I'm always studying products, techniques, and technologies that offer a uniquely effective approach to optimizing health. The latest opportunity we offer addresses one of the most stubborn conditions I encounter – impaired glucose management, which is often labeled as adult onset diabetes, insulin resistance, metabolic syndrome, chronic physical fatigue, and reduced muscle stamina. Our office has been selected as the only site in Orange County to offer Cyclic Variations in Altitude Conditioning (CVAC), which simulates changes in altitude through precise patterns. Within a 20-minute CVAC session the altitude changes an estimated 300-500 times with the pattern and targeted pressure and temperature changes arranged to enhance the fitness if your body type. Dr. Kaslow is using the CVAC himself in preparation for his climb to the 19,400 foot summit of Mount Kilimanjaro over New Years 2010.
CVAC stimulates mitochondria (the energy producing organelles inside your cells), which has been shown to markedly improve strength, stamina, glucose metabolism, tolerance to inadequate oxygenation, etc. The list of reported benefits includes:
- Marked improvement in stamina and endurance (ex- cycling)
- Increased power in sports (cycling, mixed martial arts, triathlons, etc.)
- Marked improvement in recovery from engaging in sports or other high-exertion over-exertion in competitive sports.
- Marked improvement in glucose metabolism (ex – insulin resistance, diabetes. It should be noted that there is substantial evidence that insulin resistance and oxidative stress implicated in aging, aging-related disorders, and hypertension.)
- Improved levels of testosterone (ex – muscle mass, performance, confidence, blood glucose management, bone mineral deposition, fat reduction, etc.)
- Reduction in pain and restoration of sensation in diabetic neuropathy.
A CVAC session involves sitting in the prototype altitude simulator for 20-60 minutes (shown below while it was in use at Stanford University). Clean, fresh air will move in and out of the chamber to change pressure and temperature. You are welcome to read, talk on your cell phone, listen to music or watch television, or just relax during the session. You will be able to communicate at all times via walkie-talkie with office staff who have not only used the unit themselves but who have been certified by the company to operate the CVAC system (SA Certified). We have a simple device (Ear-Popper) available to make those individuals comfortable who have trouble with ear pressure changes when flying. There are no restrictions to your activities after the CVAC session, however, CVAC Systems, Inc. recommends that you do not exert yourself physically more than your normal routine.
A study performed at the University of Hawaii presented at the 2006 American College of Sports Medicine annual meeting proved that there was a significant improvement in the oxygen-carrying capacity of study subjects' blood and that subjects achieve "a significant adaptation to high altitude in four weeks of use." Subsequent studies at Stanford University confirmed the physiologic effects of the CVAC process. Published studies show that high-altitude acclimatization causes the body to compensate for less oxygen by increasing red blood cell count, hemoglobin and the number and density of capillary blood vessels. As a result more oxygen is delivered to the tissues. Moreover, when high altitude-acclimatized individuals exercise at lower altitudes, mitochondrial density increases in response to the additional availability of oxygen, resulting in increased strength, stamina, and numerous other benefits. In addition to any "altitude effect", the cyclic changes in pressure, oxygen and temperature that occurs during CVAC is similar to total body interval resistance training that stimulates an increase in mitochondrial density, resulting in increased strength, stamina, and numerous other benefits. This concept is supported by research done at Duke (Gutsaeva, 2007) and by Dai (2002). In addition, the Stanford research showed more glucose uptake with CVAC. It follows that if an athlete can convert more sugar to energy by having more mitochondria they naturally have better performance because they would have more energy available. The synergistic combination of these mechanisms would amplify the benefit for athletes.
"Behind the scenes" CVAC is expected to remove the lactic acid, bradykinin, other toxins, and dead or injured cell parts built up during physical exertion. Any level of exercise into the anaerobic range produces waste material (most notably, lactic acid). Flushing such waste products may explain why many CVAC users report significantly enhanced 'recovery' after workouts, competition, or injuries. Pressure changes that naturally occur during the CVAC session stimulate "pressure diuresis" causing your kidneys to remove excess fluid through increased urine production. This explains why you may need to urinate soon after the session, and many report less water retention.
As mentioned earlier, one of my keen interests in using CVAC is to correct the metabolic condition that leads to insulin resistance, which has been shown in many studies to predispose you to cardiovascular disease and shorten the human lifespan. Insulin resistance is associated with a constellation of biochemical and hormonal imbalances that are associated with:
- Elevated blood glucose (and if severe enough could be classified as adult onset diabetes)
- Elevated triglycerides
- Elevated uric acid (gout)
- Elevated blood pressure (hypertension)
- Increased abdominal fat deposition
This metabolic syndrome is associated with an increased risk of cardiovascular disease and premature death. It is particular difficult to manage for a few reasons. First, it may represent an evolutionary advantage for survival during times of famine or when food was not as plentiful in the winter (reduced caloric intake with the use of fat reserves for energy). Thus it may not really be a disease but rather a consequence of excess calorie availability and consumption. Furthermore, we are blessed and cursed with lifestyles of ease and convenience rather than daily hard manual labor and calorie consumption for survival. Because the specific fat that is deposited tends to be in the abdominal area, it has a very slow metabolic rate. After all, it was placed there for storage. Because of this, it takes an extraordinary amount of exercise and caloric restriction to reduce abdominal fat.
The second challenge of the metabolic syndrome is the belief of pharmaceutical companies that if we make your body more sensitive to insulin, your blood glucose will fall and all of the other problems (weight, blood pressure, uric acid, blood fat levels, etc.) will improve. After many years of using both medications and supplements, I have not seen this approach be very effective. In fact, the idea that improving insulin effectiveness should work at all is questionable. One of the most powerful roles that insulin plays is to remove glucose from the blood stream and deliver it into cells. The cells either burn the glucose or store it. It is only logical that a cell with poor metabolism is much more likely to store the extra glucose as fat than it is to burn it – unless the cell increases its ability to burn sugar. The primary glucose-burning organelles in your cells are mitochondria. Your mitochondria are the site in which power and energy (known as ATP) is created. If you have low numbers of mitochondria you don't make as much energy. CVAC specifically increases the number of mitochondria found in your cells, and thus it increases your capacity to burn glucose into energy. As a result, the extra calories consumed year round and our lifestyles of reduced energy use promote the metabolic syndrome. CVAC seems to address this issue by increasing the number of your mitochondria, which in turn burns the extra calories and reverses the metabolic syndrome and insulin resistance.
What are your other options to successfully address insulin resistance – caloric restriction (eat a lot less food) and high intensity short interval exercises to stimulate you to adapt by increasing glucose utilization preferentially to fat. By exercising in this specific way, your body stops storing fat because it "learns" you prefer to use sugar for exercise rather than fat. Slow low intensity exercise does the opposite – it relies more on fat than sugar use. Your body "learns" to store your preferred fuel source. High intensity short interval exercisers prefer to use glucose, slow endurance exercisers prefer to use fat and therefore store it accordingly.
Because we anticipate a lot of interest in CVAC from my existing patients and referrals from other health care professionals, we are prioritizing appointment times for a select number of patients. You do not need to be a patient in our office to use the CVAC. Call the office 714-565-1032 to schedule your initial session. The initial session (Tier 1) lasts about 40 minutes and consists of relatively low altitude simulation. It is divided into five, 5 minutes phases to help you feel the process as it sequentially progresses to higher altitudes. These help to train your ears to adapt to the changes in pressure that are resultant from the changes in altitude. The charge for the first session is $60.00. Although the first session may have an impact, once you have satisfactorily completed Tier 1, you are ready to take 20 minute sessions of progressively greater altitude sessions. The cost of the subsequent sessions is timed based – 20 minutes for $40.00 if paid for on a "pay as you go" basis for sessions taken during our regular office hours. 20 minute sessions after hours or on weekends carry a higher charge in order to cover staffing charges ($47.50).
CVAC is not considered a medical procedure, the unit is a prototype, and since there is no CPT code for CVAC at this time, we are unable to bill your insurance. The cost for the sessions may be eligible for health savings account and flex plan reimbursement.
Come prepared and bring with you:
- A bottle of water
- Chewing gum
- Something to read or do
- A blanket or jacket (the higher altitudes are associated with cooler temperatures)
Plan on needing access to a restroom within 30-60 minutes after the session.
Get ready to ascend!