Category Archives: Health & Fitness

Follow the new Dietary Guidelines for Americans? Would if I could.

The most recent update to the Dietary Guidelines for Americans was released earlier this month. This is the latest attempt to provide us with information about what we should eat—and not eat—to stay healthy. The new guidelines, and why they may be difficult for many people to follow, are the topic of my Health & Fitness column in the Aiken Standard this week.

Good food display


Like past updates, there is some debate about the recommendations in the current guidelines. Uncertainly about the role that specific foods and nutrients (saturated fat, for example) play in promoting health and political influence from segments of the food industry are causes for criticism of these guidelines.

Despite the controversy, the guidelines do provide some good advice for us to follow. For example, they recommend that we eat a variety of fruits and vegetables, something that almost everyone agrees is healthy. Refined and processed grains should be limited in favor of whole, unrefined grains. Furthermore, added sugars should be avoided. There is good support for these recommendations, and the distinction is a welcome one. The recommendations for fat are a bit less clear, but the guidelines steer us toward “healthier” fats from plants, including nuts and seeds.

No doubt, everyone could experience some health benefits from eating more fruits and vegetables, favoring whole grains over refined, and limiting the consumption of processed foods containing added sugars. In my mind, the problem isn’t the recommendations themselves (although I might make some changes), it’s the fact that following them is challenging, if not impossible, for many people.

First, access to fresh fruits and vegetables is limited for many people, either by availability or by cost. The well-meaning advice to shop the perimeter of the grocery store avoids many of the unhealthy processed foods that are found in the center aisles of most stores, but it also results in a cart filled with more expensive produce, dairy, and meat. Many people simply can’t afford or shop this way, so the prepackaged, processed foods and meals are practically a necessity.

Second, making smart decisions in the grocery store and in restaurants requires that you have some nutrition knowledge. At the very least, reading food labels is essential. Unfortunately, the “label language” used to make nutrition claims on the front of packages and the less-than-complete information on the Nutrition Facts panel makes this challenging. Claims like “fat free” and “no high-fructose corn syrup” may seem to indicate a healthier choice, when in reality these foods are often no better than the alternatives on the next shelf.

Even though interpreting and following the new Dietary Guidelines for Americans can be challenging, it is still important to try. Making real food, as opposed to processed, prepackaged “food,” your first choice whenever possible will go a long way toward making your diet healthier. This will certainly involve putting more thought into what you eat, and you may find yourself preparing more meals at home rather than eating out.

And try not to worry too much about the debate about which foods and nutrients are the healthiest. If you select food that is as close to its natural state as possible you are likely to make good choices. For example, choose plain beef, poultry, and fish as opposed to flavored, cured meats. The same is true for dairy products like yogurt—watch out for lots of added sugar!

Regardless of what the current and future Dietary Guidelines say, you should strive to follow advice of author Michael Pollan: Eat food, not too much.


Nutrition, exercise, and health information can be confusing. 
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When fat attacks! Use your muscle to fight back.

Everyone knows what fat is. It’s where the extra calories you eat end up and the reason your clothes fit too tightly. But beyond that, it doesn’t do much, right? While fat, or adipose tissue, is a place to store excess energy, research shows that it also plays an active role in health and disease. In fact, your fat may be keeping you fat! The good news is that weight loss and regular exercise can reverse the negative health effects of excess body fat. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Adipose tissue


Body fat is essential for storing extra energy, something that allowed our caveman ancestors to survive times when food was scarce. But fat cells have important biological functions beyond storing extra energy. It turns out that fat cells release chemical signals called adipokines that have effects on other organs and tissues.

For example, type 2 diabetes is strongly linked with obesity. Type 2 diabetes is a condition of high blood glucose caused, in large part, by cells not responding to the hormone insulin. Resistin, which is produced by fat cells, has the effect of causing insulin resistance in the liver and muscle, the two major places where excess glucose is stored. The result is high blood glucose, the hallmark characteristic of diabetes.

Fat cells also secrete adipokines such as leptin and TNF-alpha that promote inflammation and abnormal function of blood vessels. This is associated with atherosclerosis, the development of cholesterol-containing plaques that form in blood vessels. These plaques may be unstable and rupture, leading to clot formation that causes a heart attack. This is one reason why obesity is a major risk factor for cardiovascular disease.

The hormone leptin also plays an important role in regulating body fat stores. Leptin signals the brain about the amount of fat stored in the body. When body fat stores decrease, leptin stimulates appetite to increase energy intake and storage as fat; when body fat increases, appetite is reduced.

At least that is the way it is supposed to work. The effect of leptin on appetite is only a suggestion, and it is easy to eat despite it. The result is excess energy intake which leads to obesity. Worse, the brain develops a resistance to the high levels of leptin produced by the excess body fat and establishes a new “normal” level. When someone loses weight and leptin levels go down, the brain responds by increasing appetite. Is it any wonder why losing weight and keeping it off is so difficult?

The good news is that losing weight and body fat, no matter how difficult it can be, can reduce the negative effects of these adipokines. The even better news is that exercise can reverse some of this damage, even if you don’t lose weight. The reason is that, like adipose tissue, muscle produces chemical signals, too.

These myokines also have beneficial effects include improving insulin sensitivity and reducing inflammation. This is one way in which regular muscle activity (exercise) is thought to promote good health. Myokines can also counteract the negative effects of adipokines by creating a balance between the two opposing effects.

In fact, the myokines that are stimulated by exercise can have a greater effect than the adipokines. This helps explain why being obese but physically fit may actually be healthier than being a normal weight but unfit.

The bottom line is that excess fat is unhealthy and we are starting to understand the mechanisms that explain why. Losing weight is important for improving your health. And exercise may be even more important, so you should strive to be more active regardless of your body weight

If you want to learn more about the role of adipose tissue on health, these two articles are a good place to start (fair warning–they are high-sci):

George Ntaios, Nikolaos K. Gatselis, Konstantinos Makaritsis, George N. Dalekos. Adipokines as mediators of endothelial function and atherosclerosis. Atherosclerosis 2013;227(2): 216-221. http://dx.doi.org/10.1016/j.atherosclerosis.2012.12.029

Coelho M, Oliveira T, Fernandes R. Biochemistry of adipose tissue: an endocrine organ. Arch Med Sci. 2013;9(2):191-200. http://dx.doi.org/10.5114/aoms.2013.33181


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How washing your hands, going for a walk, and getting enough sleep can make this a healthy New Year!

Now that the holiday season is behind us and 2016 is underway we can focus on our goals and resolutions for the new year. Staying healthy is essential for achieving these goals, whatever they may be. Unfortunately, the natural spread of cold and flu viruses at this time of year can interfere with your plans. The good news is, there is much you can do to reduce your risk of getting sick, which I explain in my Health & Fitness column in the Aiken Standard this week.

sneeze


For starters, getting a flu vaccine is the most important thing you can do to prevent seasonal influenza (flu). And it’s not too late if you haven’t gotten your flu shot yet. You can also protect yourself by not touching your eyes, nose, or mouth and by washing your hands frequently with soap and water or using an alcohol-based hand sanitizer. You have probably been doing it wrong, so you may want to learn this song.

Exercise can have a positive effect on your immune system. People who exercise on a daily basis have fewer and less severe colds and have up to 50% fewer sick days than those who aren’t regularly active. Research in animals and humans shows that exercise increases the activity of certain immune cells called helper T cells. This makes the immune system response to viruses, like the cold and flu, more robust. The strongest evidence is seen when the exercise is moderate in intensity and duration, such as a 30–60 minute walk or jog each day.

More exercise isn’t always better, though. Very vigorous and prolonged exercise can have the opposite effect. Athletes who engage in long, intense training tend to be more susceptible to upper respiratory infections. Research shows that immune function is depressed in the weeks leading up to and after running a marathon, resulting in an increased risk of becoming sick. The bottom line is that while exercise improves your immune system, very vigorous exercise may not.

Regular exercise also enhances the immune system response to the influenza vaccine. This means that the flu vaccine can be more effective in people who exercise. If you don’t exercise already, you can still benefit: one study showed that a single 45 minute exercise session can improve the immune response to the flu vaccine. You can get this benefit by going for a brisk walk before your flu shot.

Good nutrition is also important for optimal immune system function. Deficiencies of certain nutrients can have a negative effect on immune function, so eating a balanced diet is essential. That said, there is no support for “boosting” the immune system by taking high doses of vitamins, minerals, or other supplements, despite the claims made by supplement companies. In fact, one supplement company paid $23 million to settle a class action lawsuit regarding false claims that it prevented colds.

You can get benefits from two more common-sense recommendations: getting adequate sleep and reducing stress. Poor sleep habits are associated with suppressed immunity and more frequent illness. Sleep deprivation can also reduce the positive immune response to a vaccine. Another study showed that sleep following a vaccination enhanced the effectiveness of that vaccine. High levels of stress increase susceptibility to colds and the flu and can lead to more sick days from work or school. Stress and poor sleep habits tend to occur together, creating a double negative effect on the immune system.

In order to have your best chance of staying healthy this year you should exercise every day, eat a healthy diet, manage your stress, and get enough sleep in addition to following the traditional advice to get a flu shot, wash your hands frequently, stay away from people who are sick, and stay home yourself if you are ill. As a bonus, many of these habits will also help you lose weight and reduce your risk of diabetes, heart disease, and some cancers along with keeping you healthy this cold and flu season.


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It’s not too late! Tips for getting started on your New Year’s resolutions.

It’s time to get started on your New Year’s resolutions! If your goal is to eat healthier, lose weight, start to exercise, or quit smoking, you are not alone. Not only are these some of the most common changes people want to make, these are also among the most challenging behaviors to alter. Progressing from just starting out on January 1 (or today) to successfully changing habits in the long run can be a difficult and lengthy process. My Health & Fitness column in the Aiken Standard this week shares some simple steps you can take right away to get your New Year’s resolutions off to a good start.

2016 time to succeed


Eating Healthier

The typical American diet contains too much processed food which tends to be high in added sugars, fat, and salt and not enough “real food.”

  1. Start with five fruits and vegetables each day—but aim for twice that many. Fresh is best, but frozen vegetables are a good alternative.
  2. Avoid added sugars and salt, especially in prepackaged foods and snacks. This will help steer you toward food that is less processed and healthier overall.
  3. Read food labels. Nutrition information can be confusing, but learning how to interpret food labels can help you make healthier choices.

Starting an Exercise Program

Regular exercise is probably the most important thing you can do for your health. The good news is that a little activity goes a long way.

  1. Dedicate time for exercise each day. At a minimum you should aim for a 30 minute walk, and you can split that up into 10 to 15 minute bouts if you need to.
  2. Start slowly. Building endurance and strength takes time, and doing too much too soon can lead to injury.
  3. Join a gym. You can get all the exercise you need at home, but joining a gym gives you more options for equipment, classes, and personalized advice.

Losing weight

Successful weight loss requires that you change your diet and activity habits. Unfortunately, there are no shortcuts that work in the long term.

  1. Reduce portion sizes. The quickest way to cut back on calories is to limit the amount of food you eat.
  2. Eat healthier food. Fruits, vegetables, and whole grains tend to be low in calories and can help you feel full. Limiting added sugar and fat in foods reduces calories even more.
  3. Exercise every day. Research shows that people who lose weight and keep it off exercise every day for at least an hour. Work up to an hour of walking each day to be a “successful loser,” too.

Quitting smoking

Smoking is a difficult habit to break, owing to the addictive effects of nicotine and the social and behavioral aspects of smoking.

  1. Get rid of all cigarettes (and matches and lighters) now. This means at home, work, and your car. Don’t forget the pack you have hidden away for an “emergency.”
  2. Check out nicotine replacement therapy. Nicotine patches, gum, and lozenges are available over-the-counter at most stores and are recommended for nearly everyone who wants to quit smoking. There are prescription drugs that can help, too.
  3. Change your behavior. Smoking is ultimately a behavior that is influenced by people, places, and situations you encounter. Learning why you smoke is essential to help you quit.

 

Your ultimate goal should be to change these habits and behaviors forever. Doing so will require that you make a series of changes that you can stick with in the long run. It won’t be easy, but the health, fitness, and wellbeing rewards are worth the effort. And focusing on making a few simple changes should get you off to a good start.


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What does it mean? A health and fitness vocabulary lesson.

When I write about health I routinely use terms like exercise, activity, and fitness. Some people have asked why I use these different words since they all have a similar meaning. That is an excellent question, since these terms are related they have different applications for health and wellness. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Exercise sign


Physical activity (PA) is defined as any movement produced by muscles that expends energy. Physical activity can be classified as occupational, what you do at work, and leisure-time, what you do in your free time. Occupational PA can vary greatly depending on the job, but it is low for most of us who spend much of our work day sitting. Leisure-time PA is all activity outside of work. This is of great interest to researchers since it reflects how we chose to spend our discretionary time. Physical activity can be measured by questionnaires or using devices such as pedometers, which count the steps you take, or accelerometers, which measure how much you move.

Exercise is a type of physical activity that involves planned, structured, and repetitive movement to improve or maintain physical fitness. Physical fitness, then, is a set of attributes that relate to the ability to perform physical activity and exercise. The components of physical fitness include endurance, strength, and flexibility. Basically, participation in physical activity and exercise improves your fitness and the greater your fitness, the better able you are to participate in physical activity. This is true for completing occupational tasks as well as traditional exercise, such as jogging or lifting weights.

The good news is that both physical activity and exercise have health and fitness benefits. Physical activity can vary in intensity, from light (slow walking), moderate (brisk walking), or vigorous (exercise like running). The 2008 U.S. Physical Activity Guidelines recommend that, at a minimum, all adults participate in moderate-intensity physical activity for 2 hours and 30 minutes per week or vigorous activity for 1 hour and 15 minutes per week along with strengthening exercises at least 2 days per week. You can meet this recommendation by going for a brisk walk for 30 minutes on 5 days per week or running for 25 minutes on 2 days per week or some combination of the two. Additional benefits come from doing more, either higher intensity or longer duration activity.

Vigorous exercise is the best way to improve fitness while moderate-intensity activity is strongly linked to health benefits. Fitness benefits result from adaptations in the heart and muscles, which get stronger and become better able to resist fatigue. These changes also lead to health benefits including lower blood pressure, cholesterol, and glucose as well as helping with weight loss and weight control.

Research suggests that health and fitness benefits also result from light-intensity or intermittent activity, especially if it replaces sitting. At home or at work, the more time you spend sitting, the poorer your health, even if you exercise every day. One study shows that getting off the couch and stepping in place during TV commercials results in nearly 25 minutes of activity per hour and burns about 150 calories, compared to 80 calories just sitting the entire time. You won’t get in great shape doing this, but it will increase your overall activity.

With this is mind, a good recommendation is to reduce sitting time in favor of light activity—stand while you read the paper or walk around while you talk on the phone—and participate in moderate or vigorous activity each day by going for a brisk walk or doing other exercises, including strength training.


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Despite appearances, Santa is probably fit and healthy (thank goodness)!

Since Christmas is only a few days away our attention is naturally focused on one person: Santa Claus. Have you ever wondered how Santa gets in shape for his yearly sleigh ride to deliver gifts to good boys and girls around the globe? Like many elite athletes, Santa does not publicly discuss his training or his fitness. There are certainly no published studies that report his one repetition maximum strength or his maximal oxygen uptake. Given this lack of information, I attempted to make an educated guess about Santa’s training, fitness, and health in my Health & Fitness column in the Aiken Standard, something I do at this time each year.

santa


By all accounts, Santa is overweight. While we don’t know his body mass index, he would probably be considered obese. Furthermore, he appears to have a large waist circumference, indicating a high level of visceral fat. This suggests that Santa is a high risk for type 2 diabetes, high blood pressure, and heart disease. This combination can lead to a heart attack and, possibly, death at a relatively young age.

But Santa has avoided this fate, and seems to be living a healthy life. His secret, no doubt, is regular exercise. There is good evidence that maintaining a high level of physical fitness can reduce the risk of death in people who are obese (and everyone else). Like many athletes, Santa trains in the “offseason” to get ready for his annual Christmas Eve journey.

Santa’s training likely includes endurance, strength, and flexibility exercises. In order to visit every home around the world in one night, Santa moves quickly. This suggests that he has a high maximal aerobic capacity as well as good endurance. This is a result of both high-intensity interval training and long-duration, lower intensity training, similar to what a marathon runner might do. Evidence for his good aerobic fitness is shown by the fact that he flies away from each home with a hearty “ho, ho, ho.” If he were out of shape, he would be too short of breath to speak, much less give such a robust farewell.

Santa must also dedicate training time to improving his strength. His sack of gifts is certainly very heavy and he repeatedly carries it up and down chimneys. In addition to traditional weight lifting, Santa probably also engages in plyometric training, which involves explosive movements that develop muscle power. Santa must also have good flexibility in order to squeeze through narrow spaces and move quickly without pulling a muscle. This is the result of stretching and, likely, other exercises such as yoga.

Santa is also educated about sports nutrition. The cookies and milk you leave for him are more than a reward for delivering gifts at your house. The carbohydrates (sugar) in the cookies help Santa maintain his blood glucose to delay muscle fatigue. Some research suggests that combining carbohydrates with protein is even more effective, so the glass of milk is a good addition. Of course, Santa could have a specialized sports drink, but that doesn’t make for such a good story.

We can learn an important health lesson from Santa. Even though he is overweight, through regular exercise, Santa has reduced his risk of health problems and maintained his fitness at a level that allows him to complete his necessary activities. Like Santa, all of us can benefit from being physically active, whether we are overweight or not. He would likely be healthier and be able to perform his job better if he lost weight, but I’m not about to tell Santa what to do!

 


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Your Health & Fitness holiday gift guide: What you should really give your friends and family this year.

You probably have a friend or family member who is planning to start an exercise program, try to lose weight, or otherwise improve their health in the upcoming year. The right gift from you could help them get a good start on their New Year’s resolutions. With so many options for books, DVDs, exercise equipment, apps, and other gadgets, it can be difficult to pick the right gift. No worries, the Health & Fitness holiday gift guide is here to help you select something that will really help. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Holiday shopping


Most gift guides for health and fitness include things that people might need to get started and succeed on a weight loss or exercise program. Activity trackers are popular for monitoring exercise and providing motivation. Many runners use GPS devices or apps to record and share their runs. A host of websites and mobile apps provide nutrition analysis of meals to help with meeting training goals or weight loss. Almost all of these allow sharing with others over social media networks to foster a group dynamic, providing support, and even a little healthy competition.

All of these apps and devices can be helpful to someone starting a health improvement project and make great gifts. But an even better gift is something that really will help your friends and family members be successful. Here are the Health & Fitness holiday gift ideas:

Time. The most common reason that people quit an exercise program or struggle with weight loss is because of time. That includes time to exercise, obviously. But it also includes time to plan, shop for, and prepare healthy meals and snacks. This year, give the gift of time. Commit to helping your friend or family member plan time to focus on their program and dedicate yourself to taking on some responsibilities to help them do that. 

Help. In addition to helping find time, you should commit to actually doing things to facilitate your friend or family member’s health improvement program. Taking on chores and projects around the house, picking up the kids after school, and helping with shopping and cooking are examples of things you can do.

Support. Anyone who makes a major lifestyle change needs the support of others to be successful. Your role can be to provide encouragement, ask about progress, and take your friend’s program into account when planning meals and other activities together. You should also be ready to provide a gentle (or not-so-gentle) nudge when you see them getting off track.

A buddy. People who take on an exercise program with others are more likely to stick with it and be successful. So get involved with your friend or family member. Going for a walk together during a break at work or developing a healthy eating plan as a family is an excellent way to play along. Chances are, these healthy changes will benefit you, too.

These gifts may not have the wow factor of a shiny exercise gadget, but they are the things that will really help your friends and family members be successful. And that’s the best kind of gift to give. After all, no one ever quit an exercise program or failed at losing weight because they didn’t have the right nutrition app or the latest activity tracker. The real reason people struggle is because of factors like time and support from family and friends in the real, not virtual, world.


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
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Just in time…tips to prevent holiday weight gain.

Thanksgiving is this week which means the holiday season is upon us. It is a time for spending time with family and friends, shopping, and eating. The bad news is that weight gain between Thanksgiving and the new year is a very real possibility. The good news is that the typical holiday weight gain is less than you might think. The even better news is that this weight gain can be prevented.


First, the bad news. Research shows that, on average, people gain about one pound during the holidays. Even subjects who said they were trying to lose weight over the holidays ended up gaining about 0.5 pounds on average. The problem is that this extra weight is not lost during the spring or summer, meaning that holiday weight gain is a major contributor to the gradual increase in weight, about one pound per year, most people experience over time.

Now for the good news: The weight gain that typically occurs during the holidays can be prevented. Since people tend to gain less than one pound, even small modifications to activity or diet can make a difference. Here are some strategies:

  1. Stay active. The average holiday weight gain could be prevented by walking about one mile, or about 20 minutes, per day. Since time may be a factor, you can turn a shopping trip into a chance to be active by taking an extra lap around the mall or parking further away in the parking lot. Go for a walk before or after a family meal or party—and take your family and friends with you.
  1. Stay away from the food. Most holiday parties include lots of food, and usually not the healthiest choices. You can reduce the amount you eat by limiting your time near the food—literally, fill your plate and move away from the food. Using a smaller plate will reduce the amount of food you take, too. Getting rid of the candy dish on your desk at work or the plate of treats on the countertop at home are also smart ideas.
  1. Don’t drink your calories. Alcoholic beverages, soda, and juice all contain calories and can add up to a big part of your total calorie intake. For example, egg nog can contain over 300 calories per glass. This doesn’t mean you can’t enjoy your favorite drinks, but enjoy them in moderation.
  1. Plan ahead. If you are trying to watch what you eat, have a healthy snack before you go to a party. You will feel less hungry so you will probably be less inclined to eat as much. If you are bringing a dish to the party, make it something healthy that you like.
  1. Focus on family and friends, not food. The holidays are a time to enjoy special meals and events with family and friends, and that should be your focus. You should enjoy your favorite foods and drinks, just do it in moderation.

You can prevent holiday weight gain by watching what you eat and staying active. It is easier to keep the weight off than it is to lose it later, so a little extra effort now is worth it in the long run. Considering that many people plan to exercise and lose weight after the holidays, you could get a jump start on your New Year’s resolutions along with making this a happy and healthy holiday season.


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Diabetes 101: What you need to know

Diabetes is among the fastest-growing health conditions in the United States. Nearly 30 million adults have diabetes, with nearly 2 million new cases each year. If you include prediabetes, which tends to lead to diabetes if untreated, over 115 million Americans are affected. Fortunately, most cases of diabetes can be treated or prevented through healthy eating, weight control, and regular exercise.

Since November is American Diabetes Month, this seems like a good time to raise awareness about the prevention, treatment, and consequences of this serious medical condition.  If you want to learn more about diabetes, a great place to start is American Diabetes Association. This is also the topic of my Health & Fitness column in the Aiken Standard this week.

diabetes


Diabetes mellitus is a metabolic disorder characterized by high blood glucose (sugar) caused by a lack of insulin production or impaired insulin action. The lack of insulin production can be caused by an autoimmune disorder that damages the pancreas. This typically occurs during childhood, as in type 1 or “juvenile” diabetes, but it can occur in adults, a condition called latent autoimmune diabetes of adulthood (LADA). For both types, injected insulin is required to control blood glucose.

More commonly, diabetes is caused by the body’s cells not responding to the insulin that is produced, a condition called insulin resistance. This is called type 2 diabetes and is thought to be caused by some combination of obesity, particularly excess abdominal fat, and physical inactivity.

Diabetes can be diagnosed based on a fasting blood glucose test, taken 8–12 hours after a meal, usually in the morning. Another test is an oral glucose tolerance test in which blood glucose is measured for two hours after drinking a special beverage containing glucose. This measures the body’s response to glucose. The hemoglobin A1C test is a long-term measure of blood glucose control. This is important because the higher the hemoglobin A1C level, the greater the risk of diabetes complications.

For most diabetics, the main treatment goal is to control blood glucose level to prevent serious complications including nerve damage, blindness, infection and amputation, heart attack, and stroke. This is typically accomplished through a combination of diet, exercise, and medications, with varying degrees of success. But “curing” diabetes is rare, so most patients require continued treatment.

Exercise is important for blood glucose control because exercise causes an increase in the uptake of glucose into cells and can improve glucose tolerance and insulin sensitivity. In addition, exercise has the added benefits of promoting weight loss and improving strength and fitness. Both aerobic and strength training are recommended, with a minimum goal of 30 minutes per day, every day.

Meal planning involves selecting healthy foods to help maintain consistent blood glucose levels while meeting energy needs for exercise and other activities. The dietary recommendations for preventing and treating diabetes are almost identical to the general recommendations for good health: Emphasize whole grains, fruits, vegetables, legumes, and low-fat meat and dairy and reduce unhealthy fats, added sugars, and salt. The diet should also promote weight loss and weight maintenance, especially for overweight patients. The glycemic index (GI), a measure of how much a food raises blood glucose, can be helpful in dietary planning, but it is not the only meal planning tool that should be used.

Proper diet, blood glucose testing, medication use, and regular exercise can improve blood glucose control, reduce the risk of other health problems, and improve quality of life in diabetics. In those with prediabetes these efforts can delay the progression to diabetes and may even result in a return to normal blood glucose. In fact, diet and exercise have been shown to be more effective than medications in preventing diabetes. Plus, these lifestyle changes lead to weight loss and improved fitness, benefits that no medication can match.


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The truth about restaurant salads

If you are looking for a healthy option for lunch or dinner at a restaurant, especially if you are trying to lose weight, chances are you will consider a salad. It turns out that at most fast-food and casual dining restaurants, salads may not be the low-calorie or low-fat choice you were expecting. However, ordering a salad can still be a healthy option, as I explain in my Health & Fitness column in the Aiken Standard this week.

Big salad


We think of salads as being a healthy choice because they contain lots of vegetables which are low in calories and high in vitamins, minerals, and fiber. But most restaurant salads are more than just vegetables. At a minimum, you would add salad dressing and many salads also include nuts, fruit, chicken, bacon, or cheese, all of which add fat and calories.

Salad dressing alone can add hundreds of calories. Creamy dressings like ranch and blue cheese tend to be higher in both calories and fat than vinaigrettes. In many cases the salad has more calories than the sandwich or entree you would have ordered instead.

As an example, consider the Premium Bacon Ranch Salad with Crispy Chicken at McDonald’s. This popular salad contains 490 calories and 29 grams of fat. Compared to a Big Mac, which has 540 calories and 29 grams of fat, this salad doesn’t seem like such a healthy option. You could improve the salad by switching from fried chicken to grilled chicken and save 180 calories and 15 grams of fat.

The real problem is the ranch dressing—one packet contains 200 calories and 17 grams of fat. You could skip the dressing altogether, but a more reasonable approach is to switch to the Low-Fat Balsamic Vinaigrette, with only 35 calories and 1.5 grams of fat. Want to really cut calories? The salad with the vinaigrette dressing and no chicken has only 230 calories, almost 300 fewer than the version with crispy chicken with ranch dressing or the Big Mac!

Despite the fact that many restaurant salads have calorie and fat content similar to burgers and other entrees, it doesn’t make them a bad choice. The salad does contain several cups of vegetables, which means it is higher in vitamins, minerals, and fiber than a burger. The salads at McDonalds have about twice as much fiber as most sandwiches.

Think of it this way: the salad may be equivalent to a burger as far as fat and calories go, but it comes with a serving (or more) of vegetables. And the salad is even healthier when you consider that the sandwich would undoubtedly come with fries! One more point: I use McDonald’s as an example here, but the same holds true for salads at other fast food and casual dining chain restaurants.

What if you are at a restaurant and want to order a salad? What can you do to make it healthier? You could order a side salad. Given the huge portions at most restaurants, this smaller serving might be enough. You can also limit the toppings, especially meat and cheese, and choose a lower-calorie dressing. Another tried and true option is to ask for the dressing on the side so you can add just as much as you want. And don’t forget, you can always share one of the large salads with a friend or save half for another meal.

The bottom line is that salads at restaurants can be as high in calories and fat as other “unhealthy” menu items, but they do provide a serving of vegetables you might otherwise miss. And by making a few choices, you can create a salad that is a healthy, low-calorie option.


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
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