Dr Mahmud Kara of KaraMD: 5 Lifestyle Tweaks That Can Dramatically Improve Your Wellbeing

Five non-intuitive lifestyle tweaks that I preach to my patients, and what I call the five pillars of good health. Some of them may seem intuitive, but I’ll try to explain why they’re perhaps not the first one.

As a part of my series about “5 Lifestyle Tweaks That Will Dramatically Improve One’s Wellbeing”, I had the pleasure of interviewing Dr. Mahmud Kara.

Dr. Mahmud Kara has 30+ years of experience with patients. After spending the early part of his career treating patients at The Cleveland Clinic, Dr. Kara spent the last several years focusing his work on functional medicine and natural remedies to help people live healthier lives. In 2018 he created KaraMD, a line of supplements focused on digestive support, heart health and reducing inflammation as the gateway to overall health.

Can you share the most interesting story that happened to you since you started your career?

The most interesting story that happened to me since I started my career is probably the story about the patient. I’m going to call her Karen. That was likely the start of my career in alternative and functional medicine. She walked into my office as a new patient complaining of shortness of breath, lightheaded and dizzy, total lack of stamina, difficulty concentrating, weight gain — you name it — she had all the symptoms. She was the proverbial medical mess. She had a weak heart. She was pre-diabetic on labs, had high cholesterol and her physical exam wasn’t much better. It was pretty bad. Back then, as a physician trained at the Cleveland Clinic, in conventional internal medicine, I did what I was trained to do and suggested a rather conventional medical regiment: medications, repeat medical testing, rehab therapy, referral to a specialist. The whole nine yards. Well, I shouldn’t have. I shouldn’t be surprised, looking back on things now, but back then, I was surprised when she said “no.” She wanted to do things naturally and left my office. She came back four months later, as a follow up, and Karen was a changed woman. She had lost 28 pounds, the shortness of breath, dizziness and gut issues were all gone. She had all her old stamina and energy back. She was a new person. I ran some more tests and the findings were even more remarkable. Her blood sugar was down to normal levels. Cholesterol was great, heart function was totally normal. I put the old and the new results side by side. You’d think I was looking at two different people. What she had done was equally remarkable, remarkable at how simple it was: diet, exercise and a few supplements. The diet being based mostly based on lean meats and lots of vegetables, and what she referred to as superfoods.

Can you share a story with us about the most humorous mistake you made when you were first starting? What lesson or take-away did you learn from that?

The most humorous mistake I made would clearly be with that same patient. The mistake being I didn’t listen to her more carefully when she tried to explain to me what she wanted to do. The lesson I learned is probably pretty obvious. Using diet, exercise, stress reduction goes a long way toward being well and healthy. That really was an eye opener for me and the day I started to pay more attention to non-conventional medicine as a mode of therapy.

Can you share with our readers a bit about why you are an authority in the fitness and wellness field? In your opinion, what is your unique contribution to the world of wellness?

I’m considered an authority in the world of fitness and wellness, and more so in wellness because of my background. I was trained with a conventional medical training and internal medicine at one of the largest, most renowned and probably best hospitals in the world: Cleveland Clinic Foundation. I spent a lot of time learning from my patients regarding how they were using diet, exercise and stress reduction.

I’ve also spent a lot of time working with patients and optimizing their hormones. I’ve seen the benefits that can lend towards wellness and prevention, which is a strong belief of mine. That goes towards what my unique contribution would be. I offer the best of both worlds. Again, my medical degree gives me the best of medicine, in particular when it comes to testing, which regardless of how you look at conventional medicine, testing does really help you get to the root cause of the problem in many cases. But I also bring to the table, the desire to use more unconventional methods in particular such as lifestyle change, dietary changes, exercise, and stress reduction, which a lot of practitioners don’t do. I also consider myself fairly well-versed in certain botanicals and what impact that can have on our health. One of the main reasons I started my own product line was because I really wanted to do it right.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

I have to go back to that original patient who I am calling “Karen.” In general, I don’t think it’s one person. It’s really all of my patients. I’ve done a lot of work in learning functional medicine alone, the courses, the certifications, my medical training, and I’m grateful to all of the people that have helped train me. But I learned a lot of what I know today from my patients, and listening to them, and seeing how they did things, and learning from their success stories.

Ok thank you for all that. Now let’s move to the main focus of our interview. We all know that it’s important to eat more vegetables, eat less sugar, exercise more, and get better sleep etc. But while we know it intellectually, it’s often difficult to put it into practice and make it a part of our daily habits. In your opinion what are the 3 main blockages that prevent us from taking the information that we all know, and integrating it into our lives?

Putting a healthy lifestyle into practice is difficult for many reasons, and there are three big reasons. The first one is stress reduction. We don’t operate well under stress, it’s hard to adopt new routines under stress and basically, like I always say to my patients, we just weren’t built for the 21st century, whether it be mentally or physically. The second would probably be industry, whether it be the food industry, agriculture and the way foods are cultivated. All of the above create nutrient deficient foods in conventional supermarkets that make it difficult to get really nutrient dense ingredients alongside the kind of vitamins and minerals we need to thrive and do well. The third would be time, or lack thereof. We’re just busy, busy, busy. It’s one of the reasons I say we’re not built for the 21st century, we’re not built to be as busy in finding time, to be healthy, to exercise to take the time to go to the better markets and get the better foods, it takes time takes a lot of time. A lot of us just don’t have that time.

Can you please share your “5 Non-Intuitive Lifestyle Tweaks That Will Dramatically Improve One’s Wellbeing”? (Please share a story or an example for each, and feel free to share ideas for mental, emotional and physical health.)

Five non-intuitive lifestyle tweaks that I preach to my patients, and what I call the five pillars of good health. Some of them may seem intuitive, but I’ll try to explain why they’re perhaps not the first one. When I talk to people, I always say I would actually put it as one, two, and three and that’s diet and nutrition. Now that may seem to be intuitive: you eat better, you’re going to be healthier. The reason it’s not is as I outlined earlier are there are so many reasons that can get in the way.

As an example, I’m going to use oranges and the vitamin C content of an orange. It’s believed and there’s decent evidence to show that an orange 50 years ago or 40 years ago — when cultivation methods were more natural, ground was cycled pesticides, herbicides were not used — that that orange probably had in the vicinity of 250 to 300 milligrams of vitamin C per orange. An organically grown orange, moderately for today, is believed to have somewhere in the vicinity of 150 milligrams. So even organically grown oranges are not quite where they were though they can reach 200 milligrams, which is not bad. Non- organic, more conventional oranges, i.e. the stuff you get off the normal grocery shelf, is no more than 50 to 60 milligrams.

The non-intuitive part of eating healthy is that a lot of people think that they are eating healthy. Unfortunately, they’re not because they’re buying nutrient poor foods. So, what’s the tweak for that? People have to do their best to go to places like farmers markets where things are growing more naturally. Certainly, buy organically wherever possible, and if you can’t get certified organic, try to avoid products that have been grown with herbicides or pesticides.

The second would be stress reduction. Again this seems intuitive. Reduce stress and you will do a lot better. It’s relatively obvious, but I think that is what is not intuitive is that it’s more important than exercise and some of the other pillars. It is extremely important and second only to nutrition and what food are you putting in your body. Another non-intuitive part of this is actually quite simple. Going into a period of quiet and silence five times, once or twice a day, whether it be at your desk or in the morning before you go to work or in the evening when you settle down. Just having a five to 10 minutes of quiet solitude without interference from the outside world can go a long way towards stress reduction. Of course, we have other methods. Yoga is a great method for stress reduction. Exercise can actually be a method for stress reduction. So those are those are what I would put as number two to achieve stress reduction.

The third is exercise, which is relatively obvious but what’s non-intuitive is that it doesn’t have to be for or a long time. People think that no pain, no gain. Honestly a 30-minute brisk walk five times per week can go a long way towards making a difference. The benefits of exercise, and there are multiple benefits, is stress reduction. The second is cardiovascular benefit because it’s good for the heart and getting the heart moving. As a muscle, getting the heart to pump more rapidly, for any period of time several times a week is good. Exercise is also great for bone health. It’s been shown that exercise can reduce osteoporosis. This is a big deal, especially in the more elderly. And of course, muscles themselves. I always say a body at rest stays at rest, a body in motion stays in motion. So, exercise I would easily put it as number three in terms of a pillar.

Fourth, and people always find it interesting, is to optimize your hormones. This is a mix of conventional and nonconventional medicine. It’s perhaps not as intuitive, because people don’t look at that and think it’s important. In fact, a lot of the conventional medical industry does not pay attention to optimizing hormones, but a part of the aging process occurs when our hormones start to decline. We are living longer and what I always tell my patients is, if you your hormones start to drop at 40 and your life expectancy is 70. By the time they really drop, you’ve got maybe 10 more years. But if your hormones start to decline at 35, or 40, and you live into your 90s, which many, many, many people are, well, now you’re looking at a 20-to-30-year period with very low hormones. That’s not very good physically or mentally for that matter. The aging process starts to really, really set in and that’s why I put optimizing hormones at number four.

Number five is disease mitigation. What I mean by disease mitigation is that if your cholesterol is high, bring it down. If you have to use a medication to bring your cholesterol down, it is the lesser of two evils. If your blood sugars are high, bring it down. Of course, diet and exercise are a great way of reducing blood sugar, but if you have to use a medication, use a medication bring the numbers down. Same with blood pressure to prevent hypertension. If your numbers are high and through conventional medicine, eating less salt, exercise, stress reduction, etc. and you can’t bring those numbers down, then use medications again. I don’t like medications but sometimes they are the lesser of two evils. The one evil being the disease process, the other evil being the medication itself.

As an expert, this might be obvious to you, but I think it would be instructive to articulate this for the public. Aside from weight loss, what are 3 benefits of daily exercise? Can you explain?

I mentioned one which is reduction in blood sugar’s improvement in diabetes or even prevention of diabetes, if somebody is a pre-diabetic. There are some very good studies in pre-diabetic population that walking 30 minutes a day, five days a week, along with a what I call a low glycemic index or low carbohydrate diet. Not too low though. 1600 calories can reduce the incidence of diabetes by anywhere from 65% to 68%. That’s a big number. Another benefit of exercise mental health. People who exercise are less likely to be to be stressed and it can be a stress reducer. A third would be heart health. An exercising heart is healthier than a non-exercising heart. You still want to push that hard periodically in the form of cardiovascular exercise. Bone health and muscle health are a big deal, especially for people over the age of 60 as it can make a big difference.

For someone who is looking to add exercise to their daily routine, which 3 exercises would you recommend that are absolutely critical?

There are three exercises that I would consider critical. The first would be cardiovascular, whether it be on a stationary bike, a treadmill or a brisk walk. It’s very important because it makes the heart exercise which is good, but it also opens up the collateral blood vessels, which are the smaller blood vessels that can help really help feed organs and provide oxygen and nutrients in a much better way than if just the larger blood vessels were open. That’s another big topic, but it is important. Another exercise is weight training. Of course, resistance training is good for bone health and good for muscles, and again, good for stress reduction. For number three, for critical exercise, you might find this amusing, but I’m going to actually use mental exercise as a form of exercise. There are a lot of mental exercises that are good for everybody, but especially good for people who are middle-aged, as a method of preventing Alzheimer’s. Whether it be crossword puzzles, community-engagement work, or being involved in book clubs or regular discussions with other people. But mental exercise, whatever the method you choose, is critical.

Is there a particular book that made a significant impact on you? Can you share a story?

A book that made a significant impact on me: Steve Jobs by Walter Isaacson. It was about eight years ago and at a time when I don’t want to say I was floundering, but I was I was having difficulty putting it all together. I had reached an inflection point in my dissatisfaction with insurance-based medicine and conventional medicine, and felt that there was another way. My medical training kept getting in the way mentally. This book had an almost immediate impact. I read that book and thought, “No, I need to do what I feel I need to do and what I feel helps people the most.” That started me off on this road that brought me to where I am today.

You are a person of enormous influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

I started an initiative a while back with the YMCA and unfortunately, it didn’t go anywhere at the time. I called it the Know Your Numbers Initiative and it speaks to number five in my five pillars, which is disease mitigation. What do I mean by that know your numbers? I think one of the biggest problems we have with medicine today is access to health care. What I mean by that is, by way of example, if everybody in the United States knew what their blood sugar was on a regular basis, we could easily identify pre-diabetics that are in a perfect stage for intervention to prevent diabetes onset. Diabetes, as we all know, is a huge burden on people both mentally and physically and on healthcare industry in general. It’s believed that at any given time, there are 10 to 15 million Americans who are pre-diabetic and don’t even know it. If I were to start a movement, I would say everybody should go and get checked for their numbers. Know what your blood pressure is, your blood sugar levels, and your cholesterol numbers. Prevention is key towards really reducing a lot of stress we put on ourselves and the healthcare industry.

Can you please give us your favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life?

I don’t know if this is a life lesson quote, but I’m going to use it anyway. “A body in motion stays in motion a body at rest stays at rest.” This is relevant to my personal life as well. When you start to have some aches and pains, whether it’s in the knees or the back, it’s your body deconditioning from movement. When you stop moving, especially after a medical or health care issue it can reach a point where people are debilitated simply due to a lack of movement. They go downhill both mentally physically and health wise. Using exercise as a way of staying in motion and keeping your health up is very, very important.

We are very blessed that some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them :-)

Even though he’s no longer with us it would have been Steve Jobs. There are two other people who I really admire, both for their contribution to society, to science and to people in general, but also to their contribution to healthcare. Elon Musk and Oprah Winfrey hands down. They’re incredible people and it would be an honor to be able to pick their brain for a few minutes, let alone for a private meal.

What is the best way our readers can follow you online?

We have a Facebook page, an Instagram account and a YouTube channel. On the KaraMD website there’s also a lot of great information in our blogs that people can use to improve their health and well-being.

This was very meaningful, thank you so much! We wish you continued success!