Dr. Jennifer Pearlman, MD CCFP NCMP FAARM ABAARM
Despite the fad diets, we are now the fattest generation in history. Obesity levels in Canada have increased from 3% in 2003 to over 20% in 2017, with the greatest rate of increase seen in women. But it is not that we are simply eating more and moving less. The calorie equation cannot account for the increase. Instead, a range of environmental, lifestyle and metabolic risk factors are leading to an obesity epidemic that is threatening our waistlines but also our survival. The emerging field of epigenetics has led to insights into the impact of gene-environment interactions on our health, aging and risks of disease including obesity. Newly established genetic susceptibilities may predispose to diet-induced diabetes and obesity. Pathological shifts in the microbiome (the collection of gut bacteria) can lead to metabolic changes and increase the risk of obesity. Environmental exposures to low-level chemicals that can also affect metabolism and lead to weight gain. These obesity-inducing environmental toxins (obesogens) may work as hormonal disruptors and can increase the risk of diabetes, cancer and other disease. These novel risk factors emerge over longer periods of low levels of exposures (i.e. toxins, stress, gene-environment interactions) and as a result contribute greatly to age-related weight gain. The complex web of interactions affecting our weight and health explains why diets, regardless of regimen, too often fail. Dieters committed to the broken calorie equation find themselves in a weight loss-weight gain yo-yo which poses risks to the body as well as to the brain. The vicious cycle of diet and rebound weight gain can indeed be hazardous. Recent research suggests that yo-yo dieting results in reduced cognitive performance and neurotoxicity as redistributed fat-stored toxins released in dieting can cross the blood-brain barrier with deleterious neurological effects during the weight loss phase. Hence the finding that diets may make you “dumb”. So if diets don’t work and the calorie equation is broken, then a new framework is needed to combat age-related weight gain. A shift from the quantitative mindset to a qualitative one is in order; what and when we eat matters. Periods of fasting intermixed with a plant-based whole food nutrient-rich diet is ideal. There are no cookie cutter solutions. But by understanding an individual’s genetic, hormonal, metabolic, inflammatory, nutritional, and behavioural profile in the context of their habits, preferences and lifestyle a comprehensive plan may be designed. The following five steps underpin a modernized approach to target midlife weight gain:- Fasting
- Lo-Hi Diet
- Reset Insulin Sensitivity
- Optimize Hormone Health
- Restore key Nutrients
- Repair the Gut
- Reset Brain Controls
By Dr. Jennifer Pearlman, MD CCFP NCMP FAARM ABAARM Dr. Pearlman is a nationally recognized expert in Women’s health, hormones and functional medicine and is Medical Director of PearlMD Rejuvenation, a state-of-the-art Women’s health and wellness facility.