In my practice, I do not recommend a classic ketogenic diet, as there tends to be muscle loss in the context of the low insulin signal. Remember, insulin is a very potent anabolic hormone and in its absence, bodily tissues are broken down or catabolized, fat and muscle alike. Yet muscle is the tissue that […]

This age-old adage should truly be changed to, “You are what you burn,” because those of us who preferentially burn fat as opposed to sugar, metabolically speaking, are not only going to be leaner but healthier, longer. So how does one accomplish this? It’s easier than you think and works one hundred percent of the […]

I spoke with a friend earlier regarding his transformation from an unhealthy, overweight, and sedentary individual to just the opposite several years later. And he’s never looked back. It’s interesting to probe people’s psyches in the context of their health and wellness pursuits; I find myself on a perpetual search for the why’s and the […]

Eat breakfast like a king, lunch like a prince and dinner like a pauper. Restated, breakfast should be the heaviest meal and dinner, the lightest. Remember, your metabolic rate is at its highest during the day and at its lowest in the evening (and during sleep). Match your metabolic rate therefore with your meal size. […]

Firstly, there is no such thing as a “diet.” Proper nutrition is a lifelong endeavor. We’re not talking about a transient weight loss in preparation for the prom. My prescribed “diet” is not based on a proprietary system or universal guidelines. It is based on science, on data, data extracted from you during your office […]

“I have two damaged discs in my neck, one at C5/6 and one at C6/7. In addition, I also have osteophytes in the foraminal openings where the nerves exit to go down my left arm. This creates occasional numbness down my arm. Doctor, do you know of ways to heal this that don’t require an artificial disc […]

My son Jack just started driving.  I gave him my 2007 Jeep Wrangler, having removed the lift kit to lower its center of gravity.  Anyone growing up in the 80’s will tell you that Jeeps were vilified in the media.  Right or wrong, the notion that they “rolled over easily” left its scars.  Aside from […]

Here are my top ten tips for better brain health: Learn new skills. Brain stimulation and activity can delay the onset of the neurodegenerative diseases such as Alzheimer’s dementia. The acquisition of a new skill, both mental and physical promotes neurogenesis or the formation of new neurons and forges intra-neuronal connections. Flex you “mental muscle” […]

Indians are known to have a markedly reduced risk of Alzheimer’s disease relative to Americans. This phenomenon may be explained by their abundant usage of the spice turmeric as a food additive. Curcumin, the active component of turmeric extract, possesses anti-inflammatory and anti-oxidant capacity and has been proven to be a neuroprotective agent. This has […]

Page 49 of Get Serious: “Your training progress will be suboptimal should squats be excluded from your regimen. So don’t even think about it. And no, you cannot exchange leg extensions for squats.” Here’s why. And I cite the same page of my recently released book. “Heavy squats generate a robust hormonal response as numerous […]

Chapter 8 of Get Serious details my top ten nutritional supplements, one of which is resveratrol. Present in red wine, it is thought to confer protection against coronary events in people consuming a high-fat diet (French Paradox) and has recently been shown to have potential neuroprotective effects as well. Go figure! It is well known […]

In Get Serious’ chapter dedicated to nutritional supplements, I strongly advocate the use of daily probiotics. What are probiotics exactly? Simple. They are ingested microorganisms with beneficial effects. Salmonella therefore is not a probiotic. It is a pathogenic (or disease causing) bacterium and often the causative agent of “food poisoning.” Probiotics such as lactobacillus and […]

Not a clinic day goes by without a patient asking me how many sit-ups I do in the context of the cover shot of Get Serious. My answer, “Few, if any.”  I quickly re-route the discussion to better address the topic at hand: low back pain (a very common presenting complaint). Why? Because the two […]

“Doctor Smith told me that if I didn’t have surgery in the next week, I would be paralyzed.” I just love this one. And I hear it all the time. It’s a sales tactic used by surgeons to goad individuals into signing on the dotted line. For the record, I’ve never said that to a […]

My son Jack just started driving. I gave him my 2007 Jeep Wrangler having removed the lift kit to lower its center of gravity. Anyone growing up in the 80’s will tell you that Jeeps were vilified in the media. Right or wrong, the notion that they “rolled over easily” left its scars. Aside from […]

I’m unsure as to whether or not it’s a manifestation of laziness or entitlement or maybe a little of both. After all, the two often coexist. I’ll let you decide. HEALTH TAKES WORK. Why is it that patients ask me if they “have to work out” if engaging me as their physician? Hmm… Do I […]

Let’s talk intermittent fasting (IF) for a second and then discuss the interplay between both of these entities. Intermittent fasting, a variation of Ori Hofmekler’s Warrior Diet, popularized more than 20 years ago (despite claims that it is actually “new science”) is founded on once or twice daily feedings punctuated by long periods of fasting […]

NOT. It’s a misnomer.  “Cardio” is a four-letter word as is “aerobics,” the exercise trend popularized in the 70’s. It mortifies me to think that people are spending hours on end in gyms, immersed in “cardio,” spinning their wheels on stationary bikes, under the assumption that they are one, training their hearts (ergo the name, […]

I recently received this comment from a reader of Get Serious: “I recommended your book to a friend and a potential client of mine and his upping the omega-3 intake to your recommended levels has had significant effects in reducing his body fat levels. He is ecstatic and called on me to thank him for […]

butter your steak AND EAT IT TOO I didn’t misspeak. Adding fat to your meal is not only acceptable but also healthy, provided carbohydrate load is low and inclusive only of the low glycemic index variety. The burger patty is fine but not the fries. Why? I’ll explain. Firstly, think not of calories and only […]

Mainstream medicine is very short sighted. Historically, doctors have been taught to wait until disease arises and then hurriedly treat it. Think about heart attack victims. I bet you know someone who has had a heart attack? Do you think their arteries became clogged overnight? Of course not.  He or she had risk factors, identifiable […]

If I’ve said it once, I’ve said it a thousand times. Get Serious, page 141: “An analog of metformin will one day be launched as an “anti-aging” drug” due to its potentially life-extending effects. And this is exactly what can be inferred from the data of a recent entry in Diabetes, Obesity and Metabolism. Bannister, […]

In the context of last week’s post, I submit to you the following summary of a study published in the latest volume of Spine (2014;39:1433-1440). Summary of Background Data: Guidelines advise against MRI for acute uncomplicated low back pain, but is an option for persistent radicular pain after a trial of conservative care.  Yet, MRI […]

For years I have been talking about the importance of blood sugar control in the context of age-related disease. I spend hours speaking about it in my lectures and even more time counseling patients in clinic about the dangers of elevated blood sugar. Chronically elevated blood sugar accelerates the aging process and predisposes you to […]

Fasting has pervaded cultures for millennia. Why? Well, it was not some sort of cruel and unusual punishment inflicted upon the masses by a shaman. And although its integration and practice were deeply tied to religion, likely it was by virtue of its salubrious benefits that fasting “stuck.” People just felt better when they fasted. […]

Some patients come into my office under the assumption that they’ve got it all dialed in, training-wise. Here’s the usual banter, “I’ve been lifting weights for 35 years, and so I don’t need any help in that department.” Fair enough. As I’ve always prided myself on being an exceptional listener, and well aware of the […]

Everyone is searching for that elusive elixir of longevity, the fountain of youth if you will. What they don’t realize, however, is that not only is the answer right in front of them, but it is also extremely inexpensive. There is no magic pill, at least not yet, nor is there a technology that rights […]

Overtraining is spectral in that there are mild and severe forms. Walk into one of these WOD-based facilities, and you’ll likely see a bunch of weathered individuals jumping around wondering why they haven’t made the muscular gains as billed. They’re overtrained! Nearly all of them. Why? Because they subscribe to the “more is better” philosophy. […]

I get a ton of questions on the ketogenic diet ranging from its merits to the purported dangers. “Going keto” is the latest craze. It’s all over the internet. There are websites dedicated to it. And Facebook forums. It’s a subculture not unlike that of modern-day obstacle course racers and that long-sock-wearing cult of exercise […]

You’ve probably heard that poor sleep hygiene is associated with a whole host of diseases. Well, it’s true. I’d be an embarrassment to the neurosurgical community if I didn’t inform you of the well-documented association between lack of sleep and Alzheimer’s disease. It’s very real and thought to be specifically REM sleep deprivation (during which […]

On May 1st, I wrote an article entitled “Longevity. Simplified.” within which I detailed the life-extending secrets of the Okinawans, the culture spawning many of the world’s supercentenarians (those that have lived to at least 110 years of age) and those of the nonagenarians living in Monaco – 90 is the average life expectancy there, […]

The brain is a biological marvel! It performs thousands of simultaneous functions and gives us the ability to think, reason, and create. Yet, for all these attributes, our brains are primarily concerned with one thing: survival. Why? Because for thousands of years, food was tough to come by. In this regard, storing fat and eating […]

So let me ask you a question. What is the best primary modality to thwart the development and progression of neurodegenerative diseases such as Alzheimer’s dementia? Well, if you missed my blurb on The Today Show last Friday, allow me to fill you in: Exercise. Surprise, surprise. What if I told that strength training is […]

How many times have you heard this one? “He has a fast metabolism, and that’s why he’s thin,” as if a “fast metabolism” is some sort of elusive genetic endowment. Truth be told, you are lesser a product of your genes than you may believe. Sure there are predispositions to a particular body type, endo, […]

On occasion, I’ll have patients return to my clinic claiming, “The protocol didn’t work.” It always makes me laugh because unbeknownst to them they are suggesting that science has failed them. A closer look, however, reveals something a bit more sinister. And it has nothing to do with science. Instead, it has to do with […]

Another question I’m asked several times per week. Whether I’m in the office sitting across a wooden desk from a patient or behind my mask, instruments in someone’s brain, the questions are endless. Not wanting to scream, I asked the circulating nurse to lower the volume of the by-any-standard-loud trance music and answered, with a […]

Eat Small, Frequent Meals/Snacks: A drop in blood sugar is the primary factor that tells us we’re hungry. Eating small frequent meals, especially those containing protein, helps stabilize blood sugar levels and prevents them from dipping too low, causing appetite to spike. To prevent this, “graze” throughout the day. Eat Less As The Day Goes […]