“To my generation, technology is second nature, while yours fumbles through it. Makes you kinda jealous, eh?
These were the words a Cartoon character, Curtis told his dad in one of the episodes.
In return Curtis’ dad brought out his yo-yo and performed some amazing tricks on it. Curtis retorted by telling his dad that the tricks he performed on his yo-yo a short while earlier were “child’s play”.
Curtis’ dad then handed the yo-yo to Curtis to see if he could replicate the yo-yo tricks seeing as he felt they were easy peasy.
Curtis began playing with the yo-yo but got increasingly frustrated. He could neither duplicate none of the tricks his father pulled off earlier nor get the yo-yo to swing up and down harmoniously.
Curtis’ father got some satisfaction from watching his son’s frustration and lack of patience.
It’s obvious there are generational differences. What one generation might be very sleek at, another may find it challenging.
Obesity generational differences
In historical terms, obesity as a phenomenon has undergone such generational transformation. Obesity has become increasingly worse in this generation than it was generations earlier.
Just have a look at those black and white photographs from the 19th and the first half of the 20th century. You will notice something stark. You may have missed it. But I should remind you to pay attention next time you look at those black and white photographs.
What you will find is that; our great great gandparents were noticeably thinner compared to images on photographs today. Obesity rates were in the region of 2% in the time period I’m talking about.
What is the explanation for the obesity generational differences?
I believe the difference lies in what is now being described as NEAT.
What does NEAT energy expenditure mean?
NEAT refers to Non-Exercise Activity Thermogenesis. Long name, I know.
But its meaning can transform the way you look at obesity and it’s associated problems.
Losing fat doesn’t have to mean doing a lot outside of your routine physical activities.
Still wondering what Non-Exercise Activity Thermogenesis actually means?
Well, it’s any physical activity that you do in your everyday existence that is not deemed as voluntary workout.
So, as I type this article now, I am engaging in a NEAT energy expenditure. So is cooking, gardening, mowing the lawn, picking up the remote control, cleaning the house, vacuum cleaning the floor…
…mopping your kitchen floor, driving, walking around the mall shopping, climbing the stairs in your house or the office, talking to your boss, husband, wife, kids, scratching your head, running after the toddler, scrubbing your feet…you get the drift.
Any movement that you make that is outside of a regular work out is deemed as NEAT (non exercise activity thermogenesis).
Why is NEAT important?
These activities may look insignificant or minor at first glance, but they all add up over the course of the day and it is the cumulative effect of all of these activities that constitute Non-Exercise Activity Thermogenesis.
And the Thermogenesis refers to the calories we burn by virtue of these activities.
James A. Levine, MD, PhD, of the Division of Endocrinology, Diabetes, Metabolism, and Nutrition at Mayo Clinic Rochester, has been studying the concept of NEAT.
James is of the view that NEAT or the lack of it; is a huge contributor to the obesity epidemic in the US and does not think the blame lies squarely on the doorsteps of increased calorie intake only.
Dr Levine explains:
“Exercise is defined as ‘bodily exertion for the sake of developing and maintaining physical fitness,’ for example, participating in a sport or visiting the gym. The vast majority of the world’s population do not participate in exercise, as so defined, and for them, exercise activity thermogenesis is zero.
Even for the minority of people who do exercise, for most of them, exercise accounts for an energy expenditure of 100 calories per day. Thus, NEAT explains why an active person can expend 2,000 calories per day more than an inactive person of the same size.
NEAT is the energy expenditure of all physical activities other than volitional sport-ing-like exercise. NEAT includes all those activities that render us vibrant, unique, and independent beings.”
How do you burn calories everyday?
Perhaps this will be a good time to talk about how we burn calories daily as we lead our lives.
Energy expenditure (how we burn calories) is accounted for by 3 mechanisms:
Basal metabolic rate – 60%
Thermic effect of food – 10%
Activity Thermogenesis – 30%
Now let’s talk about all of the 3 ways we burn calories everyday.
Basal metabolic rate
What is basal metabolic rate? Basal metabolic rate is energy spent by basically being alive. If you are wondering how you burn calories doing absolutely nothing, well this how.
Your basal metabolic rate accounts for how you burn calories when we are sleeping. Yes, even we are asleep doing nothing at all, the metabolic processes going on in your body do use up energy to keep you alive.
When you are awake and doing nothing, you still burn calories through activities breathing, blinking your eyelids, talking, your heart beating etc. Involuntary activities that have to happen to keep us alive like your breating and heart beating use up energy whether we like it or not.
Energy expenditure from these involuntary activities and bodily functions constitute basal metabolic rate.
Thermic effect of food
Thermic effect of food is the energy used up by the process of food consumption to energy conversion i.e eating, digestion and food metabolism. It is a small fraction of energy expenditure and equates to only about 10%.
Activity thermogenesis makes up the rest of the energy expenditure. Activity thermogenesis constitutes 30% of the calories we burn everyday.
Activity thermogenesis is split up in 2 – Exercise and Non-Exercise Activity Thermogenesis.
Exercise activity thermogenesis is energy expenditure that occurs from voluntary aerobic and non-aerobic exercise undertaken by an individual.
Non-Exercise Activity Thermogenesis (NEAT) which is what we are discussing right here.
Non-Exercise Activity thermogenesis can be sub-divided into Occupational activity thermogenesis and Leisure activity thermogenesis.
Occupational activity thermogenesis (Occupational NEAT) is made up of all exercise activity related to what you do for a living. Exercise activity related to your job.
A post-man will have a higher occupational activity thermogenesis than an office worker who sits in front of a computer all day.
Same goes for someone who does agricultural work. Working in the fields ploughing, planting, harvesting will burn a lot more calories compared to the bank counter clerk.
Table below adapted from this study and published by the Mayo Clinic gives some idea of how NEAT from occupational activity may differ significantly between types of jobs.
Leisure activity thermogenesis (Leisure NEAT) is the energy you burn doing regular stuff in and around the house.
Without being offensive (people get offended easily these days, don’t they), I would hazard a guess that women will have a higher leisure activity thermogenesis than men in and around the house. Of course this wouldn’t be true across the board, I should add.
James Levine from his research believes that NEAT may vary as much as 2000 Calories per day between individuals. Lots of short little movements is what constitutes your NEAT (non exeercise activity thermogenesis).
Overweight people tend to have low NEAT and their slimmer cousins tend to have high NEAT (within reason).
Our great great grandparents definitely had very high NEAT(non exercise activity thermogenesis) compared to our current level of NEAT today.
Obesity is not a problem confined to the West as most people think. The nations of the Eastern hemisphere are having their own little battle of obesity.
China is having its own little crisis with obesity and an alarming increase in the rate of heart disease compared to the earlier periods of the 20th century.
Urbanisation and industrialisation are huge contributory factors. Availability of foods rich in processed foods complicated by a wave of sedentary lifestyle, both in the workplace and at home.
I talked about generational differences earlier on in this article. I strongly believe this is a factor in the obesity epidemic the world over.
We have become too sedentary in our lifestyles. Gone are the days when walking, for instance, was actually a necessity because there weren’t many cars as we have today.
Obesity is a serious problem in America. But the rates of obesity is proportionately worse amongst American Indians such that obesity prevention programs are now being targeted at children to save their future. Nice strategy!
“Over 80% of American Indian and Alaska Native adults are overweight or obese; about half of American Indian children are at an unhealthy weight; and it’s estimated 30% of American Indians and Alaska Natives have pre-diabetes. Compare those statistics to American adults in general, two-thirds of whom are overweight or obese, and 27% of whom are estimated to have pre-diabetes”
This is the same American Indians who had an obesity rate that was less than 2% when they were doing their thing before colonisation took place.
They farmed. They hunted. They made tools. They cooked. They made their own shelters. They even participated in warfare (not encouraged by this article).
The American Indians developed their own sports, the Native American Stickball, apparently not too dissimilar to Lacrosse. They were ingenious enough to use their developed games to settle scores between communities as a substitute to going to war.
Their agricultural practices were very basic. Totally unmechanised farming that required physical labour. The American Indian woman grew her own food whilst the men went hunting and fishing.
When it was time for harvest, they knew they will get abundance of berries, roots, fruits, mushrooms, nuts, and eggs.
They ate when food was available and did without when there was scarcity.
But in all of these, you will notice a consistent trend – a very high NEAT.
Having a high NEAT helps you keep energy balance negative. Weight increase is more likely when energy balance is in the positive realm.
What we can learn from the Amish Community.
The Old Order Amish community. The Amish shun modern conveniences. They probably see them as “evil”. Just like the American Indians used to do. Their farming methods remain labour-intensive.
The result – obesity rates amongst the Amish is still 4%. Even the Amish who have the obesity gene have managed to override it by just having a very high NEAT in their daily routines.
This study of the Old Order Amish showed Amish men complete an average of 18,425 steps a day and walked an average of 12-hour week whilst the women put in a shift of 14,196 daily steps with an average walking of 5.7 hours.
The average person in the Western hemisphere struggles to get in 4000 steps a day. Something surprising in that study is the Amish diet is not strictly healthy.
The Amish diet was neither low fat nor low carb.
More succinctly, the study stated “The Amish diet is typical of the pre-World War II rural diet. It includes meat, potatoes, gravy, eggs, vegetables, bread, pies, cakes, and is quite high in fat and refined sugar”
The men in the cohort had an obesity rate of 0%.
The Amish seem to be overriding their dietary indiscretions by ramping up their NEAT (non exercise activity thermogenesis) and it is working. They have obesity rate that puts the rest of the developed world to shame.
The conclusion from the study being that the high NEAT levels is the reason the Amish community have a low rate of obesity.
There is no doubt that communities with high NEAT routines do better in terms of obesity and its related complications like type 2 diabetes, heart disease, strokes and cancer.
With this knowledge to hand, you have no excuse now not to improve what I would describe as your NEAT ratings.
Simply increasing your NEAT (non exercise activity thermogenesis) routines will do a lot for your waistline. All of it could stem from Leisure non exercise activity thermogenesis (leisure NEAT) routines as well as Occupational non exercise activity thermogenesis (Occupational NEAT) routines.
Of course, if you add some formal workout to your NEAT (non exercise activity thermogenesis) routines, then you will ramp up the negativity of your energy balance.
Remember, this is all about increasing your energy expenditure thereby tilting your energy balance into a calorie deficit daily. Doing that on a daily basis is a surefire way of burning fat…
…even if you do not undertake formal exercise work out.
Holding that thought, what can you do to increase your NEAT?
How to increase non exercise activity thermogenesis
Increasing non exercise activity thermogenesis is not rocket science. All you need is a little imagination and creativity.
The non exercise activity thermogenesis examples below will give you some ideas about how to increase or boost your NEAT (non exercise activity thermogenesis) without trying too hard or embarking on a diet.
Doing your gardening a lot more vigorously.
Become keen to undertake doing the household chores – washing, ironing, vacuum cleaning, mopping the floor, cleaning the bathrooms. You don’t need a paid domestic cleaner!
Get a lightweight kettlebell or dumb bell like a 3-lb one and do a low-level no-sweat workout whilst watching TV.
Use the stairs at work. The higher the floor your office is, the more you will get from this non exercise activity thermogenesis example.
Wash the car yourself manually instead of using the automatic car wash.
Walk to post your letters instead of driving there.
Walk to do light shopping where all your shopping will fit into one bag instead of driving.
Walk to work if your office is within 5-mile radius to your residence. Doing this will give you a return mileage of 10 miles every working day. How cool is that.
Walk to the hair salon for your hair cut or hair grooming and back.
If you use public transport to work, how about coming off at least a mile or two before your usual bus stop. Do the same on your way back home. Come off the bus early.
Use the rake to gather leaves in the garden in autumn instead of using the leaf blower.
Install tools on your PC or Mac like exertime which forces you to exit your computer after pre-set intervals and do some physical activity which must be logged before you can resume your previous task.
Have an office re-design with treadmill desks where the tasks undertaken allows for this. It doesn’t have to be on every desk. Workers can elect to use those treadmill desks in turns, but they are there for everyone to use when they so please.
When you consider the fact that NEAT (non exercise activity thermogenesis) routines are activities that you do in between workouts which could be days apart, revving them up supplements whatever else you are doing to maintain your weight.
This is not about dieting. This is about doing little non-formal exercise things better. Amplifying your NEAT may not sound like much, but cumulatively it adds up and complements any fat burning measures you already have on the map.
All it takes is a little imagination and motivation to keep going and doing more.
If you ramp up your NEAT (non exercise activity thermogenesis), maybe you never have to worry too much about what you eat any longer…just like the Amish.
My cholesterol is high. Help! Should I worry about my high cholesterol? With all the conflicting messages on you tube, blogs, twitter and facebook, it’s not surprising that people get confused about cholesterol levels.
You go to your doctor who requests lipid profile on your behalf or you order some blood tests online (you know you can do that now, don’t you?). Results come back. And voilla, your cholesterol level is high and you are not sure what to do.
You’re confused. Worse still, your doctor is not giving you straight advice because he too is confused about the significance of high cholesterol.
Why is your doctor confused?
It’s because there’s so much conflicting medical publications out there that it just gets even more confusing for us in the medical world.
Well, relax. Because on this page I am going to try and clear the confusion for you. At the end of this article, you should know what to do. Hopefully feel more reassured too.
I will give you an explanation as to why some folks have heart attacks despite normal cholesterol levels. The last word on cholesterol on the basic level…
So, should I worry about my high cholesterol?
Good question. Now it’s not a straight Yes or No answer. It’s a little more nuanced than that.
It’s high cholesterol level concern a myth?
First of all, where’s the high cholesterol concern coming from. It’s mainly from the potential damage that high cholesterol can cause on the walls of our arteries.
The ultimate damage being atherosclerosis and plaque formation on the arteries. That’s the concern. And with heart disease and stroke causing so much deaths and disability, it makes sense to know what to do with your cholesterol numbers.
But that is not always an easy thing to do. In fact, it is a challenge in itself.
The Challenge of the Cholesterol confusion
Everyone is an expert these days. Even more worrying is everyone is an expert on cholesterol these days. That’s fine.
What is not fine is; how everyone is chest-puffing about how much they know about cholesterol. The cholesterol fight has become inextricably tied to the polarity of the diet world.
In one corner, we have the meat-lovers. These folks are transfixed on hovering up as many animal products as possible.
On the other corner are the vegans. Naturally, these are plant-based eaters. It’s just that veganism is an extreme form of plant eating.
What is clear is that in the majority of meat lovers, there seem to be a problem with their bodies handling cholesterol in one form or another. Either they have problems with Total cholesterol, or problems with LDL Cholesterol (the bad cholesterol) or even their triglycerides or a combination of those parameters.
The vegans on the other hand seem to do fairly well, within reason, that is. Because not all vegans are healthy eaters. There’s a perception out there that all vegans are healthy. Nope.
There are lots of unhealthy vegans about and some of them do have issues with cholesterol too.
Yes, both groups may end up with cholesterol issues but the meat lovers win hands down in the poor cholesterol performance stakes.
So, to defend their corner, the animal food loving Gurus tell their crowd not to worry about their cholesterol numbers. They reassure their followers that cholesterol does not cause heart disease or strokes. They should go to bed and sleep well. Nice!
The only group that seem to point out a cautious message to their followers are are the vegans. If your cholesterol numbers are abnormal, do something about it. Seems reasonable to me…
Obviously those in the middle between veganism and carnivorism would want to pay attention to that warning too.
But is it right to tell people not to worry about your cholesterol numbers? Would that be an ethical thing to do?
Some Cholesterol background information
Okay let’s delve into some background information regarding cholesterol because it will help us understand where we stand better.
The concern is; atherosclerosis, right? Yes, it is.
The truth is; there are many factors involved in the development of atherosclerosis. One of them is cholesterol. That should not be in question.
What is in question is whether cholesterol is there in the beginning, the orginator, an active participant or just there as a byestander. What’s cholesterol’s contribution to the development of atherosclerosis?
1.Not everyone with high cholesterol will develop atherosclerosis and consequent build up of plaque. Meaning not everyone with high cholesterol will suffer a heart attack and or a stroke.
2. On the flipside, people with life long very low cholesterol levels hardly develop plaques in their arteries leading to heart attack and strokes.
Those 2 facts do leave you with a conundrum, right?
Some Basic Cholesterol Biochemistry
Okay, let’s do some basic biochemistry as it relates to cholesterol.
Fats are insoluble in water. I’m sure you know that from your kitchen dealings already.
Unfortunately, blood is 90% water. But we need to move our cholesterol from one part of the body to another.
To do that knowing that cholesterol is fat and it wouldn’t dissolve in water i.e blood, then, we are going to need a transport system. We need a solution…fast.
Cue, Proteins. Hurray!
Yes, proteins are going help us move our cholesterol fats in blood from one place to another. Around the body, that is. Proteins are going to be the “taxi” that will ferry our cholesterol from one tissue to another. I like that.
These proteins are called carrier proteins. These proteins will be moving fats like Cholesterol, Triglycerides and Phospholipids around the body for us. Perfect.
So, the combination of Fat plus its carrier protein is called Lipoprotein.
And Lipoproteins are what’s going to interest us when it comes to cholesterol and it’s potential problems.
Why do the Lipoproteins interest us?
Here’s the reason why lipoproteins are significant to us. It’s because lipoproteins may have their greasy hands in the causation of these killer diseases.
Lipoproteins (remember they are a combination of fat and proteins) are the molecules that interact with the walls of our arteries to trigger a cascade of events that cause inflammation.
Finally, that word. Inflammation. I know you have been waiting to hear it. Or should I say, read it.
Yes, inflammation is what leads to atherosclerosis and subsequent plaque build up.
And lipoproteins carrying cholesterol are involved in that inflammatory process. Cholesterol is not alone in that inflammatory process. there other agents too – white blood cells, macrophages, inflammatory mediators, platelets, T-cells etc.
Where opinion is divided is whether the presence of the cholesterol kicks the whole inflammatory process off or cholesterol comes in later on in the process.
Some other people believe in theory that, there some microtears or physical injury that occur on the arterial wall and cholesterol latches on to the tears and it all kicks off after that.
Yet, there are also the animal lovers who believe that just because cholesterol is there doesn’t mean it was involved. These folks believe cholesterol is just a byestander in that ‘scene of crime’. Interesting concept, huh?
It is these individuals that will tell you not to worry about your cholesterol numbers. Because cholesterol is an innocent byestander. Of course they hold on to the argument that not veryone with high cholesterol ends up having a heart attack or stroke.
That’s true but they are mistaken and I shall give you an explanation as to why shortly.
Back To Cholesterol Biochemistry
Okay, I went off on a tangent there. But an important one, you have to admit.
So, where was I? Oh, yes, I was talking about Lipoproteins.
You know 2 of them already because we never stop talking about them. There are actually 5 different types of lipoproteins. And they are:
High Density Lipoprotein (HDL cholesterol) – The Good cholesterol
Low Density Lipoprotein (LDL cholesterol) – The Bad cholesterol
Intermediate Density Lipoprotein
Very Low Density Lipoprotein (VLDL cholesterol) – carries Triglycerides
The 2 most popular ones are the bad cholesterol (LDL cholesterol) and the good cholesterol (HDL cholesterol). Popular because everyone keeps talking about them. That’s a good thing because the awareness is there.
Of the other 3 lipoproteins that aren’t so popular, the most important one is the VLDL cholesterol. You can ignore the chylomicrons and intermediate density lipoproteins because they aren’t so important clinically.
But VLDL cholesterol is one you need to be familiar with because this is the lipoprotein that carries triglyceride fats. And this is very important.
As for the HDL cholesterol, the so-called Good Cholesterol, it is named that for a reason. The HDL cholesterol is a scavenger cholesterol. It carts away cholesterol from the walls of our arteries. Takes it to the liver for processing and possible excretion.
So, what cholesterol should you worry about?
Now that we are done with our basic knowledge of cholesterol and their carrier proteins. Let’s turn our attention to the cholesterol that should concern you and your health.
Should you worry about your cholesterol numbers?
Here’s the truth.
Your total cholesterol (the sum total of your cholesterol parameters) only gives you an overview of your cholesterol status. It is okay to look at this cholesterol figure but note this:
Your total cholesterol is a poor predictor of your risk of having a heart attack or stroke. High or Low Total cholesterol doesn’t mean a lot in terms of predicting if you are at risk of a heart attack or stroke.
So, if your total cholesterol doesn’t tell you a lot, what does?
How about we talk about the bad cholesterol i.e LDL cholesterol. They don’t call it “bad” for nothing.
This one is important but even then LDL cholesterol is only important up to a point. What do I mean by that? I’ll tell you now.
Does Cholesterol size matter?
Oh yes, the old well worn out debate. Does size really matter? Actually it does when it comes to LDL cholesterol. Cholesterol particle size matters…a lot.
Here is the thing:
LDL cholesterol comes in 2 different sizes – Large particle LDL cholesterol and Small particle LDL cholesterol.
The large particle LDL cholesterol is fluffy and cotton wool-like whilst the small particle LDL cholesterol is dense.
Studies have shown that the small dense particle LDL cholesterol is one cholesterol to worry about. Because people whose cholesterol is predominantly small particle dense cholesterol are 3 times more likely to have Coronary Heart Disease.
And guess what. There’s a suggestion that the large particle LDL cholesterol could be protective of Coronary Heart Disease. Are you following?
So, LDL cholesterol can be harmful or beneficial at the same time. But which way it swings depends largely on whether you have a predominance of small particle LDL or large particle LDL.
The predictive value of LDL cholesterol giving a heart attack or stroke is poor unless you break it down to small or large particle. Makes sense?
Can I have a heart attack with normal Cholesterol numbers?
Answer to that question: Yes, you can.
Let me explain:
The reason some people with normal Total cholesterol and normal LDL cholesterol numbers end up having a heart attack is because of the their small particle dense cholesterol concentration.
Oh yes. You can have a normal range of bad cholesterol but if within that normal range, you have a relatively high small dense LDL cholesterol, your risk of a heart attack goes through the roof.
If your risk is high (and you do nothing about it), then it is a question of ‘when’ not ‘if’.
Does that explain why that happens and tends to make people feel bewildered when it happens.
It’s all about how much small dense LDL cholesterol you have. That matters a huge deal.
How about that Pesky VLDL cholesterol?
Should you worry about your VLDL cholesterol?
I’m glad you asked.
Yes, that VLDL cholesterol (remember it carries the Triglycerides) is another cholesterol that should concern us. Why?
The reason is this:
High Triglycerides levels in your blood correlates with a high Small particle dense LDL cholesterol. In the same vein, low levels of Triglycerides floating around correlates with high levels of large fluffy LDL cholesterol.
Meaning your blood Triglyceride level can be a window to knowing your small particle LDL or large particle LDL cholesterol status. Especially in individuals who cannot access Lipoprotein Sub-fraction testing which I shall be talking about shortly.
So, what should you do if you are worried about your cholesterol numbers?
Here’s what you need to do if your cholesterol numbers on the standard lipid panel come back as abnormal.
Do not worry too much about your Total cholesterol number. Poor predictor, remember?
Look at the LDL cholesterol and the Triglycerides. If they are abnormal, request lipoproetin sub-fraction testing from your doctor. It’s called LDL-P testing. Whilst you are at it, also ask for Apolipoprotein B.
LDL-P and Apolipoprotein B are better predictors of your risk of coronary heart disease or stroke. They are way better markers than your LDL cholesterol alone.
Remember LDL cholesterol number is just the total concentration of cholesterol in the LDL. It does not tell you the differential particle concentration within the LDL molecule. That’s why sub-fraction testing which breaks down the particle concentration is the way to go.
Of course, if you want to take things to the next level, then Calcium scanning of your coronary arteries will be a reasonable step too.
Having said that, I also know that there are readers of this article who may not have access to those specialised tests either for reason of cost or test availability in their locality.
If you are one of those people, then you should take your VLDL cholesterol result on the standard lipid panel seriously because of it’s correlation with small particle LDL.
Also in the absence of specialised subfraction testing, you should assume your risk of heart disease to be high if your LDL cholesterol is high especially if your Triglyceride is high too.
Can I have the LDL-P Reference range?
To round up, I feel I should let you have a reference range for LDL-P testing if you can access the test through your doctor.
Remember, we are using this test to assess our risk of heart disease and or stroke. So it makes sense to know what the result you get back means.
Here’s how to interprete your LDL-P result:
<1000 – Your Risk is Low 1000-1299 – Your Risk is Moderate 1300-1599 – Your Risk is Borderline High >1600 – Your Risk is High, Buddy.
Now how was that. I told you this was going to be your last word on your cholesterol concerns. Did I deliver on that promise? Let me know below please…if you can.
There’s always a surprise around the corner when it comes to our health. Insulin resistance and high blood pressure is one. Is there a relationship between insulin resistance and high blood pressure?
Okay, let’s get direct. Does insulin resistance cause high blood pressure? Let’s explore that question on this page. This is very important because it constitutes part of the spectrum of the metabolic syndrome. A syndrome that is making us sick the world over. Worse in the Western hemisphere.
So, does insulin resistance cause high blood pressure?
The simple answer to that question is: Yes, insulin resistance does cause high blood pressure. In fact, the relationship is so strong that some scientists now believe that what we call ‘Essential Hypertension’ should no longer be called that.
Because we now have a cause for that high blood pressure of indeterminate origin. Insulin resistance. In case you didn’t know, essential hypertension is hypertension (high blood pressure) for which there’s no known cause.
But now we know essential hypertension is not neccessarily without a cause. It has a cause that has been missed all of these years. Insulin resistance is the cause of most essential hypertension cases.
If you have any doubt, ask your doctor the next time you visit him/her, if most people with type 2 diabetes also have high blood pressure. Your doctor will probably smile at you and will answer in the affirmative.
Yes, a relationship exists between hypertension and glucose intolerance without doubt.
What’s the background to insulin resistance and high blood pressure relationship?
Here’s the background.
The first thing to remember is that when you have insulin resistance, your insulin levels in the blood are going to be persistantly high. The reason is that your pancreas will keep pumping insulin into circulation to overcome the resistance of the cells to respond to insulin action.
Insulin’s primary job is to drive glucose out of the blood circulation into the cells of our body where the glucose is needed for energy production. In insulin resistance, the insulin receptors which are the “doorman” guarding glucose entry into the cells become desensitized.
Once desensitized, they are no longer responsive to signals to let glucose into the cells. The result is high blood glucose levels. This triggers further release of insulin from the pancreas as a compensatory mechanism. The idea being to lower blood glucose levels at all cost.
And because the insulin receptors on the cells are not “listening” to these signals, the result is higher and higher levels of insulin in the blood circulation. A sort of reactive hyperinsulinemia, if you like.
Imagine the pancreas as a pump station. It will keep pumping insulin until the blood sugar levels drop. Unfortunately those high levels of insulin in the blood circulation through a cascade of events result in high blood pressure.
This study was able to reproduce the effect of insulin on blood pressure when it observed a rise in blood pressure in patients commenced on insulin therapy. Meaning the presence of insulin through insulin shots is enough to trigger a rise in blood pressure.
There’s even a suggestion that high insulin levels especially high fasting insulin levels play a huge role in the development of high blood pressure independent of weight.
Highlight: Insulin resistance always carries the inescapable misfortune of elevated insulin levels (hyperinsulinemia). It is the hyperinsulinemia that forms the bedrock of the unhealthy relationship between insulin resistance and high blood pressure.
So, how does insulin resistance cause high blood pressure?
There are 3 possible mechanisms. And they are all related to the high insulin levels.
Mechanism #1 – Insulin resistance and the autonomic nervous system
The first is that; high insulin levels in blood drives sympathetic activity. If you have high blood pressure, the last thing you want is high sympathetic activity of your autonomous nervous system. Not good.
The sympathetic nervous system raises blood pressure. That’s a direct response and is bad for your health. Someone with high blood pressure should be hankering for what I decsribe as ‘Parasympathetic Domination‘.
For instance, if you were confronted by a lion. The sympathetic nervous system will automatically take control. It is needed in that instance to protect you. For self-preservation, if you like. It automatically prepares you for the ‘Fight or Flight response‘.
But there are other instances where the action of the sympathetic become undesirable. High blood pressure is one of them. With high blood pressure, the parasympathetic nervous system is a better friend to you.
Highlight: The pressor effect exerted through the sympathetic nervous system narrows your blood vessels mainly the arteries resulting in higher blood pressure. Not good!
Mechanism #2 – Insulin resistance and the kidney effect
High insulin levels has an effect on what happens in your kideneys as urine is being formed. Normally the kidneys have a fine balancing act where they control how much Sodium is retained in the body and how much is expelled out of the body through urine.
This fine balancing act is influenced by a couple of substances in particular Aldosterone. This is done through a well co-ordinated system called the Renin-Angiotensin-Aldosterone System (RAAS).
But it would appear that when insulin levels are high, insulin gets in on the action too. Insulin influences what happens in the kidneys at high levels.
What does insulin do in the kidneys?
Insulin levels when high, facilitates retention of sodium in the body through the RAAS.
The overriding influence of insulin on the Renin-Angiotensin-Aldosterone (RAAS) is extensively reviewed here and here.
In fact, the relationship between insulin resistance and high blood pressure is so close that the class of blood pressure medications called ACE inhibitors like Lisinopril, Ramipril and the ARB medications like Valsartan, Losartan, Candesartan are thought to actually improve insulin sensitivity.
Mainly because those class of medications block the RAAS mechanism at various points which in turn reduces the influence of insulin.
This the second mechanism through which insulin resistance causes high blood pressure.
Highlight: The net effect of sodium and water retention in the body is high blood pressure.
Mechanism #3 – Insulin resistance and your arteries
Persistent high insulin levels almost ineveitably leads to lipid dysfunction. Dyslipidemia is one of the hallmarks of metabolic syndrome.
Why is this?
Quite simply; insulin is a fat storing hormone. Insulin facilitates the storing of fat both viscerally and underneath the skin too. Along with that is the elevation of triglycerides and LDL cholesterol.
Over time, high lvels of LDL cholesterol (the bad cholesterol) and triglycerides, results in hardening of arteries. When arteries are hardened, they become inelastic.
If your arteries are in elastic, they are less stretchy, less relaxed. Blood pressure goes up because of the inelasticity. Obviously if the situation is allowed to prgoress unchecked, plaques will form in the arteries making the situation worse.
Highlight: High insulin level is bad for the health of the walls of your arteries. Insulin is in fact, atherogenic.
What should you do?
As I stated in the video above, if you have high blood pressure, it makes sense to screen yourself for insulin resistance. The relation between insulin resistance and high blood pressure is so strong that screening yourself is best thing you can do for your health.
You should assume that if you have high blood pressure, then you probably have insulin resistance until proven otherwise. Act on the basis of that premise.
Ideally you would want to check your blood fasting insulin levels but such a test is beyond the reach of most of us.
So the best alternative is to check your fasting blood sugar levels. It’s very simple to do. All you need is a blood sugar monitor.
One of the queries I get often on this blog is: does drinking water reduce blood pressure? If we flip that question on its head, the question can be framed differently.
What will that be? It will be: does dehydration affect blood pressure?
I shall answer both questions for you on this page and you shall know the truth regarding water and blood pressure reduction.
Plus, you also get to know briefly the importance of water to our bodies, why we need water, how much water to drink and the effect of over-consumption of water on blood pressure too.
And you get my recommendation on the best drink for high blood pressure.
The way I am going to approach the subject is this. I will discuss the effect of dehydration on blood pressure first, then talk about how drinking water (rehydration) affects your blood pressure afterwards.
Kinda make sense to do it that way.
But if you’re in a hurry and only want to know if drinking water reduces blood pressure, then you can scroll towards the later part of this article for an answer straightaway.
Using water as a blood pressure remedy can seem a little far fetched but there’s some truth in it, within reason.
I know that some people do take it a little too far. I have read some people claim that drinking just water only without any medications whatsoever lowered their blood pressure and now they live life happily ever after.
We live in a world where anyone can make any claim regarding anything. This is worse online. After all, people make all sorts of claims about diabetes and cancer online. These claims range from the sublime to the ridiculous.
So, it’s not surprising we have people making ridiculous claims about blood pressure treatment at home…and even low blood pressure.
Before I delve into the possibility of dehydration causing high blood pressure and the fact that drinking water is one way you can lower your blood pressure naturally, let’s talk about the importance of water to our bodies briefly first.
How important is water to our bodies?
Well, make no mistake about it. Water is very important to our very survival. Without water we won’t be here on this planet.
This is exemplified in the fact that the average adult body is made up of 55 – 60% water. Babies have even more water content in their bodies. Babies are made up of 75% water until they are 1 year old when their water content drops to 65%.
Water plays a huge role in our bodies. From joint lubrication to keeping our brain well hydrated. Your brain is 75% water, believe it or not. Our brains have the same amount of water as you’ll find in ripe bananas. Our lungs are to a large extent a wet organ too.
Let’s not forget body temperature regulation. Water plays a major role in heat generation for our bodies. In fact, without water, there will be metabolic mayhem in our bodies. Undoubtedly so.
Why do we need to drink water daily?
We need to drink water daily because some of our body functions mean we lose water every day. We lose water through urine. We lose water through bowel movement. We lose water through sweat. We lose water through our breathe.
All of that water loss needs to be replaced.
If we fail to replace the water lost through those bodily functions, dehydration will result. But there has to be a fine balance between how much we are losing and how much we replace.
This fine balance prevents dehydration and over-hydration. Both over-hydration and dehydration are bad for our health.
Indeed, too much water in the body from over-hydration is just as bad for our blood pressure as dehydration is.
So, does dehydration affect blood pressure?
Yes, it does. And dehydration does affect blood pressure through 3 different mechanisms. Dehydration is a potent trigger for a whole host of metabolic events.
Let’s just talk about hormonal events that occur when you are dehydrated. Because this is how dehydration can affect your blood pressure.
The 1st Dehydration-BP Elevation Mechanism
Dehydration leads to renin secretion. Renin is an enzyme produced in the kidneys in response to low blood volume or low salt levels in the blood.
When renin is released, it triggers the conversion of another pro-enzyme called angiotensinogen to angiotensin 1.
A chain of events follows. I don’t want to bore you with the details. All you need to know is that; the end result of that chain of events is the production of another hormone called aldosterone.
The job of aldosterone is to conserve the mineral called sodium. Of course, wherever there’s sodium, water follows. Aldosterone raises blood pressure as a result.
Aldosterone raises blood pressure by preventing the kidneys from losing sodium in urine. Conserve as much sodium as possible.
And because water follows the sodium saved by the aldosterone (don’t forget that sodium is salt), our blood pressure gets elevated when we are dehydrated.
Blood pressure rises when salt and water are retained in the body.
This chain of events caused by dehydration is initiated by renin. In fact, this research tells us a 24-hour episode of dehydration induced a 3-fold increase in renin activity in the body.
That’s the power of water deprivation with a ripple effect on our blood pressure. That’s one mechanism.
The 2nd Dehydration-BP Elevation Mechanism
A second mechanism of how dehydration can affect our blood pressure is via another hormone called Anti Diuretic Hormone (ADH).
ADH is released from the hypothalamus in our brain when dehydration signals are received by the brain.
Anti Diuretic hormone as the name implies stops you losing water in urine. Meaning ADH will concentrate your urine to conserve water in the body.
By reducing the amount of urine excreted by the kidneys, blood volume increases and blood pressure rises as a conseqence. This is a protective mechanism to prevent the fatal consequences of dehydration on your body.
This action in turn will elevate your blood pressure too.
The 3rd Dehydration-BP Elevation Mechanism
There’s a 3rd mechanism through which dehydration elevates your blood pressure. It involves a direct effect on the tiny vessels we call capillaries.
Dehydration causes these capillaries to “narrow up”. When these tiny vessels become narrow, the pressure inside them rises causing a blood pressure elevation.
So, whereas initially dehydration leads to a lower blood pressure, compensatory mechanisms move things in the opposite direction leading to high blood pressure.
That’s how our body protects itself from harm caused by dehydration.
So, does drinking water reduce high blood pressure?
Yes, drinking water does reduce high blood pressure but with a caveat. You only need to drink what your body requires for the effect of water on blood pressure to be within the safe margins.
You just need to stay well hydrated. Nothing more.
The reason water does cause a reduction in blood pressure is the reverse of the events I discussed above.
Staying well hydrated by drinking plain water, mineral water or decaffeinated tea means you suppress renin release. Inhibiting the release of renin means you avoid elevated aldosterone levels.
Remember I said, aldosterone causes blood pressure elevation, so we don’t want to trigger its release.
We also want to suppress Anti Diuretic Hormone release by drinking enough.
Drinking enough water staves off those hormonal events that lead to blood pressure rise. Meaning drinking adequate water helps us lower high blood pressure naturally.
The effect of drinking water to lower or reduce blood pressure may not be as dramatic as eating foods that lower blood pressure quickly, but it helps a great deal.
What about over-hydration…
Does drinking too much water cause high blood pressure?
If you remember, I did say, to use water as a natural blood pressure remedy, you only need to drink enough to stay well hydrated.
This means you don’t need to go over-board because drinking too much water can actually cause high blood pressure.
It’s got to be finely balanced.
What’s the fine balance?
How much water should I drink a day?
Well, conventional teaching has always been that we should aim to drink 8 glasses of 8-oz glass per day.
But that advice is changing.
The amount of water we need to drink a day largely depends on our weight and our environment.
The recommended daily water intake does vary but it ranges from 2.5 liters – 3.7 liters for men and between 2 liters – 2.8 liters for women.
Obviously, that recommended daily water intake is not set in stone. Our daily water intake can be dialled up or down depending on how healthy we are, how old we are, how active we are and how hot the environment we are located is.
So, drink enough water or decaffeinated beverage like tea or mineral water or even coconut water to stay hydrated but don’t overdo it.
Because when you drink too much water especially within a short time interval, you can cause salt dilution in the body.
Does coffee break a fast? A very good question. Some people just cannot get on with their day, if it doesn’t start with a regular morning routine that includes a coffee drink. That’s a habit of a lifetime for them and it’s pretty hard for them to change it.
And with all the rave about intermittent fasting as one of the healthiest things you can do for your health, you don’t want to miss out. You know the drill. Fear of missing out (FOMO). So you join in the fun of intermittent fasting.
Now you have a clash of concepts in your hands. I’m supposed to be fasting and I like my coffee. How do I marry the two ideas. Hence, you have to ask the all-important question; does coffee break intermittent fasting?
If you go on this wonderful platform we call the internet to research this, all you get is conflicting opinions and views.
The Plan – What You’ll Get On This Page
You needn’t worry, because you have just landed on the right page where you’ll get the low-down on:
The effect of plain black coffee on intermittent fasting and the effect of bulletproof coffee on fasting (water fast and dry fast). Plain black coffee and bulletproof coffee affect fasting differently. You’ll get to know this.
The science, the effect of coffee on insulin, coffee effect on ketosis, coffee effect on autophagy, ampkenzyme and of course that will include bulletproof coffee as well.
Not forgetting how coffee with cream, stevia, dairy milk, nut milk affects fasting.
Plus, you get my suggested approach to using coffee during your fast.
I’ll clear the confusion for you. You’re going to love this.
First things first…
It makes sense to want to know ‘what a fast is’ and why you’re fasting. Kinda makes sense, right?
“Fasting is the willing abstinence or reduction from some or all food, drink, or both, for a period of time. An absolute fast or dry fasting is normally defined as abstinence from all food and liquid for a defined period”
So, the fact that you are thinking of drinking coffee in the morning or any time for that matter, during your fast means you are not doing a Dry Fast. Because a dry fast means nothing goes through your mouth. Nothing!
If you are doing a dry fast, and you drink coffee, that means you have broken your fast. Period.
The fact that drinking coffee does break a dry fast is not debatable. Right?
I’m glad we cleared that up…quickly. Now, let’s move on.
What about the more Popular Water Fast and coffee?
Okay, not everyone is suited to a dry fast. I love doing it. You may not.
So, if you’re not doing a dry fast, then you are most certainly doing a Water Fast, right?
And that’s where the question then pops up; does coffee ruin a water fast?
Let’s talk about coffee and water fast then. Because water fast is what we are doing, if we are even considering a coffee drink at all.
Does Coffee break a fast?
As usual with these things, it’s not a straight ‘Yes and No’ answer.
Because coffee comes in various “shapes and sizes”. Not the size of the cup or the shape of the cup. No, not that. I mean coffee is prepared in different ways.
More ways than you can imagine. In fact, I saw an ad the other day on facebook about ‘CBD oil with coffee’. Wow. If that’s not a contradiction in terms, I don’t know what is. But I digress there.
The answer as to whether drinking coffee will ruin your water fast will depend on what type of coffee. I know you are thinking, isn’t coffee just coffee?
Not quite. Because you can have coffee with cream, bulletproof coffee, plain black coffee without sugar or cream or milk, coffee with stevia, coffee with almond milk, coffee with collagen, coffee with monk fruit extract etc. And that’s just a tip of the iceberg when it comes to coffee preps.
Truth be told:
If you are having coffee with any other food added to it, You Are Breaking Your Fast. A true water fast is water only. Drinking anything else muddles the water (no pun intended).
The argument is whether having plain black coffee with nothing else in it breaks your fast or not. And we shall come to that in a minute.
Before then, let me talk about Bulletproof coffee and fasting.
Does Bulletproof Coffee break a fast?
It’s funny how we can try and msucle an argument over simple things just to suit our personal circumstances and sometimes to suit our pocket. Beware of commercial intentions behind what advice you are given.
Listening to podcasts about bulletproof coffee, tea break, calories, fats, ketones and healthy living, it’s amazing how we are are even debating if bulletproof coffee breaks a fast or not. Because it’s not debatable…at all. Remember our definition of a fast?
It’s funny that commercial interest will drive a debate in a direction that wants to make you scream at your smart phone or laptop device.
If you want to know the answer to the relationship between bulletproof coffee and fasting. Here it is.
Bulletproof coffee will break your fast. Period.
You can use bulletproof coffee to boost your fitness results if you want to. Nothing wrong with that. In fact, I encourage it. But just know that bulletproof coffee with break your intermittent fasting.
Why is this?
Okay, let’s look at what’s in a bulletproof coffee first of all. In fact, let’s make a cup of bulletproof coffee whilst we are at it.
How to make a bulletproof coffee
Here’s how you make 1 cup of bulletproof coffee
Scoop 2 ½ heaping tablespoons of freshly ground Amazonian Coffee Beans made with a French Press. This preserves beneficial coffee oils that paper filters tend to sieve off.
You add 1 – 2 tablespoons of Brain Octane Oil.You may use other Medium-chain triglyceride oils like Coconut oil instead.
Then add 1-2 tablespoons of grass-fed, unsalted butter or grass-fed ghee butter. Ensure the butter is unsalted. The last thing you want is Salty coffee. Not nice!
Then blend all of these mixture for about 30 seconds or thereabout. Stop the blender when you have a foamy latte.
This is how you make a lovely, creamy coffee that will send your energy stores through the roof. Think endurance.
So, you have 1 – 2 tablespoons of Brain Octane oil fetching 125 – 250 calories and the butter bringing another 100 – 200 calories making a total of 225 – 450 calories. This is liquid food, by all accounts.
Liquid food like Bulletproof coffee breaks your fast
If you are consuming anything with calories in it, you’re by definition breaking your fast. It’s that simple.
We can argue as to whether consuming bulletproof coffee is a good thing or bad thing, and I’ll clarify that in a minute. But what’s not up for argument is; if bulletproof coffee breaks your fast or not.
Because let it be known here; bulletproof coffee breaks your fast. It sure does.
If you’re potentially consuming those amounts of calories in bulletproof coffee, then you’re techically eating and indeed you are breaking your fast.
I think the question we should be answering is; does it matter at all that you break your fast with bulletproof coffee?
What about Collagen and fasting?
Before I get to that, let me quickly answer the question, does collagen break my fast? If you want to know if collagen will break your fast or not, the answer is; yes, it will.
Collagen will break your fast because it is protein and it contains calories. In fact, 1 gm of Collagen powder will furnish you with 4 Calories.
Hence, if you consume collagen during your fast, you are also technically eating. Because you are consuming calories. Fasting should be a calorie-free endeavour. Adding collagen powder to any drink would mean you are administering calories during your fast.
What about coffee with cream, dairy milk and Nut milk and fasting?
The same thing applies to having your coffee with cream or dairy milk or any nut milk like almond milk. If you consume coffee with cream, dairy milk, almond milk, hazelnut milk, hemp milk, cashew nut milk, goat milk, you are breaking your fast for the same afore-mentioned reason.
No, plain black coffee without any added sugar does not break your fast. Indeed, you may even add a calorie-free sweetner as stated above, if you like and you still will not break your intermittent fasting schedule with black coffee.
The reason is; plain black coffee has no calories. It might have some influence on insulin but that effect is sub-clinical, so long as you don’t have added sugar, added cream, added nut milk or added dairy milk.
Plain black coffee will not stimulate insulin secretion significant enough to blunt the hormonal benefits of intermittent fasting.
So, does breaking your fast with Coffee really matter?
Let’s start with bulletproof coffee. One reason bulletproof coffee became popular and indeed the reason we are talking about it now is because of Dave Asprey.
He was hiking in the Tibet mountainous regions and he was served coffee with Yak butter during his hiking escapades.
He noticed that he could hike for longer, his endurance was so much better and he wasn’t hungry for hours on end. He felt so much better and naturally when he got back home, he publicized this discovery and here we are.
We’re talking about bulletproof coffee as a standalone concept in fitness. Thanks to that serendipity.
The point is, yes, you’ll break your fast with bulletproof coffee but the fitness benefits are so much more.
You would fast for longer because the fat in the coffee keeps hunger at bay and you’ll still burn fat. Indeed, the longer you fast, the more the benefits especially when it comes to autophagy.
Fat does not stimulate insulin much, so that effect is negligible. And if you are already deep in ketosis, bulletproof coffee will not kick you out of ketosis. You should be fine staying in ketosis with bulletproof coffee.
Some people will argue that you’ll burn more fat if you didn’t have the bulletproof coffee at all. That may be true but there’s a way around that that I’ll tell you shortly.
What about coffee effect on AMPK enzyme?
Well in case you don’t know about AMPK, it is Adenosine monophosphate-activated protein kinase (AMPK). This is an enzyme you want to upregulate if you want to burn fat.
AMPK promotes fat burning whilst inhibiting fat storage. The good news is that the caffeine in coffee actually upregulates this enzyme which works in your favour. It not only does that. The caffeine in coffee is also involved in repair activities like blood vessel wall damage repair through this AMPK enzyme.
Chlorogenic acid in Coffee does what?
Coffee is one food that has chlorogenic acid in it. Guess what chlorogenic acid does?
By the way, chlorogenic acid is also found in caffeinated tea.
Will Coffee affect Autophagy?
Did you know that we all have cancer cells in our bodies every now and again. The reason these cancer cells don’t progress is because of the process called autophagy.
Autophagy is a physiological process whereby our bodies eat up these ‘bad, disordered cells’ that potentially can lead to cancer. This is what this scientific paper that confirmed coffee does promote autophagy in mice said about autophagy.
“Autophagy preferentially targets damaged macromolecules (such as unfolded and aggregated proteins) and organelles (such as dysfunctional mitochondria), it contributes to ridding the cytoplasm of aged structures and hence potentially “rejuvenates” non-nuclear portions of the cell”
That quote above might be too geeky for you but the take home message from that research is that coffee does not interfere with Autophagy. This is good news because autophagy is one of the selling points of intermittent fasting.
It will be a tragedy if drinking coffee inhibited autophagy. I particularly love this because it means drinking coffee will not ruin a water fast.
What about coffee effect on insulin?
Opinion is divided as far as the effect of coffee on insulin and insulin sensitivity is concerned. This paper talks about that.
Looking at all the research, it is clear that there may a short-term reduction in insulin sensitivity when you take coffee. But that may not matter much if tissues like your brain that prefer to use glucose as its energy source metabolize the glucose quickly.
I know this is always a concern for individuals on the ketogenic diet doing intermittent fasting as part of the ‘package’. Well be rest assured that drinking coffee (even bulletproof coffee) will not kick you out of ketosis.
Why, because caffeine in coffee actually increases plasma ketones. So, rather than worry about possible negative effect of caffeine in coffee or tea on ketone production, you should celebrate it because the opposite is true.
This reasearch tells us that caffeine drunk at breakfast actually stimulated ketone production by a whopping 88%. Nice!
What I suggest you do:
Use your coffee if you want to regardless of the fact that you are doing intermittent fasting. Don’t let it bother you.
If you are so concerned about any negative effect, be reassured by what you have read here on this page. I am telling you that it is okay to drink coffee while fasting.
==> Use black coffee if you are still dubious about it. Do not add any other ingredient, although a calorie-free sweetner should not cause any disruption to your fasting plans.
==> If you want to use bulletproof coffee, you may want to delay it until the last hour before your workout. That way any calories arising from using the bulletproof coffee will be used up during your workout. Cool!
Remember, Dave Asprey who “invented” bulletproof coffee used to drink it and then go for his energy-sapping hikes. He didn’t drink it and went sedentary. He moved…a lot. He didn’t sit around doing very little.
Hence, I will recommend you do the same and you shouldn’t have to worry about the calories in bulletproof coffee. Not one bit should you be worried if you adopted this approach.
Let me know what you think about this piece. Have I done justice to this all-important topic. Please leave your comments below. I’ll appreciate it.
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