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Metabolic Syndrome and Gynecologic Health

I was very honored to be asked to answer some questions for some ladies to discuss their Healthy Future Marriage–and I thought, let’s do a blog post!

I’m not a gynecologist, but guess what? Your metabolic health can affect EVERY ORGAN SYSTEM!!

For women, it’s important to remember that a healthy lifestyle isn’t just about fitting into that perfect outfit, it’s also about a healthy heart, healthy ovaries, and a healthy uterus!

Many gynecological problems are related to metabolic syndrome and unhealthy BMI, in particular, PCOS, endometrial polyps and cancer, and uterine fibroids (honestly, these are some I was asked specifically to touch on—there may be others).

PCOS

PCOS is polycystic ovarian syndrome. Many women present because of irregular periods. They may have more hair in places we like to pluck and wax. What I would find on my evaluation is hormone imbalances, sometimes I see the cysts on the ovaries, many times the BMI is increased, and many times there is some insulin resistance. See the last two—we are touching on metabolic syndrome here. PCOS is much more likely to be associated with metabolic syndrome, and women who lose significant weight (which tends to reverse metabolic syndrome) can see improvement or reversal on their PCOS. Additionally, one of the treatments for PCOS is metformin, a medication used in diabetes management. It normally helps control the periods and improve fertility.

Fibroids

Uterine leiomyoma (fibroid) benign masses that grow on the uterus. A couple of studies have shown that there is may be an association between fibroid developing metabolic syndrome.

Endometrial Polyps

Endometrial polyps and cancer are tumors of the lining of the uterus. They have a known association with BMI>30, diabetes, and hypertension (things that make up metabolic syndrome). They are so frequently associated that they are known as the “metabolic triad” of endometrial cancer.

  1. Adipose tissue is an endocrine organ. In excess it secretes hormones that may promote cancer growth
  2. Hyperglycemia promotes an environment for cancer cell growth
  3. Insulin resistance promotes cancer growth by promoting IGF-1 (a growth factor). (Metformin has a role here as well)

So, what do we do about it?

  1. Eat well. I always say that a healthy diet begins with a healthy plate. Plant based diets are extremely evidence based, but if you are sticking to a healthy plate, you are on your way!
  2. Move as much as possible! Cardiovascular exercise if at least 150 minutes weekly, plus strength and stretch is recommended.

I tend to believe that if you focus your efforts in these two things, the health follows. (You can also find other tips about decreasing stress through meditation and getting enough sleep in the Wellness tab). If you are having problems after trying these, then discuss with a healthcare professional who can help you further!

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Eat well, Play well

What you say, doc?! My soda, candy, soul food are messing up my sexual health?

Ummmm, it could be!

We’ve known for a long time that metabolic syndrome was a risk factor for erectile dysfunction and poor sexual health in men. It turns out that it also effects sexual health in women!

Recent studies show that metabolic syndrome affects adversely affects sexual function in women, and is most pronounce in women before menopause—meaning women still of child bearing age. This means that if you are wanting to become pregnant it becomes very important to pay close attention to your metabolic health!

Furthermore, a BMI > 30 may also negatively affect sexual function although data here are mixed.

Generally, it’s thought to be the result of inflammation, and decreased blood flow to the genitourinary tissues. It can also result in hypogonadism–decrease in size of the sexual organs and the production of the sexual hormones. In the instances of increased BMI, psychological factors may also play a role.

So, how do we address it??

This one can not be addressed by medications, and if you’ve read anything here, you know I’m not big on medication fixes!! A healthy diet and exercise are the best way to combat metabolic disease and unhealthy BMI.

I generally tell people to start with a healthy plate. The Mediterranean diet is the most tried and true for sexual health. For more information on the Mediterranean diet, see this excellent post by Mayo Clinic.

Cardiovascular exercise of 150 minutes weekly (if moderate intensity), plus additional strength and flexibility exercise are what experts recommend for an active lifestyle. In addition to all the other benefits of exercise, increasing exercise will help reduce insulin resistance, one of the major drivers of metabolic disease.

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NTCC Ladies’ Day: Shelter in a Time of Storm

Delighted to join these powerhouse sisters to encourage our sisters in Christ in this season.

This is a rough period. The Lord sometimes allows us to go through some storms, but He is always our shelter, and He always shows us ways to continue to protect ourselves.

I was asked to speak on how we secure our physical shelter through this storm.

First some background on COVID can be found here.

I strongly believe that we are to take care of our bodies and that this is scripturally sound messaging! 1 Cor 3:16 tells us that our bodies are the temple of God, and the Spirit of God dwells in us. If you remember how God was very serious about the physical temple built in the Old Testament, you know that He does not take his temple lightly. In 1 Cor 6:19-20 we are further instructed to glorify God with our bodies.

This brings me to SHELTER: Sleep, Healthy eating, Exercise, Listen to the experts, Tame your disease and do your prevention, Everything you already know, and Rest in Him.

S–Sleep

Sleep and other forms of rest and recharge are essential to your health. Science says you ideally need 7-9 hours of sleep nightly. Disordered sleep can affect blood pressures, weight, blood sugars, and increase your risk of heart disease, just to name a few things. Additionally–the reason I bring it here specifically, is it weakens your immune system. You need good rest for a strong immune system, ready to fight any obstacle it may encounter. I’d also like to speak to Meditation and Gratitude -as they are a form of recharge, and are both beneficial to your health. *click the links*

H–Healthy Eating

Healthy eating gives your body the right nutrients to strengthen the immune system. Supplements can be beneficial, but what I have researched and strongly believe is that our bodies process nutrients much better from food sources–this is how God made our bodies–it just makes sense. It also helps keep our bodies at a healthy weight, and obesity has shown to be one of the biggest risk factors for COVID-19.

In Daniel 1:8, 12,13,15, we see a story where Daniel avoided the “royal diet” in favor of eating vegetables and water. At the end of the suggested time, he and the other soldiers were far healthier and more youthful in appearance. I’m not telling you you must go plant-based (although there’s lots of evidence to support this (-:), but there’s your scriptural support for a healthy diet!!

I like to focus on a healthy plate.

For more information on other ways to address your diet see this section of my blog.

E–Exercise

Exercise has been shown to be helpful for strengthening the immune system! Anyone who knows me knows I will prescribe exercise for almost ANYTHING! There are no chemical side effects. It works to counter the obesity that places us more at risk in this pandemic. It works to control chronic illness. It works to help our mental health and sense of well-being. I truly can’t say enough great things about it.

Read my other post about exercise here.

L–Listen to the Experts

It’s a shame that we have really gotten into a culture of mistrust when it comes to our trained professionals. The truth is, that the Bible teaches us that there is a time to sit down, and listen to others. Prov 12:15 says “The way of a fool is right in his own eyes: but he that hearkeneth unto counsel is wise. ” Proverbs 1: 5 says “ A wise man will hear, and will increase learning; and a man of understanding shall attain unto wise counsels”. Mark 12:17 reminds us that everyone has their lane–Give unto Ceasar what is Ceasar’s. We are to put our full trust in God, but we are also to trust those who He has given the knowledge and understanding in certain special areas.

Finally, I have heard many people take the road of “I am just going to trust God” when opting not to follow certain well established guidelines.” This is prohibited in Luke 4:9-12, when Jesus is tested in the wilderness, and refers to older writings saying “It is written, thou shall not tempt the Lord, thy God”

T–Tame Your Disease

One thing we have found in COVID is that many chronic illness are risk factors severe illness in COVID. You want to make sure that you are taking care of yourself. Make your doctor’s appointments–virtually or socially distanced. What we are seeing is people are coming in to hospitals much sicker than they normally are from things that are not COVID because they are scared to come in to take care of their illnesses. We don’t want to see people dying needlessly from other things.

E–Everything You Already Know

Wear your masks, wash your hands, socially distance. It’s simple.

R–Rest in Him

If you take a peek at the rest of my blog, you will see that I went through my own journey before this COVID thing. I grew to a different place with my trust in God. When this COVID thing hit, I sat down, and asked, “Really, God? Something else?” But we had a talk. And he reminded me that:  “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me. 10 That is why, for Christ’s sake, I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong.” 1 Cor 12:9-11. We have to learn to submit fully to his will, because his will is perfect. He will see us through this storm, y’all! Phil 4:7 And the peace of God, which passeth all understanding, shall keep your hearts and minds through Christ Jesus.

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He Provides

Two weeks ago, I hit an emotional low point that I think had been building for a while. It was after hearing something relatively small in the grand scheme of what I’ve been through, and I’m sure the person that told me had no idea it would affect me the way it did. Hopefully, they still have no idea it affected me the way it did…lol.


Let me tell you what God did. God sent cake—literal unexpected cake in my meal prep and from a family friend. God sent words of validation: I decided to congratulate someone of status in our organization with whom I’ve worked for an award they received—they in turn praised me for the work I’ve done in the organization. In preparing for a keynote address I’m about to give, a previous intern, now colleague spontaneously told me how “awesome” I am and thanked me for my work with the residents. I needed a break: I didn’t get a single call while I was on call.


And this week, I finally received the tangible recognition award I’d been given a few months back virtually for my work with the residents, and remembered that I was recognized in the Super Doctors Rising Star edition in the July issue of the Texas Monthly. I mentioned it in my Thankful Thursday post and—the outpouring of love and support I received was so unexpected…and honestly so needed. My resident texted me to congratulate me on being the keynote speaker at this upcoming event, and it reminded me…as nervous as I am about it, it truly is an honor that they trust me to represent them in this way.

“But even the very hairs of your head are all numbered. Fear not therefore: ye are of more value than many sparrows.”

Luke 12:7 KJV

And honestly guys, there are other things I won’t even type here, for the sake of confidentiality, that have come together this week… God is always working.Sometimes we think of God as being aloof, and unconcerned with our tiny needs. But the Bible teaches us different. We are so important to Him that He knows the number of hairs on our head. It tells us if we seek first the kingdom of God, the ALL things will be added…not some. ALL. Everything else. Even cake sometimes.

“But rather seek ye the kingdom of God; and all these things shall be added unto you. Fear not, little flock; for it is your Father’s good pleasure to give you the kingdom.”

Luke 12:11-12 KJV

My 8 year old told me sometimes he wanted to call God “Daddy”, but he felt it was disrespectful. I told him I didn’t think it would be. I told him that God desires relationship, and that if He felt close enough to God to approach Him in that way, then that’s beautiful.
Because the past few weeks, God has shown that He cares for me, not like a father, but a daddy. He has paid attention to every detail—things some would seem unimportant, but made me feel important and know I’m loved and purposed.

Open your eyes, He’s working for you too, because you are His, and He loves us all so deeply.

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Exercise Benefits Your Health

Throwback–Pre-COVID

Anyone who has followed my blog posts or is a patient of mine or has been to a talk of mine knows that exercise is one of my BAEs (is that a word? Is it okay that I made it up?). I love exercise guys. And I have a whole post about the many benefits of exercise.

Well, wouldn’t you know, exercise specifically benefits the immune system?

Moderate intensity exercise on a regular basis has been shown to decrease the chances that one will become infected with viral illness. This 2019 study showed that acute exercise improves defense activity of the immune system and metabolic health, and that moderate intensity exercise was inversely related to illness. (That means that as the likelihood of someone participating in moderate intensity exercise increases, the likelihood of becoming ill decreases.)

This Science Daily article further reinforces that just because it isn’t safe to go to the gym, we aren’t saying it’s healthy or beneficial to stop exercising.

And this oldie but goodie from Cleveland Clinic is in question answer format and discusses even more about how exercise can improve your immune system.

Basically, you don’t want to do too much, because it has been shown that those that train as hard as elite athletes can see a decrease in their immune system, but at least 150 minutes weekly of cardiovascular exercise of some sort, (more is not harmful–again, we’re talking ELITE ATHLETES–doing this for a living or competition). is recommended. And if you took a look at some of the other benefits, exercise can help you beat some of the gloominess of dealing with all this COVID CRAZINESS!

So, get up GET MOVING, and stay healthy.

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A Healthful Diet

It’s extremely important that we eat to live, not live to eat.

We should begin HERE with out discussion about a healthy plate. It is the foundation for thinking about eating in a healthful way, and building a meal that will feed your body well.

You want to remember to eat as many plants as possible and as many colors as possible–this is how you get the important vitamins and minerals and substances our bodies need. Whole foods are best. You want to get a food that is most like it grew out of the ground, not a food that has been implanted or fortified with all the vitamins and minerals, although these can be fine. The most healthful diet is one with whole, fresh foods.

I have people ask me all the time what supplements to take. I will go into supplements, but as a general rule, I believe that our bodies are built to get the helpful substances from food products. Any substance, garlic, vitamin C, zinc, etc that is good for improving your immune system generally is best absorbed with other substance that are found together inside of a whole food.

Remember that our body weight tends to be very dependent on what, not just how much, we are eating. When it comes to COVID, body weight does tend to be a risk factor, so aiming for a healthy body weight can be an important goal. However, I always caution against making this the only goal. Living a healthful lifestyle is multi-factorial, and this is just one piece of the pie. Healthy eating combines with other factors can make a difference even if you don’t hit that goal weight, so don’t give up!!

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Meditation

There are many types of meditation, but mindfulness meditation is the type that has been most studied in scientific literature.

I was first introduced to the concept in college, and I wasn’t a fan. Though I’ve always been incredibly introspective, and thought myself open-minded, I didn’t get it. Meditation first became a tool that was extremely useful for me when I was working in a position that wasn’t suited to my personality, and was driving me a little crazy/depressed. I went through formal mindfulness training at that time that really helped me to survive my last few months in that job.

Now, I use mindfulness and meditation to help me with my migraines. I have become a true believer–through practice–that my migraines must be controlled through a balance of all of the interventions that I have thrown at them: pharmacology (meds), diet, exercise, physical therapy, and mindfulness. If one is out of balance, it doesn’t work.

So what does the literature say?

Well, this 2017 Journal of American Heart Association article, discusses in detail hypertension, insulin resistance, heart disease, and finds that possible benefit on cardiovascular risk although the overall quality and in some cases, quantity of study data is modest. They go on to say that Meditation should be considered as a complementary therapy to help reduce cardiovascular risk for those who are interested in this practice, with the understanding that further research should be pursued.

The mind is a powerful tool, and one I believe should be utilized fully on our wellness journey.

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Wellness is…

My happy place

I’ve had this page now for about 10 months, and it’s about wellness. I sat down to try to come up with my definition of wellness, and I realized it was still quite nebulous.

One concept that resonated with me was a concept that I believe I got from one of the books I read in the time before my migraines–its the concept that true self care isn’t bubble baths, facials, massages–I mean, it can include those things, those are nice. True self care is the concept of creating a life from which you don’t need escape.

I also decided to look up some formal definitions of wellness.

UC Davis defines wellness as “an active process of becoming aware of and making choices towards a healthy and fulfilling life…more than being free from illness, it is a dynamic process of change and growth.”

The World Health Organization defines it as “…a state of complete physical, mental and social well-being and not merely the abscence of disease or infirmity.”

The National Wellness Institute defines it as “a conscious, self-directed and evolving process of achieving full potential.”

Where I have always acknowledged that one has to be aware of the mental, physical and spiritual aspects to be completely well, the National Wellness Institute sites 6 dimensions of wellness, and UC Davis has as many as eight: occupational, emotional, spiritual, environmental, financial, physical, social, and intellectual.

It makes me chuckle to have arrived here after all this time–that wellness is a journey, not so much a destination. Something so obvious–something I have seen play out in my life and in my struggles to do this. Something I have seen play out in this blog. It took seeing it written in black and white, by scientific minds to really get it. I feel a little basic…lol.

A thought that is reinforced by this definition: Imperfection is okay, but giving up is not.

Live well, friends.

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Healthy Plate

When it comes to discussing healthful eating, I like to start with a healthy plate. With the exception of keto, any diet plan can follow this pattern, and it is essentially a carb conscious plan. I like to start here because if you are focused on the healthy plate, you don’t have to think about calories as much.

It emphasizes:

  • 1/2 plate of vegetables with some fruits
  • 1/4 of a lean protein ( this can be plant based)
  • 1/4 of a whole grain source of carbohydrate
  • Healthy fat sources are in moderation

Things to remember:

If you are doing smoothies or juices, these should be counted as part of your plate. I generally would count a juice as a carbohydrate because the sugars are so concentrated, however, a healthful smoothie or juice retaining the pulp (fiber source) made with both fruits and vegetables may be a good way to get in those servings if you wouldn’t otherwise eat them. If you’re interested in some healthy juices, check out JuJu’s juices–I can attest to the fact that they did not raise one of my patient’s pre-diabetic numbers, and this along with some changes to the diet and exercise allowed me to stop some of her medications. (Julia also does healthy meals and vegan meals.) She was ecstatic!

Sweet tea, sodas, regular juices and sweetened coffee are not a part of this plate–the are carbohydrates and should be done in moderation if at all.

Desserts are not a part of this plate (this is my weakness, ya’ll). They are an EXTRA and should not be an every day thing. If you are eating desserts regularly, they are your carbohydrate–and not a whole grain one.

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Low Calorie Diet

We were originally taught that 3500 kcal equals a pound, and if you could get a deficit of that amount, that’s what you would lose. What we now know is that works in a lab, but our bodies are just too resilient and adaptable for this to work in reality. In reality, when you cut your calories for a significant amount of time, your body begins to adapt, and burn less energy to do the same tasks. Your basal metabolic rate slows.

Why? Because our bodies are adapted for famine, not excess, and they are designed to keep us alive. Your body interprets a deficit as a threat, and counters that threat by slowing down for survival. So, yes, you need a calorie deficit, but it should’t be the main focus.

The focus should be feeding the body healthfully, ideally in the way it wants to be fed, being as active as possible, minimizing and modulating stress, getting enough sleep, addressing any medical barriers, and hopefully, our bodies will respond in kind by approaching a more healthful weight. Hence, my focus on complete wellness, and tailoring a diet plan specific to the individual. I don’t believe in one-size-fits-all health or diet plans–we are individuals and should be treated as such. There are calorie guidelines to follow for healthy weight loss: they are 1400-1600 kcal for women and 1600-1800 kcal for men.

I typically don’t recommend anything under 1200 kcal for extended periods or unless instructed specifically by a healthcare professional. I feel these diets should be utilized for short term weight loss goals (i.e. prior to bariatric surgery to reduce the size of the liver) in those who have very large amounts of weight to lose. You should generally supplement your diet with a multivitamin, because it is difficult to get the full spectrum of required nutrients below 1000-1200 kcal.

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