The Cometa Wellness Center
We reviewed the "whole person" approach towards Irritable Bowel Syndrome (IBS) in the June 23, 2010 blog. The effect that food intolerance has on our gut integrity was described. The present blog outlines how to best manage IBS Naturally and Effectively.
How do we manage IBS Naturally and Effectively?
Food Allergy Testing
Please refer to the June 23, 2010 blog Treat Irritable Bowel Syndrome Naturally and Effectively for a complete explanation of this important test that so many people with IBS need to know about! It is available at The Cometa Wellness Center. One does not need to be a patient with Dr. Cometa to take advantage of this very useful test available at the Center. Call the Center at (410) 296-6100 if you would like to be tested for Food Allergy.
Natural Supplementation to Enhance Gut Integrity and Aid Digestion/Nutrient Absorption
There are many herbs and nutriceuticals (i.e. vitamins, minerals, amino acids, etc.) to consider for GI integrity and health function. Below I will describe what I consider to be some very important key players in the management of IBS. Remember, in the world of natural medicine, we always use the symptoms (i.e. irritable bowel symptoms) to help direct our program and this means addressing symptom origins!
Glutamine
Glutamine is a critical nutrient for the health and function of the gut mucosa and its immune cells. Glutamine is the most abundant amino acid in our blood stream. Its nutritional value has been studied for years. Although classified as a non-essential amino acid, it is considered a conditionally essential amino acid when a person is under "catabolic" stress such as in the critically ill patient. Glutamine is considered an essential amino acid under catabolic stress (i.e. body breakdown) because the body mobilizes glutamine from muscle tissue to provide a substrate for more needed energy. Glutamine is the main fuel for enterocytes (i.e. cells of the colon) and it plays an important role in the structure and function of the GI tract. Supplementation with glutamine has been proven through many studies to lower morbidity and mortality in the critically ill patient through its value as an important dietary nutrient. It provides respiratory fuel for the immune cells, liver cells and intestinal mucosal cells, and it is key to the nitrogen balance required by these systems when protein metabolism must be "amped up". In my medical practice, the nutritional support provided by the addition of the amino acid glutamine is integral to a successful GI support program. The relevance of glutamine enriched diets for required nutritional support in disease is well supported in the literature. Glutamine can also be found as an individual supplement or in a combination formula. I prefer to use Glutamine and all other GI support supplements in a formula, because together, they work synergistically to enhance each other's effectiveness.
N-Acetyl-D-Glucosamine
Just as glucosamine sulfate is used for joint support, N-Acetyl-D-Glucosamine is a naturally occurring amino sugar integral to GI support. N-acetyl-d-glucosamine (NAG) is incorporated into glycosaminoglycans and is a major structural component for intestinal mucous secretions. This mucous is both protective as well as necessary to propel digested food through the GI tract. Supplementation with NAG helps maintain normal glycosaminoglycan synthesis and intestinal mucous production. In patients with GI integrity breakdown such as GERD and IBS, conversion from glucosamine into NAG is less efficient. That's why for the GI tract, NAG supplementation is usually preferred over glucosamine sulfate. N-Acetyl-D-Glucosamine is available with glutamine and other gut enhancing nutrients in the formulated supplements through our Holistic Pharmacy.
Digestive Enzymes
Digestive enzymes assist the digestive tract from the acidic stomach environment to the alkaline environment of the small intestine. They are responsible for preparing the food for the colon, where the microflora of our "good bacteria" take over the work to complete nutrient absorption. Depending upon your digestive needs there are many types of enzymes to choice from. Apple Cider vinegar is a nice and wholesome way to restore the natural pH in your stomach. pH balance is integral to your digestion. Apple cider vinegar stimulates your own digestive enzymes. See the GI Integrity package below regarding which enzyme preparation is best for you. If you are not sure which enzyme preparation is best for you, Digestion GB is an excellent formula and my favorite!
Prebiotics and Probiotics
The role in colonic health for both probiotics and prebiotics has been a topic of clinical research for years. According to the currently adopted definition by FAO/WHO, probiotics are: "Live microorganisms which, when administered in adequate amounts, confer a health benefit on the host." A prebiotic is "a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal microflora and confers benefits upon host well-being and health." Both affect the composition of the microflora, and hence the health of the colon. Butyrate (aka buyric acid) is a prebiotic. It undergoes fermentation in the colon and gives rise to short-chain fatty acids (SCFA). SCFA are the major source of energy for colon cells (enterocytes). Butyrate is a specific SCFA that is known to enhance the growth of lactobacillus and bifidobacterium (i.e. the good bacteria in the colon). As a "food" for colonic cells, butyric acid has historically helped my patients recover from both IBS as well as Inflammatory Bowel Disease (IBD). Probiotics (e.g. lactobacillus and bifidobacterium), like the prebiotics, help balance the microflora of the intestines. Unbalanced microflora is one of the reasons a person experiences gas with the associated symptoms of abdominal pain, cramping and bloating in IBS. Probiotics developed in the United Kingdom and provided by the company Pharmax are the only probiotics carried at The Cometa Wellness Center. They have been proven effective, not just over the test of time, but through clinical research, Pharmax makes superior and highly bioavailable bacterial probiotic strains.
Carminatives
Carminative herbs sooth cramps of the digestive tract. Many times cramps are accompanied by flatulence (i.e. gas). Carminative herbs assist in the expulsion of gas from the stomach and intestines. They ease griping pain in the GI tract associated with eating. Herbs that comfort the intestine through their carminative properties also facilitate digestion as they help to relieve gas. I prefer the combination of peppermint, rosemary, and thyme extracts in an enteric-coated soft gel which releases into the intestines, not the stomach. Mentharil, formulated by the company Integrative Therapeutics, makes an excellent formula and with the release of these therapeutic herbs into the intestines, the antispasmodic and soothing benefits are maximized.
Serotonin, Stress and IBS
Irritable bowel syndrome is a complex disorder associated with altered gastrointestinal motility, secretion and sensation. Serotonin is an important signaling molecule in the gut as well as our mental health. The stress in our life is major contibutor to IBS in many people. I bet you did not know that most of the body's serotonin is present in the cells of the gut! WOW! Serotonin binds to three types of cells in the GI tract: the enterocytes (colon cells), the smooth muscles that line the intestine and the enteric neurons (nerve cells). We know that in IBS, altered serotonin signaling involves both the intestinal and extra intestinal systems. Tegaserod, is a medication which acts like serotonin. It is used in constipation predominant IBS. Tryptophan is an essential amino acid and is easily converted into serotonin in our body (i.e. it is a serotonin precursor). Thus, taking Tryptophan can naturally increase serotonin levels in the body which in turn may reduce the stress response in our lives as well as IBS symptoms. Tryptophan has been an excellent natural solution for many of my patients with IBS and who feel "stressed out". This is especially true in the individual who has an IBS picture which involves more constipation or has alternating bouts of constipation with diarrhea.
G.I. Support Supplements in Summary
(each product can be investigated by clicking on the name of the supplement)
1. GI Integrity contains the essential nutrients Glutamine and N-acetyl-Glucosamine as well as other gut mucosal integrity support. Take 2 after breakfast and 2 after lunch and/or 2 after dinner.
2. The digestive enzyme formula Digestion GB Take 1-2 capsules with each meal.
For other enzyme selections, visit our Holistic Pharmacy and browse through the others available.
Dosage for all enzymes: Take 1-2 capsules with each meal.
3. The Probiotic preparation I like by Pharmax is HLC High Potency Capsules. Take 1 with meals and/or 1-2 before bed.
For other Probiotic selections, visit our Holistic Pharmacy and brows through the others available.
4. Tryptophan 500 mg is very uselful if IBS is predominated by comstipation.Take 3 capsules before bed and consider three in the AM upon awakening.
5. For gas abd bloating use the carminativepreparation, Mentharil Take as needed and as directed on the bottle.
6. For the IBS patient who is also predisposed to bowel inflammation such as Diverticulitis or Colitis, please consider the Prebiotic preparation ButyrEn 500 mg. This Butyrate preparation is best taken 2 tablets with each meal.
Visit our website to view the G.I. Integrity Support Package.
Doctor's message
A wholesome diet optimizes our digestion and a healthy GI tract. Remember, with IBS, the recognition and treatment of food intolerance is imperative. The temporary elimination and gradual reintroduction of foods that we are allergic to or simply do not tolerate is essential if we want to maximize gut mucosal integrity with our diet. A strong supplement program which will Enhance Gut Integrity and Aid Digestion/Nutrient Absorption also needs to be considered. Do not forget to reduce stressors in your life and when needed, modify the stress response with helpful tools like meditation, yoga, walking and the very beneficial amino acid, Tryptophan.
For those of you who suffer with IBS, I hope that you find the healthful tips outlined in this August and last Junes blog @ drcometablog.com helpful and informative.
Ariane Cometa MD, the holistic doc
Sunday, August 1, 2010
Wednesday, June 23, 2010
Treat Irritable Bowel Syndrome Naturally and Effectively
The Cometa Wellness Center
"No one knows exactly what causes irritable bowel syndrome". This is a very common statement made by the medical profession. This is why I have always recommended that my patients follow the old adage...
"View the forest not the trees"
In this vein, the most important thing to remember when it comes to your digestion is that it is responsible for digesting your food! As simple as this may sound, it is easy to lose this awareness, and become a victim of our diet.
Have you ever wondered why or how medicine can describe symptoms, give the symptoms a name (i.e. the "diagnosis"), bill for the symptoms by 'name' (i.e. the diagnosis) but cannot give the patient a clear etiology for these symptoms or even an effective treatment program? In my opinion, a prescription is often not an effective treatment plan. A perfect example of this 'phenomena' is the diagnosis, Irritable Bowel Syndrome. There are many 'diagnoses' in this category such as Chronic Fatigue Syndrome and Fibromyalgia. My 'favorite' etiology in medicine for a patient's symptoms is "Idiopathic". This is a fancy term for "we do not know" and yet can still be used and billed for through insurance companies. Even when medicine does not know the cause of a problem, it must come up with a fancy name for it! I think part of the reason for WHY medicine needs to do this is the system-based or specialized practice of medicine which now exists and breaks the patient into many parts. The specialization of medicine has made it very difficult for a person to be viewed by the doctor as a WHOLE person. Hence, discovering the cause of a patients symptoms is often left for 'the other' specialty referral and the patient may go from doctor to doctor with a few potential diagnoses attached to their symptoms and no clear plan of action! Does this sound familiar? I bet it does.
What is IBS?
Irritable bowel syndrome (IBS) is one of the most common disorders that presents to the doctor's office. This is most likely because the symptoms of IBS are so easily triggered. The symptoms of irritable bowel syndrome can vary widely from person to person and often resemble those of other diseases. Among the most common are:
~Abdominal pain or cramping.
~A bloated feeling.
~Gas (flatulence).
~Diarrhea or constipation - sometimes alternating bouts of constipation and diarrhea.
The Whole Person Approach to IBS
Food Intolerance
Integral to most of the GI support programs I have successfully implemented in my medical practice, is the recognition and treatment of food intolerance. The loss of food tolerance leads to hypersensitivity. Such food hypersensitivity can lead to an array of gastrointestinal disorders. The many causes of food intolerance are still a quandary to conventional medicine. This is not the case for those of us who implement natural medicine. One very common type of food intolerance is "food allergy". Whether it be GERD, IBS, Colitis, Gastritis, Peptic Ulcer Disease (PUD), or any combination of the above, the identification of food allergy in that patient is imperative. Most doctors do not believe that what a person puts in their mouth has any impact on their GI health. How many people have been told that their GI symptoms are UNRELATED to food?! I would like to review what we know about food allergy and how it impacts GI health.
Pivotal to food allergy is a breakdown in immune system messaging that occurs when the body has lost tolerance to certain food proteins (i.e. hypersensitivity). Food allergy occurs when ingested proteins from food act as "antigens". Antigens are protein substances which are regarded as foreign by the immune system and hence, stimulate an immune response (i.e. make antibodies). We know that daily dietary challenge to food protein 'antigens' is a set up for both local gut micro-inflammation as well as systemic inflammation. What results is called 'gut permeability'. Many people have heard the well known term "Leaky Gut Syndrome". How does such permeability or Leaky Gut occur, you ask? The answer lies in the integrity of our gastrointestinal lining, aka Gut Integrity.
Gut Integrity
Gut mucosal integrity is essential for both competent digestion and the correct absorption of nutrients. Normally, there are tight junctions between the cells that line the gut mucosa. These tightly adhered cells form the primary barrier between the external environment (e.g. our food) and the internal environment of our body. Our gut mucosa is the largest body surface area in contact with our external environment! I guess it is understandable then, that the majority of the cells which constitute OUR IMMUNE system reside in the gut. The Gut Associated Lymphoid Tissues, also called "GALT", is the term applied to the immune system of the GI tract. The GALT system is a tightly regulated mucosal immune response protecting us from untoward micro-inflammation. When food allergy occurs, the GALT system has become compromised and complexes of antibodies form with food protein (i.e. antigen). These complexes become a constant challenge for the intolerant person. Such insult leads to a hypersensitive state and the likelihood of subsequent inflammation which leads to structural changes in gut mucosal integrity. Food allergies are implicated in many disease states, but by far the most well known example is Celiac disease.
Factors such as low stomach pH (i.e. an acidic environment in the stomach), digestive enzymes, mucus and bacterial flora are integral to mucosal integrity, health and function. Proton-pump inhibitors (e.g. Nexium, etc), NSAIDs (e.g. Motrin), steroids, antibiotics and poor dietary habits all interfere with:
1) our first line defense against hypersensitivity to food proteins.
2) the aid we need for digestion and nutrient absorption.
Stress Response and IBS
Most people with IBS, find that their signs and symptoms are worse or more frequent during stressful events. Even events that are not considered very stressful, such as a change in your daily routine or family arguments can bring on IBS symptoms. Hormonal changes can also cause a stress response in women with IBS. Many women find that IBS symptoms are worse during or around their menstrual periods.
Stay tuned to The Cometa Wellness Center blog with drcometablog.com to learn how to Treat IBS Naturally and Effectively through support for enhanced gut integrity and digestion/nutrient absorption.
Food Allergy Testing is available at The Cometa Wellness Center. One does not need to be a patient with Dr. Cometa to take advantage of this very useful test available at the Center. Call the Center at 410-296-6100 if you would like to be tested for Food Allergy.
Doctor's message.... So always remember when it comes to food and you:
View the forest, not the trees, because you are what you eat!
Ariane Cometa MD, the holistic doc
The Cometa Wellness Center Pharmacy
"No one knows exactly what causes irritable bowel syndrome". This is a very common statement made by the medical profession. This is why I have always recommended that my patients follow the old adage...
"View the forest not the trees"
In this vein, the most important thing to remember when it comes to your digestion is that it is responsible for digesting your food! As simple as this may sound, it is easy to lose this awareness, and become a victim of our diet.
Have you ever wondered why or how medicine can describe symptoms, give the symptoms a name (i.e. the "diagnosis"), bill for the symptoms by 'name' (i.e. the diagnosis) but cannot give the patient a clear etiology for these symptoms or even an effective treatment program? In my opinion, a prescription is often not an effective treatment plan. A perfect example of this 'phenomena' is the diagnosis, Irritable Bowel Syndrome. There are many 'diagnoses' in this category such as Chronic Fatigue Syndrome and Fibromyalgia. My 'favorite' etiology in medicine for a patient's symptoms is "Idiopathic". This is a fancy term for "we do not know" and yet can still be used and billed for through insurance companies. Even when medicine does not know the cause of a problem, it must come up with a fancy name for it! I think part of the reason for WHY medicine needs to do this is the system-based or specialized practice of medicine which now exists and breaks the patient into many parts. The specialization of medicine has made it very difficult for a person to be viewed by the doctor as a WHOLE person. Hence, discovering the cause of a patients symptoms is often left for 'the other' specialty referral and the patient may go from doctor to doctor with a few potential diagnoses attached to their symptoms and no clear plan of action! Does this sound familiar? I bet it does.
What is IBS?
Irritable bowel syndrome (IBS) is one of the most common disorders that presents to the doctor's office. This is most likely because the symptoms of IBS are so easily triggered. The symptoms of irritable bowel syndrome can vary widely from person to person and often resemble those of other diseases. Among the most common are:
~Abdominal pain or cramping.
~A bloated feeling.
~Gas (flatulence).
~Diarrhea or constipation - sometimes alternating bouts of constipation and diarrhea.
The Whole Person Approach to IBS
Food Intolerance
Integral to most of the GI support programs I have successfully implemented in my medical practice, is the recognition and treatment of food intolerance. The loss of food tolerance leads to hypersensitivity. Such food hypersensitivity can lead to an array of gastrointestinal disorders. The many causes of food intolerance are still a quandary to conventional medicine. This is not the case for those of us who implement natural medicine. One very common type of food intolerance is "food allergy". Whether it be GERD, IBS, Colitis, Gastritis, Peptic Ulcer Disease (PUD), or any combination of the above, the identification of food allergy in that patient is imperative. Most doctors do not believe that what a person puts in their mouth has any impact on their GI health. How many people have been told that their GI symptoms are UNRELATED to food?! I would like to review what we know about food allergy and how it impacts GI health.
Pivotal to food allergy is a breakdown in immune system messaging that occurs when the body has lost tolerance to certain food proteins (i.e. hypersensitivity). Food allergy occurs when ingested proteins from food act as "antigens". Antigens are protein substances which are regarded as foreign by the immune system and hence, stimulate an immune response (i.e. make antibodies). We know that daily dietary challenge to food protein 'antigens' is a set up for both local gut micro-inflammation as well as systemic inflammation. What results is called 'gut permeability'. Many people have heard the well known term "Leaky Gut Syndrome". How does such permeability or Leaky Gut occur, you ask? The answer lies in the integrity of our gastrointestinal lining, aka Gut Integrity.
Gut Integrity
Gut mucosal integrity is essential for both competent digestion and the correct absorption of nutrients. Normally, there are tight junctions between the cells that line the gut mucosa. These tightly adhered cells form the primary barrier between the external environment (e.g. our food) and the internal environment of our body. Our gut mucosa is the largest body surface area in contact with our external environment! I guess it is understandable then, that the majority of the cells which constitute OUR IMMUNE system reside in the gut. The Gut Associated Lymphoid Tissues, also called "GALT", is the term applied to the immune system of the GI tract. The GALT system is a tightly regulated mucosal immune response protecting us from untoward micro-inflammation. When food allergy occurs, the GALT system has become compromised and complexes of antibodies form with food protein (i.e. antigen). These complexes become a constant challenge for the intolerant person. Such insult leads to a hypersensitive state and the likelihood of subsequent inflammation which leads to structural changes in gut mucosal integrity. Food allergies are implicated in many disease states, but by far the most well known example is Celiac disease.
Factors such as low stomach pH (i.e. an acidic environment in the stomach), digestive enzymes, mucus and bacterial flora are integral to mucosal integrity, health and function. Proton-pump inhibitors (e.g. Nexium, etc), NSAIDs (e.g. Motrin), steroids, antibiotics and poor dietary habits all interfere with:
1) our first line defense against hypersensitivity to food proteins.
2) the aid we need for digestion and nutrient absorption.
Stress Response and IBS
Most people with IBS, find that their signs and symptoms are worse or more frequent during stressful events. Even events that are not considered very stressful, such as a change in your daily routine or family arguments can bring on IBS symptoms. Hormonal changes can also cause a stress response in women with IBS. Many women find that IBS symptoms are worse during or around their menstrual periods.
Stay tuned to The Cometa Wellness Center blog with drcometablog.com to learn how to Treat IBS Naturally and Effectively through support for enhanced gut integrity and digestion/nutrient absorption.
Food Allergy Testing is available at The Cometa Wellness Center. One does not need to be a patient with Dr. Cometa to take advantage of this very useful test available at the Center. Call the Center at 410-296-6100 if you would like to be tested for Food Allergy.
Doctor's message.... So always remember when it comes to food and you:
View the forest, not the trees, because you are what you eat!
Ariane Cometa MD, the holistic doc
The Cometa Wellness Center Pharmacy
Monday, March 29, 2010
Are you tired and can't fix the problem?
The Cometa Wellness Center The power of natural medicine in treating all disease is magical. Yet, it can still be a challenge for the individual with fatigue to find a cure even with all of the various natural medicine options available. Part of this challenge comes from the fact that the mitochondria has not been understood or addressed by those suffering from fatigue and trying to treat this disabling condition.
The evolution of the mitochondria is fascinating and debated to this day. The most accurate and well supported theory for the origins of the organelle we call, the mitochondria, is The Endosymbiotic Theory. This theory was first postulated by former Boston University Biologist Lynn Margulis in the 1967 and officially in her 1981 book "Symbiosis in Cell Evolution". Although now accepted as a well-supported theory, both she and the theory were ridiculed by mainstream biologists for a number of years. Thanks to her persistence, and the large volumes of data to support the hypotheses postulated by her and other scientists over the last 30 years, biology can now offer a plausible explanation for the evolution of the mitochondria. Margulis' original hypothesis proposed that aerobic bacteria (those that require oxygen) were ingested by anaerobic bacteria (poisoned by oxygen), to provide both with survival advantages. Each would have performed mutually beneficial functions in their symbiotic relationship; the aerobic bacteria handling the toxic oxygen for the anaerobic bacteria, and the anaerobic bacteria ingesting food and protecting the aerobic "symbiote". Endosymbiosis is the term used when a cell is engulfed by another cell, and is not digested but instead lives together with its host in a mutually beneficial relationship, or symbiosis.
The end result of such endosymbiosis is The Cell, as we know it today and which contains a double-membrane bound organelle called the mitochondria. In The Endosymbiotic Theory, the inner lipid bilayer would have been the engulfed aerobic bacterial cell's plasma membrane, and the outer lipid bilayer came from the anaerobic bacterial cell that engulfed it. Hence, mitochondria are the evolutionary result of endocytosis (ingestion) of aerobic bacteria by anaerobic bacteria. Interestingly, Chloroplasts are the result of endocytosis of photosynthetic bacteria, and are to plants what the mitochondria are to us humans.
So, why is the evolution of the mitochondria so important to us when we want to treat fatigue? The mitochondria IS the organelle in the cell that provides us with our cellular energy. It is literally the cells internal battery from which all our oxygen-dependent energy must come. Among other jobs, the mitochondria is responsible for making adenosine triphosphate, ATP. ATP production is oxygen dependent, and is the energy our mitochondrial battery makes. Without ATP, we die. For example, when rigor mortis sets into the human being after death, it is because ATP production has ceased and the muscles freeze up in the position that they last had their life preserving ATP before cell death. Cool huh? The importance of supporting the restoration of mitochondrial health to our cells is integral to cell health and energy when we want to address FATIGUE.
Thermogenesis was described in the March 6, 2010 blog. Thermogenesis is the term used to describe how our body produces cellular energy in the form of heat. Remember, that as we raise our metabolic rate through thermogenesis, we are literally burning our stored fat for daily fuel. Now, guess where thermogenesis takes place in our body. That's right; thermogenesis takes place in the mitochondria! So just imagine that while you are burning calories and losing fat and inches, you can create more energy, by making ATP at the same time. Sounds too good to be true but it is not. Yet, it does require a healthy lifestyle, because your cells are smarter than you are! You may be able to fool yourself, but you cannot fool your cells!
When addressing fatigue, let's begin with a very basic addition to our diet. This is the five carbon sugar, D-Ribose. If I was to make ONE addition to the diet and it was to come as a dietary supplement, it would be a canister of D-ribose powder. Let me explain why. D-ribose is a naturally occurring five-carbon sugar found in all living cells. The body naturally converts glucose into D-ribose. D-ribose is vital for the mitochondria to keep our cells supplied with energy because the mitochondria uses D-ribose to generate our ATP. D-ribose is essential for all the pathways of energy metabolism. Chronic fatigue syndrome (CFS) and fibromyalgia (FMS) are both associated with decreased mitochondrial function and declining tissue levels of adenosine triphosphate (ATP). Supplementing the diet with additional D-ribose can increase the rate at which ATP is generated as it is constantly being broken down and "recreated". Why is this? One of the problems faced when the body's D-ribose stores have been depleted, is that our tissues are unable to produce the essential nutrient, D-ribose quick enough to restore depleted energy stores. Cellular energy depletion is considered a major contributor to both fatigue and muscle pain. Without supplemental D-ribose, energy depletion becomes more severe and creates a vicious cycle between an increase in cellular energy demand and the diminished reserves. This is because energy is used faster than fuel such as D-ribose is made available to renew it.
In 2006, an open-label uncontrolled pilot study was done to evaluate the effect of D-ribose on symptoms in forty-one patients with CFS and FMS. Well over half of these patients experienced significant improvement while using D-ribose, with a 45% average increase in their energy. The form of D-ribose we carry at The Cometa Wellness Center is the same used by Teitelbaum MD in this 2006 pilot study. Corvalen contains pure D-RIBOSE, a safe and clinically-proven ingredient that accelerates the natural way our bodies produce energy. Taking Covalent every day helps the body restore lost energy quickly and reduces muscle stiffness, soreness and fatigue.
Do you need D-ribose? Corvalen, as all well made D-ribose is safe and associated with no remarkable side effects when dosed correctly. Quite frankly, everybody benefits from D-ribose to support mitochondrial health and essential ATP energy production. Check out Corvalen today at the Cometa Wellness Center Holistic Pharmacy. It even tastes good!
Ariane Cometa MD, the holistic doc
The Cometa Wellness Center
The evolution of the mitochondria is fascinating and debated to this day. The most accurate and well supported theory for the origins of the organelle we call, the mitochondria, is The Endosymbiotic Theory. This theory was first postulated by former Boston University Biologist Lynn Margulis in the 1967 and officially in her 1981 book "Symbiosis in Cell Evolution". Although now accepted as a well-supported theory, both she and the theory were ridiculed by mainstream biologists for a number of years. Thanks to her persistence, and the large volumes of data to support the hypotheses postulated by her and other scientists over the last 30 years, biology can now offer a plausible explanation for the evolution of the mitochondria. Margulis' original hypothesis proposed that aerobic bacteria (those that require oxygen) were ingested by anaerobic bacteria (poisoned by oxygen), to provide both with survival advantages. Each would have performed mutually beneficial functions in their symbiotic relationship; the aerobic bacteria handling the toxic oxygen for the anaerobic bacteria, and the anaerobic bacteria ingesting food and protecting the aerobic "symbiote". Endosymbiosis is the term used when a cell is engulfed by another cell, and is not digested but instead lives together with its host in a mutually beneficial relationship, or symbiosis.
The end result of such endosymbiosis is The Cell, as we know it today and which contains a double-membrane bound organelle called the mitochondria. In The Endosymbiotic Theory, the inner lipid bilayer would have been the engulfed aerobic bacterial cell's plasma membrane, and the outer lipid bilayer came from the anaerobic bacterial cell that engulfed it. Hence, mitochondria are the evolutionary result of endocytosis (ingestion) of aerobic bacteria by anaerobic bacteria. Interestingly, Chloroplasts are the result of endocytosis of photosynthetic bacteria, and are to plants what the mitochondria are to us humans.
So, why is the evolution of the mitochondria so important to us when we want to treat fatigue? The mitochondria IS the organelle in the cell that provides us with our cellular energy. It is literally the cells internal battery from which all our oxygen-dependent energy must come. Among other jobs, the mitochondria is responsible for making adenosine triphosphate, ATP. ATP production is oxygen dependent, and is the energy our mitochondrial battery makes. Without ATP, we die. For example, when rigor mortis sets into the human being after death, it is because ATP production has ceased and the muscles freeze up in the position that they last had their life preserving ATP before cell death. Cool huh? The importance of supporting the restoration of mitochondrial health to our cells is integral to cell health and energy when we want to address FATIGUE.
Thermogenesis was described in the March 6, 2010 blog. Thermogenesis is the term used to describe how our body produces cellular energy in the form of heat. Remember, that as we raise our metabolic rate through thermogenesis, we are literally burning our stored fat for daily fuel. Now, guess where thermogenesis takes place in our body. That's right; thermogenesis takes place in the mitochondria! So just imagine that while you are burning calories and losing fat and inches, you can create more energy, by making ATP at the same time. Sounds too good to be true but it is not. Yet, it does require a healthy lifestyle, because your cells are smarter than you are! You may be able to fool yourself, but you cannot fool your cells!
When addressing fatigue, let's begin with a very basic addition to our diet. This is the five carbon sugar, D-Ribose. If I was to make ONE addition to the diet and it was to come as a dietary supplement, it would be a canister of D-ribose powder. Let me explain why. D-ribose is a naturally occurring five-carbon sugar found in all living cells. The body naturally converts glucose into D-ribose. D-ribose is vital for the mitochondria to keep our cells supplied with energy because the mitochondria uses D-ribose to generate our ATP. D-ribose is essential for all the pathways of energy metabolism. Chronic fatigue syndrome (CFS) and fibromyalgia (FMS) are both associated with decreased mitochondrial function and declining tissue levels of adenosine triphosphate (ATP). Supplementing the diet with additional D-ribose can increase the rate at which ATP is generated as it is constantly being broken down and "recreated". Why is this? One of the problems faced when the body's D-ribose stores have been depleted, is that our tissues are unable to produce the essential nutrient, D-ribose quick enough to restore depleted energy stores. Cellular energy depletion is considered a major contributor to both fatigue and muscle pain. Without supplemental D-ribose, energy depletion becomes more severe and creates a vicious cycle between an increase in cellular energy demand and the diminished reserves. This is because energy is used faster than fuel such as D-ribose is made available to renew it.
In 2006, an open-label uncontrolled pilot study was done to evaluate the effect of D-ribose on symptoms in forty-one patients with CFS and FMS. Well over half of these patients experienced significant improvement while using D-ribose, with a 45% average increase in their energy. The form of D-ribose we carry at The Cometa Wellness Center is the same used by Teitelbaum MD in this 2006 pilot study. Corvalen contains pure D-RIBOSE, a safe and clinically-proven ingredient that accelerates the natural way our bodies produce energy. Taking Covalent every day helps the body restore lost energy quickly and reduces muscle stiffness, soreness and fatigue.
Do you need D-ribose? Corvalen, as all well made D-ribose is safe and associated with no remarkable side effects when dosed correctly. Quite frankly, everybody benefits from D-ribose to support mitochondrial health and essential ATP energy production. Check out Corvalen today at the Cometa Wellness Center Holistic Pharmacy. It even tastes good!
Ariane Cometa MD, the holistic doc
The Cometa Wellness Center
Saturday, March 6, 2010
Burn Stored Fat through Thermogenesis
The Cometa Wellness Center
There are many facets to an effective weight-loss program. Losing weight is all about changing the composition of the body. When someone tells you, "you look like you've lost weight", they are not looking at what you weigh on the scale; they are looking at you. This is a very important principle to remember when embarking on any effective weight loss program. The goal is to burn stored fat in our body as fuel, AND to build lean body mass. As we effectively replace fat mass with lean body mass, our body changes, but the amount of actual weight we lose will vary and the process of pounds lost can be slow. This is why the scale is not your friend, but your foe when you want to "lose weight".
Any effective and positive change that we make in our body towards healthy weight loss must start with a shift in the internal process of Thermogenesis. Thermogenesis is the term used to describe how our body produces cellular energy in the form of heat. The best source of the cellular energy for heat conversion is our fat cells. The ultimate goal in weight loss is to increase our metabolic rate through thermogenesis. As we raise our metabolic rate through thermogenesis, we are literally burning our stored fat for daily fuel.
I can’t count the number of people whom I have heard recite the same words: "I haven't changed a thing; I eat the same food, do the same exercise and yet I have gained 10 pounds this year!" Although how we eat and exercise may not change, WE humans CHANGE! Our physiology is always in flux and changes day to day, especially over the years. Aging itself is associated with a reduction in our metabolic rate, which means we do not burn calories as effectively as we age. Reduction in cellular energy expenditure was, at one stage of our evolution, life saving when starvation was an issue and concern. Of course, starvation still exists, but when it does not, we need to be more proactive in our role to promote thermogenesis through changes in diet, exercise and the correct supplement program. This will eventually bring balance on a cellular level, so that we are better able to use stored fat as cellular energy and shift our metabolism away from the storage of energy as fat.
Proper nutrition is the hallmark for all good health, including a healthy weight-loss program. Unfortunately, it is not something we were all taught or raised on. "Health-full" eating takes time, thought and energy. Eating a whole foods diet is KEY. What does it mean to eat "whole foods"? Whole foods are all about eating fresh food. Some simple guidelines for wholesome eating are not to eat anything you need to cook in a microwave oven, and avoid anything that comes out of box, jar, can or freezer package. Shopping the perimeter of the grocery store for everything you put in your mouth will help this process A LOT!
"Eating Right" is a responsibility. It is as important as breathing and sleeping (two other aspects of healthy living that people are not great at!) It is always nice to learn that the more fresh (raw or lightly steamed/sautéed) vegetables a person eats daily, the easier it is to burn fat as fuel through Thermogenesis. Plus, eating fresh vegetables helps to eliminate retained water that stored fat brings into the tissues. Yes, that is right! Fresh vegetables burn fat and help to get rid of water retention!
Consider an effective weight loss program more like a shift in your metabolism. The TWO benchmarks for effective weight loss are:
1. Raise the metabolic rate for fat cell energy expenditure (i.e. burn fat as calories).
2. Don't store fat as calories.
Nutritional changes to reach your weight loss benchmarks
We must always remember that our bodies are designed to store calories. It may not sound fair, but we store calories better as we age, and our ability to burn calories naturally diminishes as we age. OUCH! It is up to us to keep those calories for fuel and not store them away as fat. Integral to correct calorie handling is to NOT stimulate Insulin. INSULIN STORES EVERYTHING. Starches such as pasta, rice and grains, potatoes of all colors, breads and all sugar-containing foods WILL stimulate insulin.
Dietary Strategies for reducing Fat Mass and increasing Lean Body Mass
~Reduce all starchy carbohydrates in the diet, such as bread products, pasta, rice and potatoes
~Avoid all sugar.
~Avoid anything from a box, can, jar or boxed from the freezer.
~Shop the perimeter of the grocery store for all of your food.
~Consume at least four cups of fresh vegetables daily.
~Limit fruit to 2 servings of low-glycemic idex (LGI) fruit a day. LGI fruits are all berries, apples, pears, citrus, peaches, plums and cherries. Avoid high-glycemic idex fruit. These are bananas, pineapples, grapes, mangoes, all dried fruit and most fruit juices.
A diet rich in lean proteins, vegetables and low-glycemic-index fruit does not stimulate insulin.
When we need to jump start the fat burning and calories expenditure machine, it would be worthwhile to consider Thermo-fit. Thermo-Fit contains botanical extracts which optimize metabolism, increase thermogenesis, and decrease the conversion of excess carbohydrates into fat. In conjunction with a healthy lifestyle, Thermo-Fit helps to promote and maintain healthy body composition.
To encourage the safe and effective process of weight loss, we can also look at the very innovative Isagenix nutritional and cleansing formulas created by John Anderson. Through the flushing of impurities that are often stored in the "stubborn fat", the Isagenix nutritional and cleansing systems, together with dietary changes and regular exercise, combine to maximize our thermogenesis potential.
The cellular effects of chronic toxin exposure, stress and hormonal imbalance must be considered and addressed if we are to lose and keep off extra weight and inches. The key to supplementation for burning calories is to reach our TWO benchmarks for effective weight loss. Remember, these are to both raise the metabolic rate for fat cell energy expenditure (i.e. burn fat as calories) and to NOT store fat as calories. Eating right is the foundation for any weight loss program. But, you can always support yourself further with the supplement Thermo-fit to increase your metabolic rate through enhanced thermogenesis to burn stored fat more effectively. In turn, the Isagenix nutritional and cleansing formulas further support weight loss through the flushing of impurities that are often stored in the "stubborn fat". In combination, this very strong program WILL certainly allow your body to finally lose fat, unwanted pounds and inches for good! Good luck and always remember when it comes to food and you:
View the forest, not the trees, because you are what you eat!
Ariane Cometa MD, holistic doc
The Cometa Wellness Center
There are many facets to an effective weight-loss program. Losing weight is all about changing the composition of the body. When someone tells you, "you look like you've lost weight", they are not looking at what you weigh on the scale; they are looking at you. This is a very important principle to remember when embarking on any effective weight loss program. The goal is to burn stored fat in our body as fuel, AND to build lean body mass. As we effectively replace fat mass with lean body mass, our body changes, but the amount of actual weight we lose will vary and the process of pounds lost can be slow. This is why the scale is not your friend, but your foe when you want to "lose weight".
Any effective and positive change that we make in our body towards healthy weight loss must start with a shift in the internal process of Thermogenesis. Thermogenesis is the term used to describe how our body produces cellular energy in the form of heat. The best source of the cellular energy for heat conversion is our fat cells. The ultimate goal in weight loss is to increase our metabolic rate through thermogenesis. As we raise our metabolic rate through thermogenesis, we are literally burning our stored fat for daily fuel.
I can’t count the number of people whom I have heard recite the same words: "I haven't changed a thing; I eat the same food, do the same exercise and yet I have gained 10 pounds this year!" Although how we eat and exercise may not change, WE humans CHANGE! Our physiology is always in flux and changes day to day, especially over the years. Aging itself is associated with a reduction in our metabolic rate, which means we do not burn calories as effectively as we age. Reduction in cellular energy expenditure was, at one stage of our evolution, life saving when starvation was an issue and concern. Of course, starvation still exists, but when it does not, we need to be more proactive in our role to promote thermogenesis through changes in diet, exercise and the correct supplement program. This will eventually bring balance on a cellular level, so that we are better able to use stored fat as cellular energy and shift our metabolism away from the storage of energy as fat.
Proper nutrition is the hallmark for all good health, including a healthy weight-loss program. Unfortunately, it is not something we were all taught or raised on. "Health-full" eating takes time, thought and energy. Eating a whole foods diet is KEY. What does it mean to eat "whole foods"? Whole foods are all about eating fresh food. Some simple guidelines for wholesome eating are not to eat anything you need to cook in a microwave oven, and avoid anything that comes out of box, jar, can or freezer package. Shopping the perimeter of the grocery store for everything you put in your mouth will help this process A LOT!
"Eating Right" is a responsibility. It is as important as breathing and sleeping (two other aspects of healthy living that people are not great at!) It is always nice to learn that the more fresh (raw or lightly steamed/sautéed) vegetables a person eats daily, the easier it is to burn fat as fuel through Thermogenesis. Plus, eating fresh vegetables helps to eliminate retained water that stored fat brings into the tissues. Yes, that is right! Fresh vegetables burn fat and help to get rid of water retention!
Consider an effective weight loss program more like a shift in your metabolism. The TWO benchmarks for effective weight loss are:
1. Raise the metabolic rate for fat cell energy expenditure (i.e. burn fat as calories).
2. Don't store fat as calories.
Nutritional changes to reach your weight loss benchmarks
We must always remember that our bodies are designed to store calories. It may not sound fair, but we store calories better as we age, and our ability to burn calories naturally diminishes as we age. OUCH! It is up to us to keep those calories for fuel and not store them away as fat. Integral to correct calorie handling is to NOT stimulate Insulin. INSULIN STORES EVERYTHING. Starches such as pasta, rice and grains, potatoes of all colors, breads and all sugar-containing foods WILL stimulate insulin.
Dietary Strategies for reducing Fat Mass and increasing Lean Body Mass
~Reduce all starchy carbohydrates in the diet, such as bread products, pasta, rice and potatoes
~Avoid all sugar.
~Avoid anything from a box, can, jar or boxed from the freezer.
~Shop the perimeter of the grocery store for all of your food.
~Consume at least four cups of fresh vegetables daily.
~Limit fruit to 2 servings of low-glycemic idex (LGI) fruit a day. LGI fruits are all berries, apples, pears, citrus, peaches, plums and cherries. Avoid high-glycemic idex fruit. These are bananas, pineapples, grapes, mangoes, all dried fruit and most fruit juices.
A diet rich in lean proteins, vegetables and low-glycemic-index fruit does not stimulate insulin.
When we need to jump start the fat burning and calories expenditure machine, it would be worthwhile to consider Thermo-fit. Thermo-Fit contains botanical extracts which optimize metabolism, increase thermogenesis, and decrease the conversion of excess carbohydrates into fat. In conjunction with a healthy lifestyle, Thermo-Fit helps to promote and maintain healthy body composition.
To encourage the safe and effective process of weight loss, we can also look at the very innovative Isagenix nutritional and cleansing formulas created by John Anderson. Through the flushing of impurities that are often stored in the "stubborn fat", the Isagenix nutritional and cleansing systems, together with dietary changes and regular exercise, combine to maximize our thermogenesis potential.
The cellular effects of chronic toxin exposure, stress and hormonal imbalance must be considered and addressed if we are to lose and keep off extra weight and inches. The key to supplementation for burning calories is to reach our TWO benchmarks for effective weight loss. Remember, these are to both raise the metabolic rate for fat cell energy expenditure (i.e. burn fat as calories) and to NOT store fat as calories. Eating right is the foundation for any weight loss program. But, you can always support yourself further with the supplement Thermo-fit to increase your metabolic rate through enhanced thermogenesis to burn stored fat more effectively. In turn, the Isagenix nutritional and cleansing formulas further support weight loss through the flushing of impurities that are often stored in the "stubborn fat". In combination, this very strong program WILL certainly allow your body to finally lose fat, unwanted pounds and inches for good! Good luck and always remember when it comes to food and you:
View the forest, not the trees, because you are what you eat!
Ariane Cometa MD, holistic doc
The Cometa Wellness Center
Wednesday, February 10, 2010
Cleanse the Stubborn Fat Away
Cleanse the Stubborn Fat Away!
An integral aspect of any effective weight loss program is Cleansing our system gently. The storage of cellular waste and impurities can easily impede a strong nutritional and/or exercise weight loss program which would otherwise lead to success and happiness. It is important to distinguish the concept of Cleansing from the much talked about and popular topic of “Detox”. Indeed, we live in a world surrounded by “toxins”-- from pesticides, herbicides, petrochemicals, heavy metals, food additives to refined foods and pharmaceutical drugs to name a few. Certainly, we can all benefit from detoxification. A gentle cleansing program, however, is much more than detoxification. When we naturally cleanse our system, we enable the body to shed unwanted pounds and inches through the process of removing cellar waste and stored toxins. What follows is the gradual ability to burn off what I call “stubborn fat” as we eliminate the “storage depots” our body no longer needs. For many successful individuals, nutritional cleansing has been the missing link to weight loss when healthy eating and exercise were not enough. Eating right and exercise are integral to positive changes in our body composition. Yet, even with taking these steps, there is a time when the cells need to be addressed on a deeper, more therapeutic level. This internal cellular cleansing step is one that needs to take place FIRST, before any change in weight and body composition occurs. Otherwise, it occurs later, when one notices that they are at a plateau in their program progress. This ‘plateau’ may represent a cessation in weight lost, inches loss, symptom improvement or any combination of the three. In either case--the “initial step” or “plateau-breaking” scenario--we ALL benefit, and ultimately NEED to cleanse our cells. So, what do I mean by “cleanse” and how do we cleanse our cells?
A useful analogy to consider when conceptualizing the role of ‘cellular cleansing’ in weight loss is to imagine the difference between climbing a steep hill with a 50 pound lead weight around your waist OR climbing the hill without this excess weight. Ultimately, you have a say in the matter, right? You can either wear the burden or not? It would be one thing if you put the 50 pounds around your waist to boost your cardiovascular and strength training program! But, when you can’t take the extra weight off after you are done exercising (i.e. climbing the hill), it is an insult on your physiology and health all the way around. Our cells are analogously imposed upon after years of toxin exposure from the environment we live in, poor dietary choices and lifestyle. These insults burden our cellular function, interfering with normal cell functioning and efficiency. How can our cells help us lose unwanted pounds and inches as well as improve our quality of life when they are so busy “dealing with” and “tolerating” everything they must do from day to day just to get their job done? For example, most “detox” programs claim to cleanse the colon and/or the liver, right? What about the heart, the lungs, the brain, the muscles and the rest of the body? Don’t these organs need help detoxifying as well? This is where I want to clarify the difference between what we mean when we say “detox” vs. what we can do when we are cleansing. When we cleanse our system, we gently remove the cellular waste and impurities that impede cellular function by improving the cells' ABILITY to do so for themselves! BUT to improve our cells natural ability to do their job, we must FIRST nourish them. It is through correct nourishment that our cells can improve their inherent strength and stamina to gently detoxify themselves. Cellular nourishment provides the revitalizing support our cells need to function more efficiently and thus, provide for their own detoxification. Herein lays the integral difference between a mere “detox” program and a deep, effective cellular cleansing program.
As stated above, the foundation for an effective weight loss program must start with the correct nutritional and exercise program. I have found that many of my patients are quite successful with one arm of this foundational base, yet are not necessarily able to consistently follow through with both.
Our goal is to rid the body of toxins and impurities which it is exposed to on a daily basis. Unlike most "detox" programs which can deplete the body of essential nutrients, we want to nourish the body every day. Nourishment supports the body in its natural ability to function efficiently while simultaneously allowing the body physical endurance and vitality. Such revitalization is energizing but not stimulating. Through the flushing of impurities that are often stored in the "stubborn fat", the body is allowed to finally lose fat and this will naturally expedite the loss of unwanted pounds and inches. To encourage the safe and effective process of weight loss, we can look at the very innovative formulas created by John Anderson. Through his Isagenix nutritional cleansing system, John Anderson has created a supercharged blend of ionic minerals, antioxidants, natural plants and gentle cleansing herbs that nourish and support the entire body on a cellular level. Together with dietary changes and regular exercise, these unique formulas have revolutionized the concept of weight loss by removing cellular impurities and providing cellular nutrition which together combine to burn off stubborn fat once and for all.
Consider yourself deserving and ready to make cellular change today!
Ariane Cometa MD, the holistic doc
Isagenix Independent Associate
An integral aspect of any effective weight loss program is Cleansing our system gently. The storage of cellular waste and impurities can easily impede a strong nutritional and/or exercise weight loss program which would otherwise lead to success and happiness. It is important to distinguish the concept of Cleansing from the much talked about and popular topic of “Detox”. Indeed, we live in a world surrounded by “toxins”-- from pesticides, herbicides, petrochemicals, heavy metals, food additives to refined foods and pharmaceutical drugs to name a few. Certainly, we can all benefit from detoxification. A gentle cleansing program, however, is much more than detoxification. When we naturally cleanse our system, we enable the body to shed unwanted pounds and inches through the process of removing cellar waste and stored toxins. What follows is the gradual ability to burn off what I call “stubborn fat” as we eliminate the “storage depots” our body no longer needs. For many successful individuals, nutritional cleansing has been the missing link to weight loss when healthy eating and exercise were not enough. Eating right and exercise are integral to positive changes in our body composition. Yet, even with taking these steps, there is a time when the cells need to be addressed on a deeper, more therapeutic level. This internal cellular cleansing step is one that needs to take place FIRST, before any change in weight and body composition occurs. Otherwise, it occurs later, when one notices that they are at a plateau in their program progress. This ‘plateau’ may represent a cessation in weight lost, inches loss, symptom improvement or any combination of the three. In either case--the “initial step” or “plateau-breaking” scenario--we ALL benefit, and ultimately NEED to cleanse our cells. So, what do I mean by “cleanse” and how do we cleanse our cells?
A useful analogy to consider when conceptualizing the role of ‘cellular cleansing’ in weight loss is to imagine the difference between climbing a steep hill with a 50 pound lead weight around your waist OR climbing the hill without this excess weight. Ultimately, you have a say in the matter, right? You can either wear the burden or not? It would be one thing if you put the 50 pounds around your waist to boost your cardiovascular and strength training program! But, when you can’t take the extra weight off after you are done exercising (i.e. climbing the hill), it is an insult on your physiology and health all the way around. Our cells are analogously imposed upon after years of toxin exposure from the environment we live in, poor dietary choices and lifestyle. These insults burden our cellular function, interfering with normal cell functioning and efficiency. How can our cells help us lose unwanted pounds and inches as well as improve our quality of life when they are so busy “dealing with” and “tolerating” everything they must do from day to day just to get their job done? For example, most “detox” programs claim to cleanse the colon and/or the liver, right? What about the heart, the lungs, the brain, the muscles and the rest of the body? Don’t these organs need help detoxifying as well? This is where I want to clarify the difference between what we mean when we say “detox” vs. what we can do when we are cleansing. When we cleanse our system, we gently remove the cellular waste and impurities that impede cellular function by improving the cells' ABILITY to do so for themselves! BUT to improve our cells natural ability to do their job, we must FIRST nourish them. It is through correct nourishment that our cells can improve their inherent strength and stamina to gently detoxify themselves. Cellular nourishment provides the revitalizing support our cells need to function more efficiently and thus, provide for their own detoxification. Herein lays the integral difference between a mere “detox” program and a deep, effective cellular cleansing program.
As stated above, the foundation for an effective weight loss program must start with the correct nutritional and exercise program. I have found that many of my patients are quite successful with one arm of this foundational base, yet are not necessarily able to consistently follow through with both.
Our goal is to rid the body of toxins and impurities which it is exposed to on a daily basis. Unlike most "detox" programs which can deplete the body of essential nutrients, we want to nourish the body every day. Nourishment supports the body in its natural ability to function efficiently while simultaneously allowing the body physical endurance and vitality. Such revitalization is energizing but not stimulating. Through the flushing of impurities that are often stored in the "stubborn fat", the body is allowed to finally lose fat and this will naturally expedite the loss of unwanted pounds and inches. To encourage the safe and effective process of weight loss, we can look at the very innovative formulas created by John Anderson. Through his Isagenix nutritional cleansing system, John Anderson has created a supercharged blend of ionic minerals, antioxidants, natural plants and gentle cleansing herbs that nourish and support the entire body on a cellular level. Together with dietary changes and regular exercise, these unique formulas have revolutionized the concept of weight loss by removing cellular impurities and providing cellular nutrition which together combine to burn off stubborn fat once and for all.
Consider yourself deserving and ready to make cellular change today!
Ariane Cometa MD, the holistic doc
Isagenix Independent Associate
Sunday, January 31, 2010
Break the Fat Cycle
The Cometa Wellness Center Holistic Pharmacy
In the previous blog, The Excess Weight Conundrum, I reviewed the vital role that leptin resistance plays in fat metabolism and human physiology. The phenomenon of leptin resistance is a complex metabolic process and requires a multifaceted treatment approach.
Fat cells are known as adipocytes. Adipocytes secrete command signals that regulate the size and number of their fat cells. One command signal is the hormone leptin. When released by adipocytes, leptin performs two critical roles. First, it stimulates centers in our brain to give us the signal of satiety. This means, we “feel full”, and stop eating. The other important job that leptin has is to help us access and utilize fat stores for fuel in our body. In other words, leptin helps us burn our stored fat.
The second command signal released by adipocytes is a hormone called adiponectin. Adiponectin enhances insulin sensitivity, and enhancing insulin sensitivity is important to restoring metabolic health in disease associated with Type 2 diabetes, obesity, and atherosclerosis. This hormone is an important modulator of insulin sensitivity and reversing insulin resistance.
The third adipocyte command signal is glycerol-3-phosphate dehydrogenase. This enzyme is produced in adipocytes to help convert blood sugar into triglyceride stores in fat cells.
The three adipocyte command signals are thus:
1. Leptin
2. Adiponectin
3. Glycerol-3-phosphate dehydrogenase
An ideal weight loss agent would:
1. Reverse leptin resistance
2. Increase adiponectin
3. Decrease glycerol-3-phosphate dehydrogenase
In the jungles of the central western region of Africa, Cameroon, there grows a plant with a long known use in local culinary tradition; it is called Irvingia gabonensis. The indigenous population of Cameroon has been eating Irvingia for centuries. It was the unexplained resistance to diabetes and obesity demonstrated by the members of two local Cameroon tribes that first caught the attention of researchers, Oben and associates. According to Professor Julius Oben, research scientist, biochemist, and lecturer at the University of Yaounde I in Cameroon, the two native communities shared something unique—they used Irvingia seeds as soup thickeners, and “bush mango”—as Irvingia is known locally—is a food sold in every market, where the locals typically eat it at least once a day.
It may seem illogical that leptin is much more abundant in the blood of obese individuals, but this is because obese people have more adipocytes that secrete leptin and C-reactive protein. C-reactive protein (CRP) is a marker of systemic inflammation and predictor of cardiac risk. As our abdominal girth increases, pro-oxidant cytokines, such as CRP, react with fat and create oxidized free radicals which can lead to atherosclerosis (hardened arteries), heart attack, stroke and cancer. In fact the hormone leptin actually reacts and binds with the pro-inflammatory marker, C-Reactive-Protein (CRP). CRP binds with leptin and blocks both the leptin transport across the blood-brain-barrier to signal satiety and also blocks the leptin signaling at a cellular level to break fatty acids down for energy expenditure. Hence the release of C-reactive protein by adipocytes is a leptin-binding protein and neutralizes the natural adipocyte-controlling effects of leptin. The result is a vicious fat cycle, where more leptin accumulates in the blood of obese individuals because it is not able to be picked up by leptin receptor sites on cell membranes. This is leptin resistance.
Irvingia is associated with dramatically lower levels of C-reactive protein, thereby unblocking the “leptin resistance” that causes so many weight loss programs to fail.
Irvingia increases beneficial adiponectin levels. In up-regulating the expression of adiponectin, Irvingia improves insulin sensitivity and is capable of reversing insulin resistance.
Glycerol-3-phosphate dehydrogenase is an enzyme that facilitates the conversion of blood glucose into triglycerides that increase adipocyte size. Irvingia inhibits glycerol-3-phosphate dehydrogenase, thus reducing the amount of ingested sugars that are converted to body fat.
Amylase is an enzyme that converts starch to sugar in the digestive tract. Irvingia is an amylase inhibitor, but this is not its primary mechanism of fat loss induction.
A recent in vitro study indicated that Irvingia gabonensis favorably impacts adipogenesis through a variety of critical metabolic pathways including PPAR gamma gene expression, leptin, adiponectin, and glycerol-3 phosphate dehydrogenase. (Lipids Health Dis. 2008 Nov 13;7:44) The next study was done to evaluate the impact Irvingia may have on body weight and associated metabolic parameters in overweight human volunteers. (Lipids Health Dis. 2009 Mar 2;8:7.) The study participants comprised of 102 healthy, overweight and/or obese volunteers (defined as BMI > 25 kg/m2) randomly divided into two groups. The groups received on a daily basis, either 150 mg of Irvingia or matching placebo in a double blinded fashion, 30-60 minutes before lunch and dinner. Significant improvements in body weight, body fat, and waist circumference as well as plasma total cholesterol, LDL cholesterol, blood glucose, C-reactive protein, adiponectin and leptin levels were observed in the Irvingia group compared with the placebo group.
The above study outcome demonstrated Irvingia gabonensis administered 150 mg twice daily before meals to overweight and/or obese human volunteers favorably impacts body weight and a variety of parameters characteristic of the metabolic syndrome. This is the first double blind randomized placebo controlled clinical trial regarding the anti-obesity and lipid profile modulating effects of an Irvingia gabonensis extract. The positive clinical results, together with the previously published mechanisms of gene expression modulation related to key metabolic pathways in lipid metabolism, provide impetus for much larger clinical studies. Irvingia gabonensis extract appears to be a useful tool in dealing with the emerging global epidemics of obesity, hyperlipidemia, insulin resistance, and their co-morbid conditions.
Citations available at the end of this blog will help those of you to learn more about the research that has been done and continues to demonstrate that Irvingia extract causes fat loss and also markedly reduces total cholesterol, LDL, glucose, triglycerides and CRP levels.
In summary, Irvingia gabonensis has been proven safe and effective for those interested in modifying their metabolism and body composition naturally. The seed from this fruit-bearing plant has been shown to work via multiple pathways to promote effective fat loss by such mechanisms as:
1. Inhibiting α-amylase activity, reducing the absorption of sugar
2. Reducing glucose levels and insulin induced lipogenesis
3. Reducing adipocyte triglycerides and the glucose-3-phophate dehydrogenase enzyme (thus inhibiting the conversion of glycerol to triglycerides)
4. Reducing immune mediated inflammatory-molecule (CRP) binding to leptin, thereby reducing leptin resistance
5. Lowering serum leptin levels
6. Increasing adiponectin levels (anti-atherogenic, anti-inflammatory and anti-diabetic effects)
7. Reducing PPAR gamma gene expression, which has been implicated in insulin resistance and the pathology of numerous diseases including obesity, diabetes, atherosclerosis and cancer
For more information about Irvingia, join us at our Holistic Pharmacy!
Please email us (Kristin@cometawellnesscenter.com) for a complete citations list.
Ariane Cometa MD, holistic doc
The Cometa Wellness Center
In the previous blog, The Excess Weight Conundrum, I reviewed the vital role that leptin resistance plays in fat metabolism and human physiology. The phenomenon of leptin resistance is a complex metabolic process and requires a multifaceted treatment approach.
Fat cells are known as adipocytes. Adipocytes secrete command signals that regulate the size and number of their fat cells. One command signal is the hormone leptin. When released by adipocytes, leptin performs two critical roles. First, it stimulates centers in our brain to give us the signal of satiety. This means, we “feel full”, and stop eating. The other important job that leptin has is to help us access and utilize fat stores for fuel in our body. In other words, leptin helps us burn our stored fat.
The second command signal released by adipocytes is a hormone called adiponectin. Adiponectin enhances insulin sensitivity, and enhancing insulin sensitivity is important to restoring metabolic health in disease associated with Type 2 diabetes, obesity, and atherosclerosis. This hormone is an important modulator of insulin sensitivity and reversing insulin resistance.
The third adipocyte command signal is glycerol-3-phosphate dehydrogenase. This enzyme is produced in adipocytes to help convert blood sugar into triglyceride stores in fat cells.
The three adipocyte command signals are thus:
1. Leptin
2. Adiponectin
3. Glycerol-3-phosphate dehydrogenase
An ideal weight loss agent would:
1. Reverse leptin resistance
2. Increase adiponectin
3. Decrease glycerol-3-phosphate dehydrogenase
In the jungles of the central western region of Africa, Cameroon, there grows a plant with a long known use in local culinary tradition; it is called Irvingia gabonensis. The indigenous population of Cameroon has been eating Irvingia for centuries. It was the unexplained resistance to diabetes and obesity demonstrated by the members of two local Cameroon tribes that first caught the attention of researchers, Oben and associates. According to Professor Julius Oben, research scientist, biochemist, and lecturer at the University of Yaounde I in Cameroon, the two native communities shared something unique—they used Irvingia seeds as soup thickeners, and “bush mango”—as Irvingia is known locally—is a food sold in every market, where the locals typically eat it at least once a day.
It may seem illogical that leptin is much more abundant in the blood of obese individuals, but this is because obese people have more adipocytes that secrete leptin and C-reactive protein. C-reactive protein (CRP) is a marker of systemic inflammation and predictor of cardiac risk. As our abdominal girth increases, pro-oxidant cytokines, such as CRP, react with fat and create oxidized free radicals which can lead to atherosclerosis (hardened arteries), heart attack, stroke and cancer. In fact the hormone leptin actually reacts and binds with the pro-inflammatory marker, C-Reactive-Protein (CRP). CRP binds with leptin and blocks both the leptin transport across the blood-brain-barrier to signal satiety and also blocks the leptin signaling at a cellular level to break fatty acids down for energy expenditure. Hence the release of C-reactive protein by adipocytes is a leptin-binding protein and neutralizes the natural adipocyte-controlling effects of leptin. The result is a vicious fat cycle, where more leptin accumulates in the blood of obese individuals because it is not able to be picked up by leptin receptor sites on cell membranes. This is leptin resistance.
Irvingia is associated with dramatically lower levels of C-reactive protein, thereby unblocking the “leptin resistance” that causes so many weight loss programs to fail.
Irvingia increases beneficial adiponectin levels. In up-regulating the expression of adiponectin, Irvingia improves insulin sensitivity and is capable of reversing insulin resistance.
Glycerol-3-phosphate dehydrogenase is an enzyme that facilitates the conversion of blood glucose into triglycerides that increase adipocyte size. Irvingia inhibits glycerol-3-phosphate dehydrogenase, thus reducing the amount of ingested sugars that are converted to body fat.
Amylase is an enzyme that converts starch to sugar in the digestive tract. Irvingia is an amylase inhibitor, but this is not its primary mechanism of fat loss induction.
A recent in vitro study indicated that Irvingia gabonensis favorably impacts adipogenesis through a variety of critical metabolic pathways including PPAR gamma gene expression, leptin, adiponectin, and glycerol-3 phosphate dehydrogenase. (Lipids Health Dis. 2008 Nov 13;7:44) The next study was done to evaluate the impact Irvingia may have on body weight and associated metabolic parameters in overweight human volunteers. (Lipids Health Dis. 2009 Mar 2;8:7.) The study participants comprised of 102 healthy, overweight and/or obese volunteers (defined as BMI > 25 kg/m2) randomly divided into two groups. The groups received on a daily basis, either 150 mg of Irvingia or matching placebo in a double blinded fashion, 30-60 minutes before lunch and dinner. Significant improvements in body weight, body fat, and waist circumference as well as plasma total cholesterol, LDL cholesterol, blood glucose, C-reactive protein, adiponectin and leptin levels were observed in the Irvingia group compared with the placebo group.
The above study outcome demonstrated Irvingia gabonensis administered 150 mg twice daily before meals to overweight and/or obese human volunteers favorably impacts body weight and a variety of parameters characteristic of the metabolic syndrome. This is the first double blind randomized placebo controlled clinical trial regarding the anti-obesity and lipid profile modulating effects of an Irvingia gabonensis extract. The positive clinical results, together with the previously published mechanisms of gene expression modulation related to key metabolic pathways in lipid metabolism, provide impetus for much larger clinical studies. Irvingia gabonensis extract appears to be a useful tool in dealing with the emerging global epidemics of obesity, hyperlipidemia, insulin resistance, and their co-morbid conditions.
Citations available at the end of this blog will help those of you to learn more about the research that has been done and continues to demonstrate that Irvingia extract causes fat loss and also markedly reduces total cholesterol, LDL, glucose, triglycerides and CRP levels.
In summary, Irvingia gabonensis has been proven safe and effective for those interested in modifying their metabolism and body composition naturally. The seed from this fruit-bearing plant has been shown to work via multiple pathways to promote effective fat loss by such mechanisms as:
1. Inhibiting α-amylase activity, reducing the absorption of sugar
2. Reducing glucose levels and insulin induced lipogenesis
3. Reducing adipocyte triglycerides and the glucose-3-phophate dehydrogenase enzyme (thus inhibiting the conversion of glycerol to triglycerides)
4. Reducing immune mediated inflammatory-molecule (CRP) binding to leptin, thereby reducing leptin resistance
5. Lowering serum leptin levels
6. Increasing adiponectin levels (anti-atherogenic, anti-inflammatory and anti-diabetic effects)
7. Reducing PPAR gamma gene expression, which has been implicated in insulin resistance and the pathology of numerous diseases including obesity, diabetes, atherosclerosis and cancer
For more information about Irvingia, join us at our Holistic Pharmacy!
Please email us (Kristin@cometawellnesscenter.com) for a complete citations list.
Ariane Cometa MD, holistic doc
The Cometa Wellness Center
Saturday, January 16, 2010
The Excess Weight Conundrum
The Cometa Wellness Center
Doctors cannot help the vast majority of obese people lose weight--and keep it off. This is because doctors don’t know what causes obesity. Many people, especially physicians, emphatically believe that obesity is caused by eating too much and not exercising enough. But such thinking is too simplistic, and is only part of the ‘obesity conundrum’. How society regards eating and the types of foods that are acceptable is a very real cultural explanation for obesity in this country. Published in the NY Times on November 20, 2008, a study from the November 2008 Journal of Law and Economics, concluded that banning fast food advertisements from children’s television programs would reduce the number of overweight children in the U.S. by 18 percent and decrease the number of overweight teens by 14 percent, as estimated by economists in this study. The researchers used several statistical models to link obesity rates to the amount of time spent viewing fast food advertising, finding that viewing more fast food commercials on television raised the risk of obesity in children.
In “Wired to Eat,” a 2005 article published in MIT Technology Review, Jeffrey Friedman, an obesity researcher at Rockefeller University, describes the scientific research to support a hunger "set point". Friedman is famous for his 1994 discovery of the gene that codes for the hormone called, leptin. Leptin is produced by fat cells in the belly. It plays a critical role in maintaining our LEAN body composition. Leptin operates in at least two different ways within our body to help prevent OBESITY. First, it stimulates centers in our brain to give us the signal of satiety. This means, we “feel full”, and stop eating. The other important job that leptin has is to help us access and utilize fat stores for fuel in our body. In other words, leptin helps us burn our stored fat.
According to Friedman, each of us has a "set point" of hunger and satiation. This "set point" we inherit genetically and may well be a genetic relic from what is called "the thrifty gene response". The geneticist James Neel in 1962 dubbed the "thrifty gene" theory and posited that in an environment prone to famine, hunter-gatherers gained a selective advantage if their genes predisposed them to storing fat when food was available. Those with such "thrifty genes" were more likely to survive famines and pass on their genes. But in modern times, the thrifty gene has proved a liability.
Why leptin resistance occurs in some people is poorly understood, Friedman says. With this statement, I take issue. In this country of "plenty", where we can buy abundant, cheap, calorically dense, nutritionally empty food, it is not hard to imagine why some people do and others do not have leptin resistance. In your average fast-food restaurant, just how many calories can you get for just four bucks? A LOT!
Just like the body can become resistant to insulin when it sees too much sugar, the body can become resistant to leptin. In fact, leptin resistance and insulin resistance go hand in hand. Leptin resistance leads to what I call "stubborn weight"; this is weight which is hard to lose and too easy to regain! Sound familiar? Basically, being chronically overweight, means that you have chronic leptin resistance and this leads to an uncontrolled appetite and difficulty burning your own stored fat as fuel.
All the more concerning, is the fact that the more fat cells grow and multiply, the more leptin they produce in an attempt to get the body to burn fat and to control the appetite ( i.e. promote satiety). But, again as in insulin resistance, the cells that are producing the leptin (or insulin) have receptor overload, and consequently can not respond to the hormone that they are producing, either insulin by the pancreas in diabetes, or leptin by the fats cells in leptin resistance. The result is that fats are not burned for fuel and hence, fatty acids are not well utilized for fuel (energy) production. This leads to fat deposition and voila, the person starts to gain weight, and in many cases becomes obese. As diabetes goes hand in hand with this problem, the blood sugar that is rising with insulin resistance feeds the obesity problem. How? The insulin resistance of diabetes makes it difficult for the cells to utilize sugar for fuel due to insulin resistance. The body tries to eliminate the circulating sugar in an attempt to get the sugar levels down. The body, hence, breaks the sugar into fatty acids, adding additional fatty acids for fat storage.
If you are overweight, you indeed have some level of leptin resistance. The development of abdominal obesity is by the far, the first and foremost dangerous type of fat deposition. As our abdominal girth increases, pro-oxidant cytokines react with fat and create oxidized free radicals which can lead to atherosclerosis (hardened arteries), heart attack, stroke and cancer. In fact the hormone leptin actually reacts and binds with the pro-inflammatory marker, C-Reactive-Protein (CRP). By binding to the CRP protein, leptin is effectively unable to pass through the blood brain barrier and bind to the satiety centers of our brain. Hence, appetite is left unchecked and people eat more food than they need. This is how leptin resistance affects the brain’s satiety centers.
Unfortunately, once we are overweight, leptin resistance can make it very difficult to consistently lose unwanted pounds and inches. How many of you are familiar with the plateau that is experienced in weight loss after a period of steady weight loss? This is common and well addressed when leptin resistance is corrected. In fact, what happens initially with weight loss is those same leptin producing fat cells that were so resistant to their own leptin are now shrunk and smaller in size and number. Now these fat cells do not produce enough beneficial leptin to burn fat and diminish appetite. It is at this time that most people who are on ‘a diet’ start to get discouraged and return to old eating habits. So what do you do? How do you lose those unwanted pounds and inches consistently?
Of course all change in our body composition which leads to a more lean physique and less fat must start with exercise and healthy eating habits. Everyday, it is essential to consume cups of vegetables and lean protein, either as a vegetarian or non-vegetarian. Lean protein helps build lean body mass and vegetables help support a healthy, fat burning metabolism and reduce excess fluid. Refined carbohydrates, processed foods and sugar all can lead to leptin resistance and obesity. As Friedman says, “some people are just programmed to eat more, and high-caloric fast foods simply allow them to do so quickly and therefore cause a faster weight gain”.
Please stay tuned. The next few blogs will focus on how to reduce leptin resistance and effectively lose inches and pounds permanently.
Ariane Cometa MD, holistic doc
The Cometa Wellness Center
Doctors cannot help the vast majority of obese people lose weight--and keep it off. This is because doctors don’t know what causes obesity. Many people, especially physicians, emphatically believe that obesity is caused by eating too much and not exercising enough. But such thinking is too simplistic, and is only part of the ‘obesity conundrum’. How society regards eating and the types of foods that are acceptable is a very real cultural explanation for obesity in this country. Published in the NY Times on November 20, 2008, a study from the November 2008 Journal of Law and Economics, concluded that banning fast food advertisements from children’s television programs would reduce the number of overweight children in the U.S. by 18 percent and decrease the number of overweight teens by 14 percent, as estimated by economists in this study. The researchers used several statistical models to link obesity rates to the amount of time spent viewing fast food advertising, finding that viewing more fast food commercials on television raised the risk of obesity in children.
In “Wired to Eat,” a 2005 article published in MIT Technology Review, Jeffrey Friedman, an obesity researcher at Rockefeller University, describes the scientific research to support a hunger "set point". Friedman is famous for his 1994 discovery of the gene that codes for the hormone called, leptin. Leptin is produced by fat cells in the belly. It plays a critical role in maintaining our LEAN body composition. Leptin operates in at least two different ways within our body to help prevent OBESITY. First, it stimulates centers in our brain to give us the signal of satiety. This means, we “feel full”, and stop eating. The other important job that leptin has is to help us access and utilize fat stores for fuel in our body. In other words, leptin helps us burn our stored fat.
According to Friedman, each of us has a "set point" of hunger and satiation. This "set point" we inherit genetically and may well be a genetic relic from what is called "the thrifty gene response". The geneticist James Neel in 1962 dubbed the "thrifty gene" theory and posited that in an environment prone to famine, hunter-gatherers gained a selective advantage if their genes predisposed them to storing fat when food was available. Those with such "thrifty genes" were more likely to survive famines and pass on their genes. But in modern times, the thrifty gene has proved a liability.
Why leptin resistance occurs in some people is poorly understood, Friedman says. With this statement, I take issue. In this country of "plenty", where we can buy abundant, cheap, calorically dense, nutritionally empty food, it is not hard to imagine why some people do and others do not have leptin resistance. In your average fast-food restaurant, just how many calories can you get for just four bucks? A LOT!
Just like the body can become resistant to insulin when it sees too much sugar, the body can become resistant to leptin. In fact, leptin resistance and insulin resistance go hand in hand. Leptin resistance leads to what I call "stubborn weight"; this is weight which is hard to lose and too easy to regain! Sound familiar? Basically, being chronically overweight, means that you have chronic leptin resistance and this leads to an uncontrolled appetite and difficulty burning your own stored fat as fuel.
All the more concerning, is the fact that the more fat cells grow and multiply, the more leptin they produce in an attempt to get the body to burn fat and to control the appetite ( i.e. promote satiety). But, again as in insulin resistance, the cells that are producing the leptin (or insulin) have receptor overload, and consequently can not respond to the hormone that they are producing, either insulin by the pancreas in diabetes, or leptin by the fats cells in leptin resistance. The result is that fats are not burned for fuel and hence, fatty acids are not well utilized for fuel (energy) production. This leads to fat deposition and voila, the person starts to gain weight, and in many cases becomes obese. As diabetes goes hand in hand with this problem, the blood sugar that is rising with insulin resistance feeds the obesity problem. How? The insulin resistance of diabetes makes it difficult for the cells to utilize sugar for fuel due to insulin resistance. The body tries to eliminate the circulating sugar in an attempt to get the sugar levels down. The body, hence, breaks the sugar into fatty acids, adding additional fatty acids for fat storage.
If you are overweight, you indeed have some level of leptin resistance. The development of abdominal obesity is by the far, the first and foremost dangerous type of fat deposition. As our abdominal girth increases, pro-oxidant cytokines react with fat and create oxidized free radicals which can lead to atherosclerosis (hardened arteries), heart attack, stroke and cancer. In fact the hormone leptin actually reacts and binds with the pro-inflammatory marker, C-Reactive-Protein (CRP). By binding to the CRP protein, leptin is effectively unable to pass through the blood brain barrier and bind to the satiety centers of our brain. Hence, appetite is left unchecked and people eat more food than they need. This is how leptin resistance affects the brain’s satiety centers.
Unfortunately, once we are overweight, leptin resistance can make it very difficult to consistently lose unwanted pounds and inches. How many of you are familiar with the plateau that is experienced in weight loss after a period of steady weight loss? This is common and well addressed when leptin resistance is corrected. In fact, what happens initially with weight loss is those same leptin producing fat cells that were so resistant to their own leptin are now shrunk and smaller in size and number. Now these fat cells do not produce enough beneficial leptin to burn fat and diminish appetite. It is at this time that most people who are on ‘a diet’ start to get discouraged and return to old eating habits. So what do you do? How do you lose those unwanted pounds and inches consistently?
Of course all change in our body composition which leads to a more lean physique and less fat must start with exercise and healthy eating habits. Everyday, it is essential to consume cups of vegetables and lean protein, either as a vegetarian or non-vegetarian. Lean protein helps build lean body mass and vegetables help support a healthy, fat burning metabolism and reduce excess fluid. Refined carbohydrates, processed foods and sugar all can lead to leptin resistance and obesity. As Friedman says, “some people are just programmed to eat more, and high-caloric fast foods simply allow them to do so quickly and therefore cause a faster weight gain”.
Please stay tuned. The next few blogs will focus on how to reduce leptin resistance and effectively lose inches and pounds permanently.
Ariane Cometa MD, holistic doc
The Cometa Wellness Center
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