But First, A Review

  • Those Who Ignore History are Doomed to Repeat It
    George Santayana, 1905
  • Winston Churchill, 1935, 1948
  • Every Thing Old Is New Again
    Vigo the Carpathian; Ghostbusters II
    1989

Brief History of Diets

  • 8000 B.C.:
    Stone Age man eats meat, meat, some plant leaves, and more meat.
  • 1614
    Giacomo Castelvetro, an Italian living in England, touts the benefits of a produce-rich diet in The Fruits, Herbs, and Vegetables of Italy. The British are unconvinced.
  • 1860s:
    A book called Letter on Corpulence outlines a diet plan that emphasizes meat and vegetables and avoids bread, pastry, and potatoes.
  • 1930s:
    Studio-system starlets subscribe to the Hollywood diet: half a grapefruit before every meal, coupled with restrictions to limit calories.
  • 1950s:
    A crash diet of unlimited cabbage soup for a week—a rumored weight-loss remedy—doesn’t keep off the pounds and can be flatulence inducing, but nonetheless catches on.
  • Mid-1950s:
    Urban legend has it that opera singer Maria Callas dropped 65 pounds on the Tapeworm Diet, allegedly by swallowing a parasite-packed pill.
  • 1963:
    Weight Watchers is founded by Jean Nidetch, a self-described “overweight housewife obsessed with cookies.“
  • 1960s:
    An American physiologist living in Salerno, Italy, publishes the first scientific study on the Mediterranean way of eating.  1970s: The grapefruit diet experiences a resurgence in popularity after it’s mistakenly associated with the Mayo Clinic.
  • 1970:
    The Sleeping Beauty Diet, which involves sedation, is rumored to have been tried by Elvis.
  • 1972:
    Dr. Robert Atkins publishes his Diet Revolution, which claims that avoiding carbs will peel off pounds and lower the risk of metabolic syndrome, diabetes, and high blood pressure.
  • 1975:
    The Stone Age Diet introduces modern man to his dietary history.
  • 1975:
    Miami doctor Sanford Siegal introduces a “specially formulated” diet cookie. Patients nosh six to nine cookies a day, followed by sensible meals.
  • 1977: Slim-Fast
    a shake for breakfast, a shake for lunch, then a sensible dinner — becomes a diet staple.
  • 1978:
    Dr. Herman Tarnower publishes “The Complete Scarsdale Medical Diet.” Two years later he is shot by his girlfriend.
  • 1979:
    Dexatrim, a diet drug containing phenylpropanolamine (PPA), appears on drugstore shelves. Its formula changes after PPA is linked to an increased risk of stroke in 2000.
  • 1988:
    Optifast, Medifast Lliquid Protein Diets,
  • 1990s:
    The Atkins diet experiences a revival with the release of a second book.
  • 1995: The Zone Diet, which calls for a specific ratio of carbs, fat, and protein at each meal, begins to attract celeb fans.
  • 2003:
    The South Beach diet cross-pollinates the Atkins and Mediterranean diets.
  • 2010s:
    Repackaged as the Paleo diet, the ancient meal plan of meat, eggs, greens, fruits, and zero processed foods becomes the preferred diet of CrossFit enthusiasts.
  • 2011:
    The HCG Diet, which combines a fertility drug with a strict 500- to 800-calorie-a-day regimen, invites interest.
  • 2013:
    The Mediterranean diet (lean meats, produce, olive oil, nuts, wine, and whole grains) is found to reduce the chance of heart attacks, strokes, and death from heart disease by 30 percent.

A Brief History of Diets

  • 2014 What’s New?

William Nat Clearfield D.O.

Obesity

  • Beginning in the early 1980’s the low fat, high carbohydrate diet was deemed the holy grail of dietary intake.
  • Were we ever wrong!
  • Within 5 years of the medical community’s acceptance of the low fat diet, a major health crisis developed in the United States. Americans became fat.
  • As counter intuitive as it seems:

Low Fat=Fat

Obesity

  • In 1985, only 15% of the U.S. population was overweight.
  • Today some areas of the country experience an obesity rate of 70%.

Silent Inflammation and Obesity

  • What Happened?
  • We Doctors Told Everyone That High Fat Diets Caused Heart Disease.
  • We Took As Gospel Low Fat, High Carbohydrate Strategies Made Sense
  • Excess Carbohydrate load triggers insulin production.
  • Chronically elevated insulin levels triggers an inflammatory response in the vascular system leading to abnormal hormone production.
  • This inflammation is not overt, red or oozing, like an infected finger, but “silent.”
  • Fat (such as abdominal fat) is an active endocrine and metabolic organ, playing a major role in producing chronic disease. Fat tissue, once considered an inert deposit, secretes a host of inflammatory toxins
  • This “silent inflammation” accelerates chronic disease processes like diabetes, heart disease, high blood pressure, metabolic syndrome, Alzheimer’s disease, and various cancers among others.
  • Obesity is associated with impaired function of organ systems, serious medical disease, and premature mortality.
  • Proper nutrition, like the proper fuel in an automobile, can increase the life expectancy and the quality of that life, by reducing silent inflammation and its burden of chronic disease.
  • Losing weight aids in attaining optimal physical, mental, and emotional well-being. It lowers the risk of developing future diseases.

The Test

  • Lab Test c Reactive Protein (cRP) is an excellent marker of oxidatitve stress.

Dr. Clearfield’s LIFESTYLE PROGRAM DIETARY PRINCIPLES

  1. Eat 5 meals per day. Do not skip meals.
  2. Review and choose low-glycemic foods (<50)

      Glycemic Index

    • Glycemic index offers information about how foods affect blood sugar and insulin.
    • Waffles, Aunt Jemima (Quaker Oats) 76
    • Bagel, white, frozen 72
    • Corn tortilla 52
    • Wheat tortilla 30
    • Cornflakes™, average 93
    • Oatmeal, average 55
    • Instant oatmeal, average 83
    • Watermelon 72
    • Pear, average 38
    • Macaroni and Cheese (Kraft) 64
    • Spaghetti, white, boiled, average 46
  1. No white flour, white sugar, dairy except for a limited amount of Greek yogurt
  2. Choose something from Column A (Protein), Column B (Complex) Carbohydrates and Column C (Fats) for each meal.
  3. Add flax seeds and plain, unsalted almonds
  4. Watery fruits, while better than candy bars, are high in natural sugars. Go easy on anything that needs to be mopped up after you bite into it (Bananas, mangos or melons.)
  5. No carbohydrates after 8:00 pm. If hungry eat lean protein.
  6. Add Fage or natural Greek yogurt to your routine.
  7. Go easy on tropical fruit such as bananas, mangos or melons. (If you bite into a fruit and you get soaked, it’s tropical)
  8. Avoid fresh juices and all dried fruits.
  9. Bragg’s Amino Acids with Lemon Juice is the best salad dressing. Oil and Vinegar are a close second.
  10. Use slow cooked (Steel cut oats) 30 min. oatmeal.
  11. Use a two week food–log periodically to get useful feedback.
  12. Eliminate dairy except for adding to tea or coffee.
  13. No diet drinks. Avoid all artificial sweeteners.
  14. Restrict alcohol to 2 drinks/day. No beer is ideal. Refer to the   Dr. Clearfield’s Adult Beverage Paper in your sent via email for   those beers that are acceptable on a limited basis.
  15. Always shop at the periphery of the grocery store, avoid the aisles.
  16. Rather than cheating a little each day, have a Mardi Gras Meal once per two weeks.
  17. Drink 100 oz. of water per day. (8- 16 oz. extra water for every 20 min. of exercise).
  18. Eat slowly.

Dr. Clearfield’s LIFESTYLE PROGRAM

  1. Nutritional Plan: The Original Human Diet
  2. The Paleo – Diet is the most important single key for effective weight loss.

  3. Medications: Specific Pharmaceuticals
  4. The Dr. Clearfield’s Lifestyle Program uses several FDA approved medications when appropriate.

  5. Advanced Supplementation: Individualized Rx
  6. Fish – Oils
    Anti – Oxidants
    – Select herbs, Multivitamins

  7. Weekly injections:
  8. Vitamin B 12, Methionine, Inositol, Choline – These amino acids promote weight reduction by increasing fat metabolism   and through the Krebs Cycle.

  9. Restoration of Hormones: Bioidentical Hormones
  10. As part of any lifestyle program, Dr. Clearfield may recommend various hormones appropriate to your age, lifestyle  and laboratory studies.

  11. Exercise
  12. We review and monitor your activity and energy output.

  13. Behavioral Support:
  14. Each week we assign a “homework” assignment consisting of goal setting, dietary and supplement recommendations, exercise goals and spiritual inspiration.

  15. Detoxification:
  16. In certain cases a “detoxification” strategy is needed to remove any difficulty in weight loss.

  17. Sleep:
  18. Rescue Remedy Sleep or a combination of Vitamin D3 5000 IU, Melatonin 3-6 mg, and Magnesium taurate 400 mg, may be prescribed for sleep issues.

    • Dr. Clearfield’s Medical Steps to Wellness
    • Week 1 Homework Assignment
    • Make a Written Commitment To Change with a Specific Deadline
    • Medical Steps to Wellness
    • Week 1 Goal
    • Family/Relationship Acton Step
    • Spiritual/Contribution Action Steps Health/Physical/Nutrition Action Steps
    • Intellectual/Educational Action Steps
    • Financial Action Steps
    • Week 2 Home Work

    Rate Yourself in the Following Categories from

    10 (terrific) to 1 (terrible)

    • Diet  Friends
    • Exercise  Financial Planning
    • Life Plan  Music, Art, Dance
    • Love of Work   Hobbies
    • Romance  Adventure/Risk
    • Follow Up  Down Time
    • Children  Giving Back/Gratitude

    Eat broccoli two times weekly (place in boiling water w 1 drop Olive Oil-Boil 5 minutes. Drain).
    Eat Cold Northern fish (wild salmon, kippers, mackrel or sardines once per week)

    Paleo Foods

    Using the Old Chinese Restaurant Method Choose For Each Meal :

    • One Item from Column A
    • One Item from Column B,
    • One Item from Column C

    Column A Proteins

    • Lean Beef (trimmed of visible fat)
    • Lean Pork (trimmed of visible fat):
    • Lean poultry (white meat, skin removed):
    • Eggs
    • Other meats
      -Rabbit meat (any cut)
      -Goat meat (any cut
      -Organ meats
    • Game meats
    • Fish
    • Shellfish
    • Vegetarian Protein

    Column B Carbohydrates

    • Fruits
    • Vegetables
    • Nuts
    • Herbs and Spices

    Column C Fats

    • Oils:
      • Olive
      • Avacado
      • Walnut
      • Flaxseed
      • Canola
      • Coconut Oil

     Foods to Avoid

    • Cereal Grains
    • Grain like Seeds
    • Certain Legumes
    • Starchy Vegetables
    • Salted Foods
    • Selected Dairy
      1. Nutritional-Power Foods

        • Include with each meal Almonds
          • Spinach (and Greens)
          • Eggs
          • Turkey
          • Olive Oil
          • Protein (Denatured Whey Shakes)
          • Berries
      2. Medications

        • Qsymia-Combo Phentermine and Topiramate
          1. Phentermine-appetite suppressant
          2. »Releases norepinephrine
            »Increases Leptin (sappetite regulating hormone)

          3. Topiramate
          4. »Increases feeling of fullness
            »Makes food taste less appealing
            »Increases calorie burning

        • Belviql
        • Increases serotoninl
        • Same mechanism of action as hallucinogens such as LSD
        • Lower doses
      3. Supplements

        • Leptin Manager
        • Leptin is a fat cell derived hormone
        • -Controls appetite and energy balance
        • -Elevated levels indicate satiety
          -Excess adipose tissue causes leptin resistance
          -Reduces the Number of Fat Cells
          -Reduces Leptin
          -Reduces Weight

      4. PURE LEAN PACK (7 supplements/pack)

        • Enhanced Fat Metabolism (Taurine)
        • Fish Oil
        • Glucose Support (Chromium, Cinnamon)
        • Lipid Management (Green Tea Extract)’
        • Vitamin C
        • 5MTHF (Cardiovascular Support)
        • Magnesiumt
      5. DETOXIFICATION

        • Are You As Healthy and Energetic As You Should Be?
        • Are You Constantly Exposed to a Toxic Enviornment?

      The Test

      • Medical Symptom Questionnaire (MSQ)
      • 11-30 Mild S/S
      • 31-50 Mild to Moderate Toxicity
      • 50-75 Moderate to Severe Toxicity
      • > 75 Severe Toxicity

      The 4 R’s

      • Remove
      • Repair
      • Replace
      • Retest

      Remove

      • Eliminate inflammatory items from the diet
      • Dairy
      • Fatty Meats
      • Gluten
      • Alcohol, caffeine
      • Yeast containing foods (e.x. cold cuts, peanuts,   vinegar)
      • Limit fruit to 1-2/d

      Replace

      • Inflammatory Foods With Hypoallergenic Foods
      • Eat 5-7 meals per day (every 2-3 hours)
      • Eat Protein/carb/fat with each meal

      Repair

      • Add ”functional” food shakes and supplements
      • Add in targeted nutritional formulas
      • Add in detoxification supplements

      Retest

      • Reintroduce Foods, one every 2-3 days
      • Reintroduce allergic potential foods one at a time
      • Keep a food diary
      • Watch for allergic S/S
      • Rash, Itching, Swelling, Difficulty Swallowing Diarrhea
      • The Key To Losing and Maintaining Proper Weight Is To Reduce Silent Inflammation.
      • The Key To Reducing Silent Inflammation Is To Reduce Free Radicals.

      What Are Free Radicals?

      • Slice into an apple. Let it sit for several hours. It turns brown.
      • Leave Cooked Fish Open To The Air
      • -It becomes rancid

      • Cut your skin
      • -It becomes raw and inflamed.

      • All of these result from oxygen interacting with cellular substances.
      • -Oxidation produces changes in cells Fruit dies.

      • Skin generates new cells, a scar.
      • This is a continuous 24 hour a day, 98-99% efficient natural process
      • 1-2% of cells are damaged in the oxidation process
      • Damaged Cells Are Described as Missing A Molecule, exposing a “free” electron.
      • Cells with a free molecule (called free radicals) rampage through the organism trying to pair these “free” molecules.
      • Free Radicals often injure cells, damage it’s DNA and plants the seed for disease.
      • Damaged DNA results in mutated cells.
      • The mutated cells grow and reproduce abnormally.

      The Rescue!

      • Nature Provides an Antidote for Free Radicals (called Anti-oxidants)
      • Sources of anti-oxidants:
      • Fruits, vegetables, whole grains, nuts and legumes
      • Exercise

      Mother Nature To The Rescue!

      Types of Anti-oxidants:

      Nutrients:

      • Vitamin C, E, Selenium, Beta Carotene

      Enzymes:

      • Superoxide dismutase (SOD)
      • Catalase
      • Glutathione peroxidase
      • SOD adds electron to free radical s to form oxygen and hydrogen peroxide.
      • Catalase and Glutathione reduces hydrogen peroxide to water(Glutathoine is then reduced by glutathione reductase)
      • Result is repaired DNA, diminished oxidative protein and destroyed oxidized lipids.
      • Glutathione is the most powerful anti-oxidant in the body.
      • –Naturally produced in Liver
        –Consists of three proteins, cysteine, glycine and glutamine
        –As of September 2012, 103,572 articles on Glutathione in the NIH/National Library of Medicine database.

      • Glutathione is touted as the secret to prevent aging, heart disease, anemia, radiation poisoning, dementia, autism and Alzheimer’s disease.
      • Acts as a chelator, removing mercury, lead, cadmium and arsenic from the blood stream.Prevents or reverses alcohol induced fatty liver, cirrhosis, hepatitis and liver tumors and improves the prognosis of stroke victims.
      • Skin lightening.
      • Glutathione Deficiencies:Cataracts, glaucoma, chronic fatigue syndrome, cancers of all kinds, asthma, arthritis, liver disease and most chronically ill individuals.
      • Adequate glutathione levels are necessary for mental and physical well being.
      • Low tGSH in adolescent boys is a significant independent predictor of parental CHD.(1)
      • Morrison JA1, Jacobsen DW,Sprecher DL, Robinson K, Khoury P, Daniels SR.,Serum glutathione in adolescent males predicts parental coronary heart disease.Circulation. 1999 Nov 30;100(22):2244-7.

      Glutathione oxidizes fat

      • Glutathione contributes to strength, endurance and a shift from fat to muscle metabolism.
      • In our practice we first used glutathione intravenously to relieve symptoms of Parkinson’s disease. Patients exhibited improvement in tremors, movement, muscle rigidity, balance, speech and arm movement. As a by product our patients reported a significant (20-30 pound) weight loss.

      Glutathione

      Weight Loss Dose:

      • 600 mg in 7 cc sterile water Intravenous over 5 minutes
      • Increase up to 1400 mg (7 ml) in 3 cc sterile water
      • Twice Weekly
      • Oral Weight Loss Dose:Stomach acid degrades the proteins that comprise glutathione Only 1-3% of the active ingredient following digestion. Precursors can increase glutathione production.
      • Glutathione Precursors
      • Bioactive Whey Protein
      • N-acetyl cysteine, 500 mg daily
      • Asthma, COPD, and liver failure from acetaminophen   overdose.
      • Alpha-lipoic acid 300 mg twice daily
      • Blood sugar control, neuropathies, energy production and detoxification.
      • Methylated Folic acid, B6 and B12
      • Selenium, Vitamin C and E and Milk Thistle
      • Curcumin

      Side Effects of Glutathione

      • Patient W Migraine HA
      • ? zinc levels.
      • Nebulized glutathione can lead to sulfite formation in the bronchial airways, reducing the caliber of the airway
      • Abdominal pain, cramps and bloating have been reported with oral glutathione.
      • Some patients may experience a transient rash from oral glutathione.  These are seen in patients with milk related allergies.

      What’s New In Weight Loss

      Genetic Testing

      Personalized Dietary Guidelines

      • Simple Test-7 Genes
        1. Vitamin C
        2. Folic Acid
        3. Whole Grains
        4. Omega 3 (Fish Oil) Fat
        5. Saturated Fat
        6. Sodium
        7. Caffeine
      • Advanced Testing
        1. Specific Diet
        2. Exercise
        3. Health Conditions
          »Diabetes, Arthritis, Venous thrombosis
        4. Cholesterol (good and bad)
        5. Medications
          »Statins, coumadin, plavix
      • Advanced Testing
        1. Nutrients
          »Vitamin A, B2,B6, B12
          »Folic Acid
          »Vitamin C,D,E
          »Adiponectin (Leptin)
      • Weight Management
        -Diet (Specific for genetic makeup)

      • Diet Type
      • Eating Behavior traits
      • Fish Oil Use (Good/bad/indifferent)
      • Tendency to Regain Weight
      • Exercise
      • Medication Response
        -Health Conditions
      • Eating Behavior Traits
        1. Snacking
        2. Feeling Full
        3. Eating Dishinibition
        4. Food Desire
        5. Sweet Tooth
      • Complementary Supplements
        1. Green Tea, Green Coffee Extract