Focusing on weight-loss has become a yearly obsession especially around the New Year. However, rather than addressing the underlying lifestyle factors, many opt for quick fixes as in taking weight-loss medications.

In 1997, two very popular weight-loss drugs; fenfluramine (the fen in fen-phen) and dexfenfluramine (Redux), were recalled due to increased risk for fatal heart value abnormalities. No sooner were these two drugs recalled that another drug was introduced to take their place - sibutramine (Meridia) hit the market in November of1997 for the treatment of overweight and obesity.

Meridia is an antidepressant drug classified as an MAO (monoamine oxidase) inhibitor. It works by inhibiting the reabsorption of serotonin, a neurotransmitter that among other actions, regulates appetite. Unfortunately, Meridia has its own set of problems.

A recent (11/23/09) medical news alert reported that Meridia increases the risk of cardiovascular events including myocardial infarction (heart attack) and cardiac death, and stroke especially in high-risk patients. These findings were obtained from a placebo-controlled study (SCOUT Trial) of 10,000 overweight and obese patients, 55-years or older with a history of heart disease or type 2 diabetes plus one additional risk factor.

The FDA was informed of these findings in mid-November, but as of now, no recommendations have been made other than to advise avoiding its use in higher-risk patients or those with a history of coronary heart disease, congestive heart failure, arrhythmias, or stroke.

Appetite suppressants are not only dangerous, but their usage will eventually sabotage your weight-loss efforts by causing increased breakdown of muscle tissue resulting in metabolism slow down.

My thoughts can best be described from an excerpt of my book, “The regulation of appetite is highly complex with numerous interactions and interconnections between endocrine, adipose, gastrointestinal, and neurological pathways. These redundant hormonal and neurochemical pathways, which regulate appetite and energy homeostasis, are crucial and deeply entwined within our circuitry, and serve as a self-preservation mechanism. Overcoming these pathways through anti-obesity pharmacological intervention, although arduous, has researchers adamantly pushing forward as if searching for the Holy Grail. Moreover, although a noble and necessary remedy for the morbidly obese and those afflicted with uncontrollable hyperphagia, it is not the entire solution and should be looked at with consternation. The concern is not so much for the critically obese individual, but rather for the overweight person who might supplant good nutrition and exercise with appetite suppressing medications. In a society that is greatly pill reliant and overly medicated, these drugs will only serve to dissuade many from pursuing the very knowledge that might enlighten them to a healthy lifestyle which can be passed on to their children. “

Dr. Sardone

Are you one of those people who buy only organically grown corn, or other vegetables and fruits, in an attempt to avoid genetically modified foods? Okay, I applaud your intentions - to avoid GMO foods to protect yourself from hidden toxins and unknown ill effects. That is admirable; however, how do you know that the food you are buying is really 100% organic?

Unfortunately, most organic farms are located within collateral damage distance from genetically modified crop farmers. Pollen from genetically modified crops is contaminating organic crops via wind, rain, birds, bees and insect pollinators, and there is very little that organic farmers can do about it, except move their farms where birds and bees will not find them - really?

Genetic pollution has become such an inevitable problem, that the environmental protection regulators are considering setting an "allowable limit" for genetic contamination of non-GE or organic foods. In other words, since genetic pollution is so widespread and uncontrollable, the feds are going to come up with an acceptable or safe level for this type of collateral damage. Organic advocates and farmers are not very happy.

Organic soybean farmers are also unhappy about soy processing manufactures throwing them under the bus by buying "organic soybeans" from China. Organic soybeans from China, who are they kidding? Okay, no offense intended to my Chinese friends, but their tract record is not very good, especially when supplying Americans with imported goods. They do not have to follow USDA guidelines for organic farming or any other guideline for that matter.

So, even though the bag reads organic, does not necessarily mean it is, and this is food for thought, pun intended.

Dr. Sardone

Ever wonder why you crave sweets or why eating other high-glycemic carbohydrates uplifts your mood – makes you “feel good.” Of course, the negative health consequences associated with eating them far out weigh their mood altering effects, which are temporary and require eating more carbohydrates to sustain.

One of the main reasons behind these cravings and mood altering effects is increased serotonin synthesis. Serotonin is a neurotransmitter found predominantly in the brain, but is also found in other tissues; intestinal wall, blood vessels, and lung tissue. Its functions are diverse including appetite regulation, sleep/wake cycles, memory/learning, sexual behavior, temperature and pain regulation, muscle contraction, hormone regulation, cardiovascular function, and depression and mood.

Tryptophan, an essential amino acid (protein) found in foods like turkey, eggs and dairy, is the precursor to serotonin synthesis. Tryptophan crosses the blood-brain barrier entering into the brain where it is converted into 5-hydroxytryptophan (5-HTP) with the aid of an enzyme and vitamin B3 (niacin). 5-HTP is then converted into serotonin with the assistance of another enzyme and vitamin B6.

However, in order for tryptophan to cross the highly selective and protective blood-brain barrier, its blood concentration must be higher than other similar amino acids (tyrosine, phenylalanine, leucine, isoleucine, valine and methionine), and this is where carbohydrates come into play. Consuming high-glycemic carbohydrates results in high blood sugar and this stimulates the release of insulin from the pancreas gland. Insulin not only clears the blood of extra sugar, but it regulates the amino acid tissue uptake too – resulting in a higher tryptophan blood concentrations.

So, the intake of carbohydrates and especially sweets and simple sugars, increases insulin levels, which allows more tryptophan to enter into the brain where it can be used to make serotonin – the effects of which are mood altering. But, over consumption of high glycemic carbohydrates has negative consequences like reactive hypoglycemia, sugar cravings, increased body fatness (weight gain), insulin resistance, metabolic syndrome, diabetes, heart disease, and various cancers. So, how do you remedy this paradox?

To unravel this quagmire, I tell my patients to follow a well-balanced (not high carb and low-fat) diet consisting of low-glycemic carbohydrates, quality proteins and fats spread out throughout the day consisting of three main meals and two to three snacks – all balanced and based on their particular needs. Doing so will keep blood sugar and insulin levels within normal, and provide greater amounts of tryptophan available for serotonin synthesis, without the negative effects of consuming too many carbohydrates or high glycemic carbohydrates.

• On a side note, taking 5-HTP can circumvent tryptophan and insulin, and allow for greater production of serotonin, because 5-HTP does not require carbohydrate consumption. However, this natural supplement cannot be taken by those on antidepressant or selective serotonin uptake or MAO inhibitors. Check with your doctor before taking this supplement.

Of course, following a lifestyle program consisting of solid nutrition, supplementation and exercise is optimum for achieving overall good health and a much better outlook on life – good mood included.

Dr. Sardone

Melatonin (n-acetyl-5-mehoxytryptophan) is a hormone synthesized from serotonin in the pineal gland located inside the brain, but is also found in other tissues. Tryptophan, an amino acid naturally found in foods like eggs, turkey, and dairy, can cross the blood-brain barrier where it is converted into serotonin, which can be further converted into Melatonin, however, melatonin can itself cross this barrier. Melatonin is referred to as the “hormone of darkness” because it is mainly secreted at night in the absence of light, and typically peaks between 2 and 4 AM. Its synthesis is inhibited by sunlight, and artificial light that night shift workers are generally exposed. Melatonin’s production is highest during childhood then slowly declines (with few exceptions) over a lifetime reaching very low levels - typically around 55 years of age and thereafter.

Researchers believe that it’s both the natural age-related decline and inhibition of melatonin synthesis by nighttime exposure to artificial light, that predisposes individuals to increased disease risk and accelerated aging. Conditions associated with melatonin deficiency are:

* Accelerated Aging
* Brain Degenerative Diseases (Alzheimer’s, Parkinson’s and Huntington’s)
* Depression/Mood Disorders
* Increased Cancer Risk (Breast and Colorectal)
* Increased Cardiovascular and Stroke Disease Risk
* Insomnia

Although melatonin is commonly known for its sleep-inducing properties, many individuals are unaware of its other very important physiological functions including anti-aging, antioxidant and anti-cancer properties. Unlike other antioxidants like vitamin E (lipid only) and vitamin C (aqueous only), melatonin works in both lipid (fat) and aqueous (watery) parts of the cell neutralizing the damaging effects of free-radicals, highly disruptive chemicals that damage mitochondrial DNA, lipids and proteins through oxidative stress. It’s melatonin’s ability to work in both mediums, which makes it such a potent antioxidant.

Because melatonin declines throughout life, reaching very low levels in the elderly, many researchers believe that this decline contributes to aging and its related neurodegenerative conditions like Alzheimer’s disease (Elderly Alzheimer patients have half the amount of melatonin as elderly individuals not afflicted with this dreadful disease). Researchers believe that oxidation and amyloid plaque buildup are contributory factors in the development of Alzheimer’s, and that melatonin’s effectiveness is secondary to its free-radical scavenging properties and ability to inhibit amyloid plaque formation. Although melatonin supplementation has not proven beneficial in reversing advanced Alzheimer’s disease, it has preventative properties as an antioxidant and antiamyloidogenic that warrant its appropriate usage.

Melatonin’s anti-cancer properties are attributed to its antiproliferative, antioxidative and immunostimulatory effects. It is well known that breast cancer tissue contains higher levels of aromatase activity than normal breast tissue – aromatase is an enzyme responsible for converting testosterone into estradiol, a potent estrogen and breast cancer cell stimulator. There is evidence that melatonin protects against breast cancer by inhibiting aromatase expression. Studies show that women, who worked night-shifts resulting in less melatonin synthesis, had higher incidences of both breast and colorectal cancers.

Levels of melatonin can be assessed either through blood or saliva samples; however, collecting your saliva during the nighttime peak hours (2-4 AM) of synthesis is more practical. Knowing your level is important especially when considering supplementing this hormone, and supplementing with melatonin rather than its precursors is more practical and reliable, and should always be done under a qualified healthcare provider’s supervision. The dosage will vary based on particular needs and desired effects. Typically, taking 0.5 to 1mg at bedtime (time-released capsule) is sufficient for sleep inducement and for its other noted benefits.

Appendix D of my book discusses the importance of melatonin and other hormones, and offers a checklist of symptoms associated with their deficiencies or overproduction. A list of diagnostic labs offering both blood and saliva testing is also provided.

Dr. Sardone

It is important to differentiate between a true milk allergy from lactose intolerance. The former involves the immune system reacting to specific milk proteins, typically casein, and the latter is secondary to digestive inability to breakdown lactose or milk sugar.

A true milk allergy might cause immediate symptoms after consumption such as:

1. Hives
2. Wheezing
3. Vomiting
4. Anaphylaxis, although rare, this reaction is serious (airway constriction, severe drop in blood pressure, flushing of the skin) and requires immediate medical attention.

Delayed milk allergy symptoms might include the following:

1. Runny and itchy nose
2. Watery and itchy eyes
3. Coughing
3. Skin flushing
4. Abdominal cramps
5. Diarrhea (colic in babies)

On the other hand, lactose intolerance causes irritable bowel syndrome (IBS), producing digestive symptoms shortly after consumption such as:

1. Bloating
2. Gas
3. Abdominal cramps
4. Diarrhea

As you can see, these digestive symptoms are similar to delayed milk allergy symptoms and this can cause some confusion. However, lactose intolerance only produces irritable bowel symptoms as described.

Here is something else to consider, irritable bowel syndrome or IBS is not the same as inflammatory bowel disease or IBD. Confused? The latter in this case, is an inflammatory condition of the colon (ulcerative colitis) or of the small intestine and colon referred to as Crohn's disease. Differentiated by location, both are considered autoimmune conditions with various dietary triggers, and cause similar symptoms such as bloating, gas, abdominal cramps and diarrhea (severe) leading to malabsorption and malnutrition. Although IBD does cause other symptoms, it does have similar digestive symptoms as milk allergies and IBS.

Then you have celiac disease, an autoimmune reaction to gliadin, a protein found in gluten (wheat, barley and rye). And you guessed it, celiac disease also causes similar digestive symptoms as well as other systemic symptoms.

Finally, soy proteins also cause allergic reactions very similar to milk proteins, and in fact, is more common than milk allergies. It is very important to understand the difference between milk and soy proteins, and how they effect us, including infants and children. This is a topic that I devote great time to in my book and is worth learning about.

So, the key is how to differentiate and then how to treat? Of course treatment will vary based on the condition and is too involved to discuss in this post. However, aside from allergy blood tests, there is another test that I use in my practice to help differentiate gastrointestinal conditions: the Comprehensive Digestive Stool Analysis (CDSA 2.0) by Genova Diagnostics. This is an easy test to perform at home over a three day period.

For more information about this test, please email me via my contact page.

Dr. Sardone

Overall, a person's lifestyle can effect their health in many ways - typically, the American diet promotes systemic inflammation through imbalances of omega-6 and omega-3 pathways. In other words, the Western diet consists of too many omega-6 fats and not nearly enough omega-3 fats. Omega-6 fats are found in almost every food you eat and are especially high in margarine, vegetable, canola and soybean oils. Omega-3 fats are found in fewer foods such as green leafy vegetables, walnuts, flax meal and oil and cold water fish (salmon). The average American consumes omega-6 oils 20 to 30 times more than omega-3 oils, and this ratio should be more in line with 2-4 to 1. Also, the American diet consists of too many processed foods loaded with high-glycemic sugars and unhealthy fats like trans fats derived from partially hydrogenated vegetable, canola and soybean oils.

A poor diet and lack of exercise promotes weight gain and increased body fat storage, especially around the midsection. Central (intra-abdominal) fat cells produce chemicals (cytokines) that promote systemic inflammation similar to omega-6/omega-3 imbalances. Together, these factors induce a systemic environment prone to inflammation and disease including heart disease, diabetes and various cancers in conjunction with other conditions like allergies and asthma - those suffering from seasonal allergies and chronic asthma are predisposed to inflammatory reactions producing symptoms such as runny noise, watery eyes, sneezing, post-nasal drip, bronchial congestion, coughing, wheezing and difficulty breathing.

Here are some tips that you might want to consider and speak to your healthcare provider about. It is important to speak to a qualified healthcare provider regarding dietary, exercise and supplementation before commencing. Various supplements can interfere with prescription or over-the-counter medications, as well as various medical conditions.

Some basic tips to help fight allergies and asthma

1. Lose the midsection - Generally, a waist circumference measured at the belly button, more than half your height in inches is a red flag. Example: a 64 inch (5'4") tall person should have a waist measurement less than 32 inches.
2. Eat Right - eliminate processed foods including fast foods and beverages (sodas sweetened fruit juices). Eliminate high-glycemic sugars and white flour, and stay away from high-fructose corn syrup and trans fats (partially hydrogenated oils). Eat a well-balanced diet including whole foods, grains, nuts, plenty of fruits (especially berries) and vegetables, and quality proteins and fats.
3. Stay away from wheat, barley and rye, if allergic to gluten.
4. Drink green, white and black teas.
5. Exercise: incorporate an aerobic and weight training exercise plan based on your particular ability and medical situation.
6. Use a natural nasal spray that contains saline and xylitol (see below).
7. Take a broad-spectrum multiple vitamin and mineral supplement.
8. The following supplements may prove beneficial in reducing inflammation and relieving various allergy and asthmatic symptoms: If you are taking medications, check with your doctor or pharmacist for possible interactions before taking any supplement.

* Vitamin C and bioflavinoids (500-1000 mg - 2 X day)
* Quercitin (250-500 mg - 3 X day)
* Boswellia or boswellic acid (300 mg - 3 X day)
* Fish oils (EPA/DHA) - (1000 mg - 3 X day)
* Flaxseed oil (cold pressed) - (1 tbsp - 1 X day)
* N-acetylcyteine or NAC (500 mg - 3 X day)
* Butterbur - make sure that this product is UPA-free (unsaturated pyrrolizidine alkaloid) - (50-75 mg - 2 X day)

Nasal Spray: I recommend using Activated Nasal Mist by Now Foods to help reduce nasal and sinus irritation.

Of course, seeking the help and guidance of a qualified healthcare provider who specializes in functional medicine, is always recommended because one size does not fit all; however, the above suggestions may prove beneficial. For more information or if you have any questions you can send me an email via my contact page.

Dr. Sardone