David Lobur, MD

07/04/2023

Our 4th of July salad is an annual treat to celebrate this great day 🇺🇸

03/04/2023

Let’s put “Food First!” In healing complex chronic disease!

Food First! Fortifying the Frontlines of Health

“What you put at the end of your fork is more powerful medicine than anything you will find at the bottom of a pill bottle.” -Dr. Mark Hyman

Wouldn’t it be AMAZING if our society truly took this phrase to heart?

March is “National Nutrition Month” but I bet you were not aware of this. There are no clever ad campaigns nor ribbons or well-funded advocacy groups to promote this health awareness topic. But in reality this should be the MOST important awareness month of them all, for optimizing nutrition can reverse and prevent chronic disease more effectively than ANY other healing modality around.

Case in point - We recently cared for a young man at PCFM who was having chronic unexplained abdominal pain. He was seen over several years by several gastroenterologists and had upper endoscopies and colonoscopies without acute findings. He had CT scans and gastric emptying studies and ultrasounds with no abnormalities. He tried multiple proton pump inhibitors, histamine blockers and anti-spasmodic medications to no avail. I read through many lengthy consult notes detailing these efforts to explore what was happening. But unfortunately (and sadly not to our surprise) NOT ONCE was any mention of food/poor nutrition as a means to explain the underlying problems, nor was a healthy diet prescribed as a therapeutic prescription for his symptoms. At PCFM we started him on a clean Paleo diet and within weeks his symptoms were COMPLETELY resolved.

Our conventional healthcare system has very smart people who can perform extremely precise and detailed procedures and prescribe advanced pharmacologic therapies to treat many symptoms and conditions. It is extremely valuable to have this type of medical care available, but we should only “call in the calvary” when absolutely needed. We as a society need to “fortify the frontlines” of health with the battlecry of “Food First!”. Our current healthcare model is a “wait until you break and then we’ll save you” model that generates an immense amount of societal debt yet provides big gains for pharmaceutical, food and insurance companies as well as hospital systems and allied health professionals. We need a new approach that puts “Food First!” We often say here at PCFM that if everyone followed the guiding nutrition principles within the simple book “Food Rules” by Michael Pollen, our chronic disease burden would easily be cut in half almost instantly.

Food is frontline medicine. Improving one’s nutrition is often the most important change we need to help guide our patients through when we first meet. More than any other therapeutic endeavor - medications, supplements, detox, lifestyle changes etc. - optimization of one’s diet can improve vitality across the board in about every possible way.

Functional medicine certainly emphasizes the “Food First” approach, but wouldn’t it be great if ALL healthcare providers led with diet instead of meds in our regular well-visits? Or prescribe food to combat illness ahead of or in tandem with procedures or pharmaceuticals?

So let’s get the word out during “National Nutrition Month” of the power of “Food First!” and spread it virally to our friends and family. Here’s hoping this way of thinking becomes contagious.

02/24/2023

Dietary Fat: Friend or Foe?

“Fat” gets a bad wrap. The word itself carries a negative connotation associated with obesity. Dietary fat was demonized by the healthcare industry stemming from consensus opinion from the 1950s that gained even more traction with a report from the Surgeon General in 1988 linking dietary fat directly to heart disease. For decades now media and popular opinion has connected dietary fat consumption to elevated cholesterol and heart disease. The food industry responded with a gullet of low fat foods (that were higher in simple carbs…). The stigma still persists surrounding heart disease and eating fat BUT thankfully over the last several years the underlying truth is being ever exposed to properly exonerate fat as the primary driver of cardiovascular disease. Let’s examine what REALLY is happening a bit.

Our bodies are primally conditioned to convert excess sugar via the liver into adipose tissue (fat tissue) that can be utilized for future use. Insulin is a catalyst for this process and insulin is triggered by higher blood sugar, NOT dietary fat. Fat travels through the gut into the bloodstream without the liver/insulin connection. Fat can be used directly for energy, especially if there isn’t excess sugar floating around.

I often use the analogy of a metabolic fireplace to emphasize the importance of minimizing sugar and up-regulating fat. If we use “newspaper” aka sugar to light our metabolic fireplaces, it provides a quick burst of flames/energy but will soon fizzle out. Our body needs to carry a bunch of extra newspaper on it (stored fat) that can be converted back into sugar for sustaining that inefficient energy pathway.

But if we use “logs” aka fat for our metabolic fire, this will burn longer and provide more energy. Fat holds nearly twice the amount of energy as a similar amount of sugar, so we won’t need to eat as much or as frequently. And we can keep the need for stored fat low and thus lower the circulating triglycerides/cholesterol that is the “afterburn” of the sugar metabolism pathways that is the true participant of pathological small dense LDL prominent in cardiovascular diasease.

Now saturated fat CAN be concerning for those with certain conditions like leptin resistance or having TRUE genetic propensity to hyperlipidemia, but the vast majority of us will do very well with a higher fat/lower carb approach.

So don’t fret the fat, cut the (sugary) carbs and reap benefits it will have for your health!

02/23/2023

The Lobur kids will be selling our own homestead’s eggs on Friday 2/24 at Pittsburgh Center for Functional Medicine from 1-5PM. If interested please leave a comment and we’ll set some aside for you to pick up!

🥚 Organic
🥚 Free Range
🥚 Soy Free
🥚 Corn Free
🥚 $6 a dozen

02/21/2023

The Impact of Sugar on Cardiovascular Disease

Whether it be a diagnosis of heart disease, hyperlipidemia, hypertension, peripheral vascular disease or cerebrovascular disease (stroke), the first question I’ll have in mind for that particular patient is always the same:

What’s the blood sugar status look like?

Sugar is kindling for the cardiovascular fire in numerous ways.

1. Sugar raises insulin and insulin drives inflammatory responses in the body. Insulin resistance creeps up SLOWLY over time and is often NOT checked in any routine way in standard conventional medical practice. I advise fasting insulin as a routine lab to assess insulin with goal of OPTIMIZATION of levels in 5-7 range
2. Sugars from simple carbohydrates (bread, pasta, cereal, sweets, soda, junk foods) are readily processed into triglycerides, which are then transformed into more inflammatory small dense LDL which contributes to plaque formation, damaged and fibrosed (stiff) blood vessels which creates hypertension and impaired oxygen flow to critical tissues
3. Elevated blood glucose, insulin and small dense LDL burden lead to plaque burden which is recognized as “foreign” by one’s own immune system. Over time the burgeoning immune response will lead to bigger and unstable plaques that will be prone to ruture resulting in clots and vessel occlusion i.e. heart attacks and strokes

By reducing the influence of the sugar-fueled inflammatory cascade through clean eating, weight loss, stress reduction and regular physical activity, we can stop and even reverse cardiovascular disease.

So be sure to screen for fasting glucose/insulin and HbA1c on a regular basis!

02/13/2023

It was a TEAM effort putting our Super Bowl menu together 🏈

Homegrown Organic Wings
Homemade Paleo Rach Dip
Crispy Smash Potatoes with Dynamite Sauce
Paleo Pigs in a Blanket
Paleo Choclate Chip Cookie Dough Brownies

We cook our wings for 45min at 450, gives skin a “crisp” texture

“Three Sisters” Ranch recipe is our absolute fave

The potatoes and mini almond flour hot dogs are from the new Defined Dish cookbook “ The Comfortable Kitchen”. We were looking for a great time to try these out! The hot dogs were Teton grass fed brand from Costco

Brownies are from the “Paleo Running Momma Paleo Baking at Home” Cookbook

We had a great time hanging out in the kitchen together !

02/02/2023

“Groundhog Day” Your Way to Making Meaningful Changes☀️

I remember watching the movie Groundhog Day for the first time in theaters 30 years ago now (makes me feel old to say!). I really enjoyed it then, but I love it even more now after becoming a functional medicine doc and appreciating its deeper messages of making meaningful change and appreciating the good in our daily lives.

Groundhog Day is ingenious in how it makes one strive to make the most of every day and live life to the fullest. It makes you think “What could I think, say and do differently today?” So instead of living on autopilot, replaying the same old patterns, you can create a new and better experience.

Change, as the movie shows, can be very slow and difficult, but it only takes a single day to spark a change in a positive direction. And sometimes that change is simply in one’s attitude to appreciate the joys that are already around them!

So check out the movie again through the lens of functional medicine and see if it can help you enact some of the changes you’ve been aiming for☺️

02/01/2023

Heart Health at PCFM!

February is American Heart Month and we’ll be exploring this critical health issue through a functional medicine perspective for the next several weeks. There are MANY upstream ways to prevent and reverse heart disease risk factors.

So if you or a loved one have concerns about a personal or family history of coronary artery disease, hypertension, diabetes, stroke or hyperlipidemia please stay tuned to our page for valuable clinical pearls to help get your heart health into optimal shape ❤️ 💪

And let us know in the comments which specific cardiovascular topics or questions you’d like us to cover this month!

01/18/2023

We’re very excited to introduce our new initiative here at PCFM for 2023, the “ Functional Health Reset”! 🥦 🏃‍♂️ 🧘 🛌

In functional medicine, our focus is addressing health issues at the root cause level. But no matter how complex an individual’s constellation of symptoms or medical diagnoses may be, there are four foundational physiologic functions that need optimized to achieve sustained success: Food, Exercise, Stress and Sleep. These are the “upstream” variables that when nurtured to their fullest potential will radically reduce “downstream” functional imbalances leading to chronic illness.

With the “Functional Health Reset” we are looking to bring focused awareness to these fundamental areas of importance so that anybody can start engaging with actionable changes to better their health right away. So, whether you are completely new to functional medicine or need to “hit the reset button” on past successes, we hope these four intro videos and free handouts contained in our January newsletter will bolster these four key areas en route to achieving a renewed focus on realizing your health goals in 2023 and beyond.

Please be sure to check out the four core videos devoted to Food, Exercise, Stress and Sleep on our Pittsburgh Center for Functional Medicine FB page and reach out to us via email at davidloburmd@pghfm.com to obtain our January newsletter which includes key handouts to help optimize these four foundational focuses to start/rekindle your functional medicine journey.

And please keep on the look out for many more tips here on Facebook in the coming weeks to further coach you along in the functional medicine approach to optimizing health!

01/15/2023

Paleo Pittsburgh Salad! 💛🖤

Our daughter Adalyn was a great help in the kitchen today putting the grain-free coating together for our chicken. Getting kids involved with making real food in the kitchen inspires them to appreciate how important nutrition truly is!

The key to this chicken is brining it in pickle juice all day which gives it that “chick-fil-a” flavor. Check out the full recipe in the Defined Dish cook book.

Be sure to use a high heat tolerant oil like ghee or avocado oil to lightly fry the chicken strips.

The fries are homemade and coated with duck fat, salt and new bae seasoning prior to baking at 450 for 30 minutes. It’s a process but worth it - need to soak the cut fries in cold water for at least 20 min to break starch down so they’ll crisp up nice. Fries then have to be dried thoroughly prior to mixing in duck fat/seasoning mixture before baking.

The dressing is a honey mustard homemade from paleo running mama recipe online.

A great example of “comfort food” done right ✔️