Tag Archives: exercise

The case of the missing beach body. How to get yours back…and keep it!

Now that spring has arrived you may have noticed that your eating and exercise habits over the winter (or past several winters!) haven’t been kind to your body. For some people this comes as a surprise, and they wonder where their beach body from last summer went. For others, their beach body may long gone, but they want to lose some weight and get in shape before summer.

Obviously, this will mean making changes to what you eat and your exercise habits. If you want to lose 5–10 pounds and get back in shape, this means small changes to your diet and exercise designed to meet your fitness goals. If you have more significant weight to lose you will need a stricter diet and an exercise program that will help you to burn calories and build your strength, endurance, and flexibility.

While diet and exercise can help you get back in shape, staying in shape requires making lasting behavior changes. My Health & Fitness column in the Aiken Standard this week includes a few key questions that will help you find your missing beach body now and, importantly, not lose it again in the future.Luddington beach


When did you last see it?

Many people can identify a time in their life when their lifestyle changed and weight gain began. Commonly, this is getting married, starting a new job, or having children. Other people notice that they have gained weight, but can’t point to any specific reason why. In both cases, healthy eating and exercise routines get replaced with other less beneficial habits. The result for most people is gaining weight, either very quickly or slowly over time. Understanding what led to your weight gain is important for making changes to fix it.

How long has it been gone?

The longer you have been inactive and eating poorly, the longer you have been developing these unhealthy habits. The consequence is that it will be more challenging to undo the damage these habits have caused and teach yourself new habits that are consistent with better health. Your task is relatively easy if you have just gained a few pounds since last summer. Trying to reverse years or decades of inactivity and unhealthy eating is a bigger challenge, but one you simply must take on!

Where did you last see it?

The environment has a huge impact on our health, largely through influencing our activity and eating behaviors. In many cases, weight gain may be at least partly a consequence of where we spend our time. For example, a new job that involves long commutes by car and workdays spent sitting can make gaining weight almost inevitable. Quitting that job probably isn’t reasonable, but knowing how it has affected your health allows you to focus your efforts on increasing your activity outside of work. For many women, weight gain occurs after graduating from college, getting married, and having children. While there are many contributing lifestyle factors in this case, the change from an active college campus to a more sedentary environment certainly plays a role.

Once you figure out when and where you last saw your beach body you will have an idea of what you need to do to get it back. Keep in mind that the type of behavior changes you need to make to lose weight and get back in shape are difficult and will take time to adopt. While you shouldn’t expect any miracles in the next month or two, developing healthy eating and activity habits can have a miraculous effect on your weight, your health, and how you feel in the years to come!


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Your Heart Month action plan

Heart disease, sometimes called coronary artery disease, is the leading cause of death in the United States. Despite improvements in prevention, diagnosis, and treatment, it is still 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. 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. You can learn much more about heart disease from the American Heart Association.

Since February is Heart Month, this is an ideal time to assess your own risk of heart disease and take steps to improve your heart health. If you aren’t sure where to begin, my Health & Fitness column in the Aiken Standard this week includes four simple steps you can take to assess and lower your risk for heart disease. If you aren’t sure where to begin, these four steps should be a good start to prevent and treat heart disease.

Heart

 

 

 

 

 

 

 

 

 


Here is your Heart Month action plan:

  1. Assess your risk. 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. You may be able to find a health fair or other event in the community at which you can have many of these measurements made, but only your doctor can help you determine the best course of treatment given your personal risk profile.
  1. Be active everyday. The benefits of as little as 30 minutes per day physical activity 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, that can have such a broad impact on reducing heart disease risk!
  1. Improve your diet. If you are like most Americans, your diet is too high in unhealthy fats, salt, and added sugar and lacking adequate whole grains, fruits and vegetables, and fiber. This type of diet is associated with obesity, high blood pressure, high cholesterol, and diabetes. All of these conditions are risk factors for heart disease, so you may literally be eating your way to a heart attack. Changing what you eat to include more whole grains, fruits, vegetables, and low-fat meat and dairy and minimizing added sugars, fat, and processed foods can help you lose weight and prevent or treat high cholesterol, diabetes, and high blood pressure.
  1. Quit smoking. There is no way around this one—quit! Ask your doctor about prescription medications that can make quitting easier. Nicotine replacement therapy in the form of patches, gum, and lozenges can help manage cravings and are available over the counter. Ultimately, though, quitting smoking is a behavior change that takes motivation, willpower, and time. But it is worth it—your risk of heart attack goes down within days and can drop 50–70% within five years after quitting.

The potential impact of these steps is great. Knowing which risk factors are most concerning can help you and your doctor make the most effective treatment decisions. Even modest changes in diet and activity can lead to improvements in risk factors and reduced heart attack risk. The best news is that you can start today by putting down your next cigarette, going for a walk, and eating a healthier dinner. Your heart will be glad you did.


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

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

sneeze


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

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

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

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

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

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

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


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

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

santa


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

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

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

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

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

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

 


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Diabetes 101: What you need to know

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

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

diabetes


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

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

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

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

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

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

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


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Breaking the chain: What you can do to prevent a relapse in your diet or exercise program.

Making changes to diet and exercise habits for weight loss or to improve health and fitness are among the most difficult behavior modifications to make. Being able to change these behaviors now and in the future is a key to success. Since what we eat and our activity become habitual, many people have spent years developing bad habits, so it will take time and effort to change them.

Making lasting changes—think years, not weeks or months—means that these behaviors must be maintained, and success depends on much more than simply following a diet or exercise program. Perhaps the most important tool for promoting long-term behavior change is relapse prevention.

A lapse is a one-time or short-term “slip up” in making a behavior change. For example, a bad day or even a bad week following a diet is considered a lapse. A relapse is a lapse that is continued for so long that you have essentially gone back to your previous behaviors, what some might call “falling off the wagon.” Since getting back on is so difficult, your goal should be to stay on the wagon by preventing a lapse from becoming a relapse. This is the topic of my Health & Fitness column in the Aiken Standard this week.

breaking the chain


No one is perfect, so lapses will naturally occur. While we often think that lapses occur without warning, the reality is that these events are often the last link in a chain of behaviors. This is illustrated by Barbara, a participant in one of my weight loss programs.

After several weeks of success on her diet Barbara faced her first real challenge, attending a catered event after work. She was rushed in the morning getting her kids ready for school and she didn’t have time for her usual breakfast. She settled for a banana and coffee, but she was hungry by midmorning. She spent her lunch break running errands. Instead of grabbing something unhealthy to eat while she was out, she didn’t eat anything. After a busy afternoon, she was tired and hungry when it was time to go to the event. She made her way to the food table and filled a small plate with the healthiest options she could find. But she wound up standing near the food talking to friends, and she ended up filling her plate a few more times with the very things she meant to avoid at first, including desserts.

Barbara’s story is a perfect example of a lapse, both because it is so common and because it demonstrates the chain of events leading up to it. The lapse—overeating at the party—actually started much earlier in the day. Not having her normal, filling breakfast and skipping lunch meant that Barbara was unusually hungry when she arrived at the party. And standing near the food table made it easy for her to go back for seconds (and thirds). Barbara was able to identify the links in the chain that led to the lapse in her diet, allowing her to get back on track the next day and make efforts to break those links in the future.

Like Barbara, recognizing the steps that lead up to a lapse in your diet or exercise program can help you avoid a slip-up in the first place and prevent a lapse from becoming a relapse. In many ways, long-term success is as much about building confidence in your ability to handle difficult situations as it is the number on the scale or the time you spend in the gym.


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Take steps to reduce breast cancer risk. Literally.

Many local and national organizations are busy promoting breast cancer awareness, sharing information about the disease, raising money to support research, and celebrating survivors as a part of Breast Cancer Awareness month. This represents the most visible part of a year-round effort to educate about, screen for, and hopefully cure this devastating disease. Of course, these are all worthy goals that deserve our attention and support. What is often missing are the steps women—especially young women—can take to reduce their risk for, or even prevent, breast cancer. This is the topic of my Health & Fitness column in the Aiken Standard this week.

cancer exercise group


Approximately 1 in 8 women will develop breast cancer. The American Cancer Society estimates that around 300,000 new cases of breast cancer are diagnosed and nearly 40,000 women die from this disease each year. Breast cancer can occur in men, but these cases are rare, so the focus is rightfully on women.

Much attention is given to genetic factors that increase the risk of breast cancer. These include certain gene mutations, including BRCA1 and BRCA2, as well as family history. A woman who has a first-degree relative (mother, sister, or daughter) who has had breast cancer has nearly twice the risk of being diagnosed herself.

Considering that most women diagnosed with breast cancer have no family history, it is also important to try to reduce other modifiable risk factors. This involves making health behavior changes that are probably familiar to most people. Among these is regular exercise.

Regular activity and exercise can lower breast cancer risk by as much as 30%, according to a study of over 3,000 women. The intensity of the activity didn’t seem to matter, so participation in light activity such as housework and gardening was as effective as walking. What did matter was the amount of time spent being active. Women who reported even low amounts of activity showed a 6% reduction in breast cancer risk, but the greatest benefits were seen in women who were active for over 10 hours per week.

Women who exercise regularly also have a lower chance of recurrence of breast cancer. As many as 1 in 5 of breast cancer survivors experience a recurrence within 10 years. Even relatively low levels of exercise may reduce this risk, and women who do exercise have greater rates of survival. The amount of exercise needed to realize these benefits is equivalent to 45–60 minutes of brisk walking five days per week.

Exercise is effective for reducing breast cancer risk because it lowers levels of the hormone estrogen. This is important because estrogen is linked with the majority of breast cancers and is especially relevant for women with estrogen receptor-positive cancers.

Exercise can also reduce the risk of breast cancer by helping with weight control. Excess body fat increases levels of estrogen, resulting in a higher risk of breast cancer diagnosis and recurrence. Regular physical activity is essential for losing weight and keeping it off. Exercise can also help reduce the increased risk of breast cancer that comes with weight gain, something that is common as women get older.

Women who have been active their whole lives have the lowest risk of breast cancer, but it is never too late to start. Women who exercise also tend to handle breast cancer treatment better than women who aren’t active. In fact, post-cancer exercise programs are becoming more common as a way to help women recover from cancer treatment and prevent recurrence.

Other lifestyle changes that can reduce the risk of breast cancer include maintaining a healthy body weight, consuming alcohol in moderation, not smoking, and eating a diet rich in fruits and vegetables. The good news is that these changes will also help you reduce your risk of other cancers, cardiovascular disease, and most other chronic diseases, too.


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How to avoid doing too much too soon when you start an exercise program

Regular exercise is one of the most important things you can do for your health. For many people, this means walking on the treadmill for an hour, doing a circuit on the weight machines, or going through the same aerobics class again all in the name of losing weight and getting fit. But it doesn’t have to be this way.

The current trend of high-intensity exercise workouts (CrossFit is one example) that emphasize shorter bouts of vigorous aerobic and strength exercise can hardly be described as boring and can produce even greater results than traditional exercise regimens. Some of these programs claim that you can “transform your body” or lose 10–20 pounds by participating in a three-week fitness challenge. Or maybe you are interested in trying high-intensity interval training (HIIT) to get the benefits of exercise in as little as 10 minutes per session.

It’s not as easy as it sounds, though. In order to get the fitness and weight loss benefits, the exercise must be done at a very high intensity, which may not be right for everyone. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Boot camp workout


To be sure, these types of fitness programs can be safe and effective for burning calories and improving fitness. But because they are intense means that you need to be fit to even get started, so they may not be a good choice for people who are not already in shape or who are new to exercise. There is a greater risk of injury and even heart attacks in people who are unfit and start exercising at a very high intensity. At the very least, muscle soreness is likely and may impact your ability—and motivation—to repeat that exercise the next day.

Ideally, an exercise program would begin with a health and fitness assessment by a certified exercise professional to determine potential health risks. These results would be used to create an exercise prescription. For participants who have risk factors like high blood pressure or diabetes, those variables would be monitored to make sure the exercise sessions were safe and effective.

In the real world, many people who have these conditions simply show up at a gym to begin an exercise program, often with little or no review of health history or assessment of fitness. In most cases this is safe, but without some form of monitoring participants who have high blood pressure or diabetes may have problems. This is especially concerning since many people don’t know they have these conditions, which is why seeing a physician is often recommended before undergoing fitness testing or starting an exercise program, especially if you are over 40 years of age or have other health problems.

A good personal trainer or exercise leader should ask about your health history and perform some type of assessment to gauge your current fitness and use this information to start you at an appropriate level. Even the most intense exercise programs, classes, or videos are scalable to all fitness levels, but you need to know where you are starting from. Additionally, a qualified personal trainer or group exercise leader can help you learn proper techniques to reduce the risk of injury and improve your progress.

Once you begin, resist the temptation to do too much, too soon by going at your own pace. This is especially important in group exercise programs where you may feel pressure to keep up with other, fitter participants. Listen to your body, too. Feeling some level of fatigue and soreness is normal, but severe shortness of breath, chest discomfort, or muscle and joint pain, especially if it comes on suddenly, is a good reason to slow down or stop. Make sure you communicate how you are doing to trainer or exercise leader, too.

Maybe you will find that the intensity and variety of these exercise programs keeps you motivated to meet your goals.  But don’t forget that even if you aren’t pushing yourself, any exercise you do will have significant health and fitness benefits.


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How low should you go?

When it comes to your health, making even small changes can lead to big improvements. Whether you are trying to eat a healthier diet, get in shape, or lose weight, a little effort can go a long way. But doing more can produce even more meaningful changes.

The same is true for risk factors including blood pressure, cholesterol, and glucose. For example, if you have high blood pressure, you can reduce your risk of having a heart attack or stroke by lowering it, even if it doesn’t get into the “normal” range. This is often a goal for patients with high cholesterol or diabetes, too.

According to recent news reports, a major study suggests that treating risk factors—specifically, hypertension—to bring them well below previous targets has even greater benefits. This study, and how it applies to other health indicators, is the topic of my Health & Fitness column in the Aiken Standard this week.

blood pressure


The study, which examined the effect of lowering blood pressure on heart attack and stroke risk, produced such remarkable findings that the results will be published two years ahead of schedule. The researchers found that lowering systolic blood pressure (the top number) to less than 120 mmHg resulted in a risk of heart attack or stroke that was significantly lower than that of treating blood pressure to a typical goal of below 140 mmHg.

This suggests that getting your blood pressure out of the “high” category isn’t enough and that lowering it more is beneficial. Not only is this is good news for people with hypertension, but it also likely applies to other conditions as well. For example, the goal for people with type 2 diabetes is to get blood glucose level, frequently determined by the “A1c” number, as low as possible to prevent complications like blindness, kidney failure, and amputations. And it seems that the risk of heart problems are reduced proportionally to how low LDL cholesterol gets.

This concept can also be applied to health behaviors. For people who are mostly sedentary, something as simple as a 30 minute walk each day can lead to big improvements in fitness. And simply swapping high-calorie drinks like soda or sweet tea for water or other calorie-free beverages can result in noticeable weight loss for many people. And overweight individuals can reduce their risk of diabetes by losing as little as 10% of their excess weight.

But greater changes to activity level or diet almost always have even bigger benefits. Cutting back on calories from drinks is a good start, but losing significant weight almost always requires making other changes in what you eat and how active you are. Walking is an excellent exercise, but greater improvements can be achieved by doing more, either longer duration or a higher intensity. And building muscle will require doing some form of resistance training—walking typically isn’t enough.

It’s true that every pound of weight loss matters, and many people notice changes in how they feel or how their clothes fit after losing as few as 10 pounds. But real transformations in appearance or health require more significant weight loss, especially for people with greater obesity.

Although the SPRINT study focused on only one factor, blood pressure, we shouldn’t limit ourselves to making only one change when it comes to our health. Indeed, the benefits of increasing activity, losing weight, and eating healthier together far exceed doing only one. And, while even small changes make a difference, doing more will almost always result in bigger benefits.

Forget about low-carb, go smart carb.

Nutrition advice tends to be complicated and contradictory, making simple answers to the question, “What should I eat?” anything but simple (but you still need to do it!). This is particularly true when it comes to carbohydrates. On one hand, current recommendations call for carbohydrates to be the major part of your diet. On the other hand, low-carbohydrate diets are at odds with these recommendations but are still very popular.

For example, the Atkins diet restricts all carbohydrates, including refined grains and sugars. The Paleolithic diet emphasizes minimally processed foods that may have been consumed by our ancient ancestors including lean meat, eggs, fruit, and vegetables while restricting the consumption of grains and added sugars. Both have been shown to promote weight loss better than traditional low-fat diets.

Proponents of low-carbohydrate diets claim that restricting carbohydrates promotes fat loss and eating carbohydrates leads to fat storage and weight gain. It is also likely that people who follow low-carbohydrate diets find them easier to stick to than other diets, so they may actually end up eating fewer calories.

But the problem may not be carbohydrates in general, it might be eating too few of the right carbohydrates. Given that September is Whole Grains Month, this seems like a good time to explore the benefits of going smart-carb instead of low-carb. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Food grains


Sources of carbohydrates include whole grains (such as whole wheat bread), refined grains (white bread), and sugars. Both refined grains and sugars tend to raise blood glucose rapidly, called the glycemic index, which leads to an increase in certain hormones, including insulin. Insulin stimulates the uptake of nutrients into cells, including the storage of fat in adipose tissue. This is one reason why carbohydrates are linked to fat gain and why restricting carbohydrates leads to fat loss.

But carbohydrates from whole grains don’t raise either blood glucose or insulin as much. This “low and slow” response has several benefits, including improved blood glucose regulation, lower triglycerides, and, potentially, reduced fat storage. For these reasons, complex carbohydrates from whole grains are called “good carbs,” in contrast to refined grains and sugars, known as “bad carbs.”

Considering that the typical American diet contains too much carbohydrate from sugars and refined grains and not enough whole grains, restricting carbohydrates may have some benefits. But there is another approach: be smart about your carbohydrate choices. Instead of cutting out all carbohydrates, focus on reducing refined grains and sugars and emphasizing whole grains.

You can meet this goal by limiting your intake of sugars, especially added sugars, and refined grains while increasing your consumption of whole grains, fruits, and vegetables that are high in fiber. When comparing food labels, look for foods that contain whole grains (the first ingredient should be something like “whole wheat flour”) and higher levels of fiber. But be aware that some foods, like many breakfast cereals, contain whole grains but are also high in added sugar. The best advice is to get the majority of your carbohydrates from real food, including vegetables, fruits, whole grains, and legumes, rather than from processed foods.

Something to keep in mind is that although low-carbohydrate diets are associated with weight loss and good health, they are not the only way to achieve these benefits. Indeed, people who are considered to be fit and healthy have a wide range of eating patterns, from vegetarian and low-fat diets to extreme low-carbohydrate diets and everything in between. The one factor they have in common is that they are active. It may be that regular exercise is just as important as what you eat when it comes to promoting health.


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