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Reducing your risk of heart disease

Posted on February 10, 2014 | Leave a comment

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.

 

 

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What is a healthy breakfast?

Posted on February 3, 2014 | Leave a comment

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.

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Honesty is the best policy

Posted on January 27, 2014 | Leave a comment

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!

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The Health & Fitness holiday gift guide.

Posted on December 16, 2013 | Leave a comment

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!

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Go Nuts (again)!

Posted on December 11, 2013 | Leave a comment

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.

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

Posted on December 3, 2013 | Leave a comment

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.

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Realistic advice for a healthy Thanksgiving.

Posted on November 25, 2013 | Leave a comment

Let’s face it…Thanksgiving isn’t the healthiest of holidays. It usually involves some combination of food, relaxing, watching the parade or a football game, and more food. Then it’s time for leftover turkey sandwiches and more pie.

I’m sure you have seen the  recommendations about how to make Thanksgiving a bit more healthy which usually include avoiding high-fat and high-calorie foods, limiting your portion sizes, and skipping dessert. While this is good advice, it isn’t realistic. After all, Thanksgiving is a day for food and family, not counting calories.

I think a better approach is to accept that you will overeat on Thanksgiving and not worry about the food so much. Instead, focus on including activity in your day. Going for a walk before dinner can help reduce the effect the meal has on your blood lipids and going for a walk after dinner gets you out of the house and away from the food.

The end result is that a little activity can make your Thanksgiving a bit healthier. And if you make going for a walk (or two) every day a habit, the health benefits will extend into the New Year.

This is the topic of my Health & Fitness column in the Aiken Standard this week. Go ahead, check it out.

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Weight loss and exercise project management

Posted on November 18, 2013 | Leave a comment

Almost everyone who starts a weight loss of exercise program does so with good intentions. Many get off to a good start and see beneficial results, at least initially. Unfortunately, long-term success is uncommon.

There are myriad reasons for this, but the way people manage their weight loss and exercise efforts is certainly among them. Think about it: when someone takes on a new diet or exercise program it is usually added to their typical routine. The problem with this approach  is that most people are busy, and there is little extra time in their day. As a consequence, the diet and exercise doesn’t get the time or attention is needs in order for people to be successful.

This is where the lessons of good project management can be helpful. In the workplace a major project is usually accomplished though defining the scope to the project, appropriate goal setting, allocation of resources (including time), and a mechanism to assess progress.

But many people who approach projects this way at work tend not to apply this process to health improvement projects at home. The result is poor planning, setting unrealistic goals, and failure to allocate appropriate resources, including time.

Especially time. Time to set goals, time to plan and prepare meals,  time to exercise, and, perhaps most important, time to assess and adjust the plan along the way.

Many of these problems could be avoided through the same good project management techniques that would be used at work. The idea of treating weight loss, exercise, and other health improvements as a project is the topic of my Health & Fitness column in the Aiken Standard this week.

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Your DIY health care plan.

Posted on November 4, 2013 | Leave a comment

The new health care law, the Affordable Care Act, has been the center of controversy for some time. Claims that it is unconstitutional (it’s not), concerns about how it will affect employer-offered health care coverage, and recent reports of problems with the registration website, have led to confusion and frustration among citizens. The confusion is so great that some people don’t even know whether or not they support the A.C.A.!

In addition to expand access to affordable health care, the Affordable Care Act should also make it easier for people to get preventive care. However, it is not clear (at least to me) exactly how effective that will be. Furthermore, there still appears to be an interest in repealing the law in the future.

Given this uncertainty, it makes sense for us to take steps now to improve our health now and stay healthy in the future. The good news is that a few simple lifestyle modifications, including being active, eating a healthy diet, managing stress, and quitting smoking, will go a long way towards promoting good health, regardless of what happens with the Affordable Care Act.

You can read more in my Health & Fitness column this week in the Aiken Standard.

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Go for a swim!

Posted on July 22, 2013 | 2 comments

It’s summer and it’s hot, so it seems like a good time to write about the health and fitness benefits of swimming. Which is exactly what I did in my Health & Fitness column in the Aiken Standard this week.

Swimming is a great way to get in shape, build muscle, and to help you lose (and maintain) weight. Lap swimming is is about as aerobically demanding and burns as many calories as land-based exercise such as walking or jogging. (Obviously, it depends on the stroke you use and how fast you swim).

Since water is more dense than air, aquatic exercise is lower impact that exercise on land. This means that water aerobics, aqua walking or jogging, and resistance training using foam “weights” or webbed gloves can be done by people with conditions such as arthritis or for injury rehabilitation.

Even swimming leisurely or playing in a pool or lake can burn a substantial number of calories, so it is a healthy way to beat the sumer heat.

If you are interested in using your pool for exercise, you can find information about aquatic exercise in general here and links to suggested exercises here. You can learn more about aquatic exercise specifically for arthritis and fibromyalgia, too.

 

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