’s not that big a deal, let’s just not worry about it.”  Symptoms are your body’s way of talking to you.  People who ignore their symptoms are the one’s that end up with medical conditions or injuries that could likely have been prevented with earlier intervention.  If you feel something is wrong, there probably I something wrong.  Instead of just living with it, how about calling your doctor, making an apt, and getting it sorted out!

Food and feelings always go hand in hand.  Get a good hold on both concerning all aspects of your life and your diet and you will be happy you did.

Sleep:  This is such an important part of your life, I don’t want you to overlook it in any way.  The number of people out there who chronically get too little sleep is staggering.  Do something for me, for the next month keep a sleep log.  You can get great little apps for your smart phone if you would like, but it’s easy enough to do on your own.  Here is a link to the sleep diary Sleep Diary my sleep center gives out to patients and it is very useful.  I want everyone to be very aware of how much sleep they are getting and how much they are not getting.  Everyone is also different with how much sleep it “enough” for them.  The sleep literature says normal sleep is anywhere from 6-10 hours a night, but you have to see what is best for you.

The most common cause of chronic fatigue is a very technical sleep diagnosis known as ISS, or Insufficient Sleep Syndrome J.  Do you suffer from this?  Well, do the sleep log and see how many hours of sleep you are getting.  Then ask yourself this question: “Am I more tired in the day than I feel I should be?”  If the answer is yes, make a concerted effort to increase your nightly sleep by at least one hour and keep logging your sleep.  Do you see an improvement in how you feel?  If you do, then keep getting more sleep.  If you don’t, or you have trouble falling asleep, don’t settle for how you feel please.  Look up a board certified sleep physician and make an appointment.  You will NEVER feel or be your best if you are not sleeping enough.  Insufficient sleep does more than make you tired, it is dangerous and increases your risk of chronic disease.  Most people simply go through life dealing with how they feel and not trying to fix it.  Become conscious of your sleep patterns and sleep volume, and make adjustments to improve them if needed.

Ultimately you can read every book and follow every blog, but nobody out there is talking directly to you.  Only your body is talking directly to you, but you have to learn to be conscious of it and adjust to its needs.  Always remember that success with a Paleo lifestyle is up to you, and nobody can change that.  Don’t fall victim of thinking you can’t do it “right” so why bother, or that you are doing all you can.  Are you really?  Is there some place you can improve your health?  Do you have strongholds you are still not willing to give up?

You want to succeed with your Paleo goals?  Learn to cook at home, be patient with yourself, acquire the understanding of why Paleo is right for you, and become conscious of every aspect of your life.

Do you have specific keys that have helped you?  Post a response and share your experiences with everyone else.  If you have specific questions, always feel free to email me at PaleolithicMD@gmail.com.  And as always, share this blog with anyone out there who you feel could benefit from learning more about the Paleo lifestyle.

-E

In today’s Wednesday gear review, we review and compare two popular fire starters, or ferro rods. We look at the Bear Grylls Fire Starter by Gerber, and the UST Strike Force Orange. Lets take a detailed look at the specs, what kind of sparks I can get from each one, and which one I prefer to use day to day.

Come along with our family as we head to a local small lake for an overnight camping trip. We face MULTIPLE challenges along the way, so the question is, will we make it through the night!