247: How To Beat Weight Gain, High Cholesterol and Diabetes with Dr. Spencer Nadolsky

Today’s Guest

Dr. Spencer Nadolsky

Dr. Spencer Nadolsky, DO, is a practicing board-certified family medicine physician. After a successful athletic career at University of North Carolina (UNC) at Chapel Hill, he enrolled in medical school at Virginia College of Osteopathic Medicine in Blacksburg. He aspired to change the world of medicine by pushing lifestyle before drugs (when possible).

Lifting, eating, laughter, and sleeping are his current first-line medicines for whatever ails patients. “Although, those don’t cure pneumonia, unfortunately,” he told MedPage Today.

During his time as an UNC Tar Heel, Nadolsky was ranked in the nation’s top four heavyweight division wrestlers. Nadolsky said he owes much of his success to nutrition, exercise science, and, of course, hard work. His goal is to use what he learned as an athlete and apply it to his patients to help them get as healthy as possible using lifestyle as medicine. He now practices in the Norfolk, Va., area.

You’ll Learn

• Why Spencer isn’t your average doctor (04:14)
• What is metabolic health (09:18)
• What is your waistline telling you about your health (11:46)
• Understanding your cholesterol numbers (13:03)
• 7 Ways to boost your metabolism (09:35)
• The link between diabetes and cardiovascular disease (19:21)
• How high blood pressure and stress damages arteries (21:56)
• How to find the right doctor (29:00)
• 5 reasons you are not seeing results (31:27)

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Link Mentioned:

• SteadyMD

Connect with Dr. Spencer Nadolsky:

• Website
• Facebook

Listener’s Question:

“I’m a follower of Mark Sisson and Dave Asprey regarding diet and exercise. I am 49 years old and in pretty darn good shape but I have a high total cholesterol number since I have become more of a healthy fat eater. Most recent was 260, should I be concerned? My HDL was 70; my cholesterol HDL ratio is 3.8. They didn’t list my triglyceride number.”

 Dr. Nadolsky’s Response:

“When we look at some of these numbers in isolation it’s easy to make blanket recommendations. I’ll give a few different levels of how I would do this if he had some other health issues. If he is perfectly healthy and no other issues like insulin resistance and no blood pressure issues or a history of heart disease that number is on the higher side but not on the level where I would go, “Oh my God, you need to take a Statin or one of these other cholesterol medicines.

It would be pretty high if you did have some other conditions like type 2 diabetes or some other risk factors. Age plays a role, smoking and blood pressure and stuff like that. So we take the whole patient and do all these calculations to see the risk but at a very healthy state of life, it’s probably not too concerning but definitely something to ask your doctor about looking at your whole health.

A lot of times these high-fat diets focus on a lot of butter and coconut oil and some of these in certain individuals can raise your cholesterol but a lot of the low carb people will say it’s harmless and not a big deal but I would argue that it takes a long time to build atherosclerosis so a lot of these studies they don’t show that.

I would personally change the diet just a little bit to hopefully lower those levels but your HDL is very good and your total cholesterol is a little bit high but if you really want to check you can get what’s called the high sensitivity c-reactive protein test which can show if you have some inflammation going on and that can risk stratifying a little bit more to basically say, hey this level is high and you’re actually at a higher risk of having heart disease or things like. Or if it is low you could say maybe you’re not as much at a risk.

There is another thing called a calcium heart scan, coronary artery calcium score that you can get that also risk stratify you as well. It’s hard to say in isolation it is on the higher level but if you are perfectly healthy in everything else in your life I wouldn’t be jumping to medicine right away.”

Listener’s Question 2:

“Why does the health care system demonize cholesterol and what roles come into play for optimal health?”

Dr. Nadolsky’s Response:

” I will try to defend other doctors by saying it’s a system failure. I think as family doctors specifically we have the broadest scope of medicine you could ever think of. We have to know pretty much a little bit of everything…but the system fails. If you have to see 20-30 people in a day and your cooperation is pushing you to see more and more patients to meet overheads…You get forced to read just brief guidelines and then the guidelines in your mind you’re not following those even though these things are very brief.

So, you not even following what we call evidence-based medicine because the guidelines are there and very good at discussing—you got to look at the totality of everything. But people don’t even see it all what they see is a number and they have 5 minutes with a patient and they don’t get to talk about lifestyle… And so you leave with a prescription because your cholesterol was a little bit elevated. I think more doctors should go back to their medical school training and understand it’s not necessarily just the cholesterol there is also a difference between what we eat and the cholesterol circulating in our blood and what’s carrying the cholesterol…It’s an issue they look at from a population standpoint. If we can get everybody’s cholesterol down you’re going to save X many persons…It’s a system failure I would say.”

Ted’s Takeaway

1. Don’t be your own doctor

2. Be a results oriented person – With all the nutrition and training approaches, are you getting results? This is a straight forward question to ask yourself. If your answer is no, then you need to try something else or perhaps you need to follow it correctly or have one on one coaching to get you the results you want to see.

3. Be careful where you get your information from –  Evaluate the information you’re getting and make sure you are buying into the principles behind what they do and not the marketing hype.