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Say what? A health and fitness vocabulary lesson.

When I write about health I routinely use terms like exercise, activity, and fitness. I often get 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.

vocabulary crossword


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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Forget about low-fat or high-carb: Focus on food, not nutrients, for weight loss.

If you are confused or frustrated by the conflicting claims about whether a low-fat or low-carbohydrate diet is the best for promoting weight loss, you are forgiven. First, we were told that eating a low-fat diet was the best way to lose weight and improve heart health. Then, research suggested that low-carbohydrate diets were better.

Although there are hundreds of diets and weight loss plans you can follow, most fit into one of these two broad categories, reducing calories by cutting back on fats or by restricting carbohydrates.

A recently published study in the Journal of the American Medical Association compared low-fat and low-carbohydrate diets for promoting weight loss. The results say a lot about diets and weight loss in general and I interpret them to suggest that you should focus on food, not nutrients, to achieve your weight loss goal.

This is the topic of my Health & Fitness column in the Aiken Standard this week.

 


feet on scale

This study was a bit complicated, but it basically compared a low-carbohydrate diet with a low-fat diet for weight loss. After one year, both groups lost about the same amount of weight, showing that both diets were equally effective. This shows that restricting fat or carbohydrates didn’t seem to make a difference for promoting weight loss.

 

But it might be better to consider that what the two diets had in common is what made them both effective. In addition to the emphasis on fats or carbohydrates, both groups were encouraged to eat less added sugar, more vegetables, and fewer processed foods. It is likely that these factors played such major role in promoting weight loss that they outweighed the effect of which nutrients were restricted.

 

This isn’t much of a surprise, since eating less added sugar, more vegetables, and fewer processed foods are the three recommendations almost all diets and eating plans have in common. They are also among the very few things everyone seems to agree on when it comes to nutrition recommendations.

 

When it comes to picking the perfect diet, we should stop thinking on how they differ from one another and focus on what they all have in common. By faithfully following those key recommendations, it almost doesn’t matter what the rest of the diet includes. Avoiding processed foods and added sugar and making vegetables a major part of each meal will lead to healthier choices than simply cutting back on either fats or carbohydrates. In this way, food matters more than nutrients.

 

This study also demonstrates an important truth about weight loss. The average weight loss wasn’t impressive, only 6 kg in one year, or just a bit over 1 pound per month. I think that most people would be disappointed with this weight change after a year of effort. There was also a big range in weight loss, with some subjects losing over 60 pounds and some gaining about 20 pounds.

 

Modest average weight loss with some people losing significant weight and others losing very little or even gaining weight is typical for most weight loss programs. What you tend to hear about weight loss programs is the highest expected weight loss—”you can lose up to 40 pounds!” for example, but they don’t tell you what you should really expect. Be skeptical of promises of rapid, significant weight loss. Also be wary of diets that require you to avoid or emphasize certain nutrients like fats or carbohydrates, and remember that the real key to weight loss seems to be food, not nutrients.


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Most New Year’s resolutions are destined to fail. Here’s what to do instead.

Have you made your New Year’s resolutions yet? If not, there is still time. Among the most common resolutions are changes to improve health, including quitting smoking, losing weight, and starting an exercise program. Some people set specific goals, such as losing 20 pounds or running a marathon, while others take a more general approach, like eating healthier or getting in shape. Either way, these are excellent goals, but they should not be your only New Year’s resolutions.

Your resolutions should also include the things you need to do and change to achieve these goals. For example, losing 20 pounds is a good goal for many people. But what that really means is learning about a healthier 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.

With this in mind, here are a few resolutions that can help you achieve your health improvement goals:

Resolution list


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 10k 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 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 eating 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 that 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.

The idea of making resolutions that are steps in the process leading toward a goal instead of the goal itself may be new. But focusing on the changes you need to make rather than the outcome may well be the step that helps you keep your resolutions, achieve your goals, and make 2018 a happy, healthy year.


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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!


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It’s not your fault, but it is your responsibility.

Eating well and being physically active are two of the most important things you can do to promote good health. But knowing you should do these things does not always mean it is easy to actually do them.

Despite the simplicity of the message “eat healthy and exercise,” many people struggle with knowing exactly what to do and how to do it. This is largely due to the complicated and ever-changing nature of nutrition and exercise information and the fact that most people receive no education in these areas.

You may even feel like the information you read and hear is designed to confuse you. That may be true, considering that much of the nutrition information we get comes from food companies that are trying to convince us to buy their products. Even scientific research can yield conflicting results, challenging even the most knowledgeable professionals, myself included, to make sense of it. And even if you do decide to make eating or activity changes, the “best” diet or exercise program claims may make you wonder if you made the right choice.

Given this, it’s not your fault if you struggle to understand basic health information and recommendations. But it is your responsibility to learn as much as you can to make the best choices for you and your family.

This is the topic of my Health & Fitness column in the Aiken Standard this week

Man shopping in supermarket

 


This won’t be easy, of course. The popular media, as well as social media, promote confusion and false promises about nutrition by making claims that some foods are “toxic” while others are “superfoods.” The old good carb, bad carb or good fat, bad fat arguments have been given a new life as eat this, not that lists. The problem is that many of these claims are not supported by science. The research that is done often yields complicated or conflicting results that aren’t explained in a way that actually helps people make good decisions.

The same is true for exercise. No one doubts that exercise and physical activity are essential for good health, but there are conflicting claims about specific benefits of exercise and what the best form of exercise really is. This can lead to the idea that if you aren’t doing the right exercise, it doesn’t count. Nothing could be further from the truth! While there are reasons why some athletes might want specific types of training, the majority of people can benefit from simply spending less time sitting and going for a walk each day.

So, what can you do? Given the confusing and changing nutrition recommendations it’s best to focus on what hasn’t changed. That is, to focus on eating real food rather than processed, prepackaged foods. Planning meals and snacks to include fruits, vegetables, whole grains, nuts, legumes, lean meat, eggs, and dairy should give you plenty of healthy fats, carbohydrates, and proteins.

Instead of worrying about the “perfect” exercise, make it your goal to do something active for at least 30 minutes every day.  Beyond that, dedicating time for aerobic, strength, and flexibility exercise will bring greater benefits. Remember, the best exercise for you is the one you will do! Seek advice from people you trust and credible professionals, but remember that if it sounds too good to be true, it probably is.

Your responsibility isn’t to understand all of the nutrition, exercise, and health information you hear. It’s to make an effort to make a few simple, healthy choices despite that confusing information: Sit less, move more, and eat real food.


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Obesity: It’s in your jeans. And your genes.

Have you ever noticed that some people struggle to lose weight while others seem to have no trouble maintaining a healthy body weight? Why is it that some people lack the motivation to exercise while others are can’t seem to stop moving? What about people who appear to have no interest in desserts while others have a “sweet tooth”? Why do overweight parents tend to have children who are also overweight?

The traditional answer is that some people lack willpower which makes it more difficult for them to make healthier eating and activity choices. While motivation and dedicated effort are essential for making healthy choices, genetic research has resulted in the identification of a host of genes that appear to affect physical activity and eating habits, food preferences, and responses to a diet or exercise program.

obese jeans


The link between genetics and obesity is not new. Decades ago researchers found that obesity tends to cluster in families. But is this due to shared genes or a shared environment? The answer is both, but heredity plays an important role. Studies of siblings raised apart show that their body weight and fatness more closely resembled each other than the families they lived with. Other studies show wide variation in body weight among relatives, where some are obese but others are at a healthy weight. This suggests that although genes can predispose people to being overweight, personal behavior can modify this risk.

Genetic variations also explains why people respond to exercise training differently. Much of this knowledge comes from the Heritage Family Study which examined body fatness, fitness, and other health factors in over 700 individuals from 130 families. After completing the same exercise program, some people improved their fitness significantly while others experienced only a minor improvement. The prevailing explanation was that varying degrees of compliance accounted for these differences, but the Heritage study showed that genetic factors were at responsible for 40–50% of the variation in both initial fitness and improvement in fitness.

Your genes can also influence what you eat. Eating habits, including how much you eat as well as food preferences, are at least partly under the control of certain genes. Two separate genes that regulate appetite and the type of food people eat, have been identified. This might explain why some people say they always feel hungry while others are satisfied after a small meal or why  some people crave foods that are high in sugar and fat while others do not. Of course, what you eat is a behavior that you can control—you are putting the food in your own mouth, right?—but it is interesting to know that there are genetic factors that make these decisions more challenging for some.

Does this mean that healthy behaviors including eating and exercise are out of your control? Does it give you an excuse for being unhealthy? Absolutely not! Your genes may predispose you to certain health conditions, meaning you are at higher risk, but they do not predetermine your health. The expression of these genes is modifiable by your environment and your behavior. Even though you may be at higher risk for obesity, you still need to eat too much and not be active enough to gain weight. Be aware that “too much” varies greatly among people, so there is no single eating and activity pattern that applies to everyone. But knowing that you have a family history should give you even more motivation to eat a healthy diet and get regular exercise.


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Aaaa-chooo! Exercise and seasonal allergies.

 

Spring means blooming flowers, new leaves on trees, and green grass. But for millions of people, spring also means seasonal allergies. Also known as allergic rhinitis or hay fever, seasonal allergies are caused by pollen produced by plants. Tree pollen is the most common culprit in the spring, with grass and ragweed in the summer and fall, respectively. Allergy symptoms — watery eyes, runny nose, sneezing, congestion, and cough — may start within 5–10 minutes of exposure in sensitive individuals and last for hours.

sneeze

Seasonal allergies are an abnormal response of the immune system to pollen. Inhaled pollen acts as an allergen, which stimulates the immune system to produce antibodies, including IgE. Antibodies are produced whenever the immune system encounters a foreign antigen, whether it is a virus or pollen. The IgE stimulates specialized cells in the airways called mast cells to produce histamines, which cause the familiar symptoms of seasonal allergies. This is the same process that causes allergies to dust mites, animal dander, and certain foods.

Since histamines are an important step in triggering an allergic response, seasonal allergies can be treated by using antihistamine drugs such as fexofenadine (Allegra), loratadine (Claritin), cetirizine (Zyrtec) and diphenhydramine (Benadryl). Some antihistamines also include a decongestant (Claritin-D, for example).

Allergy symptoms can be diminished by reducing exposure to pollen. This means keeping the windows of your home and car closed and minimizing outdoor activity when pollen levels are highest, particularly early in the morning, on windy days, and when the pollen count is high. Pollen levels are often reported with weather forecasts.

People often ask if it is safe to exercise if they have seasonal allergies. In most cases, the answer is yes. Allergy symptoms are typically similar to cold symptoms, so the usual advice about exercise with a cold also applies: If the symptoms are above your neck (runny nose, watery eyes, sneezing), it is safe to exercise. That said, allergy symptoms are based on exposure to pollen and the more you inhale, the worse your symptoms. Since your breathing increases significantly during exercise, so does your exposure to pollen.

There are some cases in which exercise with allergies could have serious effects. Exercise-induced bronchospasm (EIB), also called exercise-induced asthma, is a condition that affects the majority of people with asthma, many of whom also have seasonal allergies. EIB is thought to be caused by the cooling and drying of the airways due to the high ventilation during exercise or exposure to particulate matter in the air, typically from pollutants, or pollen. EIB results in the constriction of airways, severely limiting airflow into the lungs. Asthmatics typically carry a rescue inhaler (bronchodilator) during exercise for this reason.

Interestingly, EIB also occurs in athletes, including those who compete at the Olympic level. It is more common among athletes competing in outdoor winter events (cooling and drying of airways) and indoor ice events (pollutants from ice resurfacing equipment). Through careful warm-up and use of certain approved medications, athletes with allergies and EIB can successfully compete at an elite level.

Since most of us don’t reach the exertion level of athletes, there is no reason to let seasonal allergies stop you from exercising. You may be able to exercise outdoors on days in which the pollen count is lower, especially if you do lower-intensity exercise like walking. Antihistamine medications may help ease the symptoms and shouldn’t interfere with exercise. For many people, allergy season is a good time to exercise indoors. Walking on a treadmill or an indoor track or participating in a group exercise class at a local gym are great ways to stay active on days when exercise outdoors just won’t work. By taking some precautions, you can and should exercise even if you have seasonal allergies!

 


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drparrsays@gmail.com | @drparrsays