Activate Metabolism. Reverse Disease.

The start of a new year is a time I love to reflect back on what has helped get me to where I am now and where I want to head. This phrase, “Activate Metabolism. Reverse Disease” is the tag line of my direct care metabolic clinic, Summon Health, and was my vision when I started Summon Health. I am thrilled to see that it has continued to be the goal and success of patients at Summon Health - and I wanted to take the opportunity to explain this tag line and why it is so important. 

Metabolic Health is the most important component of health to understand and focus on in order to live healthy long and prevent complications of chronic diseases. 

Yep, that’s a pretty bold statement and I stand by it; 100%. 

You see, compromised metabolic health increases the risk of heart disease, contributes to obesity and the development of dysfunctional fat, which leads to inflammation. This inflammation can lead to multiple different types of cancer, as well as leads to insulin resistance which causes type 2 diabetes and metabolic dysfunction associated liver disease. 

As an Endocrinologist - metabolic health is my jam and expertise. When I went into solo practice, I purposefully decided to leave general endocrinology to focus on working with people to optimize their metabolic health. I needed a tag line that was succinct, but also clear in what Summon Health was about. And with help from my college friend and roommate,(current CMO of one of the NBA teams) this tagline was born and continues to ring true. 

In this month’s blog I will go over HOW to activate metabolism and how this helps treat and even reverse metabolic disease.

In simple terms, metabolism is the energy our body generates in order to perform its many functions - from deep down cell function to major organ functions like digesting, breathing, to body movements like sitting, walking, and more.

This energy needed to perform all of these important functions is known as Total Energy Expenditure, or TEE. TEE is made up of resting energy expenditure (REE), non-resting energy expenditure (NREE) and the thermogenic effect of food (TEF). 

So you see, TEE is made up of three components: REE + NREE + TEF.

REE

This is the energy our cells generate to perform their everyday essential functions. REE makes up the biggest part of total energy expenditure. And it has long been taught that because this is the energy generated on a cellular level, there is not much we can do to change this. But the truth is there is certainly a lot we can do from a lifestyle perspective to maximize and optimize our REE so that our cellular function throughout the day is generating as much energy as possible. Here’s how:

*Get your Sleep: the goal is 7-9 hours of good quality sleep

Sleep helps cellular processes and helps in cell repair

Sleep helps increase a person's alertness for the next day. This helps leverage movement and spontaneity

*Avoidance of Risky Substances: This refers to avoidance of alcohol, tobacco, and illicit substances

The cells have to work hard to break down these toxins and the metabolites impair cell function. Therefore, avoidance of these substances is recommended.

*Engage in NREE (description following) since increased muscle mass contributes to REE - bigger muscles, bigger myocytes (cell muscles) and increased REE. Therefore increasing muscle is crucial for this (see previous month’s blog here for more on this)

NREE 

This refers to movement, both unintentional and intentional movement. This component of TEE is VERY responsive to our intention. We have a huge opportunity to maximize NREE by setting intentions on a variety of movements and I encourage everyone to find a way to be active on a daily basis in one form or another. To motivate this, I share how exercise has consistently been shown in studies to be the major determinant of long-term health and is also a major determinant of cognitive health in the long term. So make your plans to exercise and make sure to include different types of movement! 

Here are some examples:

*Strength training - pushing and pulling against something heavy

-Free weights

-Weight Machines

-Resistance Bands

-Pilates/Yoga

*Cardiovascular 

-Walking, cycling, swimming: inefficiency in exercise!

*Combined exercises that offer both cardiovascular and strength components

-Rowing

-Rucking

TEF

Digesting food requires energy and while a small component of TEE, it certainly IS a component and we can maximize the amount of energy we generate from TEF by also being intentional in the quality of the food we eat. To maximize TEF, we can do this through choosing to eat fiber rich foods (think legumes, cruciferous vegetables) as well as LEAN protein, which are proteins low in fat. Another important fact to remember is how gut microbiome health is an important part of metabolism - so ensuring we are nourishing our microbiome in ways to promote the healthy gut bacteria growth is important. The healthy gut bacteria thrive off fiber, so focus on increasing fiber-rich foods, fermented foods (like kraut, kimchi, lupini beans, tempeh), and whole-food eating in general.

So to summarize ‘Activate Metabolism’: Get enough good quality sleep, avoid alcohol and tobacco, get a variety of intentional movements in on a daily basis, and increase fiber, lean protein, and whole food eating.

How does this lead to the second part of the Summon Health tag line, ‘Reverse Disease’?

Well, the summary above is crucial in preventing and treating inflammation and insulin resistance. Here are some of the conditions that I have actively seen patients reverse with the approach above:

Insulin Resistance Conditions:

-Pre-diabetes

-Type 2 Diabetes

-High insulin requirements in Type 1 Diabetes

-Metabolic Dysfunction Associated Liver Disease

-High triglyceride levels

-PCOS

Obesity and its related conditions like:

-High blood pressure

-Osteoarthritis

-Obstructive Sleep Apnea

-Gastric Reflux

-Heart Disease Risk

Skin:

-Acne (as it relates to insulin resistance and inflammation)

-Rashes (as some are related to insulin resistance or food intolerances)

Bone

-Osteopenia/Osteoporosis

Gastric

-Irritable bowel syndrome

-Reflux Disease

Combining optimization of lifestyle medicine and personalizing the use of medications when necessary results in health transformation that is not only meaningful, but sustainable. This attention to detail requires time and continued motivation, but feeling good and healthy well into our later decades of life is undeniably attainable - and working with a physician that aligns with your health goals is a key component to making this a reality. 

So as you reflect on health goals moving forward, I encourage you to think about how you may incorporate activating your metabolism and reverse (and prevent) disease.

Wishing you many, many years of health to come!