Category Archives: Health & Fitness

Juiced! Why fruit juice isn’t quite the same as eating fruit.

Nutrition information is often confusing and conflicting, making healthy food choices a challenge. Fortunately, there are some recommendations that are consistent. Among these is eating more fruit. But what if the way you were consuming fruit meant that you were missing some of the nutrients that make it so healthy?  This is the topic of my Health & Fitness column in the Aiken Standard this week.

Orange-orange juice


Fruits are excellent sources of essential vitamins, minerals, and fiber. Fruit also provides energy in the form of naturally occurring sugar. Whole fruit and fruit juice are considered equivalent in current nutrition recommendations. However, fruit juice has been implicated as a contributor to weight gain and poor health, especially in children.

This is because fruit juice often comes in the form of fruit-flavored drinks that contain little or no actual juice but plenty of added sugar, so they are essentially soda without bubbles. Even though real fruit juice contains about the same amount of sugar and calories as soda or other sweetened drinks, they are not comparable when it comes to nutrition.

One consequence of consuming food and beverages that are flavored like fruit but are actually much sweeter is that it may make real fruit less palatable. People, especially children, may develop an expectation that “fruit” should taste as sweet soda or candy and prefer the sugar-sweetened version over the real fruit.

It seems reasonable that since juice is made from fruit, drinking juice must be the same as eating fruit. This isn’t always the case. Depending on how the juice was made will determine whether it is comparable to eating fruit.

Juice that is pressed is missing some of the nutrients of the fruit, most importantly fiber. A good example is apple juice. Apples contain sugar, vitamins, minerals, and fiber. The fiber is in the cell membranes of the apple and the juice, containing the sugar and other nutrients, is in the cells.

When you eat an apple, you are getting all the components of the apple, including the fiber. Apples that are pressed into juice contain the sugar, but not the fiber. In this case, eating the whole fruit is better than drinking the juice.

If the juice is made from whole fruit that is blended it may contain the fiber. Many smoothies are made with whole fruit, so these drinks are comparable to eating fruit. Better yet, some smoothies also include vegetables making them a good source of both fruits and vegetables.

Fruit smoothies are often used as meals or snacks to promote weight loss, but this requires some careful consumption to be effective. Many smoothies contain additional ingredients, some of which contribute nutrients as well as others that simply add sugar and calories. These extra calories can interfere with weight loss.

Additionally, drinking your fruit may lead to overconsumption that you don’t notice. It is far easier to drink juice or a smoothie than it is to eat a piece of fruit, so you are more likely to consume excess sugar and calories with juice. A single 8 oz. serving of apple juice can contain the juice of 3 or more apples. While drinking a glass of apple juice may not seem like a big deal, eating three apples would certainly get your attention!

While eating whole fruit is recommended over drinking juice, the most important thing is to include fruit in your diet. But make sure you are getting 100% real fruit, not sweetened, flavored drinks and snacks that are essentially candy and soda!


drparrsays blog footer

Fat: More than skin deep

Everyone knows that fat is where the extra calories you eat end up and the reason your clothes fit too tightly. Body fat, or adipose tissue, is an efficient way to store excess energy. When you eat more calories than you expend, the extra energy can be stored as fat. Body fat is essential for storing extra energy, something that allowed our caveman ancestors to survive times when food was scarce. Beyond simply storing energy, research also shows that fat plays an active role in health and disease. This is the topic of my Health & Fitness column in the Aiken Standard this week.

waist circumference


Some fat is stored beneath your skin, which you can feel when you “pinch an inch.” This is called subcutaneous fat, and it is what most people think about when they think of body fat. It is also the fat that people see change when they gain or lose weight. But you also store fat in other places in your body, which can have important health effects.

Subcutaneous fat is stored between the skin and muscle and may or may not be distributed evenly throughout the body. Some people tend to store fat in their hips and thighs while others store it in their upper body. Much of this is determined by genetics, which also influences where fat is lost during weight loss.

Fat is also stored beneath the muscle wall in the abdomen. This is called visceral fat because it surrounds the intestines and other internal organs. Visceral fat is known to be associated with a greater risk for diabetes, high blood pressure, and heart disease than subcutaneous fat. This is in part due to the chemical signals called adipokines that are released from visceral fat and have effects on other organs and tissues resulting in insulin resistance and inflammation.

A simple way to tell if you have excess visceral fat is to measure your waist circumference. If it is greater than 36” for females or 40” for males, you are at risk. This is especially true if you aren’t able to pinch much fat around your waist, which suggests you have less subcutaneous fat and more visceral fat. Keep in mind that this isn’t foolproof, and a high waist circumference doesn’t always mean excess visceral fat, but it’s a good indicator.

Fat can also accumulate inside the liver, a condition is called fatty liver disease. You might expect this to be the result of eating too much fat in your diet, but a more common cause is too much sugar. When you eat excessive amounts of sugar, the liver can turn it into fat. This is especially true if the sugar is fructose, which is found in many artificially sweetened foods and beverages as high fructose corn syrup. When the liver converts fructose to fat it damages the liver and can lead to inflammation, cirrhosis, and liver failure.

The bottom line is that excess fat anywhere is unhealthy, but some forms of fat are particularly dangerous. Losing weight and body fat can reduce the negative effects of body fat. Improving your diet to reduce sugar intake is important for weight control and to minimize liver damage. Exercise also plays an essential role in reducing or reversing some of the negative effects of excess fat so you should strive to be more active every day regardless of your body weight.


drparrsays blog footer

Low carb? No carb? Try going smart carb!

Nutrition information tends to be complicated and contradictory, making an answer to the question, “What should I eat?” anything but simple (but you still need to do it!). This is particularly true when it comes to carbohydrates. On one hand, current recommendations call for carbohydrates to be a major part of your diet. On the other hand, very popular low-carbohydrate diets are at odds with these recommendations.

Low-carbohydrate diets work because eating too much carbohydrate leads to fat storage and weight gain, so restricting carbohydrates can promote fat loss. People who follow low-carbohydrate diets to tend to lose weight, so this approach makes sense. It is also likely that people who follow low-carbohydrate diets find them easier to stick to than other diets, so they may end up eating fewer calories.

Considering that the typical American diet contains too much carbohydrate from sugars and refined grains and not enough whole grains, restricting carbohydrates may have some benefits. But there is another approach: be smart about your carbohydrate choices. Instead of cutting out all carbohydrates, focus on reducing refined grains and sugars and emphasizing whole grains. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Bread bread bread


Sources of carbohydrates include whole grains (such as whole wheat bread), refined grains (white bread), and sugars. Both refined grains and sugars tend to raise blood glucose rapidly, a measure called the glycemic index, which leads to an increase in certain hormones. One of these is the hormone insulin, which stimulates the uptake of nutrients into cells, including the storage of fat in adipose tissue. This is one reason why eating carbohydrates is linked to fat gain and why restricting carbohydrates leads to fat loss.

But carbohydrates from whole grains don’t raise either blood glucose or insulin as much. This “low and slow” response has several benefits, including improved blood glucose regulation, lower triglycerides, and, potentially, reduced fat storage. For these reasons, complex carbohydrates from whole grains are called “good carbs,” in contrast to refined grains and sugars, known as “bad carbs.”

You can be smart about carbs by limiting your intake of sugars, especially added sugars, and refined grains while increasing your consumption of whole grains, fruits, and vegetables that are high in fiber. When comparing food labels, look for foods that contain whole grains (the first ingredient should be something like “whole wheat flour”) and higher levels of fiber. But be aware that some foods, like many breakfast cereals, contain whole grains but are also high in added sugar. The best advice is to get the majority of your carbohydrates from real food, including vegetables, fruits, whole grains, and legumes, rather than from processed foods.

Something to keep in mind is that although low-carbohydrate diets are associated with weight loss and good health, they are not the only way to achieve these benefits. Indeed, people who are considered to be fit and healthy have a wide range of eating patterns. The one factor they have in common is that they are active. It seems that regular exercise is just as important as what you eat when it comes to promoting health. So, regardless of what you eat, make physical activity part of your daily routine.


drparrsays blog footer

 

 

What is a healthy breakfast?

Everyone knows that breakfast is the most important meal of the day, right?

You have probably heard that eating a healthy breakfast is important. After all, breakfast is often said to be the most important meal of the day. It’s difficult to prove that any one meal is more important than another, but research does show that eating breakfast can lead to important health benefits.

Breakfast provides energy to start the day. This is especially important if you will be active in the morning, either through an early trip to the gym or if you have a strenuous job. But even people who are less active may find that they feel more alert if they eat breakfast—and not just because of coffee. A healthy breakfast is also important for attention and learning, especially in kids.

Eating breakfast can also help reduce hunger and overeating later in the morning or at lunch. This is why breakfast is often emphasized in weight loss diets.

But what is a healthy breakfast? This is the topic of my Health & Fitness column in the Aiken Standard this week.

donuts


Unfortunately, there is no specific answer to that question. I think most experts would agree that a good breakfast should include a combination of carbohydrates, protein, and even some fat but be low in added sugar. These broad guidelines suggest that there are many ways to create a healthy breakfast, even if it doesn’t include traditional breakfast foods.

Instead of making a list of all the foods that could be part of a healthy breakfast, I took the opposite approach and made a list of foods that shouldn’t  be part of a healthy breakfast. The idea being that if your breakfast contains these items,  it could likely use some improvements. And if you avoid these foods, your breakfast can’t be all bad.

So, here is my list of foods that almost certainly aren’t part of a healthy breakfast:

1. It has frosting on it.

I think everyone would agree that foods that are frosted are better classified as dessert than breakfast. That said, from donuts to Pop Tarts to breakfast bars, many unhealthy breakfast foods are covered with a layer of frosting.

2. One of the ingredients is marshmallows.

Just like frosting, breakfast foods that contain marshmallows are probably better choices for dessert. Marshmallows are found in cereals, granola bars, an other packaged foods that are almost always high in added sugars beyond the marshmallows.

3. It is topped with whipped cream.

A fruit smoothie can be a healthy breakfast. But a fruit smoothie topped with whipped cream is likely closer to a milkshake as far as sugar and calories are concerned. The same goes for coffee drinks. A mocha-caramel-latte with whipped topping may contain coffee, but it also has far more sugar, fat, and calories than you might expect.

4. It contains chocolate.

Research shows that eating chocolate may have health benefits. But the research involves consuming small amounts of dark chocolate, not chocolate donuts or chocolate-flavored cereal. Again, save the chocolate for dessert.

5. You are eating it in your car.

More specifically, you got the food while you were in your car, which means it likely came from the drive-through window at a fast food restaurant. Fast food is just as poor of a choice for breakfast as it is for lunch or dinner.

Of course, there are certainly some exceptions to these guidelines. And there is nothing wrong with treating yourself to a chocolate frosted donut once in a while. But if your daily breakfast includes items from this list, you could benefit from a breakfast makeover, and this list should help you avoid many unhealthy choices.


drparrsays blog footer

Driving yourself to the doctor–why spending time in the car is bad for your health, and what to do about it.

Have you ever thought about how much time you spend in your car? On average, Americans face a 50-minute round-trip drive each day just for their jobs, and nearly thee-quarters of commuters drive alone. In suburban and metropolitan areas the commute can be much longer. Even in Aiken the average commute time is about 23 minutes. When you include driving to work, taking the kids to school, and doing errands, sitting in a car can easily account for an hour or more each day.

The impact of spending time in the car on your health is the topic of my Health & Fitness column in the Aiken Standard this week.

line of cars at drive thru


 

You can find the average commute time in your area using this really cool interactive map from WNYC.

You are probably very aware of the time you spend in the car. What you may not know is that sitting in your car can also have negative effects on your health and happiness. This is the conclusion of several studies that examined the relationship between commuting time and indicators of health. One of these studies suggests that vehicle miles traveled is a strong predictor of obesity. In another study, commuting a greater distance was associated with lower levels of physical activity and fitness as well as a higher waist circumference and blood pressure.

This makes sense because spending more time sitting in your car means you have less time to dedicate to being physically active, something we know is good for your health. Add to that the fact that driving is sedentary. There is accumulating evidence that spending more time sitting in the car, at work, or at home is a predictor of poor health, regardless of how active you are the rest of the day.

It gets worse. Many people eat in their cars during long commutes. Much of the time these “meals” consist of fast food and other prepackaged foods—not many people eat salads while they drive! Since these foods are typically of questionable nutritional quality and high in calories, this alone can contribute to obesity and poor health. The combination of inactivity and eating behind the wheel can easily shift the balance toward weight gain. Plus, eating while you drive is dangerous!

Beyond the direct impact on health through eating and activity behaviors, commuting alone in a car is a form of social isolation. Research suggests that this can lead to depression, itself an important factor leading to poor health.

The problems with long commute times are well established and easy to appreciate. Unfortunately, the solutions are not. Most people can’t move in order to have a shorter commute and relying on public transportation isn’t practical or even possible for many people, especially in our area. Replacing driving a car with active modes of transportation simply isn’t practical.

Aside from the time requirement, our environment doesn’t adequately support active travel—imagine how long a 25-minute drive would take on a bike or on foot! Being able to walk or bike requires access to safe bike lanes and sidewalks that connect people’s homes to work, school, and other destinations. Even public transportation increases activity over driving and enhances social connections. Sadly, this infrastructure doesn’t exist in most communities, which were built to support cars, not people.

But we can take steps to undo some of the damage that so much driving can cause. Making activity at other times of the day a priority is a good start. This could include exercise at the gym, going for a walk, or even yard work or housework. When possible, replace car trips with walking or biking. Planning these activities with others can strengthen social connections as well as improve health and fitness. Finally, act as an advocate for changes in the community that will make active transportation more realistic.


drparrsays blog footer

Back to school 2017

Physical activity and good nutrition have long been recognized as essential for promoting good health in adults and children. More and more research suggests that these behaviors can have beneficial effects beyond health, including how we perform both physically and mentally. The emphasis here is on children in school, but it applies to adults, too. This is the topic of my Health & Fitness column in the Aiken Standard this week, just in time for the first day of school here.

school lunch


Unfortunately, taking time for activity and good nutrition is seen as a luxury or a distraction to learning in most schools. Far from being a distraction, physical activity and healthy eating are prerequisites for learning and academic achievement. In short, these often ignored factors can help make sure children are ready to learn.

Regular physical activity is essential for good health, growth, and physical development, including maintaining a healthy body weight. This last point is important given the epidemic of childhood obesity and related health problems, including “adult” diseases like high blood pressure and type 2 diabetes.

Current recommendations call for all children to get at least 60 minutes of activity per day. This can include activity at school from physical education classes, recess, other classroom activities as well as games, sports, and unstructured play. Unfortunately, most kids don’t get nearly enough activity at school and many aren’t active at home.

Physical activity is also important for academic performance. Research shows that children who participated in an activity program had better executive control, which includes resisting distractions and maintaining focus, improved memory, and doing better switching between tasks. This is particularly relevant for children with ADHD, but the effects can be seen in all kids. These positive changes can maximize class time and lead to improvements in academic achievement, especially math and reading test scores.

Similarly, good nutrition is also essential for health, growth, development, and academic achievement. Eating a good breakfast improves cognitive function, alertness, and academic performance in students of all ages. It should be no surprise, then, that skipping breakfast impairs cognitive function and academic achievement. This is one reason that many schools offer breakfast to start the day or include a healthy mid-morning snack.

The same is true for lunch, too. A good lunch can support learning in the afternoon and gives a chance to teach kids about good nutrition by providing healthy food that, unfortunately, many children may not get at home.

Schools have a unique opportunity to use physical activity and nutrition to promote health, support academic achievement, and teach healthy habits. Since formal nutrition education is missing from most curriculums and PE programs are being reduced or cut completely, schools must be creative to incorporate these essential subjects.

A way around this problem is to make sure children get a chance to move and play, ideally multiple times during the day. This is what recess is for. Teachers can also incorporate activity and nutrition education in the classroom and get away from the idea that kids must be sitting still to learn. As research shows, quite the opposite is true!

Schools are often hesitant to teach about nutrition and activity because it is thought of as a responsibility of parents, not schools. But most parents don’t teach these good habits at home, which affects what happens at school. Despite the obvious benefits, it will probably take years of effort to change this view.

In the meantime, parents can encourage their kids to be active and make smarter food choices at home so they are ready to learn in school.


drparrsays blog footer

Chill out! Why less stress is essential for good health.

Chronic stress can have serious emotional, psychological, and physiological effects that contribute to or exacerbate many health problems. In fact, the negative health effects of chronic stress are like those of eating a poor diet or not getting enough physical activity. That said, managing stress, including getting enough sleep, is often overlooked as a key component of good health.

The effects of stress and the importance of stress management is the topic of my Health & Fitness column in the Aiken Standard this week.

stress


The word “stress” is typically used to indicate both the feeling of being “under a lot of stress” as well as the things that cause that feeling. The events and situations that cause stress are properly called stressors, which lead to a stress response that includes consequences we feel as well as physiological changes we may not notice.

The immediate effect of a stressor is called the “fight or flight” response since it prepares the body to deal with a dangerous situation. A classic example of this is a caveman who encounters a saber-toothed tiger, clearly a stress-inducing event.

The sympathetic nervous system is immediately activated, which raises heart rate and blood pressure to pump more blood to the muscles. Additionally, stored fat and carbohydrate fuels are broken down as fuel for the muscles. The adrenal glands release catecholamines (adrenaline) and cortisol (the stress hormone) to prolong and enhance this effect. This coordinated response makes sure the caveman’s body is ready for action. After the danger passes, everything returns to normal.

This physiological response is appropriate for major events like saber-toothed tiger encounters, but not for less perilous stressors like being stuck in traffic, pressure at work or home, and other personal and family issues. But the body responds with the same increase in blood pressure and hormones to them all. Unlike a rare saber-toothed tiger encounter, these stressors tend to occur on a daily basis, leading to continuous stress response.

The increase in hormones can lead to high blood pressure, obesity, type 2 diabetes, and other chronic diseases. This is partly due to elevated levels of cortisol, a hormone that plays a role in storing fat and increasing appetite. While elevated cortisol during exercise (including running away from a saber-toothed tiger) is normal, chronic overproduction can have negative effects.

While it is impossible to avoid all stress in life, minimizing stressors and managing the way you respond to stress can have important benefits. To the extent that it is possible, avoiding stressful situations through better time management, setting realistic expectations for ourselves and with others, and learning to say “no” are common recommendations.

Learning how to deal with stressors to avoid the negative effects of stress is also important. Techniques that can be implemented in the heat of a stressful moment include taking a break from the situation, listening to calming music, and progressive relaxation. Even taking a deep breath can help.

Exercise has long been recognized as beneficial for reducing stress and the long-term effects of stress on your health. This includes doing something active during a stressful situation and exercising regularly to improve the way your body responds to stress. While all forms of exercise seem to work, much research and practice has focused on specific types of exercise including yoga and Tai Chi.

Other effective strategies traditionally include meditation and relaxation exercises. More and more research shows that getting enough sleep is also critical for reducing stress and the impact it has on your health. Eating a healthy diet can reduce the effects of stress as well.

The bottom line is that a healthy lifestyle includes stress management as well as a good diet and regular activity. Since all three are essential for good health, it would be wise to eat smart, move more, and chill out!


drparrsays blog footer