Tag Archives: obesity

Telling the truth to yourself and hearing–no, expecting–it from others.

Earlier this week I wrote about the importance of being honest with yourself about your health. Unless you can honestly assess your own health and health behaviors, making meaningful changes simply won’t work. Living in denial about your weight or eating and exercise behaviors means that you can’t recognize what you need to change.

We should also expect others to be honest with us, too. While family and friends may be hesitant to voice their thoughts, especially about sensitive topics like weight, we should expect them to be supportive. And we should certainly expect medical professionals to tell us the truth about our health, even if we don’t want to hear it.

Unfortunately, many doctors, nurses, and fitness/wellness professionals are reluctant to bring up topics like weight for fear of offending a patient or client. This was expressed eloquently in a recent article in the New York Times.

While the goal should never be to offend or ridicule, I believe that health professionals should always bring up potential health issues and talk honestly about what people can do to improve their health.


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

Honesty is the best policy when it comes to your health

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


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 or 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 ( 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!


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

What children gain and lose over the summer

Summer vacation is a rite of passage for children. Long summer days to play, go to camp, and relax are an important part of growing up. But many educators and health professionals are concerned about what gets lost, and what gets gained, when kids are away from school.

Kids playing outdoors


Summer learning loss is a real concern. It is estimated that children lose, on average, two months of reading skills and one month of overall learning over summer break. Those losses must be made up when school starts again in the fall, so teachers spend about six weeks re-teaching material that was covered in the previous grade. That is six weeks that children are not learning at grade level, which certainly has an impact on achievement over time.

Not all kids are affected equally. Much of the disparity in summer learning losses falls along socioeconomic lines. Some children have more opportunities than others to continue learning over the summer through formal educational programs and camps and informal encouragement to read.

To address this issue, many institutions implement summer “school” through classes, on-line learning programs, and encouraging reading at home. Some target the students who need them the most while other programs are instituted for all children. In fact, all three of my kids are completing online learning programs this summer.

Learning losses are not the only concern with an extended break from school. Many children gain more weight over the summer than during the rest of the year. Furthermore, fitness gains made during the school year are frequently lost over the summer. While poor nutrition and a lack of activity in schools is a real concern, many children get more exercise and eat better at school than they do at home. Being at home over the summer can lead to poor eating habits—too much unhealthy food or not enough food in general—and lack of chances to be active.

This is important because the combination of poor nutrition, physical inactivity, and obesity has physical, psychological, and social consequences for children that frequently persist into adulthood. Overweight and obese children are at increased risk for type 2 diabetes, high blood pressure, heart disease, and even stroke – conditions usually associated with adulthood. Even if an overweight child does not have these conditions now, he or she is likely on that path. In fact, many experts predict that children born today will be the first generation in history to have a shorter lifespan than their parents due to obesity-related diseases that begin in childhood.

Children who are overweight are also more likely to suffer other consequences including lower self-esteem, social functioning, and academic performance. Overweight children are also less likely to play sports or participate in other forms of physical activity, which creates a cycle leading to poorer health and, potentially, poorer academic success.

Now that school is almost out for the summer, this is a critical time of year to focus on good nutrition, physical activity, and continued reading and learning to help prevent a summertime slump in health and academics. Schools can only do so much, so adults should model good diet, activity, and reading behaviors themselves. A good place to start is by turning off the TV and reading a book or going outside to play. It’s something all of us—adults and children—will benefit from.


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

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!

 


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

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.


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

New reasons why it is so easy to gain weight. And what you can do to stop it.

If you have been gaining weight or find it more and more difficult to maintain your weight, you are not alone. According to current statistics, one-third of U.S. adults are obese and two-thirds are considered overweight. Being overweight is now the norm in America, since only about 3 in 10 people are at a healthy body weight.

This is consistent with other reports that show that the waistlines of Americans are expanding. One recent study looked at the percentage of adults who had a high waist circumference (over 35 inches for women and over 40 inches for men). Overall, the average American added over one inch to their waist circumference over the past decade. As of 2012, over half of U.S. adults meet the criteria for abdominal obesity. This is bad news, since excess fat, especially around the waist, increases the risk of type 2 diabetes, hypertension, and heart disease.

It wasn’t always this way. As recently as the 1980s the prevalence of obesity was much lower, around 15%. There has been much interest in figuring out why this widespread weight gain has occurred. While there is no single cause, there are a host of factors that contribute to the obesity epidemic. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Obesity


Among the forces that seem to be working against you are your genetics and our environment, specifically as it relates to eating and activity behaviors.  Over the past several decades our “food environment” has changed so that now low-quality, high-calorie food is readily accessible and more nutritious food is harder to find and more expensive. Our “activity environment” has changed, too. For most of us, the physical activity that was common at work and home years ago has been replaced by lots of sitting. While there are genes that influence our eating and activity behaviors, these genes have not changed enough over time to explain the obesity epidemic.

A practical explanation for weight gain, both for individuals and the population as a whole, is that we are eating more and expending less energy through activity. Indeed, even small changes in energy balance can add up to increased weight over time . A new study, however, suggests that there may be other factors that may have contributed to the rise in obesity beyond eating and activity.

Among these factors are exposure to certain chemicals in the environment, the use of prescription drugs that cause weight gain, and how our current diet has changed the bacteria in our intestines, that we now know regulate our physiology in surprising ways. For example, bisphenol A (BPA), still found in some plastics, food containers, and receipts, alters normal hormone activity in a way that may increase fat storage.

There is some good news, though. Eating a healthy diet and being active everyday can help you lose weight and maintain a healthy weight. This is true whether your concern is changes in your own eating and activity habits or these other potential causes of weight gain. Indeed, regular exercise may help treat many conditions, like depression, for which prescription medications that may cause weight gain are often used. And a diet rich in fruits, vegetables, and whole grains and low in added sugar may help restore more normal gut bacteria which might help with weight control.

Until we know otherwise, eating smart and moving more is still your best approach to weight control and good health.


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

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.


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

Despite the controversy, energy balance still matters.

The concept of energy balance has been in the news again this past week. Unfortunately, the media reports focused on controversial funding for a network of researchers, not on practical information that could help people with weight control. In my Health & Fitness column in the Aiken Standard this week I take the opportunity to explain what energy balance means and, despite the controversy, how it can help you achieve and maintain a healthy body weight.

walking weight loss


First, it is worth explaining what energy balance means. Basically, the energy balance model suggests that your body weight is determined by the balance between the number of calories you consume and the number of calories you expend each day. It is often illustrated as “calories in, calories out” and is the basis for the most basic weight loss advice: eat less and move more.

Now for the controversy. It was recently reported that the Global Energy Balance Network (GEBN), an organization aimed at promoting activity and health, received money from Coca-Cola, a company that promotes the consumption of sugar-sweetened beverages.  Furthermore, the obesity and exercise researchers at GEBN started focusing more on the lack of activity, instead of unhealthy food, as a major cause of obesity. Whether this is truly a real conflict of interest or simply a reality of funding a non-profit health organization remains to be seen.

It is important to note that this doesn’t mean that the efforts of GEBN scientists or the concept of energy balance in general should be dismissed. In fact, the energy balance model is a simple and effective way to explain how weight gain and weight loss occur. In fact, the only treatments we have for obesity focus on changing energy intake and energy expenditure. While some suggest that the “calories in, calories out” idea is too simplistic, it certainly helps people understand why they have gained weight and provides an intuitive guide to losing weight. This is most commonly expressed as “eat less, move more” and is the foundation of nearly every effective weight loss program.

For most researchers, practitioners, and people in general, the focus is typically on the “energy in” and “eat less” parts of the equation. Nearly all diets work by reducing the number of calories someone eats, even if they claim that you can eat as much as you want. Common recommendations to cut back on sugar or fat tend to lead to eating fewer calories, especially if those foods are replaced by fruits, vegetables, whole grains, and lean meats. Since we now know that eating fat won’t necessarily make you fat, the emphasis has shifted to sugar as a cause of weight gain. And sugar-sweetened beverages, including soda, are a major source of sugar for many people, especially children. So, most experts recommend consuming less soda, candy, and other sources of added sugar.

But there is another part of the energy balance model that can’t be ignored—energy expenditure. One goal of the GEBN is to emphasize the importance of activity in achieving energy balance and a healthy body weight. The focus on physical activity makes sense considering that the component of energy expenditure you can control is your activity level. This includes exercise, other occupational and leisure activity, and limiting sedentary (sitting) time, with a goal to be as active as possible throughout the day. The key is to achieve a balance between what you eat and drink and the energy you expend by being active.

The importance of exercise and energy expenditure for weight loss is shown by the members of the National Weight Control Registry, commonly called the “successful losers” because they have lost an average of over 50 lbs and kept it off for over five years. They lost weight by following a variety of diets and programs but nearly all continue to exercise regularly. This suggests that physical activity to promote “energy out” is at least as important as diet when it comes to maintaining weight loss.

In fact, if energy expenditure is high enough, a person could get away with eating almost anything he or she wants. In the 2008 Olympics, swimmer Michael Phelps famously revealed what he ate on a typically day. The amount and type of foods he consumed were not what you would expect from someone so fit and healthy! Without the hours of training he engaged in each day that diet would almost certainly have resulted in obesity and poor health.

Clearly, increasing physical activity is important both for weight control and health in general. But diet matters, too. And while the energy balance model says that there is nothing wrong with having your favorite foods or drinks as long as you are active, most of us could benefit from drinking less soda and moving a bit more. In this way, keeping yourself in energy balance should allow you to maintain a healthy weight without depriving yourself too much. The key is, and always has been, to find a balance between what you eat and drink and the energy you expend by being active.


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

We have known for a long time that kids who spent more time watching TV were more likely to be obese. This was thought to be due to the fact that sedentary time in front of the television replaced physical … Continue reading