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See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog The newest miracle drug for weight loss is changing the lives of thousands of people who have battled obesity for extended periods of time….These GLP-1 medications are also treating or preventing the diseases that go with long term obesity: Diabetes, Heart Disease, Joint replacements, Arthritis, Sleep Apnea, and Alzheimer’s Disease. Researchers are finding more indications every day for patients to take these weight loss medications. But like anything else there is no perfect answer to any problem. Among the few side effects of this drug, the most frequent side effect is reflux, also called acid indigestion, or GERD (gastroesophageal reflux disease). Often my patients don’t even know what their diagnosis is, they just tell me about their symptoms. The symptoms of GERD include: Asthma symptoms A bad taste in the mouth Difficulty swallowing Dry, hacking, cough Chest pain after meals These symptoms are worse after a big meal, at bedtime, after spicy food, or dose related. Most of my patients don’t want to discontinue the GLP-1 inhibitors because they are finally losing weight! We manage the GLP-1 side effect of GERD by decreasing dose of the medication and slowly increase the dose back to an effective level. We also offer lifestyle and dietary treatments before we offer prescription medication. Therefore, if reflux is not constant, and is not causing any lasting damage to the patient’s esophagus, we can treat it with lifestyle changes and over the counter medication, to lower the stomach acid that is refluxing into the esophagus. The lifestyle changes patients can employ on their own are described below. Lifestyle changes needed to avoid or treat Gastric Reflux caused by GLP-1 agonists. What can you do to prevent and treat this side effect: Eat smaller meals: Large meals expand your stomach and put pressure on your lower esophageal sphincter (LES). Don’t go to bed less than 2 hours after eating Avoid trigger foods see below Sleep on your left side Elevate the head of your bed Avoid tight clothing: Chew your food well– chew each bite for 20 seconds. Quit smoking: Smoking weakens your LES and makes your stomach more acidic. Stop drinking alcohol Chew (non-mint) sugar-free–gum In addition to changing your active lifestyle, changing your diet is necessary as well. There are trigger foods to avoid minimizing your reflux symptoms. tomato sauce and other tomato-based products high fat foods, such as fast food and greasy foods fried foods citrus fruit juices soda-diet and regular Caffeine Garlic onions mint of any kind milk based products My patients ask me, “So what can I eat?” …I admit I did take away some of the most exciting foods, however my patients ask me what they can eat so the list of foods that help avoid and treat GERD are listed below. High-fiber foods: vegetables, fruit, and whole grain bread. Alkaline foods. Foods fall somewhere along the pH scale (turns litmus paper blue). Drink alkalinized water (PH greater than 8) Ginger—fresh sushi Ginger from Asian food stores. Apple cider vinegar on salads and a Tablespoon in water every morning Lemon water—just squeeze a slice of lemon in your water. Coconut water Honey. Lean Protein including meat Low-Fat and Nonfat Dairy Products. Non-Citrus Fruits like apples, pears, bananas, and melons Vegetables like broccoli, Carrots, Corn, Cucumbers, Green Beans, Green peppers, Potatoes and Sweet potatoes For my patients who take herbal and other supplements, the following is a list of the supplements that may decrease your symptoms of GERD. Chamomile Tea Licorice Marshmallow Slippery Elm Tablets Probiotics-Mega Brand Prebiotics-Mega Digestive Enzymes Aloe Vera Juice Baking Soda Magnesium glycinate What happens when you have made all the lifestyle changes you can and have lowered your GLP-1 dose or changed to a different type of GLP-1 Agonist, and you still have GERD? As a physician I prescribe medications to help my patients treat their GERD, however most of the medications have been placed over the counter so I can recommend them to my patients, and they can buy the medication without a script. The class of medication that treats GERD include Antacids, H2 Blocker, and Proton Pump Inhibitor. Antacids neutralize stomach acid, but they typically only work for short periods. They are generally made of calcium. This type of medication is best used prn for symptom relief. Side effects of antacids may include constipation and diarrhea. The second option for treatment of GERD is an H2 blocker. These drugs reduce the amount of acid the stomach releases. Eg. Pepcid, Tagamet, Gaviscon.

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The #StairMaster strikes fear into the hearts of many gym go-ers. Why? Because as simple as it is, it’s a brutally difficult workout to stick with for more than a few minutes at a time. Even if you’re in great shape, you’ll probably still struggle during your first couple of workouts on the stair machine. But even though it’s hard, and we know it burns lots of calories, can the StairMaster actually help you get the results you want? Let’s take a look at 4 big changes you’ll notice in your body after just a month or so of working out on the stair machine at the gym. --- Increased Stamina On average, a stair machine is far steeper than even the most intimidating hills — you’re practically climbing straight up! That’s why, even if you’re moving slowly, the stairmaster is quite a bit more difficult than most treadmill workouts. But the good news is that stair climbing workouts are incredibly effective at building stamina and endurance. In one recent study, participants who exclusively worked out on the StairMaster saw a 17% increase in their cardio thresholds in just 8 weeks. So it’s safe to say if you can stick with the stair machine for a month or more, you’ll definitely notice huge improvements to your conditioning. --- Weight Loss When it comes to calorie burn, it’s tough to do better than the StairMaster. You could burn up to 820 calories per hour on the machine, though it’s doubtful many of us could last that long. Still, when it comes to calorie burn — which is a huge driver of fat loss — the StairMaster is right up there with the rowing machine and high-intensity running. It’s generally considered safe and attainable to lose 1 to 2 pounds per week, so in a month of work on the stair machine, you could lose up to 6 or 8 pounds. Remember, though, that weight loss is heavily dependent on your diet. Burning tons of calories is great, but you’ll see the best results if you can stick to filling, nutritious foods and avoid undoing all of your hard work at the gym. --- Lower body and core strength Where the stair machine really starts to set itself apart is in the way it tones and strengthens your entire lower body and core. Climbing stairs requires great stability from your core muscles, and the steep incline demands lots of power from your legs. Expect noticeable differences in your core strength and all of the major leg muscles, including your hamstrings, calves, and quads — even after only a month or so. Some trainers say that the StairMaster doesn’t activate your glutes as much as real stairs, so if you’re looking to build your booty, you might want to incorporate some extra glute exercises with traditional weights. --- Better bone health The high resistance nature of stair machine workouts can lead to one benefit you won’t see with your eyes: Increased bone mass. As we age, our bone density and overall mass start to degrade, which can lead to a number of health issues. All forms of exercise are good for promoting bone health, but usually strength training offers more potent benefits than cardio. The StairMaster, though, is the exception. Though you won’t see or even feel the difference, regular stair climbing workouts will do wonders for the long term health of the bones in your lower body. Just make sure you include some upper body work to keep your arms, back, and shoulders healthy, too. --- Stair machine workouts are incredibly hard, but you’ll find they’re worth the effort once you build up the stamina to tackle them head on. Not only will you burn calories and lose fat, if that’s your goal — you’ll also strengthen your abs, lower body, and legs in ways the treadmill could never dream of matching! You’ll want to give your upper body some love, too, for the best results — pair the StairMasters with some regular resistance training and you’ll start to see your physique really pop.

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