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Our toxic activity environment, and what you can do about it.

Last week I introduced the idea that we live in a “toxic environment,” which provides easy access to high-calorie, unhealthy, inexpensive food and promotes physical inactivity. The focus was on the toxic food environment, so now it is time to explore our toxic activity environment and how you can modify it to increase your activity, which can help you lose weight.

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The environment affects our physical activity on several levels. The built environment refers to the layout of our communities, including roads, sidewalks, availability of public transportation, where homes and businesses are located, and even the design of buildings. If you live in a mixed-use area in which there are lots of well-maintained sidewalks that connect your home to schools, parks, churches, restaurants, shops, and businesses, the built environment is likely to support more activity. In larger cities, an effective public transportation network can increase your activity.

However, many people live in areas where there aren’t sidewalks or, if there are, the distances between destinations are too far to make walking convenient. Or they live in a neighborhood that is separated by distance or geography (a busy road, perhaps) from other places they go. Even when sidewalks are present, using them may be challenging due to poor maintenance, automobile traffic, or dangerous road crossings. Even when signals for pedestrians exist, there may not be enough time to safely cross the street, a serious limitation for those with limited mobility. In many cases, the built environment can actually discourage—even prevent—physical activity.

The built environment includes indoor spaces, too. If the building you work in has clean, safe, and accessible stairs, you will be more likely to use the stairs rather than the elevator. Even the design of offices and workspaces can influence activity. If your office has a desk and a chair, it is almost guaranteed you will sit much of the day. Even the small increase in activity that comes from using a standing desk or an alternative to a traditional chair, like sitting on a stability ball, can add up during the day. Some people even have treadmill desks, so they can walk while they work!

At work and at home, technology and labor-saving devices make it easy to be inactive. At work you can communicate with coworkers by phone or email instead of walking to their office to talk. Entire groups of people can have meetings via video in which each person is seated at their own desk, even though everyone works in the same building. At home you can change the TV channel, connect with friends and family, even order dinner from the comfort of your couch. Riding lawn mowers and leaf blowers reduce the physical effort needed to do yard work and robotic vacuums allow you to sit and watch your floors get cleaned.

The good news is that you can change the way in which you interact with the toxic activity environment to increase your level of activity. You may need to drive to a store or restaurant if it is too far to walk, but you can park farther away to get a few extra steps. You can get up from your desk to talk to a coworker rather than calling or sending an email. At home you can get up off the couch during commercials or take short “screen time” breaks to move. And it is perfectly alright to leave the leaf blower in the garage and use a rake to clean up the yard.

A simple way to limit snacking in the evening: brush your teeth after dinner.

Earlier this week I wrote about the potential benefits of an overnight fast. Not eating between dinner and breakfast can have metabolic benefits that may help with weight control.

Of course, this means resisting the temptation of snacking in the evening. Something that might help you keep from eating in the evening is to brush your teeth after dinner.

Since most people brush their teeth right before going to bed, this acts as a signal that you are finished eating for the day. Simply moving that signal from bedtime to earlier in the evening may limit snacking after dinner. Try it!

Good sources of protein for your low-carb diet

Thanks to a recent study and media coverage (including me), low-carbohydrate diets are a popular topic of discussion. For many people, cutting back on carbohydrates is a good way to reduce calories to promote weight loss.

Most low-carbohydrate diets also emphasize protein intake. But finding healthy protein sources is important for promoting weight loss and good health.

This recent discussion about the best protein for optimal weight loss  on the Train Your Body show on RadioMD should help.

Being mindful of eating habits, according to Shannon.

I had an interesting conversation with my friend Shannon earlier this week that fit with the topic of being mindful of health habits. (I have written about Shannon previously, but not for some time) 

She was telling me that one recent evening she drove to three fast food restaurants to get dinner for her family. Apparently, she wanted food from a different place than her husband, neither of which worked for her kids. As they sat down at the dinner table she became mindful of how ridiculous this was.

First, she spent almost an hour driving to fetch the food. This was time she could have spent doing any number of things, including actually preparing a meal for her family. Second was the cost, including the food itself and the gas required to drive to three different restaurants. Third, looking at the food they were eating made her realize that it wasn’t healthy. In fact, their meal included no fruits or vegetables (beyond french fries) at all!

What struck me was that the quality of the food they were eating was the last thing Shannon mentioned to me, almost as a afterthought. What got her attention was the time and money she sent on the food. Cooking at home could have taken less time and certainly would have cost less. It would have been healthier, too.

At least they ate dinner together

 

Being mindful of eating habits, according to Shannon.

I had an interesting conversation with my friend Shannon earlier this week that fit with the topic of being mindful of health habits. (I have written about Shannon previously, but not for some time) 

She was telling me that one recent evening she drove to three fast food restaurants to get dinner for her family. Apparently, she wanted food from a different place than her husband, neither of which worked for her kids. As they sat down at the dinner table she became mindful of how ridiculous this was.

First, she spent almost an hour driving to fetch the food. This was time she could have spent doing any number of things, including actually preparing a meal for her family. Second was the cost, including the food itself and the gas required to drive to three different restaurants. Third, looking at the food they were eating made her realize that it wasn’t healthy. In fact, their meal included no fruits or vegetables (beyond french fries) at all!

What struck me was that the quality of the food they were eating was the last thing Shannon mentioned to me, almost as a afterthought. What got her attention was the time and money she sent on the food. Cooking at home could have taken less time and certainly would have cost less. It would have been healthier, too.

At least they ate dinner together

 

Stay cool and get fit in the pool

It’s hot! Whether you are swimming laps or splashing in a lake, swimming is a great way to stay cool. Swimming is also an excellent exercise for improving your fitness and helping with weight loss.

This is the topic of my Health & Fitness column in the Aiken Standard this week. You can also find more information about the fitness and health benefits of swimming from something I wrote previously.


There is nothing that feels better on a hot summer day than going for a swim. But beyond being a fun way to cool down, swimming is a great way to get in shape. Swimming is also an excellent exercise for injury rehabilitation or for people with certain conditions like arthritis.

The fitness benefits of swimming are well established. Since swimming is a whole-body exercise it uses all of your major muscle groups, building strength, endurance, and aerobic fitness. Highly trained swimmers have VO2max values, considered the best measure of aerobic fitness, that are similar to runners and cyclists. If you have doubts about the fitness benefits of swimming, think back to the last Olympics and how muscular and lean the swimmers looked.

Depending on the stroke and speed, swimming ranges between 5 to 10 METs. (METs are units used to measure the intensity of activity; one MET is equivalent to sitting at rest) For example, doing the backstroke at a moderate speed is about 5 METs while swimming laps freestyle with vigorous effort is about 10 METs.

This range is similar to walking at 4 mph up to jogging at a 9 minute per mile pace. What if you are just spending time in the pool or lake rather than swimming laps? Swimming leisurely is 6 METs, still a decent workout.

Swimming is a great way to burn calories, too. Even at a moderate pace, swimming laps for 30 minutes can burn over 200 calories. The exact energy expenditure depends on the stroke (butterfly is highest, backstroke is lowest) and the speed, but for most people swimming will burn as many calories as spending the same amount of time exercising on land.

There are two major reasons for this. First, water is more dense than air, so you need to expend more energy to move your body through the water. Second, swimming is a whole-body exercise which requires more muscle activity compared to walking or jogging which mostly involve the legs.

You may be surprised to learn that novice swimmers expend more energy per lap than elite swimmers. For example, one study showed that competitive swimmers expend only 280 calories to swim a mile, while less experienced swimmers burn about 440 calories to cover the same distance. The reason for this is that experienced swimmers are more efficient, so they expend less energy.

Aquatic exercise is popular for both therapeutic and fitness purposes, especially for people who don’t tolerate exercise on land well. When you are submerged up to your waist, 50% of your weight is supported; when you are up to your chest, about 75% is supported. This reduces the impact of exercise in the water, perfect for people who have arthritis, osteoporosis, severe obesity, or who are recovering from injuries.

Exercise in the water doesn’t have to mean swimming laps. Water aerobics, aqua walking or jogging, and resistance training using foam “weights” or webbed gloves offer safe ways to increase strength and endurance for almost everyone. Most fitness facilities that have a pool offer group aquatic exercise classes and you can find instructions online for exercises that you can do in your own pool.

The hot summer weather makes swimming and other water exercise appealing. But even if you don’t use the time for exercise, spending time playing in the pool or lake can still burn as many calories as going for a walk and is a great way to have fun and cool down!

Worried about low T? Lose some W!

I heard a story on Morning Edition on NPR on my way to work on Monday about low testosterone levels in men.

Low T,” as it is called, seems to be increasingly common in men. This has led to a huge increase in the sale of prescription drugs and non-prescription supplements designed to increase testosterone levels in men, whether they need it or not. To be sure, some men do need testosterone therapy, but it seems that many more don’t, but use it anyway. Testosterone therapy is not without risks and can increase the risk of heart attack.

Back to the NPR story…The doctor quoted in the story, Dr. Ronald Tamler, said that,“the most common reason for low testosterone in my practice, I find, is obesity.”  He goes on to explain that excess fat can alter the balance of hormones, reducing testosterone and increasing estradiol. His research shows that weight loss (via surgery) is the most effective way to treat “low T.”

So maybe the solution to low T isn’t to (always) worry about replacing T. Many times the answer may be to lose some W!

 

 

 

 

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!

The Health and Fitness week in review.

Keeping up with exercise, nutrition, and health news takes some doing. There is so much new research, commentary, and discussion that it’s practically impossible to read everything. Here are a few  items that caught my attention this week:

I read more than usual about the negative health effects of sitting. This isn’t necessarily new to me, but it’s nice to see more attention given to what I think will be the “next big thing” in health promotion. Research suggests that sitting too much can increase the risk of heart failure, especially in people who are also otherwise inactive. Inactivity can also affect the brain and not in a good way, at least in rodents. In case you aren’t aware of the many ways sitting too much can impact your body and health, this infographic  is excellent. Now, if I can just get my boss to get me that stand-up desk I have been asking for! In the meantime, I can try this approach.

It turns out 

that the U.S. ranks nearly last (120/125 countries) for healthy eating, according to one report. It’s not that we don’t have access to healthy food (for access we ranked #21), it’s that we apparently choose not to eat that healthy food.

Did you know that you are more likely to die from a heart attack on nights and weekends than at other times during the week?  It has to do with how quickly care is delivered. Something I will keep in mind when I schedule an MI!

I’m a bit of an infographic geek, so this one about obesity from the American Public Health Association caught my eye. The information isn’t new, but it captures the whole obesity problem in one graphic, so it is a nice resource.

Any conversation about obesity and weight loss inevitably turns to personal responsibility. Dr. David Katz addressed this issue in an interview. Key point, in my mind at least: “Before we can ask people to take responsibility we have to make sure they are empowered.”

Good news as I help myself to another cup: Coffee consumption is inversely associated with the risk of type 2 diabetes in a dose-response manner.

Finally, I am a college professor, so this explanation of what my colleagues and I actually do got my attention. I hope it also gets the attention of the people who think college professors “just teach a few hours a week.”

 

 

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!