Blog Archive

The Holiday season is a challenging time to hit all your targets when it comes to good nutrition, regular exercise, quality sleep, and stress management. You can set your self up to be ahead of your usual January state by practicing the skill of "getting back on track quickly." Picture...

Holiday stress is common and likely impossible to avoid altogether. However, a few strategies could help to effectively reduce your stress this Holiday season, leaving you with more time and energy to experience the joy and happiness. First, think about stress like a teakettle on the stove with the temperature...

The Holidays are meant to be wonderful, but they can also be filled with challenges! From difficult family members to long periods of darkness and cold, to challenging food environments, the Holidays are one of the harder times of the year to keep on track with your good intentions for...

"Elevate Food Quality." This is one of the tenets of improving your nutrition. I thought I'd share a short video (8 min) discussing two interesting studies that show us the importance of food quality. To watch, click here. Nutrition for prediabetes shouldn't be hard. Yet we live in a world and we...

Your body has the amazing ability to take in, store, regulate, and burn energy to keep all of its systems functioning. It does this in the "fed state" when calories are entering the system, in the "fasting state" when no calories are coming in, and even in the "exercise state"...

Non-alcholic fatty liver disease (NAFLD) occurs when excess fat accumlates in the liver in the absence of high alcohol intake. NAFLD is on the rise in the population, affecting 30% of adults worldwide, and 55% of people with type 2 diabetes. Why it happens: As we consume excess energy and...

When setting health goals, wouldn't it be great if you could see the future? What if you could know in advance where problems would arise so you could focus your efforts on reducing your risk for those issues that would cause future suffering? You could then save time and energy by not...

Healthcare tends to be reactive. What is hurting now? What's out of kilter? What ability has been lost or taken away? Go get that fixed. Getting broken things fixed is how our healthcare system was built, and it's actually pretty good at helping if you have an acute problem like...

I think medications are misunderstood. Of course no one wants to take medicines, and I admit that healthcare should do a way better job of incorporating non-medical approaches into treatment whenever possible. However, medications can be powerful tools to help you achieve your health goals.  The web defines a tool as  an...

When striving for good nutrition, a majority of people focus on what not to eat. While limiting added sugars, refined grains, and highly-processed food will be helpful, this focus leaves many folks feeling stressed as they focus on abstinence. An complimentary approach is to focus on "getting the good stuff in" rather...

One reason it is difficult to maintain good, healthy habits over the long term is that there are no immediate consequences for straying from your desired path. Skipping a workout or eating the extra dessert might feel good right now, and it may be years or even decades before the "pain"...

The Fogg Behavior Model is a powerful framework for understanding behavior. Why is it that even though we know the "right thing to do" we often struggle to follow through. (It's all of us, not just you :) Understanding the model:The Fogg Behavior Model, created by behavior scientist Dr. BJ...

Two kinds of care exist in healthcare - scripted and unscripted care.  Some treatments, like hip replacement, occur after a diagnosis has been made and getting the best result is facilitated by systems that ensure all the necessary steps are taken and are of high quality. You need to get...

Personalized medicine (PM) is a powerful tool for the future. While there are varying definitions for PM, I'll be discussing the use of a person's genetic code or other biological markers to tailor treatment to that person. In a personal example, there is a strong family history of dementia in my...

As you make progress, you can look at how far you have to go to reach your goal (the gap), or you can look at how far you've come since you started (the gain). If you're like most people, you naturally focus more easily on the gap and not the gain....

Adiposity-based chronic disease (ABCD) arises from obesity, and represents a complex, chronic illness with multiple causitive factors - genetics and epigenetics, dietary choices, activity level, medications, sleep quality, etc. Conditions associated with ABCD include high blood pressure, abnormal cholesterol/lipid levels, heart disease and stroke, sleep apnea, non-alcholic fatty liver disease (NAFLD), type 2...

Our culture teaches us that we should be able to make good choices by the force of our own will, and that we are weak if we cannot do this. Why it matters:The concept that we can use willpower to make good choices is a myth. Multiple studies of willpower...

A Common Pattern You start a new health program, full of enthusiasm and excited for the change it will bring. The first days and weeks go well, you are making all the right steps, and you see early signs of progress. You’ve been exercising for a week and feel a...

Decreased quality of life is largely attributable to 3 categories of health issues: Musculoskeletal problems Cognitive problems Mental health/relationship problems Why it matters:Just like the main causes of death (cardiovascular disease, cancer, dementia), the main causes of human suffering can largely be prevented or at least delayed with attention to...

Quality sleep should be a priority. But what can you do when sleep eludes you? Sleep framework: Understand the importance of quality sleep Make quality sleep a priority in your life Diagnose and treat sleep disorders Why it matters:Sometimes sleep is elusive, even if you are attempting to make sleep...

Insufficient sleep makes your body want to store fat. Why it matters:Most people understand that regular exercise and good nutrition are vital for good health, and important for weight loss in people who are overweight. However, it has been a more recent "discovery" that good sleep is equally important for...

Every healthy eating plan needs to meet four goals: Meet weight and blood sugar goals Provide adequate nutrients Allow enjoyment of eating Be sustainable Why it matters:A nutrition plan that doesn't meet all 4 of these goals is generally destined to fail over time. A bit deeper: Meet weight and...

You deserve a better experience with your healthcare. Why it matters:In 2017, when working at my previous practice, I remember a day when I felt, "I am not proud of the care we deliver." It was a terrible feeling. Most everyone in the practice - staff and providers - was trying...

Look for the "nudge" or "upgrade" to improve your nutrition. Nudge = a small step you can make in a positive direction, like focusing on vegetable snacksUpgrade = a small change you can make in your food choices to improve the health quality of your meals and snacks Why it...

The path to good nutrition shouldn't be so confusing. Why it matters:The "Standard American Diet" is a loser.  Average American calorie consumption increased by over 500 calories between 1970 and 2003  Three categories of ingredients - added sugars, refined grains, and commercial oils (think highly-processed foods) accounted for almost all...

Having insufficient muscle likely creates as many health problems as having too much body fat. Why it matters:We've been discussing the value of quality muscle for the last 3 weeks (click here for past articles). Studies show that both increased muscle mass and muscle strength are associated with longer life and better health While I meet...

Poor fitness increases the risk of death. Why it matters:When we consider how live our best quality and longest life, overall fitness is a strong predictor for our risk of death. Take a look at the graphic below, which comes from a study of 122,000 people ranked by their performance on a...

Quality muscle is vitally important to live your fullest life. Why it matters:Healthy muscle serves mulitple roles in our bodies. Of course it helps us move about in our world, and it has many other important roles. Here are a few: Glucose (sugar) metabolism. Muscle serves as the largest storage reservoir for...

Quality living requires mind, body, and spirit. Why it matters:Two weeks ago we discussed the concept of healthspan. Last week we looked at conditions that frequently cause our demise. When we turn to look at quality of life, 3 categories of problems are with particular attention: Problems with the body. Deterioration in our musculoskeletal system -...

Delaying or escaping chronic illness is better than surviving it. Why it matters:The table below shows the top 10 causes of death by age group. Beyond age 55, chronic illnesses top the list - mainly heart disease, cancer, emphysema/COPD, and Alzheimer's disease. Studies of centenarians, folks who've lived to age...

Healthspan is the length of time spent living a high quality life. Why it matters:In the sketch above, length of life is shown on the X-axis, while quality of life is represented on the Y-axis. The image shows 3 benefits of improving healthspan, which on the graph would be to...

The Sweet Spot is the intersection between medical science and your life. Why it matters:Medical science teaches us many ways we can improve our health and treat illness, but it does not show us how to apply this information to your circumstances. Understanding your preferences, values, and limitations is vital...

A note for those who take thyroid hormone... We work with many folks who experience frustration because their thyroid dose never seems to be stable.  "Every time I get my blood drawn, it seems my dose needs adjustment!" While there are many factors that can affect the reliability of the...

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New Client Information We are grateful you have chosen our clinic and we are excited to get to meet you!  YOUR NEXT STEPSYes, you have homework! We promise to limit the amount, but there are a few items that need your attention before your visit: New client forms. You may...

Telemedicine Instructions We are glad to serve you through our telemedicine service called Doxy! Here is what you'll need to know. 5-10 minutes before your appointment time, please click the link below (note that there are separate links for Dr. Fox and for Sarah Sato, NP) To meet with Dr. Fox:...

Can people with prediabetes eat carbs? This answer to this question is the source of a lot of confusion, frustration, and misinformation for people who need to control their blood sugar. Let's review what happens to carbs when you eat them and how that influences your "carbohydrate tolerance." Understanding this...

Hey Doc, why are you on Facebook/YouTube? You may be wondering why a doctor is spending his time on Facebook and YouTube. I thought this week I'd share a little about more own journey and why I'm here each week sharing thoughts about how to get healthy and stay healthy....

Can you really win by making 1% improvements? Can you really improve your health by staking together small improvements over time? While it may seem counterintuitive, making consistent small upgrades to your choices and behaviors can yield amazing results. Making a 1% improvement every day for a year leaves you...

Hey Doc, what if I don't want to pay attention to my health all the time? Do I really have to live like that?If that thought resonates with you, don't worry. You're not alone. The idea that you might have to think about good nutrition, regular exercise, and quality sleep...

Could you live to be 100 years old? Let's look at strategies that could help you do just that. Insights from 2 key resources reveal the key actions that have helped others not only live to be 100, but maintain their vigor and vitality along the way. The New England...

Nutrition for prediabetes shouldn't be hard. Yet we live in a world and we live with an internet that is full of confusing and often conflicting information. Trying to understand what makes up good nutrition often leaves us confused and frustrated. Two recent studies by Dr. Kevin Hall are fascinating...

You really only need 2 ingredients if you want to improve your health with lifestyle - nutrition, exercise, and sleep. The problem is most of us get this one wrong. Our culture teaches us to focus on one ingredient. Healthcare focuses on one ingredient. If you don't focus on BOTH...

Hey Doc, can my prediabetes be reversed? This is an important and very common question when you've been diagnosed with prediabetes. The short answer and good news is YES. Prediabetes can be reversed.Prediabetes indicates the current combination of your genetics, environment, and lifestyle has you on the wrong path. In...

Hey Doc, what foods do I need to avoid if I have prediabetes? What should I eat and what should I NOT eat are two very common questions folks have after a diagnosis of prediabetes. Available nutrition information on the internet is confusing and conflicting. It labels individual foods as...

Do you ever feel like you're too busy to improve your health? Getting healthy just takes too much time? If so, you are not alone. The idea that improving your health will take up all of your spare time and bandwidth is a common sentiment, and it's actually not true....

Healthy food that tastes good. Wouldn't it be great if you didn't have to join a cult to use good nutrition to control your blood sugar, prevent diabetes, and ideally reverse prediabetes altogether? Wouldn't it be great if you didn't have to commit to overhauling your entire way of eating...

Dear Valued Clients, On behalf of Sarah Sato, NP, and myself, I want to offer our sincere apologies for the difficulty we've had over the last 2 weeks. We know this has impacted our ability to deliver a high level of personal service to you, and it breaks our hearts....

Hey Doc, just tell me what to eat! This is the statement I hear more than just about any other from women who've been diagnosed with prediabetes. The internet wants us to believe that good nutrition requires learning some secret formula for success, an it's full of confusing and conflicting...

Nutrition for prediabetes shouldn't be hard. The internet is full of conflicting and confusing information about how to use good nutrition to control your blood sugar, but the principles of healthy lifestyle are really straightforward. They're easy to learn. In this part 1 of a 3 part series, let's learn...

"Hey Doc, what should I eat? "I've been diagnosed with prediabetes, just tell me what I should eat." What to eat to control your blood sugar is the most common question I hear in my practice from folks who've been diagnosed with prediabetes. And nothing creates more confusion and frustration...

What would you do if you were shipwrecked on a desert island? Where would you start? Food? Shelter? Water? The "Robinson Crusoe" phenomenon states that when we have limited time, we can't do everything - at least not well. Something has to give. When it comes to making all the...

Menopause is a time when women face special challenges when it comes to maintaining health, controlling blood sugar, and living well. One of these challenges relates to loss of muscle. It turns out that maintaining or increasing muscle mass of crucial importance for preventing diabetes and reversing prediabetes. Watch this...

Hey Doc, is this food good? Or bad? Diet culture teaches us to label foods as good or bad, healthy or unhealthy. It's rarely that black and white. Here's another way to look at food using a game called "Better Than." It can help you move past the labels, and...

Good habits can be hard!Building good habits is one key strategy for improving health, but it can be one of the harder to implement well.Watch this short training for insights about habits and 3 tips you can use to help yourself dial in your habits. Watch now

Do you like things spicy? Spices have 2 great benefits for helping you in your pursuit of good health. First, the vast majority of spices have been shown to have health benefits like reducing blood sugar, treating inflammation, or decreasing pain. Second, spices can help keep you from getting bored!...

Boulder County is rolling out COVID-19 vaccinations. At The Alpine Center, we recommend everyone be vaccinated when the vaccine is available to you. Several of our staff have already received the first dose, with nothing worse than a sore arm, and the rest of our staff will be starting the...

The Brain is Fascinating When my daughter was about 5 months old, I watched as she figured out how to rotate a toy so she could pass it through the bars on her crib. I realized in that moment that at 5 months old she could solve a problem my 5-year-old...

The Gap Knowing what to do is only part of the solution when it comes to making healthy choices. Do you ever feel like you know what you're supposed to be doing, but find it's just really hard to stick to your plan? Rest assured, you are not alone. For...

The burden we all carry An ailing parent. A struggling child. Jobs lost. Unexpected bills. Frustrating relatives and coworkers. Everyone has to deal with stress in some fashion, and at times it can seem like the bad news is piling up. This is especially true in our current time, with...

What is it for? Not too long ago I listened to a talk by Seth Godin titled “Stop Stealing Dreams” in which he discussed the educational system. The thesis of the talk was that we need to ask a very important question about education, yet we really don’t ever do so. The...

Changing behavior can be hard It can be really hard to change habits and routines, to live healthier lifestyle. Whether this means you don’t exercise as much as you should, or you succumb to late night snacking, or you just can’t seem to turn off Netflix and get to bed in time...

Atomic Habits In his book Atomic Habits writer James Clear describes a study where researchers wanted to help 248 adults build better exercise habits. They pided the subjects into 3 groups. The first group was asked to track how often they exercised. The second group, the “motivation group,” was asked to track...

When I was in medical school and learning how to perform basic tasks, like reading an ECG or a chest x-ray, I was taught very specific protocols for each process. For example, reading an ECG was RRABEIIM – rate, rhythm, axis, bundles, enlargements, intervals, ischemia, morphology. The goal was to...

(from https://www.ncl.ac.uk/media/wwwnclacuk/newcastlemagneticresonancecentre/files/fat-threshholds-slides.pdf) I’ve noticed something interesting. When someone is diagnosed with type 2 diabetes, the doctor thinks about controlling risk factors. Control the blood sugar. Control the blood pressure. Control the cholesterol. All of this to reduce the risk of developing problems related to diabetes. Most people when diagnosed, however, think...

Meet your river guide Just before I got married, several of my friends took me on a guys’ adventure day, which included a day whitewater rafting on the Arkansas River. As we signed in, we received instruction about river safety, got our life vests, and hopped on a bus that...

Yesterday I swept out my garage in the morning. It’s amazing how quickly the dust and dirt accumulates in that space. Then I swept the kitchen. We have a new dog (our pandemic addition), doubling our canine count and apparently our dog hair production. In the evening, I sat on...

“Eat breakfast like a king, lunch like a prince, and dinner like a pauper.” It’s likely you’ve heard this statement before. Results from a new study add additional support for the idea that this might be the way the human body was designed to eat. Bigger dinners may increase risk of metabolic...

The Value of Exercise You know that exercise is important. The body just doesn’t work right if you are not moving. In particular, it becomes harder for you to efficiently burn fat when you are sedentary. But even though we know exercise is important, it can be really hard to...

Is this food healthy? Before the pandemic, I ordered a latte from a local barista. In our exchange, the barista mentioned I might like to try it with coconut milk, because it’s “healthier than cow’s milk.” Whether it’s a blessing or a curse I haven’t decided, but statements like these...

Reconnecting with old friends during COVID-19 As I write this, one of my college housemates, a cardiologist in Miami, has been sick with COVID-19 and on a ventilator for almost a month. He is showing signs of improvement but it’s been really slow, nail-biting progress. While this is of course...

Everyone loves a hero When I was a kid, every week I could not wait for Saturday morning cartoons. I would get up, race downstairs with my sister, and spend the next 2-3 hours watching the week’s new shows. My favorite cartoon was Super Friends, which brought together all the superheroes from...

I beat myself up pretty well last week. During this time of coronavirus and social distancing I had grand plans to take advantage of fewer commitments and increased downtime to accomplish so much. I wanted to develop a number of new educational training programs at work, clean out the garage,...

The 8 Pillars of Joy My daughter Maddie is a science and math geek (much like her father). But she’s also got this really cool artistic side. Take a look at the photo accompanying this blog post. Those are 3 art pieces Maddie and her friends are working on in...

Where does your mind go when you eat? I heard this question recently when listening to the Ten Percent Happier podcast interview with Evelyn Tribole, one of the developers of the intuitive eating. I have to admit, when I heard the question my first thought was, “huh, I’m not sure.” How about you? Where...

His blood sugar was up, and he was feeling like everything was falling apart. James’ system was breaking. It was too much for James*. His father was ill, and he was travelling back east frequently to help with his father’s healthcare. Combined with his business travel, lots of stress, and...

Ready, Set…Fizzle Karl* wants to get back into the habit of running regularly. He’s gained about 10 pounds over the last 2 years, and where he used to regularly hit the trails about 5 times weekly, lately he’s “just not motivated” to get out the front door. Do you have...

Confession Time My 15-year-old son has a metabolism like a hummingbird. It seems that if he doesn’t eat every 2 hours he’s likely to waste away. And because of this incredibly fast metabolism, he can get away with less than optimal food choices without showing any adverse effects. It was...

Headlines won’t always tell you the whole truth I’d like to come back to the question of “what’s the best diet?” This week let’s look at a study that compared a low carbohydrate ketogenic diet vs. a low glycemic index diet. Take a look at the authors’ conclusion from this study (bold text mine): “Dietary modification...

“Overfed and Undernourished” One hundred years ago, if you ate a food that had calories, it also contained nutrients – vitamins, minerals, and other small molecules that help your body produce energy, heal itself, and fight infection and cancer. Over the last 70 years food production has changed substantially, leading...

Time for an Added Sugar Audit Today we’ll focus on reducing or eliminating added sugar from your diet. But before we get to that, let me give you some background information. What’s the best diet? Time and again I get asked, “what’s the best diet?” There is so much confusion...

The Diabetes Fire Triangle and How Many Carbs You Can Eat “You have diabetes.” Jane was not surprised to hear those words. Many people in her family already have diabetes, including both her parents. She’d been thinking she needed to make some changes in her life for a few years,...

It’s February 22 nd , you just realized you haven’t used your new gym membership in almost 3 weeks, and your plan to lose weight on the keto diet was blown up by a bag of Cheetos, a bottle of wine, and Seinfeld reruns. In your MSG-induced fog, you ask...

You’ve known for some time that you want to improve your health. You’re carrying extra pounds you can’t seem to drop, or you lack energy to enjoy your kids after work, or you feel like your concentration is lacking and your brain is foggy. You’ve made plans to change, perhaps...

Optimal. Adj. Most desirable or satisfactory.   Do you strive to achieve optimal health? Have you ever thought about your health this way?When I was younger, I took my health for granted. I was never particularly ill during childhood, just the usual colds, viruses, and occasional ankle sprains. In my 20’s and...

Recently I was asked to do a newspaper interview about a best-selling book that discussed treatment of Hashimoto’s thyroiditis (low thyroid function caused by one’s own immune system). In the end I was not thrilled with the accuracy of the information provided in the article, nor with my role as...

vi·tal·i·ty: noun. The state of being strong and active   What does it mean to have vitality? Take a look at the definition above. Being vital means to have energy, to be strong and active. Do you want to have vitality? Vitality sounds wonderful to me, and as I get older and...

I strive to practice medicine in the “Sweet Spot” that sits right where medical science and your individual circumstances meet. Medical science tells us how to best treat certain populations, then you and I figure out how to best apply that science to your health. I’d summarize practicing in the Sweet...