The Truth about Man Boobs

I have recently encountered a number of patients complaining about having man boobs. It seems to be a growing problem (pardon the pun). I think everybody knows what we are talking about when we say man boobs.

Gynecomastia is the medical name that we commonly refer to as man boobs. But not all man boobs are created equal. Gynecomastia is a medical condition that causes the male breast to increase its fat deposition. It can cause some pain and otherwise discomfort. Many adolescent boys have some gynecomastia.

There is a difference between gynecomastia and just a fatty chest. Maybe we are talking semantics here, but many overweight guys have fatty chests and refer to this as man boobs.

Generally, gynecomastia occurs when there is an imbalance between the androgen hormones and estrogen. You read that right. Guys do have estrogen. When young boys are going through puberty, they have an increase in both estrogen and testosterone. If this gets out of balance a little, it can cause some breast development. It almost always goes away, but there are occasions when more help is needed.

There are many medications that can cause gynecomastia. Some of the more common ones are used for stomach acid reduction. Cimedidine and omeprazole are common medications used by millions that can cause gynecomastia. Many prostate medications can cause some problems as well. A simple search of the internet will reveal a long list of medications that are associated with gynecomastia.

Another common cause is testosterone “boosters.” One of the common ingredients for enhancing testosterone is DHEA. It’s a precursor to testosterone and estrogen. It can raise your testosterone, but it often raises your estrogen levels. Again, the higher your estrogen levels, the more your chances are for developing gynecomastia.

So, what is a guy with man boobs to do? First thing is to realize gynecomastia usually is benign and will often go away on its own. If you are taking some medications that might cause it, talk with your doctor about alternatives. If you are having pain or feel a hard lump, it’s best to get it checked out. If it’s simply lasting longer than you think it should, please get it checked out. I have ordered many mammograms for guys over the years and do occasionally run into some problems.

The best solution is to lose weight. The higher levels of fat in our bodies can often translate into higher levels of estrogen. High levels of estrogen are the root of the problem. It certainly would not hurt to do some bench presses and weight training, but it is weight loss itself that can really help. (People often wonder if doing sit-ups and other abdominal exercises will burn the belly fat off faster than other exercises. Unfortunately, we cannot pick and choose where are body mobilizes fat and stores it for energy.)

Be careful of any quick cures you read about on the web. There are many products that are reported to help, but I am skeptical. 

Wishing You an Amazing Life,

Dr. Curtis Brown

Is Money a Risk Factor for Poor Health?

If you read about your health on the internet, you will find all sorts of information that may or may not be helpful or correct. I often will find lists of things to do, to eat, or to avoid. It can be hard to sort through the information and make practical applications to your own situation.

I usually like those articles that list bullet points because I can scan them for relevance and then move on or dig deeper if desired. Today, I just have one bullet item. It is really more of a question or actually an observation.

1.     Is money, or the lack of money, a risk factor for poor health?

I have traveled to third-world countries where the average citizen lives in poverty and for the most part, the people are healthy. I have also seen affluent citizens in our country who are in poor health.  Obviously, the opposite situations can be observed as well. I have seen kids go to bed hungry and malnourished. I have seen others who can spend time and energy on good food, gym memberships, and advanced medical treatments and develop horrible health problems.

I think I am asking a deeper question. Money certainly gives options and can provide expensive medical care, doctors’ visits, immunizations, and medications—all of which should lead to better health.

Is there a connection, at least in our culture, to money and health? Is it possible that the way we handle our resources can predict our health to some degree? I’m not suggesting that if you are unhealthy it’s because you’re not a good steward of your money or vise versa.

I have the privilege of taking care of many Medicare patients. Many of them do very well from a health prospective and from a financial prospective. Unfortunately, I have several elderly patients who are living only on social security. Some of them are surviving (somehow) on only around $800 a month.

They are very limited to their abilities to purchase healthcare and supplies, such as medications and healthy foods. Most of them that come to my mind were hard-working, good people. They were and are productive citizens and bring great value to our culture. But they have limited resources.

There is a growing wave of Baby Boomers who will be retiring over the next 10–20 years. Many are poorly prepared for retirement. Many will need to continue in the labor force out of necessity, not desire.

My whole intent on this article is to simply sound a warning bell to those far from retirement (or to those who are close to retirement). You will probably need more money than you think to live comfortably. I want you to have an amazing life.

I am not a retirement specialist. So please talk to someone who is. I know many people who are totally prepared and will have an amazing life in retirement. But I also see currently many who are not prepared.

My encouragement to you is to get prepared! Give some thought to your retirement. Seek good council.

One of the major disciplines that will help you financially is also good discipline for your health: delayed gratification. Spend less than you make. This is the primary key to having financial resources later. Eat fewer calories than you burn. This is the primary way to lose weight. Delay gratification.

Know where your money is going. (Have a budget.) Know how many calories you eat a day. Check your bank account every now and then. Get a physical every now and then. There are so many similarities to the habits that create good financial health to good physical health.

Most of us have good intentions. We intend to do all sorts of things that are good for our families and good for us. The problem is we are usually going to start tomorrow. Tomorrow never comes.

“Where there is no vision, the people perish.”

Develop a plan, put some thought to your future, and start today!

Wishing You an Amazing Life,

Dr. Curtis Brown

Can You Trust Your Fitness Device?

Technology is very cool and has amazing applications as it relates to our health and fitness. Fitbits and other devices are used to measure heart rate, steps, calorie expenditure, and other biometrics. Plus, they are extremely popular. But can you trust them? How accurate are they?

There are several studies out recently, and they all seem to agree. They are generally pretty accurate when used to measure heart rate and steps or distance. Most popular devices such as the Fitbit and the Apple Watch were within about 5% of heart rate and distance. That is pretty good!

Calorie expenditure is another matter. In various studies, it seems they are often as much as 30% off and some even much more. There are several reasons for this, but ultimately you should not rely on them to get an accurate reading of your calorie expenditures. There are many resources you can use along with your device to help get an idea or an estimate of your calorie burn.

If you simply do a search, you will find programs that will help you. If you want to get as good a number as you can, find an online program and use it and your device together. It should get you quite close and give you a general idea about how many calories you are burning.

Counting calories can be critical when trying to lose weight. You will lose weight when you burn up more calories than you consume. If you read about calories and weight loss, it is generally reported that one pound of fat is equal to 3,500 calories. In order to lose one pound then, you would want to burn up or decrease your input by 3,500 calories.

The problem with the 3,500-calorie number is that it is just way more complicated than that! If we are in a controlled setting (such as a laboratory), this number is probably really accurate. But counting calories or estimating how many you consume is at best an educated guess. Even the professionals are off as much as 25% and our devices may be off as much as 30%!

I believe it is still a good idea to try to understand how many calories you are consuming and/or burning up, but it is a guessing game. Hopefully, you can get to within about 10% to 20% with some education and help from your device. Chances are your device is really close on the distance and heart rate, but not so much on calories.

Do you have a Fitbit or Apple Watch? Do you think they’re accurate?

Wishing You an Amazing Life,

Dr. Curtis Brown

The Midsummer Five-Day Diet Challenge

It’s midsummer and the Fourth of July is behind us! If you’re like me, you’ve let your diet slip a little. It’s so easy to cheat, especially around the Fourth. I’ve found challenges like this one (even if it’s relatively short) help me reset my mindset and appetite and improve my success with eating clean.

My goal with this five-day challenge is to lose about 2.5 pounds. Perhaps more importantly, I want to improve my healthy eating moving forward for the rest of the summer. I firmly believe we become what we eat and if we are not eating a healthy diet, we will not like the ultimate results.

This is a simple challenge I am starting on July 17 and ending the evening of July 21. It’s a Monday through Friday challenge. For five days, I am going to avoid any bread, potatoes, pasta, rice, sugar, and milk. Wednesday, I am going to do at least a 12-hour fast from any calories. (I will drink water and maybe tea or coffee.) I might do a 24-hour fast, but this will be a game day decision.

I am going to try to eat around 1,750 calories a day except on Wednesday when I will be fasting. If you do this challenge with me, I would suggest you pick your ideal body weight (whatever it is you want to weigh) and then add a zero to it. This number will be the number of calories to eat daily. I want to weigh around 175 pounds so I’m going to limit my total calories for the day to 1,750.

It is my hope many of you will join me on this short challenge and post comments and/or questions of my Facebook! It is always more fun and seems easier when doing these challenges with friends and family. I do have some good recipes for smoothies and meals on the blog.

Let me know if you are in!

Wishing You an Amazing Life,

Dr. Curtis Brown

What Are the Benefits of Fasting?

Fasting is almost a four-letter word! F-A-S-T(ing)! It is an ancient ritual that is not practiced much in our culture. In ancient times, it was mainly a spiritual practice to draw one closer to their Creator and to practice self-denial. (Obesity was not much of a problem in the ancient world.)

Today, I want to review some physical benefits our bodies have to fasting. One of the major ones is to reduce our insulin levels. Insulin is a pro-growth hormone that slows our basic metabolic rate down and promotes fat storage in our liver and abdomen. Lower levels of insulin facilitate fat burning. (Who doesn’t want that?)

Chronic high levels of insulin can cause many problems we face in our society today. Insulin-resistant diabetes is the most common form of diabetes and is the result of long-standing elevated insulin levels.

Fasting also promotes elevated levels of human growth hormone, which improves fat burning and increases muscle mass. Fasting improves cellular repair through reducing oxidative stress. This can have several positive effects on our bodies to include better overall immune function.

Fasting also positively affects gene expression. This is an area of great possibilities, and we are really just now unraveling some of the secrets of our DNA.

Fasting, if practiced regularly, has been shown to increase basic metabolic rate from 3 to 14%. It has also been shown to decrease abdominal fat by 4 to 7%. The abdominal fat is particularly inflammatory.

As mentioned earlier, fasting decreases insulin. It has been shown to decrease it as much as 20 to 30%. This will improve insulin resistance and can lower the overall blood sugar by 3 to 6%. Fasting has been shown to improve blood pressure, lipids, and inflammatory markers as well.

So, as you can see, there are many benefits to fasting. There are also many ways to fast. I am not an advocate of fasting from everything. I think we can do harm to our bodies if we fast from liquids and get dehydrated. I am an advocate of fasting for 12 to 24 hours from anything with calories.

I must confess: it has been a while since I have fasted. But I am going to remedy that problem. I am going to start a new ten-day weight loss challenge this coming July. Part of the challenge will include a fast for 24 hours!

One of my main goals is to lead us into the practice of fasting. I also want to bring back fasting in my own life and use it to draw me closer to God. I believe fasting will improve our physical health and can also improve our spiritual health. I will be posting more details about the next ten-day challenge. It will be some time after the Fourth.

Until then,

Wishing You an Amazing Life,

Dr. Curtis Brown

23 Reasons to Get a Heart Scan

1.     Heart disease is the leading killer in the USA for both men and women.

2.     About 610,000 people a year die from heart disease.

3.     One in four deaths is related to heart disease.

4.     735,000 Americans have heart attacks annually.

5.     Heart disease kills about the same number of people annually as does cancer, lower respiratory disease, and accidents combined.

6.     47% of sudden death from heart attacks occurs outside the hospital. This suggests that people do not understand the risk and/or symptoms of heart attacks.

7.     Men are at higher risk than women.

8.     African-American men are 35% more likely to have heart disease.

9.     High blood pressure, high cholesterol, and smoking are key risk factors for heart disease.

10.  About 47% of Americans have at least one of these risk factors.

11.  Family history of heart disease increases your chances of having a heart attack.

12.  Diabetes, poor diet, physical inactivity, obesity, and excessive alcohol use greatly increase your risk of heart disease.

13.  Oklahoma has one of the highest incidences of heart disease in all of the USA.

14.  About 800,000 people a year have a stroke.

15.  Heart disease and stroke cost about $313 billion a year in healthcare costs and lost productivity.

16.  The American Heart Association predicts the annual cost of heart disease will exceed 1 trillion dollars by 2035.

17.  According to the American Heart Association, your risk of cardiovascular disease is 50% at age 45.

18.  It is 80% at age 65.

19.  The emotional pain and suffering inflicted on people is unmeasurable.

20.  No one wants to die too early.

21.  Heart disease can be treated and prevented.

22.  Screening for heart disease is easy.

23.  Not knowing if you are at risk is not very smart!

Heart disease does not have to keep kicking our proverbial butts! Screening is very simple. A heart scan is an inexpensive way to screen for cardiovascular disease. It is not perfect, but you do get valuable information to help evaluate your personal risk for coronary heart disease.

A CT heart scan measures the amount of calcium that builds up in the arteries that feed your heart. It can be correlated to a degree of blockage in those arteries. It is not super accurate in the sense that you will not get a number such as 76% blockage. It will get you in the ballpark. It will generally correlate to no blockage, mild, moderate, or severe blockage. If you are in the moderate or severe category, generally you should have more testing.

Most places will do a heart scan for around $50. Insurance does not cover heart scans. Since you are paying cash for it, you do not need a doctor’s order. Simply call your favorite place and schedule.

Remember, this is only a screen. If you are having any symptoms at all, check with your doctor. You can still have problems in spite of having a normal heart scan. It is not perfect, but you do get good information and it is relatively inexpensive. (It is also pain-free!)

If you have a family history of heart disease or if you have other risk factors such as smoking or hypertension, start screening around age 40 to 45. If you score a zero (perfect), probably good to get one every five years. If you do not score a zero, I would check more often.

Oh. I just had mine and I scored a 23. My previous one was a zero. I have a strong family history of coronary artery disease. I am going to repeat in one year and I am going to double-check my lipid panel and watch my blood pressure closely.

Time to go exercise!

Wishing You an Amazing Life,

Dr. Curtis Brown

20 Pounds in 2017

It's that time of the year that most of us at least start thinking about goals for next year. I try to be realistic and not set unachievable goals like starting for the OKC THUNDER at point guard. Still, I usually struggle with staying connected to my goals.

If you are like me and are thinking about dropping about 20 pounds in the year 2017 (did not make it in 2016), one of the first questions to ask yourself is not what diet or exercise plan, but why. Why do you really want to lose weight? What is your true motivation?

The sad truth is that for most of us, losing weight because we know it will be good for us and improve our health simply isn’t enough for when times get tough and we are in the messy middle. The messy middle is when you have been at it for a little while but the finish line is still weeks if not months away. There is always a messy middle.

I have found that a major event in one's life is great motivation for about 6 months. Most of my patients who have had a heart attack or stroke are really motivated for rehab for about 6 months. Then the messy middle shows up. The pain and loss suffered becomes a fading memory and many revert back to the same lifestyle and habits that got them to the event in the first place. Their motivation wanes. Only about 1 in 7 will stay with it and change their lifestyles long-term.

I am the same way. I know that dropping 20 pounds will lower my cholesterol and improve my blood pressure. I know that I will feel better and have more energy. I know it all intellectually, but here I am again trying to lose those same 20 pounds from 2016. So what can I do to be that one in seven that sticks with it? Where can I find my motivation in the messy middle?

I think there is a lot that goes into reaching your goals. But, I believe the most important question is to ask why. Why do I really want to lose the weight? Yes, I know in my mind that it is good for me, but I have proven that simply knowing so doesn’t tend to motivate me enough in the messy middle.

I am somewhat embarrassed to admit that I need something more tangible and more rewarding than simply knowing that it is really good for me, but that is the simple truth. I am a simple person. I need simple answers to the whys.

My plan is to set up some rewards along the way. I have not yet decided what they will be, but I know they will be simple. If I lose 5 pounds I will (fill in the blank). I am also going to set a timeline. I think a goal without a timeline is simply a dream; however, that is another topic.

I would love to hear from you if you have some good ideas for my simple solution for the messy middle. Also let me know if there is a certain health or wellness topic you would like to learn more about.

Summer Challenge: Revisiting the 10-Day Diet Challenge

I started the 10-Day Diet Challenge last summer, and it has been well received by many people. Hundreds of people from all over the world are trying this diet. I have even had people from Russia take up the challenge. This week, I had a patient that lost an amazing 16.6lbs in 10 days. He was very faithful to the plan and reported 3 inches lost on his waist! He was feeling more energetic and was confident he could continue to eat clean. 

It was about day five that he thought he would actually survive the plan! Almost everyone experiences carb withdrawal symptoms at some time during the challenge. If you stick with it, your energy will rebound and the brain fog will clear! On average, most men are dropping 6–8 lbs and women are dropping 4–6 lbs. This plan is easy and reproducible, and did I mention it was free?

The secret is getting off the insulin roller coaster. When your insulin level moves, up or down, it can trigger hunger. Cravings are often triggered by insulin swings. High glycemic carbohydrates (bread, potatoes, pasta, rice, and sugar) start the insulin roller coaster and create more appetite. There is a reason you can’t eat just one chip!

Protein will blunt the insulin response. Always eat some protein when you are eating even healthy carbs. A small bite of peanut butter can flatten the insulin curve from your daily fruit.

I am a believer in PGX and its benefits. It is a fiber product that can flatten the insulin curve and create a sense of fullness. I try to consume it twice a day.

If you have never tried the 10-Day Diet Challenge, give it a try. It is found on my website and is really simple to start. If you have tried it before but not recently, I want to challenge you to do it again. I like to repeat the challenge about every six weeks or so. I do not always do it for 10 days, but I always feel better for doing it.

I have found this plan to be simple to follow and an effective way to maintain a healthy body weight. It helps with my energy level and also helps eliminate brain fog!

How Much Water Should You Drink?

This is a simple question that I am asked frequently. The answer is: “It depends.” I’m sure most people have heard the rule to drink at least 8 glasses with 8 ounces of water a day. It is commonly expressed as the standard amount of water to drink. It depends on several things including your overall health, where you live, and what you are doing.

Water makes up about 60% of your body and is needed in every cell. Slight dehydration can zap your energy away. We can survive a long time with little or no food, but we must have water. Water is essential in flushing out toxins, transporting nutrients, and moisturizing our airways, skin, and joints.

The Institute of Medicine has published its recommendations. They have said that the average man needs about 13 cups (3L) of water a day and the average woman needs about 9 cups a day (2.2L).

There are several factors that can influence the amount of water you need. Moderate exercise may require another 1–2 cups of water. Extreme heat can increase your water demands. Illness such as vomiting or diarrhea increases water demands as well. Some health problems such as congestive heart problems or some types of kidney problems may require you to even consume less water.

Extreme sports such as running a marathon require close monitoring of your fluids and electrolytes. The electrolytes are basically minerals that your body needs to function correctly. A rare but potentially fatal problem for some marathon runners is hyponatremia. This is caused when someone has too much water and not enough sodium. It can lead to heart arrhythmias.

A practical way to monitor your hydration status is to monitor your urine output. You could actually measure the amount and it should be around 1.5 liters a day. A more practical way is to monitor the color of your urine. It should be clear or light straw colored. Darker urine may signify dehydration.

Water is in many things. On average, the food we eat accounts for about 20% of our water intake. Water is in milk, coffee, and other beverages. Some fruits such as watermelon are about 90% water by weight. We can get our daily requirement of water from several sources. Stay hydrated and you should feel a little better and will avoid some future problems.

It's Sugar—Not Fat!

For the last several decades, the government eating guidelines endorsed by many doctors have advocated a low fat diet. As it turns out, this is not a good idea. Eggs were once a banned food for patients with high cholesterol, but not so now.

Recent studies show that those with the highest sugar consumption have the highest risk of heart disease. In a study published in JAMA (Journal of American Medical Association), those with the highest sugar intake were at a four-fold risk of heart attacks. Drinking one 20-ounce soda increases your risk by 30%. The average American consumes about 150 lbs. of sugar a year!

Sugar is hidden in many foods, even in some we consider to be healthy. Did you know that fruit yogurt has more sugar in it than a Coke? The average serving of tomato sauce has more sugar than most cookies. The biggest source of sugar for most Americans is sugar-sweetened beverages. The average teenage boy consumes about 34 teaspoons of sugar a day. This equates to about 545 calories a day from sugar.

Our bodies need about 1,000 mg of cholesterol a day to function. Cholesterol is important for brain function and many other roles in our bodies. Most of our hormones are made from cholesterol. The liver manufactures about 75% of the cholesterol that we need. The other 25% comes from our diet. Some people have a genetic issue that causes them to make too much cholesterol, but most people simply eat too many calories in the form of refined sugars and certain fats that often lead to elevated cholesterol levels.

Sugar is a quick source of energy for our bodies and is used first. Most of the carbohydrates we eat must be turned into glucose for our bodies to absorb them. However, when you consume more sugar than your body needs, the sugar is stored in your liver in the form of triglycerides and glycogen. High intake of refined sugar also lowers the good cholesterol (HDL) and changes the size of the LDL (bad cholesterol) particles. It can lead to insulin resistance and diabetes. Fatty liver disease is often caused by the over consumption sugar. All of these changes increase the risk of atherosclerosis (hardening of the arteries).

I believe that you will lose weight, lower your cholesterol, improve your energy, and decrease brain fog by eliminating refined sugars and high glycemic carbohydrates. Take a look at my 10-Day Diet Challenge and give it try.