Category Archives: Health & Fitness

Reducing your risk of heart disease

February is Heart Month, an ideal time to assess your risk of heart disease and take steps to improve your health. This is important because heart disease, sometimes called coronary artery disease, is the leading cause of death among adults in the United States. It is responsible for nearly 600,000 deaths each year, mostly from heart attacks. Millions more are at increased risk because of certain biological and behavioral risk factors.

Identifying your personal risk for heart disease and making efforts to improve your heart health is the topic of my Health & Fitness column in the Aiken Standard this week.

Some of these risk factors cannot be changed, such as age, sex, and family history, while others can be altered to reduce risk. These modifiable risk factors include smoking, high blood pressure, high cholesterol, diabetes, obesity, and physical inactivity. While your doctor can play an important role in treating these conditions, there is much you can do on your own to improve your heart health.

The first step is to get a good assessment of your heart health. If you haven’t done so recently, you should see your doctor to have your risk factors evaluated. This includes tests for blood glucose and blood lipids (including total, LDL, and HDL cholesterol and triglycerides), measurement of your blood pressure and body weight, and an assessment of other health factors such as your family history, whether you smoke, and your level of physical activity.

The next step is to treat the risk factors that you have. Depending on the severity and your own personal health history your doctor may prescribe medications to lower your blood pressure, blood glucose, or blood lipids. These medications are most effective when combined with lifestyle changes including good nutrition, exercise, and weight loss. In some cases, poor diet and lack of activity can counteract the beneficial effects of these drugs. Furthermore, these healthy habits may help you reduce the dosage, and limiting the side effects, or stop taking the medications altogether.

The other risk factors—obesity, inactivity, and smoking—really must be treated through lifestyle management. While there are medications that can help with smoking cessation and weight loss, being successful requires making lasting behavior changes. These habits can be difficult to change, and many people have tried before without success. Keep in mind, though, that everyone who is successful at quitting smoking, losing weight, or sticking to an exercise program has experienced his or her share of difficulty. The difference is that those people kept trying until they were successful. You can be successful, too.

Even small changes can have a big impact. Take exercise, for example. The benefits of as little as 30 minutes of physical activity per day are well established and impact heart disease risk in a multitude of ways. Physical activity helps with weight control, lowers blood pressure, improves blood lipids, and prevents and treats diabetes. Think of this as a great health “deal.” By modifying one risk factor—inactivity—you can also promote beneficial changes in four others—obesity, hypertension, high cholesterol, and diabetes. There is no other treatment, drugs included, which can have such a broad impact on reducing heart disease risk!

Of course, there are steps you can take beyond becoming more physically active to reduce your risk of heart disease. The list of beneficial changes you can make to improve your heart health is long, but keep in mind that even small changes can add up to a big benefit. 

Knowing which risk factors are most concerning can help you and your doctor make effective treatment decisions. Quitting smoking, increasing your physical activity (and reducing sedentary time), and eating a healthier diet can lead to improvements in heart disease risk factors and reduced heart attack risk. The best news is that these same changes can also reduce your risk of other serious health problems including many types of cancer, stroke, and lung disease.

 

 

What is a healthy breakfast?

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

Eating a healthy breakfast provides energy to start the day, can reduce hunger to prevent overeating later in the day, and is important for attention and learning, especially in kids.

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

 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, this is a work in progress and there are certainly some exceptions. 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.

Honesty is the best policy

Being honest about your health is the topic of my Health & Fitness column in the Aiken Standard this week.

Have you ever justified your weight by saying you are “big-boned?” What about your eating and exercise habits? How often do you really eat out? How many days did you actually get to the gym last month? Are you being honest with yourself when it comes to your health? And are you asking others to be honest with you?

Being honest with yourself is essential for initiating health behavior changes and setting good goals. For example, someone who tells themselves they need to lose “a few pounds” may really need to lose much more and may not take their weight loss as seriously as they should. Convincing yourself that you are doing more exercise than you really are may mean that you won’t see the fitness or weight loss results you were expecting.

This type of self-deception is easy to do. Take body weight for example. The current standard for determining if you are at a healthy weight is body mass index (BMI), calculated from your weight and height (kg/m2). It requires a bit of math, so using a mobile app or online calculator is a good idea. A BMI between 18.5 and 24.9 is considered normal, 25-29.9 is overweight, and if your BMI is 30 and higher you are classified as obese. To put this in perspective, a BMI of 30 is equivalent to about 25–30 pounds of excess fat.

Let’s say your BMI puts you in the obese category, suggesting you should lose weight. But then you think about an article you read about how BMI isn’t accurate because you can be considered obese if you have excess muscle, not fat. And then there was the story on the news suggesting that it is okay to be obese as long as you are physically fit. So, maybe you don’t need to worry about your weight!

See how easy it is to tell yourself that you don’t really need to lose weight. In reality, BMI is an accurate method of assessing your body fatness; the inaccuracies reported in the news almost always involve athletes or people with lots of muscle mass developed through physical labor. Be honest…is that really you? It’s also true that people who are fit and fat can be healthier than people who are thin and sedentary, but it requires a lot of exercise to reach that level of fitness. Again, are you really that fit?

Probably the best test is to take a good look in the mirror and be honest about what you see. Try to “pinch an inch” of fat around your belly. One inch isn’t necessarily a problem, but take notice if you can pinch a handful of fat. Measuring your waist circumference (or looking at your pants size) can give you the same information. People who have a high BMI because of extra muscle, like athletes, have thin waists. If your waist circumference is greater than 35 inches (for women) or 40 inches (men), you have excess fat.

This honesty also applies to others, including your doctor. Many physicians are reluctant to discuss weight and weight loss with their patients, and many patients don’t want to hear what they interpret as a personal attack. Don’t be one of those patients! Ask your doctor for an honest assessment about your weight and the impact it might have on your health.

This is a real problem. According to one report, only 39 percent of obese people surveyed had ever been told by a health care provider that they were obese.     To help combat this problem, the American Medical Association has developed resources to help physicians better communicate with patients about their weight.

Making changes to diet and activity habits is a difficult process, to be sure. Telling yourself that you don’t need to make them only delays getting started and can lead to poor health in the meantime. When it comes to your health, honesty is the best policy!

Should you exercise after donating blood?

January is National Blood Donor Month, a chance to acknowledge the contributions of those who donate blood and raise awareness about the importance of blood donation. The effect of blood donation on exercise is the topic of my Health & Fitness column in the Aiken Standard this week.

Donating blood is one of the simplest ways you can help others who have been injured, undergo surgery, or who are being treated for conditions like cancer or blood clotting disorders. According to the American Red Cross, over 9 million Americans donate blood each year, but that is a fraction of those who are eligible.

Donated blood contains red blood cells that carry oxygen, platelets that are important for blood clotting, and plasma, the liquid component that also contains factors used to treat clotting disorders. Whole blood can used to replace what is lost due to injuries and surgery or can be separated into individual components, so one pint of blood can be used help multiple people.

A typical blood donation involves the removal of 450 ml, or about one pint, of blood. Since this is only about one-tenth of an adult’s blood volume, it is safe for those who meet the age, weight, and other health criteria to donate. After donation, the plasma portion of your blood, which is mostly water, is replaced by your body within 24 hours, but it can take 4–6 weeks to completely replace the red blood cells.

Blood donors are usually instructed to avoid strenuous activity for 24–48 hours. Donors may feel symptoms of low blood pressure, such as dizziness or lightheadedness. Vigorous activity can make this more likely, and staying hydrated can help reduce these symptoms. Since the red blood cells are responsible for carrying oxygen to your tissues, including your muscles, donating blood may limit your ability to exercise, especially if it is intense.

Research, including a study done in our lab at USC Aiken, shows that donating a pint of blood can decrease peak aerobic power, a key measure of fitness, for up to 3 weeks in healthy young adults. Athletes and others who are engaged in vigorous training may need to take it easy for a few days after donating.

The effect of blood donation on exercise makes sense when you think of it as the opposite of blood doping, the technique used by some endurance athletes to boost performance. Blood doping is accomplished by infusing either whole blood, usually that the athlete “donated” to themselves, or injecting erythropoietin (EPO), the natural hormone that stimulates the body to produce more red blood cells. Both have a similar effect: a higher number of red blood cells delivers more oxygen to the muscles, allowing the athletes to run, cycle, and ski faster and longer without fatigue.

Blood doping is illegal and athletes who get caught are fined, suspended, or even banned from their sport. You may remember that Lance Armstrong, the celebrated American cyclist, lost both fame and fortune after his doping scandal became public. This is something we are certain to hear about again as the winter Olympics get underway next month and athletes are looking for ways to improve their chances of winning a gold medal.

In contrast to blood doping, blood donation is legal and encouraged! The great many benefits of blood donation far outweigh the potential effects on exercise performance, which are unlikely to disrupt most people’s exercise programs.

There is still time to celebrate National Blood Donor Month by visiting a local blood center. Or, if you prefer, you can celebrate the Olympics by doing the opposite of blood doping—donating blood!

Eat smart, move more, chill out

The goal of being “more healthy” is a good one, but can include an almost endless list dietary, activity, and other behavioral changes. Some people may feel overwhelmed and unsure of where to begin. Furthermore, there is a perception that you have to implement all of the changes simultaneously or follow a complicated diet or exercise program in order to see results.

But it doesn’t need to be this way. My Health & Fitness column in the Aiken Standard this week outlines a few simple guidelines that have the potential to lead to significant improvements in health, fitness, and wellbeing. Not only are these things you can implement right now, but they are scalable, so the more you do, the bigger the benefits.

1. Eat smart.Healthy eating isn’t necessarily about eating less or avoiding certain foods, it’s about making smart choices when you shop, cook, or eat out. Many problems with the typical American diet probably have to do with the fact that we tend to eat heavily processed, calorie-dense foods. The major difference between what we eat now and what most people ate before the current obesity epidemic is the processing our food undergoes.

You can eat smart by focusing on eating real food—fresh and minimally processed plants and animals—instead of the processed and pre-packaged food that is so common in restaurants and in meals we eat at home. That isn’t to say that all processed food is necessarily unhealthy, but it would be wise to shift the balance toward more real food.

This isn’t necessarily new advice…it was featured on the cover of a popular book in 2009, after all. But this message seems to have gotten lost in the chaos of health claims made by manufacturers in advertisements and on food labels.

You can do this right now by having a piece of fresh fruit, some nuts, or vegetables for a snack. Later, you can make most of your food purchases from the perimeter of the grocery store, and less from the aisles in the middle.

2. Move more. Most people spend too much time sitting and not enough time moving. In fact, the amount of time someone sits during the day has nearly as much impact on their health as their exercise habits. So, step one is to sit less.

Next, move more, which means just that—finding ways to be active during the day. This includes simple things like standing rather than sitting when you talk on the phone, taking the stairs instead of the elevator, and getting up off the couch during commercials. It also includes dedicating time every day for structured exercise or other activity like yard work, house work, or taking the dog for a walk. Every little bit helps, but aim for a minimum of 30 minutes per day.

Right now you are probably sitting, so stand up and stretch or move around a little. Later, go for a walk or do something active around your house.

3. Chill Out. With so much emphasis placed on diet and exercise, the health effects of stress are often overlooked. Chronic stress can have serious emotional, psychological, and physiological effects that lead to or exacerbate many health problems. While it is impossible to avoid all stress in life, minimizing stressors and managing the way you respond to stress can have important benefits.

Exercise is one good way to manage your feelings of stress as well as the effects it has on your body. Yoga has long been recommended to help reduce and control stress, but all types of exercise can help. Managing time better, including getting enough sleep, is helpful for many people.

Right now you can close your eyes and take a few deep breaths to relax. Later, spend some time doing something you enjoy.

So, if you are feeling overwhelmed by complicated and confusing health recommendations, keep it simple: eat smart, move more, and chill out!

Just in time–New Year’s resolutions that will actually help you achieve your goals.

There are just a few more hours until you have to get started on your New Year’s resolutions.

There are also a few more hours to make New Year’s resolutions, if you are a procrastinator.

The most common resolutions are changes to improve health, including quitting smoking, losing weight, and starting an exercise program. Many people who make these–and other–resolutions get off to a good start, but most will end up failing to meet their goals.

While there are many reasons why people don’t keep their resolutions, part of the problem might be that these should not be the only New Year’s resolutions you make. Resolutions should be the things you need to do to achieve your goals, not the goal itself. Here is an example:

Losing 20 pounds is a good goal for many people. But what that really means is learning about a healthy way to eat, shopping for and preparing appropriate meals, finding time to exercise each day, and focusing on turning these behaviors into lasting habits. In this example, learning how to shop for and prepare healthy meals would make an excellent resolution that would lead toward the goal of losing 20 pounds.

The idea of making resolutions that are steps in the process leading toward a goal instead of the goal itself is the topic of my Health & Fitness column in the Aiken Standard this week. Here are a few resolutions that can help you achieve your health improvement goals, whatever they may be:

Be realistic
Many people fail to keep their New Year’s resolutions simply because they don’t set realistic goals or aren’t realistic about what it will take to meet those goals. For example, running a marathon is an ambitious goal for almost everyone, especially someone who doesn’t exercise at all. It is possible that someone could get in shape to run a marathon, but it will take a long time. A resolution to work up to jogging five days per week, with a goal of completing a 10 k run is more realistic and achievable.

Focus on learning
Making most health behavior changes involve learning as much as doing. Something as simple as eating a healthier meals requires learning about the nutrients that make some foods healthier than others, learning to read food labels to select healthy foods, and learning how to cook and prepare healthy meals. If your resolution is to learn about healthy meals you will be able to achieve that goal and be well on your way to eating a healthier diet.

Manage your time
Most health improvement projects require taking time to learn about, implement, and maintain those healthy behaviors. A major reason the people fail to really get started with or sustain a weight loss or exercise program is time. If you resolve to manage your time to include exercise or meal preparation in your daily schedule you will be much more likely to meet your goals. Trying to add these new activities as “extras” to your already busy day will inevitably lead to them getting squeezed out.

Plan ahead
Most people already know that changing health behaviors can be challenging, even under the best circumstances. It’s no wonder that holidays, travel, and other life events can complicate or even derail an otherwise successful diet or exercise program. Make it your resolution to think about what you can do before, during, and after these (and other) disruptions to your routine to keep yourself on track. Planning ahead and thinking “what if” can make the difference between giving up and catching up on your diet or exercise program after a vacation.

Have a happy and healthy New Year!

Santa’s fitness report, just in time for Christmas.

Right now Santa is making the final preparations for his big night, from checking his list of good boys and girls to packing the toys in the sleigh and giving the reindeer a pep talk. As we can only imagine, a trip around the world in one night is quite a physical feat, so, like an athlete preparing for the Olympics, Santa has certainly been training all year for this  event.

Of course, Santa keeps his training regimen a secret. In my Health & Fitness column in the Aiken Standard this week I make an educated guess as what he does to prepare in the “offseason” and how this training helps him maintain good health despite his less-than-athletic physique. Santa’s training likely includes a combination of endurance, strength, and flexibility exercises.

Endurance training, probably a combination of both high-intensity interval training and long-duration, lower intensity training, leads to a high maximal aerobic capacity and fatigue resistanceProof for this is 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!

Resistance training gives him the strength to repeatedly carry his heavy sack of gifts  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.

Stretching and exercises like yoga promote good flexibility so he can squeeze through narrow spaces and move quickly without pulling a muscle.

Santa certainly knows that proper training is only part of the answer, so he certainly focuses on sports nutrition, too. Many athletes use specialized sports drinks and foods that provide fluid, carbohydrates, and protein during long events. Santa relies on the cookies and milk you leave for him to provide the nutrients his muscles need to delay fatigue.

We can also 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.

Happy holidays!

The Health & Fitness holiday gift guide.

If you haven’t finished your holiday shopping yet, you are not alone. As of last week, the average shopper still has half of their gift buying left to do. The good news is that there is still time to pick out perfect gifts for your friends and family, including gifts that will help them meet their health and fitness New Year’s resolutions.

There are many good gifts that can help people get started on their exercise or weight loss programs. Gift guides including gadgets, apps, clothing, and other gear, like this one from Greatist.com. Many of these tools would no doubt be useful for getting people motivated, providing feedback, and even some healthy competition through social networking.

But these are not the things that people really need to begin and be successful making diet and activity changes. 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.

In my Health & Fitness column this week in the Aiken Standard  I provide a practical gift guide. These are the things you can give your friends or family members to really help them make their healthy lifestyle changes:

1. 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.

2. 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.

3. 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.

4. 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.

So, if you really want to help someone in your life make lasting healthy changes, use the remaining shopping days to come up with a plan. Leave the stress of shopping to everyone else!

Go Nuts (again)!

My Health & Fitness column in the Aiken Standard this week is about the health benefits of nuts. It is  a follow-up to a blog post I wrote a few weeks ago. This isn’t new, of course, since nut consumption has been recommended as a part of a healthy diet for years.

What is new is a recent study in the New England Journal of Medicine that shows that nut consumption was associated with a reduced risk of death from heart disease, stroke, and some cancers. The people who ate nuts every day got the biggest benefits.

That doesn’t mean that simply adding nuts to an unhealthy lifestyle will have some magical influence on health. In fact, the people in the study who ate the most nuts were also likely to do other healthy things like eat more fruits and vegetables, exercise, and not smoke.

The most practical advice is to eat nuts as a replacement for other snacks or to add nuts to salads and other dishes. While specific types of nuts have different health benefits, the recent study suggests that all nuts, including peanuts, are beneficial.

The mystery of how you can feel hungry shortly after eating breakfast explained.

Have you ever noticed that sometimes you can feel hungry—really hungry—midway through the morning, even after eating breakfast? Isn’t eating breakfast supposed to get you through the morning without feeling hungry?

The answer to these questions gets into why we eat and what regulates feelings of hunger. This is the topic of my Health & Fitness column in the Aiken Standard this week.

First of all, much of the time we want to eat we really aren’t hungry. Hunger is a physiological drive to seek food and is generally experienced as a negative sensation. It is a survival stimulus that got our caveman ancestors out of the cave to seek food, despite the threat of saber-tooth tigers. Hunger is a signal that energy and nutrients are needed and nearly any food will meet this need. In our world now, we rarely need such a powerful stimulus for us to seek food, and most people eat even though they aren’t truly hungry.

What we experience more often is appetite, a psychological sensation that motivates us to eat, usually in response to some sensory input. For example, the smell of fresh-baked cookies makes most people want to eat, even after a meal. In this case, it is the idea of food that triggers the sensation, not a physiological need for nutrients. Additionally, appetite is usually specific to a certain food we crave, like cookies.

One of the problems we face is that we often confuse appetite (wanting something to eat) with hunger (needing something to eat). This can lead to overeating.

It turns out that the foods we eat help determine how much we will eat in a meal and  contribute to our feelings of hunger later. A meal that contains a combination of foods providing carbohydrates, protein, fat, and fiber tend to make us feel full sooner, so we may eat less in that meal. By contrast, eating foods that contain primarily carbohydrates, especially refined grains and sugar, don’t have the same effect, and we can take in more calories before our brain gets the signal that we are full. This is called satiation.

That isn’t all. What you eat for one meal can influence how quickly you will feel ready to eat again later. This effect is called satiety. A meal that contains mostly refined carbohydrates can lead to feelings of hunger shortly after a meal. This why you can feel hungry midway through the morning after a breakfast consisting of a donut and juice.

One recommendation to help people eat less to lose weight is to eat foods that are high in fiber such as whole grains, fruits, and vegetables, since these foods tend to make us feel full sooner. Meals that contain a combination of nutrients, especially protein, can also help us go longer between meals.

So instead of a donut and juice for breakfast, try a piece of fruit (fiber!) and something containing protein, like an egg or yogurt.