SEXUAL HEALTH

A Holistic Approach to Sexual Health

BY SALLY KARLOVITZ, CN

AS PEOPLE AGE, they are becoming more and more interested in increasing their health, endurance, and vitality throughout their lifetimes, and this includes sexual health. Sexual dysfunction is a problem experienced by both men and women. Before turning to prescription medication, why not give the natural approach a try first to help promote healthy libido and overall sexual health?

LIFESTYLE SUPPORT

The same principles of good general health apply for sexual health—a healthy diet and exercise program are the foundations. Nourishing your body with organic fruits and vegetables, whole grains, lean meats, nuts, and seeds will translate into improving health in your whole body. Exercise, stress reduction, and sleep are also important factors for sexual health. People who exercise have increased sexual desire and greater satisfaction. Exercise can help boost your mood and self-esteem, which translates into feeling better about yourself. Stress and lack of sleep are two killers of sexual desire. So make sure you’re keeping stress under control and getting enough sleep to ensure you are feeling your best.

HERBAL SUPPORT

Certain herbs and nutrients have been found to play a role in enhancing libido in both men and women. The amino acid L-arginine boosts nitric oxide, which in turn can increases blood circulation and enhances physical response during sexual activity. Maca enhances sexual function and energy for both sexes. It has been shown to decrease anxiety, lower blood pressure, increase DHEA in men. Maca works in women to stimulate desire and to help balance female hormones, one of the key issues of sexual dysfunction in women. Damiana has been traditionally used in women to boost mood and libido, and Tribulus has been used in men to boost testosterone and libido.

SCENTUAL SUPPORT

Several essential oils are known for their romance-inducing properties, including jasmine, patchouli, and rose. Try using scented candles or essential oil diffusers to infuse your room with an alluring scent and create an inviting atmosphere for romance.

Bluebonnet Intimate Essentials Libido Formulas

For Her Sexual Response & Libido Boost is formulated to help intensify desire and libido in women.* It contains damiana, maca, ashwagandha, L-arginine, and rhodiola. For Him Testosterone & Libido Boost is formulated to help amplify testosterone and libido levels in men.* It contains L-arginine, Tribulus, longjack (LJ100), and boron.

IS INSULIN RESISTANCE THE FIRST SIGN OF HEART DISEASE? A GROWING BODY OF EVIDENCE SAYS IT IS.

BY JONNY BOWDEN, PHD, CNS

Back in 2012 when cardiologist Steven Sinatra, MD, and I fi rst wrote our book, The Great Cholesterol Myth, I was pretty certain that testing for “good” and “bad” cholesterol was out of date, and that our belief in its value was no longer justifi ed. “Bad” cholesterol was a lousy predictor of heart disease, was inaccurately named, and was certainly not enough on which to base a prescription for a powerful drug.

But I confess, I wasn’t 100 percent sure what we should be looking for. Now I am. It’s insulin resistance. Let me explain.

Insulin resistance is to heart disease what smoking is to lung disease

Insulin resistance (IR) doesn’t account for all cases of heart disease any more than smoking accounts for all incidences of lung cancer. But it tracks with and predicts cardiovascular disease better than any other variable yet studied. And it shows up earlier. As a predictive marker, it

blows “bad” cholesterol out of the proverbial water.

In the new and revised edition of our book—due out in 2021—we painstakingly detail the research showing that IR predates cardiovascular disease with startling consistency. In fact, the connection is so obvious and demonstrable, that we consider insulin resistance syndrome as one of, if not the primary cause, of heart disease. It’s been hiding in plain sight for a very long time.

When you have IR, you have some degree of dysfunction in your body’s ability to metabolize carbohydrates. IR is the opposite of insulin sensitivity, which is a desirable metabolic state where your body metabolizes carbs just fi ne. So the best way to explain IR is to spend a minute looking at how insulin sensitivity works so we can see what goes wrong in IR (and why it matters so much to your health!)

So what exactly is insulin resistance?

Let’s take a look at the undamaged metabolism of a healthy 8-year old kid back in the days before the internet and play dates. The kid comes home from third grade and eats an apple, which raises his blood sugar a little, causing his pancreas to react by releasing a little squirt of a hormone called insulin.

One of insulin’s main jobs is to round up the excess sugar in the bloodstream and deliver it into the muscle cells where it can be “burned” for energy. That’s just fi ne and dandy for our 8-year old, since he’s going to be climbing on monkey bars and playing tag, so his muscle cells eagerly welcome the fuel. Eventually, his muscles use up the sugar provided by the apple so his blood sugar is now slightly lower than normal, which makes him hungry. He goes home and eats a healthy dinner, and all is right with the world. End of story.

In this case, our hypothetical boy’s insulin-sensitive metabolism working just as it ought to. But in at least half of today’s population, that’s no longer the case.

Let’s look at that same “kid” 30 years later. He wakes up late with stress hormones already coursing through his body. Those stress hormones send a message to his brain to fuel up for an anticipated emergency (read: stock up on fat!). He runs out the door and stops at the local coff ee emporium for a pumpkin spice latte (380 calories, 49 grams of sugar) and a nice, lowfat blueberry muffi n (350 calories, 55 grams of carbs, 29 grams of sugar).

His blood sugar takes off like the Challenger. The pancreas says, “Code Red! Send out the big guns! This dude just ate the equivalent of ten packs of Ding Dongs!” The pancreas produces a bucketful of insulin in a desperate

attempt to get all that sugar out of the bloodstream and deliver it to the muscles. The problem is, his muscle cells aren’t having it.

“What do we need all this sugar for?”, they seem to be asking. “The only ‘exercise’ this guy’s gonna get all day is pushing a computer mouse, and when he goes home, he’s going to sit on the couch and play with the TV clicker. The last thing we need here is more fuel.”

So the muscle cells begin to resist the effects of insulin. “Thank you but no thank you. We don’t need it. Go somewhere else.” And insulin has no choice but to take its sugar payload to another location, and guess where that is? The fat cells. Which happily welcome the sugar in.

Fat, Inflammation, and Blood Sugar

Fat cells are actually endocrine organs, and they secrete a ton of inflammatory chemicals. And inflammation is one of the major causes and promoters of heart disease. And making your fat cells bigger makes them even more powerful inflammation factories.

For a while, your blood sugar levels may stay in the normal range, as the pancreas valiantly tries to pump out enough insulin to keep up with this massive dietary sugar influx. Your blood sugar may still be hanging on in the “normal” range, but the high levels of insulin—which your doc may not be testing for—tells you that the whole thing is about to come tumbling down. (You can think of chronically elevated insulin as the body’s way of shouting “Help!”)

Eventually, insulin won’t be able to keep blood sugar in the “normal” range anymore, and blood sugar will start to rise. Now your blood sugar is high (because all that sugar has nowhere else to go), your insulin is also high, and you’re well on your way to a diagnosis of full-blown diabetes.

In other words, insulin resistance syndrome is “pre-diabetes.” And prediabetes is basically “pre-heart disease.” According to the American Heart Association, at least 84 percent of diabetics die from cardiovascular disease—and that number is undoubtedly a low estimate because at least 30 percent of people who have diabetes are walking around undiagnosed.

“Emerging evidence shows that insulin resistance is the most important predictor of cardiovascular disease and type 2 diabetes,” says Robert Lustig, MD, pediatric endocrinologist and professor in the Department of Endocrinology at University of Southern California, San Francisco.

Take the Test

There are ways that you can test for IR right now, with nothing more than the numbers you already have on your basic blood test.

*One good “surrogate measure” is to calculate the ratio between your triglycerides and your HDL (so-called

“good cholesterol”). Divide your triglycerides by HDL—for example, if triglycerides are 150 and HDL is 50, your ratio is 3. A ratio of 2 (or less) is superb and shows low likelihood for IR and little risk for a heart attack. A ratio of 5 means it’s time to pay attention to your diet.

*Second way: Stand a few feet in front of a wall, and walk straight towards it. If your belly hits the wall before your nose does, you are insulin resistant.

*Third way: Order an inexpensive lab test called fasting insulin. Take the result, together with your fasting glucose (available on practically every blood test your doctor ever ordered), and plug those two numbers into an online calculator called a HOMA-2 calculator. It will give you an IR score, just like a BMI calculator tells you your BMI based on height and weight.

The state-of-the-art way—the one I recommend if at all possible—is the LP-IR test given by LabCorp. Ask your doctor to order it.

What to Do About It

The best news about IR is that if you identify it early, you can turn it around. And you can do that without drugs. It’s completely modifiable by diet—specifically, a low-carb, high-fat diet, which can (and usually does) reverse IR. You just need to find a low-carb eating plan that works for you. And stick with it. (Shameless plug: the recently released 4th edition of my book Living Low Carb can help.)

If you focus on lowering insulin resistance you will be doing your heart a much bigger favor than if you focus on lowering your LDL cholesterol. Emerging evidence—and clinical experience— is showing that insulin resistance shows up well in advance of other markers for heart disease, including elevated blood sugar, A1C, triglycerides, and disordered blood lipids. So pay attention!

And do me a favor—when the link between IR and heart disease finally becomes accepted in the medical establishment, please just remember one thing: You heard it here first.

A HEART ATTACK IS A FRIGHTENING, TRAUMATIC EVENT, BUT THE RIGHT DIET CAN IMPROVE RECOVERY, PROTECT THE HEART AGAINST FURTHER DAMAGE, AND ENHANCE ITS FUNCTION.

BY VERA TWEED

Nearly one in four people who have a heart

attack go on to have a second one, but the right foods can significantly improve the odds of a long and healthy life. More than 20 years ago, the Lyon Diet Heart Study broke new ground by testing the effects of two diets in a group of 605 men and women who had suffered a heart attack. During a period of nearly four years, it found that compared to the usual recommended low-fat diet, a Mediterranean diet reduced second heart attacks, strokes, hospitalizations, and deaths by 73 percent. This study was unique in that it looked at people after a heart attack. Many other studies have found that the Mediterranean diet is effective in preventing heart disease. With nearly a thousand patients in his practice, Steven Masley, MD, has found that a modified version of the Mediterranean diet— incorporating additional research on food and heart function—has restored circulation, blocked further growth of plaque, and even reversed heart disease.

The Ideal Diet

“The ideal diet is a combo of Mediterranean and low-glycemic load—cut out the bread and the rice and the pasta and the sugar to get a full benefit from the Mediterranean diet,” says Masley. “Glycemic” refers to how much different foods raise blood sugar—starchy and sugary foods that produce a bigger rise are high-glycemic.

One study tracked more than 20,000 people in Greece who ate a Mediterranean diet for 10 years. It found that those who ate the least starchy and sugary foods were 40 percent less likely to develop heart disease and 50 percent less likely to die from it.

“Cholesterol is really not the number one cause for heart attack, stroke, and cardiac death,” says Masley. “Blood sugar levels are the strongest predictors.”

What Is the Mediterranean Diet, Really?

Though highly touted by proponents of healthful eating, the Mediterranean diet is widely misunderstood as being based on platefuls of pasta. Having spent much time in Mediterranean regions and even working as a chef in France, Masley is quick to point out that pasta and other grains play a very small role in the traditional diets of the region.

Where we might eat a big plateful of pasta, a true Mediterranean serving would be one-fourth to one-sixth the amount, eaten on a small plate before a main dish of vegetables and protein. Pizza would be one thin-crust slice with a little cheese and sauce, eaten once or twice a month as an appetizer.

In addition, Mediterranean natives burn more carb-rich foods because they traditionally walk much more than we do. If you don’t get at least 7 hours of

What to Eat

The Mediterranean diet consists of fresh food, locally grown and in-season as much as possible, prepared from scratch. Here are some of Masley’s basic recommendations:

*If you don’t usually eat breakfast, you don’t have to. But if you find yourself snacking mid-morning, try a Steven’s Breakfast Shake (recipe available at drmasley.com) and wait until lunch to eat.

*Make lunch your biggest meal of the day. * Eat fish and seafood three to five times a week—less often will not produce the full benefits. * Eat at least 2 cups of leafy greens daily plus a variety of other brightly colored vegetables. Di erent pigments stem from di erent nutrients, so a rainbow provides the best nourishment.

*Eat beans daily. Canned beans are fine, but steer clear of canned baked beans, which can contain 3 teaspoons (12 grams) of sugar in a half-cup serving. * Avoid snacking, especially after dinner. * If you really need a snack during the day, have a handful of nuts. * If you drink co ee, have no more than 2–3 cups in the early part of the day. * Drink mostly water. If you like wine, have a glass with a meal. * Use extra virgin olive oil for salad dressings and to cook at low heat.

For medium- or high-heat cooking, use almond or avocado oil. * If you like yogurt, choose plain yogurt and add berries or the zest of an orange or lemon. Flavored yogurt contains as much sugar as cake.

SAMPLE MEALS

BREAKFAST:

An omelet with vegetables or steel cut oats with some fruit.

LUNCH:

A salad with extra virgin olive oil and vinegar, vegetable soup, or grilled or steamed vegetables with a protein such as seafood, chicken, or beans.

DINNER:

A different protein than lunch and double the amount of vegetables you might normally eat. Experiment with different recipes such as the Ratatouille with Cannellini Beans.

DESSERT:

One piece of fruit and perhaps a piece (about 1 ounce) of dark chocolate with 70 percent cacao.

physical activity per week—formal exercise and/or work-related movement—Masley recommends limiting starchy carbs.

The key ingredients that deliver benefits in the Mediterranean diet, he says, are plenty of vegetables, including leafy greens and a rainbow of brightly colored veggies; beans for protein and fiber; fish and seafood for healthy fat and protein; some poultry for protein; olive oil; nuts; and a variety of herbs.

The Mediterranean Lifestyle

Mediterranean folk traditionally take breaks from whatever they do all day to enjoy meals with others, savoring flavors and conversation. Even a simple, everyday meal is cause to pause whatever else is going on in life. Plus, they don’t snack. They don’t eat while working or doing other things. They often go for walks before or after dinner. And they enjoy their food rather than eating mindlessly.

This view of food, along with fresh ingredients, lays the foundation for the benefits of the Mediterranean diet.

Where’s the Beef?

While Masley doesn’t insist on giving up red meat completely, he recommends eating it only a few times per month, even if it’s grassfed or organic. The reason is a metabolite called TMAO (trimethylamine-N-oxide.)

When we eat red meat, bacteria in our guts produce TMAO, which is now being recognized as a harmful substance. Researchers who analyzed clinical trials with more than 10,000 people found that among people who have heart disease, elevated levels of TMAO from consistently eating red meat increased risk for heart attacks by 62 percent. Occasionally eating meat doesn’t pose the same risks, but processed meats, such as sliced cold cuts, are not recommended at all.

Following this type of Mediterranean diet reduces plaque and enhances circulation to the heart. “If you can change circulation,” says Masley, “you can really rejuvenate people and give them their lives back.”

Ratatouille with Cannellini Beans Serves 4

This fragrant and delicious recipe comes from the South of France—and lucky for all of us, it’s packed with nutrients. Ratatouille can be served hot or cold, and usually tastes better when served the next day. With the beans included, it makes a whole meal, or you can skip the beans and serve this as a side dish.

1 medium Italian eggplant, ends trimmed and cut into 1-inch cubes ¼ cup extra-virgin olive oil, divided 1 medium sweet onion, finely chopped ½ tsp. sea salt ¼ tsp. ground black pepper 1 tsp. fines herbes (or Italian herb seasoning) 3 small zucchini, cut into ½-inch cubes (about 2½ cups) 2 small yellow squash, cut into ½-inch cubes (about 2 cups) 2 Tbs. dry red wine 3 fresh medium tomatoes, chopped (about 2½ cups) 4 medium garlic cloves, minced 1 Tbs. finely chopped Italian flat-leaf parsley 1 tsp. minced fresh rosemary 1 Tbs. finely chopped fresh basil 1 (15-oz.) can cannellini beans, rinsed and drained pinch of paprika or cayenne

1. Heat large sauté pan over medium-high heat. Add eggplant and 2 Tbs. water. Cook 2–3 minutes, stirring occasionally. When water has evaporated, reduce heat to medium, and add 2 Tbs. olive oil. Sauté another 2–3 minutes, until eggplant is tender. 2. Meanwhile, heat large saucepan over medium heat. Add remaining olive oil, onion, salt, black pepper, and fines herbes. Sauté 2–3 minutes, until the onion is soft and translucent. Add zucchini, yellow squash, eggplant, and wine, and stir to combine. Cover, and cook, stirring occasionally, 3–4 minutes, until vegetables soften. 3. Reduce heat to low, and add tomatoes, garlic, and fresh herbs. Add beans, cover, and simmer 10 minutes, until squash softens and flavors blend. Taste, and adjust seasoning as desired.

PER SERVING: 330 cal; 11g prot; 14g total fat (2g sat fat); 41g carb; 0mg chol; 480mg sod; 15g fiber; 15g sugar