Age Management Medicine
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Make an Appointment Marc Darrow, M.D.,J.D. Joint Rehabilitation Services
11645 Wilshire Blvd., Suite 120 Los Angeles, CA 90025 (310) 231-7000

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Diet and Lifestyle
According to information from the American Heart Association, almost 50 million Americans can be diagnosed as having Metabolic Syndrome.

What is Metabolic Syndrome?
Metabolic Syndrome is an umbrella term to describe someone suffering from a combination of the following conditions:
1. Abdominal obesity
2. High triglycerides
3. Low HDL (good) cholesterol
4. High LDL (bad) cholesterol
5. High Blood Pressure
6. Insulin resistance

Who is at danger for developing Metabolic Syndrome?
Typically middle age people who are eating more and exercising less.

Abdominal obesity
Abdominal obesity is obesity centralized to the abdominal area that is out of proportion with fat stores in the rest of the body. A disproportionately large "waist circumference," is considered a high risk factor for many diseases including type 2 diabetes, hypertension, cardiovascular disease, and osteoarthritis that affects mostly the knees, but also the hips and back.

How much fat Is considered abdominal obesity?
Body scans and MRIs can determine with great accuracy the degree of abdominal obesity someone may have, but these tests are very costly and inconvenient and to be truthful are not needed to reveal the obvious. Someone who a big belly has abdominal obesity.

Still needing science to prove to patients that they are indeed abdominally obese, many clinicians rely on the Body Mass Index (BMI) measurement. The BMI is determined by computing a number based on the height and weight of an individual.

Using the formula above, let’s say you are a woman who weights 140 pounds and is 5 foot-5 inches tall
(65 inches). Let’s see how you would do.

Your body weight = 140
Divided by your height in inches squared
65 x 65 = 4225 (140/4225=0.033)
0.033 x 703 = 23.3 Your Body Mass Index and you would be normal.

BODY MASS INDEX RESULTS
Below 18.5 Underweight
18.5 – 24.9 Normal Range
25.0 – 29.9 Overweight
30.0 and Above Obese


But what if you were a man with some muscle? Say 6 feet tall and a muscle packed 210 pounds. You would have a Body Mass Index of 28.4 and you would be considered overweight!

You can probably see why this method of determining abdominal obesity and general obesity is often criticized. Critics point out that it fails to differentiate between body mass from fat and body mass from muscle. Recently using the BMI formula, researchers took the published weights of professional athletes in the National Football League and the National Basketball Association and determined that nearly all the footballers were overweight and half of them obese.

In addition, many of those tall, muscular and somewhat thin NBA stars were graded as overweight and a handful, including Shaquille O'Neal, arguably the best player in the league, were considered obese. At the time "SHAQ" at 7 foot 1 inch, weighed 320 pounds; few though, would consider him obese.

The BMI should never be used by itself as a diagnostic tool in determining health risks from obesity, but only one of many tools in guiding the patients towards a more healthy lifestyle.

The apples and pears
Some researchers have suggested that the WHR or Waist-Hip Ratio measurement is a more accurate measure of health risks based on being obese. They prefer this test because it takes into account the distribution of fat through the waist and hip area, where we store the majority of our fat.

Fat can be stored as abdominal fat (an "apple" body shape) or around the hips (a "pear" body shape). People who carry their excess fat in their hips are considered to have less of a risk factor than the abdominal obesity people.

To calculate your Waist-Hip Ratio

1. Measure your waist circumference at the belly button. Hold the tape measure straight.

2. Measure your hips at their widest part, that is where your buttocks peak.

3. Divide your waist by your hip measurement.

For women, ideal is a WTR of 0.8 or less. For example a women with a 29 inch waist and 36 inch hips just makes the cutoff.

For men, ideal is a WTR of 0.95 or less. A man with a 34 inch waist would be “ideal” with a 36 inch hip measurement.

In Waist-Hip Ratio, risk is rated by how high the ratio numbers are. For women, the higher the number past 0.8 the greater risk of obesity related disorders. For men, anything over .95, the higher it goes, the highest the risk.

High triglycerides
Triglycerides are fats that are chemically altered in the body so that they can be stored and then used later to meet our body's energy needs. When we need to burn that fat, we release hormones that free the triglycerides from the fat cells. Too much stored fat or triglycerides in the blood is called hypertriglyceridemia and is linked to coronary artery disease and diabetes.

LOW HDL
Cholesterol does many wonderful things in our body which is why we need it. What we especially need to have is normal levels of the "good" cholesterol, HDL (high-density lipoprotein), because the HDL cholesterol seems to protect against heart attack and stroke by carrying away or preventing the bad cholesterol "LDL" from building up plaque on arterial walls. Low HDL, low protection.

HIGH LDL
High levels of LDL puts people at risk for heart disease as mentioned above because it builds plaque. You need to exercise and watch your diet in order to start bringing your LDL numbers down.

BLOOD PRESSURE
The well known remedies for reducing blood pressure without medication are to:

1.
Lose weight, the more overweight you are, the greater the risk you will have for high-blood pressure.
2. Reduce salt intake. Most sodium comes from packaged and frozen foods.
    This is yet another reason to eat your foods in their freshest and most natural form, go for vegetables.

3.
Change your eating habits to reduce portions.
4.
Exercise. 

Insulin Resistance Syndrome
Our bodies DO need sugar (glucose) as a fuel for our cells to perform their daily cellular functions. When we eat sugar or foods that are broken down into glucose such as high-glycemic carbohydrates, our body's digestive process puts that glucose into the blood stream for the cells to collect and utilize. The cells rely on the pancreas to monitor the blood levels and to alert them when glucose is abundant. The pancreas does this by secreting insulin which circulates through our bodies delivering the message to the cells of glucose's presence.

In perfect balance, when we eat carbohydrates and produce glucose, the cells use it up as energy and  there is little left over.

When our cells ignore insulin and become resistant
Over the course of years as we get older, become more sedentary, and our diets become "sugar loaded," we process more glucose than our cells can use and the excess floats around in our blood, or is turned into fat in the cells.

Insulin Resistance also increases the symptoms and/or risk factors associated with metabolic syndrome, contributing to:

1. Accumulation of body fat
2. Obesity
3. Elevated triglycerides
4. High blood pressure.
5. Acceleration of the aging process.

DIET
It is commonly accepted that eating large amounts of simple carbohydrates (pastas, breads, and sugar filled foods) could lead to Insulin Resistance, elevated cholesterol, elevated triglycerides, and obesity. For this reason, as part of our program, we recommend that our patients change to a low-glycemic index diet.

The Glycemic Index is the rate that carbohydrates break down into sugar in the blood. The best source of low-glycemic carbohydrates are vegetables. Vegetables are slow burning carbohydrates and help keep insulin levels steady.

A diet rich in vegetables, proteins, good fats in the form of omega-3, and water is optimal for a long health span.

It is important to point out that a single diet will not work for everyone. To optimize your nutritional needs you should visit with an experienced health care professional well versed in the issues of  metabolic syndrome and nutrition.

Insulin Resistance Syndrome and Metabolic Syndrome Research
Insulin Resistance Tied To Age-Related Muscle Loss
Writing in the medical journal Diabetes and Metabolism, researchers say: "...insulin resistance could be involved in age-related muscle protein loss, progressively leading to sarcopenia. Therefore in a more general concept, insulin resistance found in many clinical settings, could be considered as a contributor to muscle wasting."

What is the Effect of Insulin Resistance and Loss of Lean Muscle (Sarcopenia) As We Age?
Researchers writing in the Journal of The Federation of American Societies for Experimental Biology say: "A reduced response of older skeletal muscle to anabolic stimuli (exercise & diet) may contribute to the development of sarcopenia. Skeletal muscle protein synthesis is resistant to the anabolic action of insulin in older subjects, which may be an important contributor to the development of sarcopenia."

Metabolic Syndrome and Stroke
Researchers writing in the Archives of Internal Medicine say that preventing and controlling Metabolic Syndrome is likely to reduce risk of stroke.

Stress at Work and Metabolic Syndrome
Metabolic Syndrome is a combination of symptoms including high blood pressure, abdominal obesity, insulin resistance and others related to coronary heart disease.


Ageless - Suzanne Somers
"As my personal sports doctor, (Dr. Darrow) has never given me a drug for any of my injuries. He is of the thinking that unless a drug is necessary, it is better to allow inflammation to do nature's work." (page 130).


Marc Darrow, M.D.,J.D.,Q.M.E.

Marc Darrow, M.D., J.D.,
is an Assistant Clinical Professor at UCLA School of Medicine. He is a world recognized specialist in many chronic disorders. He has been featured in national publications, and television and radio shows, for his innovative approach to medicine. Dr. Darrow has helped create an age management program for those individuals interested in maintaining a youthful, healthy vigor for adults through “middle age” and well into the senior years.

Patient Information

Joint Rehabilitation and Prolotherapy Information

Marc Darrow, M.D.,J.D.,Q.M.E.
Marc Darrow, M.D., J.D.,
is an Assistant Clinical Professor at UCLA School of Medicine. He is a world recognized specialist in many chronic disorders. He has been featured in national publications, and television and radio shows, for his innovative approach to medicine. As the medical director of Joint Rehab Center, Inc. in West Los Angeles, Dr. Darrow has helped create an age management program for those individuals interested in maintaining a youthful, healthy vigor for adults through “middle age” and well into the senior years.

Why am I so driven to work in the age management field?
Basically it was for my own personal, mental, and spiritual well being. Read what Dr. Darrow has to say about how he got interested in age management!

DISCLAIMER:
Neither Dr. Darrow, nor any associate of JOINT REHAB AND SPORTS MEDICAL CENTER, INC offer medical advice from this website. This information is offered for educational purposes only. Do not act or rely upon our information without seeking independent professional medical advice. The information on this website does not create a physician-patient relationship between you and Dr. Darrow or any associate of JOINT REHAB AND SPORTS MEDICAL CENTER, INC. Neither Dr. Darrow, nor any associate of JOINT REHAB AND SPORTS MEDICAL CENTER, INC guarantees the accuracy, completeness, usefulness, or adequacy of any resources, information, apparatus, product, or process available at or from this website. MEDICAL MODALITIES MENTIONED ARE MEDICAL TECHNIQUES THAT MAY NOT BE CONSIDERED MAINSTREAM. AS WITH ANY MEDICAL PROCEDURE, RESULTS WILL VARY AMONG INDIVIDUALS, AND THERE COULD BE SUBSTANTIAL RISKS INVOLVED. THESE CONCERNS SHOULD BE DISCUSSED WITH YOUR HEALTH CARE PROVIDER PRIOR TO ANY TREATMENT SO THAT YOU HAVE PROPER INFORMED CONSENT AND UNDERSTAND THAT THERE ARE NO GUARANTEES TO HEALING.

Certain studies including the Woman's Health Initiative suggest that hormone supplementation may increase the risk of certain cancers, heart disease, stroke and other ailments. These risks should be discussed with your health care professional while deciding on, implementing, or continuing Hormone Replacement Therapy (HRT)

The option to use Human Identical Hormones or Bio-identical hormones should also be discussed with your medical care provider as there is not sufficient medical evidence at this time to suggest that they are safer than synthetic hormones and may pose equal risk.

If you have or suspect that you have a medical problem, condition or issue, promptly contact your health care provider. The statements on this website have not been evaluated by the Food and Drug Administration. The photos in this Web site feature models for illustrative purposes.