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To Your Health With Dr. Jim Morrow: Episode 6, The Keto Diet

April 10, 2019 by John Ray

North Fulton Studio

To Your Health With Dr. Jim Morrow: Episode 6, The Keto Diet

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**Dr. Jim Morrow, Host of “To Your Health With Dr. Jim Morrow”**

Episode 6, The Keto Diet

The Keto Diet has grown significantly in popularity over the last couple of years. Is it effective? More important, is it safe? Dr. Jim Morrow calls it “the worse diet ever devised by man.” He offers reasons for this opinion, talks about his own struggles with weight, and offers recommendations.

Dr. Morrow’s Show Notes on the Keto Diet

What is a Diet?

The word “diet” can mean two things.
- That food plan you follow for a period of time, to your weight
- Whatever you eat on a daily basis.
The first one is what most people think about when they talk about a diet.
- It has an artificial beginning and an artificial end, e.g. “Man, I can’t wait to lose this 20 pounds so I can get off of this diet!”
The problem is, that losing weight is the easy part. Keeping weight off is the hard part.

Diet Plans

There are as many diet plans available for you to follow as there are people in the world. And many of them will work. But, are they healthy?
The whole idea is to “eat less food.” That’s it, that’s what you have to do. As long as you eat less food than you have been eating, you will lose weight.
The hard part is that you have to eat less food FOREVER!
It’s the hardest thing you will EVER do. Harder than tobacco, harder than drugs, harder than anything because you have to eat.
So, as I tell patients, “If you want to change your weight, you have to change your life.”
And THAT is why it is so hard. We are who we are, we do what we do, and we like what we like. Lifestyle and genetics
Some of you will be like my brother-in-law, who admittedly eats to live. And some of you will be like me, live to eat. Well, the ones who eat to live will forever and for always be thinner than me. It’s a mindset, it is the way they are. It’s their nature.
And those like me will forever fight a battle, or have to adjust to being heavier.
If you follow a commercially available plan like Jenny Craig or Nutri-System, you’re very unlikely to do them for the long term. You’re just not likely to pay for that food for long.
- I bought a month’s worth of Nutri-System’s food several years ago and in two weeks I was starving!
It has got to be a plan that you can stay on FOREVER. And that’s hard.
But what all of this boils down to is that you have to eat less food. So, to that end, I have written a book for those of you who really want to lose weight, or have a friend who wants to lose weight.
- “Dr. Morrow’s Guaranteed Guide to Weight Loss” is a 50-page paperback book that you can purchase for $9.92 on lulu.com
- Fifty-page book with the instructions, “Eat less food.”
- It’s that simple, and it’s also that hard.

Keto Diet

A new twist on extreme weight loss is catching on in the United States. It’s called the “keto diet.”
The keto diet was originally formulated to treat seizures. In some patients, this does help reduce the number and severity of their seizures, although experts are not quite sure why it works.
It uses the body’s own fat burning system to help people lose significant weight in as little as 10 days.
Proponents say the diet can produce quick weight loss and provide a person with more energy.
The “keto” diet is any extremely low-carbohydrate diet that forces the body into a state of ketosis. This occurs when fat tissue is used for energy instead of sugar.
Low carbohydrate levels cause blood sugar levels to drop and the body begins breaking down fat to use as energy.
Keto diets vary in detail but are usually between 75 and 90 percent fat in the diet
Ketosis occurs when people eat a low- or no-carb diet and molecules called ketones build up in their bloodstream.
Ketosis is actually a mild form of ketoacidosis. Ketoacidosis mostly affects people with type 1 diabetes. In fact, it is the leading cause of death of people with diabetes who are under 24 years of age.
Many experts say ketosis itself is not necessarily harmful.
Some studies, in fact, suggest that a ketogenic diet is safe for significantly overweight or obese people.
However, other clinical reviews point out that patients on low-carbohydrate diets regain some of their lost weight within a year.
The keto diet that has been studied and that researchers say is a healthy diet is one consisting of:
- 20 g to 30 g of carbohydrate in the form of green vegetables and salad, and
- 80 g to 100 g of protein in the form of meat, fish, fowl, eggs, shellfish and cheese.
- Polyunsaturated and monounsaturated fats are also included in the diet.
  - This is canola oil, olive oil, safflower oil, peanut oil, sunflower oil and corn oil.
  - Other foods high in polyunsaturated fats are walnuts, sunflower seeds, flax seeds or flax oil.
  - And fish, such as salmon, mackerel, herring, albacore tuna, and trout
- Monounsaturated fat foods are avocados, almonds, cashews and peanuts
BUT this is NOT the Keto Diet that most people follow. The Keto Diet, as followed by most Americans, is not healthy.
Many people on keto include “High fat days” and on these days they might eat as much as a pound of bacon a day.
I have had patients who had well-controlled cholesterol, then started this version of the keto diet, and their cholesterol climbed 40 points or more.
On the true Keto diet, cholesterol has been shown to come down. But as it is practiced in most of America, cholesterol can go up. You’ll lose weight but won’t be healthy.
Weighing less is great, but having a normal cholesterol is extremely important also.

Long Term Weight Loss

The biggest issue I have with the Keto Diet is that in any form, it is not a plan that you are going to follow for very long.
The amount of fat that many people are taking in, by not following the original Keto Diet, is grossly unhealthy.
This diet, as too many people practice it every day, is the WORST DIET EVER DEVISED BY MAN.
There is not a fad diet, one that is intended to get a lot of weight off of you in a hurry, that you are likely to stay on, or certainly be healthy on, for a long time.
I do think that people need to do their very best to eat well, to be healthy.
But you also need to be realistic. If you go to a family reunion and everyone there is grossly overweight, you are probably not going to be a size 4. You can almost certainly lose some weight, but be realistic.
Be more concerned about not gaining weight. Too many people gain 5 pounds a year, look up in 5 years and have gained a lot of weight.
Women, you are especially unlucky when it comes to weight loss. Everyone who loses weight will lose and plateau for a while, lose then plateau again.
Women plateau at the beginning. Might be three months.
The best diet for long-term weight maintenance is one that you can and will follow for a very long time.
Because of that, Weight Watchers is, in my opinion, the best commercially available plan around.
- You don’t buy your food from them,
- You can eat anything in the world,
- It helps you understand portion control, a novel idea for anyone dieting
- It can be done long term, but again it is a way of life.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be. At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!” Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

**Dr. Jim Morrow, Morrow Family Medicine**

Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce. He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

To Your Health With Dr. Jim Morrow: Episode 5, Depression

March 27, 2019 by John Ray

North Fulton Studio

To Your Health With Dr. Jim Morrow: Episode 5, Depression

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Dr. Morrow’s Show Notes on Depression

Today’s topic is one I discuss with at least one patient every single day I work – and that’s DEPRESSION.
People in general have their own idea of what constitutes depression. And in many cases, it is correct but only in a very narrow definition of the condition. So, I guess, first, I need to define depression, in the clinical sense.
Depression can be present if you are overly or unnecessarily sad – but most people who I see who are depressed are mad, and not sad. Additionally, the depressed patient might be tired, uninterested in usual hobbies or pleasure seeking activities, whether that is being with friends or others, or having sex, or engaging in any way with their surroundings.
Most people don’t come to my office with a complaint of depression. They are much more likely to complain of increased irritability, making mountains out of mole hills, trouble focusing, not being engaged or interested in their usual hobbies and things they used to enjoy.
Some are sent in by their spouse because of irritability. I tell patients, “if you think to yourself many times, ‘Why did I react like that?’, then you are likely depressed.
So, there are many different forms that this can take – if you feel like this could be part of how you feel, please see a doctor. Have this conversation with him or her.

So, why are people depressed?

Depression occurs when the levels of certain neurochemicals in your brain get too low. The main chemicals involved are serotonin, norepinephrine and dopamine – but the names of these chemicals are really unimportant. What matters is that you have to get these levels back to normal in order to feel like yourself again.
But what makes these chemical levels fall in the first place.
Some people are just born with an innate inability to maintain adequate levels of these chemicals and in most cases these individuals have felt some amount of depression from very early in life.
When it occurs any time later in life, the cause in most cases is CHANGE. Change in life or work or living situation, whatever it might be, it is usually CHANGE.
Holmes stress scale.
- Ranked life events – ranked them according to the effect each could have on your mood. Marriage, divorce, death of a spouse, getting a new job, getting fired. Good things were found to have a slightly greater effect on mood than bad things.
So, depression is a physical illness that has both physical and psychological symptoms. It is as much a physical illness as any other condition we see.
When your serotonin level is low you can feel all these symptoms that I have talked about. If you do, you might think to yourself, ‘I really should not have these feelings. I should be able to feel better,’ and then if you can’t do that you could feel even more depressed.
If, instead of serotonin and other neurochemicals, your insulin level was low, you’d be diabetic. If it was iron you’d be anemic; thyroid, you’d be hypothyroid; estrogen, you’re in menopause.
If your insulin level was low and you were diabetic, you would never, EVER, think to yourself, ‘You know, I’m just not gonna be diabetic today.’ That would never occur to you. But with depression, patients frequently think that they should be able to pull themselves up by their own bootstraps, and this just does not happen.
Realizing this goes a long way toward getting better because the longer you delay treatment, the likelihood is that you will just get worse and worse.

So, how is depression treated?

These chemicals we are talking about are only located in the brain. So the first issue is that you can’t measure these levels like you can insulin and others. There is this blood-brain barrier that does not allow the chemicals to get into the blood stream. Because of this, we can’t measure serotonin and other levels and we can’t give you serotonin by mouth because they also do not cross over to the brain.
So, how do we make you better?
In 1987, the treatment of depression changed forever. The introduction of Prozac made as big a difference in the treatment of any condition I can remember.
Prior to this, we have several medications that were antidepressants, but truthfully, they were not very good at treating the problem and they were absolutely fraught with side effects.
With Prozac (and then the other serotonin medicines like Zoloft, Paxil, Celexa and Lexapro), we had very effective medicines with very reasonable side effects.
The way these medicines work is to change how your brain metabolizes these chemicals – in this case serotonin specifically. Your brains, under periods of stress, takes up more serotonin than it should from the soup that is the brain, and these medicines block that reuptake of serotonin, so they are called Serotonin Specific Reuptake Inhibitors (SSRIs).
When you start these medicines, you could have some side effects, but for many people, the longer you take them the less the side effect bothers you.
The side effects of these medicines vary, can be fatigue or restlessness, nausea, headache, even delayed orgasm. But in most cases side effects are mild and can be managed by adjusting the dose of the medicine or changing to another.
Improvement does not happen overnight. It takes time for the medicine to get into your blood in a sufficient level to then get into the brain.
Meds are not mood altering
- Not addicting
- Don’t drug test for them in the workplace
- Safer than Tylenol
There just is no reason NOT to take these meds if you have this condition. They can make a tremendous difference in how you feel and how you react and interact with others around you. Basically, they can give you your life back.
Along with medication, other treatment modalities also can help. Therapy – psychotherapy – can help with depression and can especially help people deal with issues in their lives that are ongoing. One of the frustrating things for patients is to recognize the problem and get treatment, only to fall right back to the same feelings when you get off of medicine because you have not learned how to manage the stress and change in your life.
So, please, if this sounds like it could be affecting you, go see your healthcare provider. See them sooner rather than later.

About Morrow Family Medicine and Dr. Jim Morrow

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

To Your Health With Dr. Jim Morrow: Episode 4, Vaping

March 13, 2019 by John Ray

North Fulton Studio

To Your Health With Dr. Jim Morrow: Episode 4, Vaping

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Dr. Morrow’s Show Notes on Vaping

If we are going to talk about vaping, we have to talk about: NICOTINE.
Why nicotine? What does it do to your brain?
Nicotine activates the circuitry that regulates feelings of pleasure, the so-called reward pathways. Research has shown that nicotine increases the levels of dopamine (a key brain chemical involved in mediating the desire to consume drugs) in the reward circuits of the brain.
Cigarettes also cause a marked decrease in the levels of monoamineoxidase (MAO), an enzyme responsible for breaking down dopamine, so…. more dopamine in the circulation.
The need to sustain the high dopamine levels results in the desire for repeated drug use.
Outward Signs of Nicotine Addiction
- an inability to stop using tobacco products
- withdrawal symptoms when nicotine use stops
- a desire to keep smoking even when health complications arise
- continued use of tobacco products even if it negatively impacts your life
Treatment for Nicotine Addiction
- Wellbutrin
- Chantix
- Support groups

What We Learned

In 1950, the tobacco companies came out with a huge ad, a statement to America, that they did not believe that cigarettes were any health threat at all. Their “Frank Statement to Cigarette Smokers” essentially stated that they felt tobacco was completely safe and caused no harm, stating that “for more than 300 years, tobacco has given solace, relaxation and enjoyment to mankind.”
In 1964, the Surgeon General, Luther Terry, submitted his report on the direct link between smoking and cancer. It concluded that smoking is a cause of lung cancer and laryngeal cancer in men, a probable cause of lung cancer in women, and the most important cause of chronic bronchitis.
In 1965, labeling changes occurred and today labels show graphic evidence of what cigarettes can do.
In 1967, advertisements for cigarettes had to start giving significant time to the dangers of smoking.
What is NOT a Treatment for Nicotine Addiction: VAPING!

If you’re puffing on something electronic – it’s vaping.
Might call it e-cig, vape, Juul (a brand name)
Bottom line is that it is an ENDS (electronic nicotine delivery system)
Vaping appears to increase young people’s risk of starting smoking
Young people who reported having used e-cigarettes were more than eight times as likely to start using conventional cigarettes
Problem may be exacerbated by the many flavors used to enhance the enjoyment of e-cigarette use
Adolescents and young adults are known to be very susceptible to flavorings
Vaping is exposing them to one of the most addictive chemicals known — nicotine
Studies show teens tend to underestimate their risk for getting addicted and overestimate their ability to quit once addicted

Types of e-Cigs

1st Gen: closely resembles a cigarette and is disposable
2^nd Gen: larger, pen shaped, rechargeable
3^rd Gen: do not look like combustible cigs at all, have large batteries, replaceable parts, these are called “mods”
Latest: Sleek, modular design like Juul (looks like a USB drive) and some others. These often have a much higher nicotine content than traditional cigs or earlier devices.

Nicotine Concentrations

Levels vary – some are nearly the same as traditional cigarettes
Mislabeling is a common problem
Nicotine delivery is affected by how the device is used by the consumer.
Juul delivers nicotine almost THREE TIMES FASTER than a typical cigarette.
- This increases the likelihood of addiction
- Often, (some say 37 % of the time) youth and young adult users are not even aware that the device has nicotine in it at all.

As Harmful as Typical Cigarettes?

While e-cigarettes contain some fewer toxins than combustible cigarettes, they are not free of toxins and still deliver harmful chemicals
There is an enormous variability within the product category and there is no typical e-cigarette
- different ingredients and different hardware, and deliver highly variable amounts of nicotine and potentially toxic chemicals

What People Think

Among adults,
- 31% think they are the same as cigs
- 4% think they are more harmful
- 29% don’t know
- 36% think they are less harmful

Usage Rates

In 2011, 1.5 percent of high school age students used e-cigs
In 2017 that number was up to 12 percent
In 2011, 0.6 percent of middle schoolers used them, and
In 2017, 3.5 percent used them
Among adults, in 2015, more than HALF of users also smoked cigarettes.
Among young adults, 40% also smoked cigarettes.

Patterns of Use

In 2017, studies showed that 12% of high school and 3.5% of middle school students has used e-cigs in the previous 30 days
2018 NASEM report concluded that, “there is substantial evidence that e-cigarette use increases risk of ever using combustible tobacco cigarettes among youth and young adults”
60 percent of teens incorrectly reported e-cigarettes as being comprised of mostly flavoring.

Juul

Since 2016, Juul has surged in popularity – now with 68% of the e-cig share.
Many are unaware that the product always contains the addictive chemical nicotine
A single JUUL cartridge is roughly equal to a pack of cigarettes

Health Effects

Much is still unknown
E-cigs can deliver levels of nicotine similar to combustible cigarettes and this is causing concern about the potential risk for addiction
Exposure to nicotine among youth is particularly dangerous since it has been shown to have an effect on key brain receptors, making young people more susceptible to nicotine addiction
Effect of nicotine on developing brains may result in nicotine addiction and greater vulnerability to addiction to other drugs as well
Pregnant women who use nicotine are at a greater risk of stillbirth and preterm delivery.
At least 60 chemical compounds have been found in e-liquids, and more are present in the aerosol produced by e-cigarettes.
We don’t know what exposure to these flavors will do. Marketing has gotten out of hand with some being labeled “Thin Mint” or “Redi-Whip”, etc.
E-liquids can cause unknown problems
Explosions of devices can and do occur, although unlikely this is very dangerous.
Vaping is in its infancy. It is tobacco fifty years before the discovery that it caused lung cancer. What good could you possibly hope to derive from vaping?

Thinking about vaping? Think before you start! (Before you buy even that first device.)

About Morrow Family Medicine and Dr. Jim Morrow