The process of investing in our future makes sense in the long-run but that certainly doesn't make it easy in the present. Whether we are talking about a monetary investment or time spent it is usually easy to find ways we would rather use these means NOW. Despite the struggle we all face when we decide to invest in the future, it sure is a fantastic feeling when it pays off. Taking the annual trip, walking up to get that diploma, sending the kid to college, etc. these are rewarding ends. Well, it may be that above all health and longevity are the most important ends. If we are not healthy, or living, to enjoy our initial investments they certainly will not be as sweet.
A common theme throughout these blog entries is the effort required to fight for our health and well being. We discussed the additional expense and the extra time it may take to tip the balance in our favor. I recently experienced this process first hand by joining a gym that I had previously crossed off the list due to its high monthly fee. However, after going to the gym as a guest and taking a few of the classes it became clear that this would be a valuable investment.
The fact that I am now spending much more for this current gym than the previous one has pushed me to commit to using the facility to its full capacity. I have become borderline addicted to spinning and I have gone to a class almost everyday for the last week. When I skipped one day I missed it, although this is likely not a good balance. I have also bought a new pair of running shoes which I haven't done in probably 2 years and I am thinking about moving on from the baggy basketball shorts of my youth to more age appropriate gym gear. My point is that this investment forced to me to commit and I am very excited about this new life change. My goal is to match my previous physical condition of my teens and possibly surpass it.
From a very young age I was always engaged in group sports whether it was t-ball, junior high flag football, high school basketball, etc. My livelihood was competing in these sports and the camaraderie amongst my teammates. As I am sure many of us have faced, once we are out of school these activities often disappear or are harder to commit to on a regular basis.
My thought is that by participating in these classes I can gain back some of my excitement for exercise. I had become bored of the treadmill, elliptical, etc. I am looking forward to the NFL combine class, cardio blast, and kick boxing. One of my best friends found a kick boxing class that he loves and he wakes up at 5:30 am multiple times a week to go. This is commitment!
Based on this experience, I am going to begin encouraging my patients to invest (whether time or money) in their health by finding a physical activity that they enjoy multiple times a week. It can be an exercise video, yoga studio, wii fit, etc. The point is to extend our self and go for it!
What have you all done to invest and commit? As always, I would love for you to share your personal experiences in the comment section. We can all benefit from each other's successes.
Thursday, February 25, 2010
Sunday, February 21, 2010
Don't Disrupt Your Hormones
It was a proud moment for Endocrinologists when we were able to claim fat as the ultimate endocrine organ. Previously, adipose tissue (AKA Fat) was thought merely as an inactive tissue responsible for storing energy in the form of fat. Now it is known that our fat is much more active. Adipose tissue is a major player in the regulation of metabolism via the release of hormones such as leptin (we have discussed its role in satiety) and the cytokine TNF alpha (involved in systemic inflammation). Therefore it is not hard to fathom that any substance that interferes with our endocrine system will have potentially harmful effects on our metabolism. Well, recently it has become public knowledge that the majority of us encounter these types of substances on a minute by minute basis. The term endocrine disruptor chemical (EDC) is most likely something we will all be hearing a lot about now and in the future.
The basic definition of an endocrine disruptor is an exogenous (outside the body) substance that acts like a hormone in the endocrine system and disrupts the physiological function of endogenous (normally occurring) hormones. A few examples of EDCs include pesticides (DDT), polychlorinated biphenyls (PCBS,used as industrial lubricants and coolants), Bisphenol A (found in plastic bottles and baby bottles, dental materials, and food and infant formula cans), phthalates (soft toys, medical equipment, air fresheners) and phytoestrogens (soy). Initially the concern regarding EDC exposure was predominantly surrounding reproduction since hormones are the major contributing factor. EDCs have been identified as a likely culprit in the increased incidence of undescended testis in newborn boys, an overall decreasing sperm count, breast cancer and early puberty. These are no doubt very scary findings and now EDCs are being identified as one of the potential etiologies for the current obesity trend. The exponential increase in obesity correlates with the widespread use of industrial chemicals.
Studies in this area of research have demonstrated that the effect of EDCs occur at the fetal and neonatal stages of development which are obviously crucial stages. Increased exposure of these substances during these critical developmental stages in animal studies appeared to disrupt the normal process of fat regulation. Results demonstrated elevated levels of leptin and insulin at younger ages and prior to the development of obesity which indicates the presence of dysregulation. An alteration of genes governing metabolism during development may predispose people to a lifelong struggle with weight. The animal studies have shown that low birth weight animals exposed to EDCs develop weight rapidly, often doubling their weight in 7 days, and similar studies in low birth weight children are showing similar trends.
Given these implications it is reasonable to assume that people who eat "healthy" and exercise but continue to struggle with weight despite their greatest efforts may have been exposed to these EDCs at a young age or may have a high level of exposure currently. Unfortunately this seems to be yet another basis for confusion in this nutrition conundrum. I recently read an article in Men's Health Magazine called "The New American Diet" by Stephen Perrine and Heather Hurlock that provided some valuable insight into this new facet of nutrition.
Since pesticides and their metabolites can spur fat cell development at any age it is worth the extra price to go organic in certain areas. A study in the journal Environmental Health Perspectives showed that children who ate fruits and vegetables free of pesticides for just 5 days reduced their urinary levels of those pesticides to undetectable levels. According to the Environmental Working Group you can reduce pesticide exposure by 80% by knowing which fruits and vegetables to consume. Peaches, apples, celery, kale, strawberries, lettuce, cherries, carrots and pears are all high in pesticides so it may make sense to buy organic in these items.
We may not be tasting plastic but we are consuming it. 93% of Americans have detectable levels of BPA. Again, plastic mimics estrogen and can predispose to fat. A few points to consider, don't heat up plastic, try to avoid plastic wrapped meat and try to cut down on canned goods.
When it comes to meat, organic/grass fed is much better for a wide variety of reasons. In order to produce "fast" food conventionally grown beef is high in growth hormones that we are consuming. These hormones are obesogens that cause us to gain weight and experts have surmised this may be playing a role in the obesity epidemic.
In my opinion, I saved the best for last. Soy was the new health craze for the last decade. Thought to be good for the heart, specifically in women, many of us started drinking soy milk and eating more tofu and edamame. It turns out that soy is not all it was cracked up to be. Since we would have to eat about 2 pounds of soy per day to reap its heart benefit the American Heart Association withdrew its support of soy. Soy, specifically in men, causes the formation of more fat cells since it is estrogenic. Soy is present in french fries, salad dressing, baby formula and even chicken and fish since they now feed on soy to help them gain weight.
For me, this has been one of the most interesting entries to write since it is a relatively new body of information to consider and there is much more research to be done in this area. I also found in mind blowing!
Please continue to recommend this blog to your friends and family. Encourage them to sign up for email updates and as followers of the blog. I would love to hear your comments!
The basic definition of an endocrine disruptor is an exogenous (outside the body) substance that acts like a hormone in the endocrine system and disrupts the physiological function of endogenous (normally occurring) hormones. A few examples of EDCs include pesticides (DDT), polychlorinated biphenyls (PCBS,used as industrial lubricants and coolants), Bisphenol A (found in plastic bottles and baby bottles, dental materials, and food and infant formula cans), phthalates (soft toys, medical equipment, air fresheners) and phytoestrogens (soy). Initially the concern regarding EDC exposure was predominantly surrounding reproduction since hormones are the major contributing factor. EDCs have been identified as a likely culprit in the increased incidence of undescended testis in newborn boys, an overall decreasing sperm count, breast cancer and early puberty. These are no doubt very scary findings and now EDCs are being identified as one of the potential etiologies for the current obesity trend. The exponential increase in obesity correlates with the widespread use of industrial chemicals.
Studies in this area of research have demonstrated that the effect of EDCs occur at the fetal and neonatal stages of development which are obviously crucial stages. Increased exposure of these substances during these critical developmental stages in animal studies appeared to disrupt the normal process of fat regulation. Results demonstrated elevated levels of leptin and insulin at younger ages and prior to the development of obesity which indicates the presence of dysregulation. An alteration of genes governing metabolism during development may predispose people to a lifelong struggle with weight. The animal studies have shown that low birth weight animals exposed to EDCs develop weight rapidly, often doubling their weight in 7 days, and similar studies in low birth weight children are showing similar trends.
Given these implications it is reasonable to assume that people who eat "healthy" and exercise but continue to struggle with weight despite their greatest efforts may have been exposed to these EDCs at a young age or may have a high level of exposure currently. Unfortunately this seems to be yet another basis for confusion in this nutrition conundrum. I recently read an article in Men's Health Magazine called "The New American Diet" by Stephen Perrine and Heather Hurlock that provided some valuable insight into this new facet of nutrition.
Since pesticides and their metabolites can spur fat cell development at any age it is worth the extra price to go organic in certain areas. A study in the journal Environmental Health Perspectives showed that children who ate fruits and vegetables free of pesticides for just 5 days reduced their urinary levels of those pesticides to undetectable levels. According to the Environmental Working Group you can reduce pesticide exposure by 80% by knowing which fruits and vegetables to consume. Peaches, apples, celery, kale, strawberries, lettuce, cherries, carrots and pears are all high in pesticides so it may make sense to buy organic in these items.
We may not be tasting plastic but we are consuming it. 93% of Americans have detectable levels of BPA. Again, plastic mimics estrogen and can predispose to fat. A few points to consider, don't heat up plastic, try to avoid plastic wrapped meat and try to cut down on canned goods.
When it comes to meat, organic/grass fed is much better for a wide variety of reasons. In order to produce "fast" food conventionally grown beef is high in growth hormones that we are consuming. These hormones are obesogens that cause us to gain weight and experts have surmised this may be playing a role in the obesity epidemic.
In my opinion, I saved the best for last. Soy was the new health craze for the last decade. Thought to be good for the heart, specifically in women, many of us started drinking soy milk and eating more tofu and edamame. It turns out that soy is not all it was cracked up to be. Since we would have to eat about 2 pounds of soy per day to reap its heart benefit the American Heart Association withdrew its support of soy. Soy, specifically in men, causes the formation of more fat cells since it is estrogenic. Soy is present in french fries, salad dressing, baby formula and even chicken and fish since they now feed on soy to help them gain weight.
For me, this has been one of the most interesting entries to write since it is a relatively new body of information to consider and there is much more research to be done in this area. I also found in mind blowing!
Please continue to recommend this blog to your friends and family. Encourage them to sign up for email updates and as followers of the blog. I would love to hear your comments!
Wednesday, February 17, 2010
Seconds or Really Fourths?
Portion size appears to be the new food related hot topic in the media these days. As much as I have "enjoyed" learning a tremendous amount about the poor QUALITY of the processed food we are consuming in this country I am glad the focus has shifted to QUANTITY. Many times when I am out to dinner I am awe-struck by the huge portion sizes that we are all consuming. At any given meal at a restaurant we are most likely satisfying a large proportion of our daily calorie requirement (approx. 1500-2000 calories/day). Now that I have become more conscious of my nutrition choices, as I strive to live by my own advice, I have begun to wonder why portion sizes have become so large as well as why we all clean our plate most of the time.
One of the main lessons I have learned by delving into this nutrition world is that half the battle, if not more, is psychological. The whole concept of "Super Size" started in the fast food arena but it has quickly expanded into the whole food world (except those expensive French restaurants that give you a few fork fulls and leave you hungry). The etiology of increasing portion size stemmed from the fact that we all theoretically have a "fixed stomach" so we can only consume about 1500 pounds of food per year (I would bet this number is much higher now). Based on this concept the rate of growth of the food industry would only be 1% per year, which was not tolerable to Wall Street. Therefore, the food industry had to find a way for people to either consume more food or spend more money on the same food. The obvious choice was the latter.
Since the vendors and manufacturers understood that psychologically people may feel self-conscious about going for seconds they increased the size of the portions at a small cost to the consumer. For example, at a movie it is always tempting to get the Medium or Jumbo Popcorn and/or soda for only 25 cents more despite it being much more than we originally desired. It is not hard to fathom that this extra 25 cents/customer over the tens of thousands that see movies/day adds up to a nice sum of money. The fascinating point is that despite this larger popcorn or soda being more than we initially anticipated consuming most of us will finish it all. We tend to finish whatever food/drink is in front of us because we paid for it so we don't want to waste it and it temporarily makes us feel good (remember the release of serotonin and dopamine in response to sugar). The portion size issue goes way beyond restaurants and movie theaters since even the pre-packaged foods we purchase are misleading when it comes to quantity.
The New York Times recently ran a story about the FDA weighing in on the issue regarding serving size. The FDA wants to encourage manufacturers of food to post vital nutrition information, such as calories, on the front of boxes to better inform consumers but this highlighted the long standing issue that serving sizes are way too small. Therefore, the calorie counts that go with a specific serving size are misleading. For example, one serving size of a pre-packaged muffin may be half a muffin or one serving size of Tostitos may be 6 chips. Now, who eats only 6 chips! Most of us probably eat 1/4-1/2 a large bag of Tostitos which could be almost 1,000 calories (1/2 of a days requirement). This extends to the problem of childhood obesity because one serving size of cereal may be a reasonable 150 calories but the problem is that one serving may only be 3/4 a cup of cereal. In reality, children are most likely eating 2-3 servings of sugar cereals for breakfast. The classic example is the bag of chips or cookies that are so proud in stating they are only 100calories but in reality the whole bag may be 150 calories in total. The article elucidated the point that an inaccurate serving size makes people think they are consuming fewer calories than they actually are which may end up hindering their health.
There are so many barriers to remaining healthy these days. I am hopeful that as these issues continue to come to the forefront on a national level there will be positive implications for the health of this country. However, in the meantime we all need to educate ourselves and strive for our best health.
Over the last few weeks I have been focused on controlling the quantity of food I consume. One crucial step, as we discussed above, is to read the labels on food products with a focus on serving size so we are aware of how many calories we are consuming. Another approach I have taken in restaurants is to separate a "reasonable" amount of food for the meal and aim to take something home as leftovers. I am reading a fantastic book right now called "The End of Overeating" by David Kessler, MD who is a former commissioner of the U.S. FDA and his recommendation is to eat 1/2 of the usual amount at a meal and if you are satisfied for 4 hours then that is sufficient. If not, then next time try to eat 3/4 of the usual amount and so on. He states that a full meal should keep you full for about 4 hours and a good snack should satisfy you for about 2 hours.
I imagine that eating a smaller amount of a highly processed food is better for our health than eating a lot of that same food. However, as we all know this is much easier said then done.
If you have any useful tips to pass on to other readers please comment below the entry. Also, if you have not done so you can sign up for email updates and as a "follower" of the blog at the top right corner.
One of the main lessons I have learned by delving into this nutrition world is that half the battle, if not more, is psychological. The whole concept of "Super Size" started in the fast food arena but it has quickly expanded into the whole food world (except those expensive French restaurants that give you a few fork fulls and leave you hungry). The etiology of increasing portion size stemmed from the fact that we all theoretically have a "fixed stomach" so we can only consume about 1500 pounds of food per year (I would bet this number is much higher now). Based on this concept the rate of growth of the food industry would only be 1% per year, which was not tolerable to Wall Street. Therefore, the food industry had to find a way for people to either consume more food or spend more money on the same food. The obvious choice was the latter.
Since the vendors and manufacturers understood that psychologically people may feel self-conscious about going for seconds they increased the size of the portions at a small cost to the consumer. For example, at a movie it is always tempting to get the Medium or Jumbo Popcorn and/or soda for only 25 cents more despite it being much more than we originally desired. It is not hard to fathom that this extra 25 cents/customer over the tens of thousands that see movies/day adds up to a nice sum of money. The fascinating point is that despite this larger popcorn or soda being more than we initially anticipated consuming most of us will finish it all. We tend to finish whatever food/drink is in front of us because we paid for it so we don't want to waste it and it temporarily makes us feel good (remember the release of serotonin and dopamine in response to sugar). The portion size issue goes way beyond restaurants and movie theaters since even the pre-packaged foods we purchase are misleading when it comes to quantity.
The New York Times recently ran a story about the FDA weighing in on the issue regarding serving size. The FDA wants to encourage manufacturers of food to post vital nutrition information, such as calories, on the front of boxes to better inform consumers but this highlighted the long standing issue that serving sizes are way too small. Therefore, the calorie counts that go with a specific serving size are misleading. For example, one serving size of a pre-packaged muffin may be half a muffin or one serving size of Tostitos may be 6 chips. Now, who eats only 6 chips! Most of us probably eat 1/4-1/2 a large bag of Tostitos which could be almost 1,000 calories (1/2 of a days requirement). This extends to the problem of childhood obesity because one serving size of cereal may be a reasonable 150 calories but the problem is that one serving may only be 3/4 a cup of cereal. In reality, children are most likely eating 2-3 servings of sugar cereals for breakfast. The classic example is the bag of chips or cookies that are so proud in stating they are only 100calories but in reality the whole bag may be 150 calories in total. The article elucidated the point that an inaccurate serving size makes people think they are consuming fewer calories than they actually are which may end up hindering their health.
There are so many barriers to remaining healthy these days. I am hopeful that as these issues continue to come to the forefront on a national level there will be positive implications for the health of this country. However, in the meantime we all need to educate ourselves and strive for our best health.
Over the last few weeks I have been focused on controlling the quantity of food I consume. One crucial step, as we discussed above, is to read the labels on food products with a focus on serving size so we are aware of how many calories we are consuming. Another approach I have taken in restaurants is to separate a "reasonable" amount of food for the meal and aim to take something home as leftovers. I am reading a fantastic book right now called "The End of Overeating" by David Kessler, MD who is a former commissioner of the U.S. FDA and his recommendation is to eat 1/2 of the usual amount at a meal and if you are satisfied for 4 hours then that is sufficient. If not, then next time try to eat 3/4 of the usual amount and so on. He states that a full meal should keep you full for about 4 hours and a good snack should satisfy you for about 2 hours.
I imagine that eating a smaller amount of a highly processed food is better for our health than eating a lot of that same food. However, as we all know this is much easier said then done.
If you have any useful tips to pass on to other readers please comment below the entry. Also, if you have not done so you can sign up for email updates and as a "follower" of the blog at the top right corner.
Tuesday, February 9, 2010
It's Good To Be Green
These days there seems to be a continuous message about the importance of "going green." While "going green" may be crucial to preserve our external environment it may also be paramount in conserving our internal environment. We have always heard about consuming adequate volumes of our GREEN vegetables to maintain iron and folic acid levels but there is also a GREEN beverage that has shown some health promise-Green Tea. As I have stated before in this blog, the premise of my writing these entries is a doctor taking his own advice. Since I have been trying to substitute green tea for coffee over the last year or so, not always successfully, I figured it was time to review the literature and pass it on to you all.
The last entry focused on supplements, specifically Vitamin D and omega-3 fatty acids, that have shown proven benefit in clinical trials and from my literature review green tea also has demonstrated impressive health results. After all, as I have alluded to before it is expensive to maintain our health these days so we only want to invest in products that are evidence based.
Green tea's health benefits are primarily based on its rich content of flavonoids, specifically catechins and their derivatives. Epigallocatechin-3-gallate (EGCG, since I refuse to type out the long version again in this entry) is a potent anti-oxidant (similar to Vitamins C and E) which scavenges free radicals in the body. Free radicals are basically a result of stress on the cellular level that can destroy various tissues in the body and lead to harmful conditions such as cancer, heart disease and diabetes.
Over the last few years some of the major medical journals have covered this green tea story. In 2006 in the European Journal of Clinical Nutrition a published study found that green tea is healthier than any other beverage, including water, because not only does it rehydrate but it also contains a rich supply of polyphenols protective against heart disease. Additionally, a 2006 Japanese study in JAMA suggested that drinking green tea lowered death due to all causes, including cardiovascular disease. That is pretty significant!
I am currently overwhelmed by the amount of research on green tea as I try and squeeze the pertinent information into this entry which is intended to be a quick read. Some other benefits suggested include lowering LDL (bad cholesterol), preventing blood clots, protecting the heart and brain during acute attacks (myocardial infarction and stroke), protection against cancer, weight loss and control of diabetes. As a physician and human being I am interested in all of these but I will focus on weight loss and diabetes since this is my career path.
We have previously discussed the importance of avoiding insulin spikes throughout the day to prevent weight gain. This is primarily achieved by eating frequent small meals that are high in protein and less simple sugars (processed foods). Well studies have shown that insulin is more effective in lowering blood glucose in the body when the diet is supplemented with green tea. For example, in a study whereby one group of rats ate a diet rich in high fructose corn syrup and the other group had the same diet but with the addition of green tea over 12 weeks it was found that the group with green tea supplementation had lower blood glucose, lower blood pressure and lower insulin levels than the other group. Maybe I should have been drinking green tea with my burgers and fries all these years!
It is only recently that I learned the difference between good fat and bad fat by working on a research project. Most of us have heard about the apple shape versus pear shaped obesity in terms of risk factors, or the term "skinny fat." The apple shape essentially means a high amount of abdominal fat (visceral fat) which is more metabolically detrimental because there is more turn over of cholesterol and higher insulin resistance. Actually peripheral superficial fat (the thighs, butt, arms, etc.) are protective because they serve as a cholesterol depot which means that there is a lower amount of fat circulating in the blood that can cause heart attacks, etc. Green tea has been shown to not only promote overall body fat loss, but specifically visceral fat (the most risky).
As any good doctor should do I must provide some warnings about consuming green tea. Green tea may lower the absorption of warfarin (coumadin-a common blood thinner), pseudoephedrine and codeine. Also should be cautious in those with iron deficiency anemia and limited in the first trimester of pregnancy. If you require high levels of caffeine to function then you will need to consumee double the green tea than coffee since there is about 1/2 the caffeine, although you will be very well hydrated and healthy! All this information is available on-line if you have further concerns.
I have thoroughly enjoyed writing these entries as I am learning valuable information through this process. Please continue to spread the word if you are enjoying and encourage people to sign up for email updates. Hopefully we can make an impact on the health of others through continuing to learn and educate.
The last entry focused on supplements, specifically Vitamin D and omega-3 fatty acids, that have shown proven benefit in clinical trials and from my literature review green tea also has demonstrated impressive health results. After all, as I have alluded to before it is expensive to maintain our health these days so we only want to invest in products that are evidence based.
Green tea's health benefits are primarily based on its rich content of flavonoids, specifically catechins and their derivatives. Epigallocatechin-3-gallate (EGCG, since I refuse to type out the long version again in this entry) is a potent anti-oxidant (similar to Vitamins C and E) which scavenges free radicals in the body. Free radicals are basically a result of stress on the cellular level that can destroy various tissues in the body and lead to harmful conditions such as cancer, heart disease and diabetes.
Over the last few years some of the major medical journals have covered this green tea story. In 2006 in the European Journal of Clinical Nutrition a published study found that green tea is healthier than any other beverage, including water, because not only does it rehydrate but it also contains a rich supply of polyphenols protective against heart disease. Additionally, a 2006 Japanese study in JAMA suggested that drinking green tea lowered death due to all causes, including cardiovascular disease. That is pretty significant!
I am currently overwhelmed by the amount of research on green tea as I try and squeeze the pertinent information into this entry which is intended to be a quick read. Some other benefits suggested include lowering LDL (bad cholesterol), preventing blood clots, protecting the heart and brain during acute attacks (myocardial infarction and stroke), protection against cancer, weight loss and control of diabetes. As a physician and human being I am interested in all of these but I will focus on weight loss and diabetes since this is my career path.
We have previously discussed the importance of avoiding insulin spikes throughout the day to prevent weight gain. This is primarily achieved by eating frequent small meals that are high in protein and less simple sugars (processed foods). Well studies have shown that insulin is more effective in lowering blood glucose in the body when the diet is supplemented with green tea. For example, in a study whereby one group of rats ate a diet rich in high fructose corn syrup and the other group had the same diet but with the addition of green tea over 12 weeks it was found that the group with green tea supplementation had lower blood glucose, lower blood pressure and lower insulin levels than the other group. Maybe I should have been drinking green tea with my burgers and fries all these years!
It is only recently that I learned the difference between good fat and bad fat by working on a research project. Most of us have heard about the apple shape versus pear shaped obesity in terms of risk factors, or the term "skinny fat." The apple shape essentially means a high amount of abdominal fat (visceral fat) which is more metabolically detrimental because there is more turn over of cholesterol and higher insulin resistance. Actually peripheral superficial fat (the thighs, butt, arms, etc.) are protective because they serve as a cholesterol depot which means that there is a lower amount of fat circulating in the blood that can cause heart attacks, etc. Green tea has been shown to not only promote overall body fat loss, but specifically visceral fat (the most risky).
As any good doctor should do I must provide some warnings about consuming green tea. Green tea may lower the absorption of warfarin (coumadin-a common blood thinner), pseudoephedrine and codeine. Also should be cautious in those with iron deficiency anemia and limited in the first trimester of pregnancy. If you require high levels of caffeine to function then you will need to consumee double the green tea than coffee since there is about 1/2 the caffeine, although you will be very well hydrated and healthy! All this information is available on-line if you have further concerns.
I have thoroughly enjoyed writing these entries as I am learning valuable information through this process. Please continue to spread the word if you are enjoying and encourage people to sign up for email updates. Hopefully we can make an impact on the health of others through continuing to learn and educate.
Sunday, February 7, 2010
The Verdict Is In, For Some.
Some simple math to start. "Nutrition" + "Pharmaceutical" = "Nutraceutical. A nutraceutical is defined as a food or food product that provides health and medical benefits, including the prevention and treatment of disease. Hippocrates, thought to be the father of Western medicine said, "Let food be thy medicine."
It is nearly impossible to walk the streets or malls of any major city and not come across a Vitamin Shoppe, GNC or some other supplement type store. The nutraceutical industry in the US is about $86 billion with nearly 2/3 of Americans taking at least one type of nutraceutical health product. When I recently walked into one of these stores to buy some recommended supplements for my morning protein shake the amount of inventory was overwhelming. Amino acids, probiotics, vitamins, etc. filled the shelves from floor to ceiling. This is clearly an industry on the rise but I wonder if this is money well spent.
Over the last year the news has been dominated by the struggling economy with the resultant unemployment and the debate over health care. I was surprised to read that while the economy has fallen vitamin sales have climbed. A story in the NY Times clearly demonstrated supplement consumers rationale. The people indicated that with higher deductibles or worse no health insurance at all it makes more sense to focus on prevention. Economist Uwe E. Reinhardt stated that he "sees the growing interest in vitamins and herbs as a logical extension of the concept consumer-directed health care." One person noted that he used to spend $50/month on various prescriptions for his chronic diseases but now spends $6/month on supplements. While I would definitely not recommend substituting "traditional" medicines with supplements I have always been an advocate for prevention of chronic diseases.
The argument against alternative medicine from allopathic physicians has always been that there is not enough evidence based research to support many of the claims. Based on this challenge many of these treatments have been and are currently being studied in clinical trials. The verdict is in that Vitamin D and omega-3 fatty acids are beneficial to long term health. These are two supplements that I believe everyone should take as a means of prevention.
Vitamin D is the "sunshine vitamin" because it is synthesized by humans when the skin is exposed to UV-B rays. Vitamin D assists in calcium reabsorption which is crucial for bone strength and thus the prevention of osteoporosis (thinning bones). It is additionally thought to strengthen the immune system and may prevent against high blood pressure, autoimmune diseases (such as multiple sclerosis and psoriasis) and may defend against certain cancers. The majority of people in the US have been found to be Vitamin D deficient either due to the Western diet, sunscreen (doesn't mean you shouldn't wear it) or the long winters. Based on this trend most primary care physicians are checking Vitamin D levels routinely and recommending 1000-2000 units of Vitamin D3 (not D2) per day as maintenance. Please ask your physician to check your level next time you get blood work.
Two essential omega-3 fatty acids are EPA and DHA which are present in cold water, oily fish (salmon, mackerel, herring) or in fish oil supplements. EPA has been found to be heart protective while DHA is beneficial to support the nervous system (brain function/development). Inflammation is major component of most chronic diseases and omega-3 fatty acids work to down regulate this process that can cause strokes, heart attacks, cancer, etc. Fish oil is very effective in regulating high cholesterol and this is certainly something to have tested by your primary care physician on an annual basis.
As a homework assignment I would recommend learning your Vitamin D level and cholesterol panel (LDL-"bad" and HDL-"good". Consider starting on the above mentioned supplements which I have done recently in order to continue to take my own advice. There is still debate about the benefits of antioxidants, probiotics, etc. but I will keep you posted.
Please comment about personal experience with various supplements and sign up for email updates (top right corner) if you have not already.
It is nearly impossible to walk the streets or malls of any major city and not come across a Vitamin Shoppe, GNC or some other supplement type store. The nutraceutical industry in the US is about $86 billion with nearly 2/3 of Americans taking at least one type of nutraceutical health product. When I recently walked into one of these stores to buy some recommended supplements for my morning protein shake the amount of inventory was overwhelming. Amino acids, probiotics, vitamins, etc. filled the shelves from floor to ceiling. This is clearly an industry on the rise but I wonder if this is money well spent.
Over the last year the news has been dominated by the struggling economy with the resultant unemployment and the debate over health care. I was surprised to read that while the economy has fallen vitamin sales have climbed. A story in the NY Times clearly demonstrated supplement consumers rationale. The people indicated that with higher deductibles or worse no health insurance at all it makes more sense to focus on prevention. Economist Uwe E. Reinhardt stated that he "sees the growing interest in vitamins and herbs as a logical extension of the concept consumer-directed health care." One person noted that he used to spend $50/month on various prescriptions for his chronic diseases but now spends $6/month on supplements. While I would definitely not recommend substituting "traditional" medicines with supplements I have always been an advocate for prevention of chronic diseases.
The argument against alternative medicine from allopathic physicians has always been that there is not enough evidence based research to support many of the claims. Based on this challenge many of these treatments have been and are currently being studied in clinical trials. The verdict is in that Vitamin D and omega-3 fatty acids are beneficial to long term health. These are two supplements that I believe everyone should take as a means of prevention.
Vitamin D is the "sunshine vitamin" because it is synthesized by humans when the skin is exposed to UV-B rays. Vitamin D assists in calcium reabsorption which is crucial for bone strength and thus the prevention of osteoporosis (thinning bones). It is additionally thought to strengthen the immune system and may prevent against high blood pressure, autoimmune diseases (such as multiple sclerosis and psoriasis) and may defend against certain cancers. The majority of people in the US have been found to be Vitamin D deficient either due to the Western diet, sunscreen (doesn't mean you shouldn't wear it) or the long winters. Based on this trend most primary care physicians are checking Vitamin D levels routinely and recommending 1000-2000 units of Vitamin D3 (not D2) per day as maintenance. Please ask your physician to check your level next time you get blood work.
Two essential omega-3 fatty acids are EPA and DHA which are present in cold water, oily fish (salmon, mackerel, herring) or in fish oil supplements. EPA has been found to be heart protective while DHA is beneficial to support the nervous system (brain function/development). Inflammation is major component of most chronic diseases and omega-3 fatty acids work to down regulate this process that can cause strokes, heart attacks, cancer, etc. Fish oil is very effective in regulating high cholesterol and this is certainly something to have tested by your primary care physician on an annual basis.
As a homework assignment I would recommend learning your Vitamin D level and cholesterol panel (LDL-"bad" and HDL-"good". Consider starting on the above mentioned supplements which I have done recently in order to continue to take my own advice. There is still debate about the benefits of antioxidants, probiotics, etc. but I will keep you posted.
Please comment about personal experience with various supplements and sign up for email updates (top right corner) if you have not already.
Wednesday, February 3, 2010
You Got The Right One Baby, Uh-NO!
Beverages were let off easy in this whole obesity epidemic for a long time but now they seem to have been brought to the forefront. A few years back I heard that if someone gives up 1 soda per day for a whole year they will lose something like 10 pounds. That seemed like a relatively large change for what seemed like a simple challenge. The reason for this large weight loss by eliminating regular soda from the diet is primarily high fructose corn syrup. We have pounded (pun slightly intended) the point home about the metabolic derangements from consuming high fructose corn syrup in previous posts so I will leave that alone. However, I had previously turned my head to the calories in juices, punches, sports drink, teas, etc. that I believe also make a tremendous difference as far as calorie consumption. I remember coming home from a long day of school and chugging a huge glass of Gatorade fruit punch even though I had not worked out which in the long run probably didn't do me much good. I certainly didn't need to replete my electrolytes from sitting in class all day. A study published in Obesity Research in November 2007 concluded that over the last 37 years our calories from beverage consumption have increased by 94% which amounts to 222 additional calories from beverages daily. This adds up to about 1 full day of eating per week. This begs the question, what about diet drinks (low to no calories)?
I always loved how people, myself included, go to McDonald's or some other fast food restaurant and order a huge greasy meal but order a diet soda. How does that work psychologically? Maybe we feel that it is OK to eat that triple Angus burger (or whatever the latest menu option) if we order a diet drink. I guess it is similar to drinking a regular soda or eating some sweets after working out. It is natural to always rationalize our intake. There is definitely psychological implications for choosing a diet/low calorie beverage but are there metabolic ramifications?
A study from Purdue University was published in the journal Behavioural Neuroscience that investigated the role of sweeteners versus real sugar in calorie consumption. The researchers determined that sucrose (real sugar) trained rats that were given a high-calorie chocolate pudding treat made them eat less afterwards whereas the saccharine (artificial sweetener) trained rats showed less restraint in what they ate next. The rational behind this difference is that our body uses the combination of calories and sweetness to regulate intake and when the two do not match up we tend to look for extra calories. Basically, diet beverages are sweet but don't match up in calories so our body sends us on a search to match up the calories with the sweetness until we feel full. Therefore, it seems that drinking a diet beverage by itself will tempt us to eat a high caloric food in conjunction.
Despite all these great new options to hydrate our bodies it seems that the good old fashioned H2O is the best. In addition to being the best way to remain hydrated it also is useful in maintaining calorie consumption within normal range. Many times when we feel hungry it is actually thirst. A natural response to dehydration is for our body to crave salty foods since excess salt causes the body to retain fluid. Therefore, when I have felt hungry on these long 12 hour shifts in the mid afternoon I have been drinking a bottle of water (thinking I am most likely dehydrated) and this has been satisfying.
To conclude I will quote from an email comparing water and coke that I received last week.
Water:
75% of Americans are chronically dehydrated/even mild dehydration will slow metabolism by 3%/lack of water is the number one trigger for daytime fatigue.
Coke: highway patrol carries 2 gallons of coke in the trunk to remove blood from the highway after a car accident/put a T bone steak in a bowl of coke and it will be gone in 2 days/to loosen a rusted bolt apply a cloth of coke for several minutes/the active ingredient in coke is phosphoric acid which can dissolve a nail in 4 days and is one of the leading contributors to osteoporosis.
I have basically eliminated soda from my daily routine for the last 6 months. Not sure if that has made me feel better but when I take a sip of a soda now it doesn't taste as good as it use to. Give it a shot.
I always loved how people, myself included, go to McDonald's or some other fast food restaurant and order a huge greasy meal but order a diet soda. How does that work psychologically? Maybe we feel that it is OK to eat that triple Angus burger (or whatever the latest menu option) if we order a diet drink. I guess it is similar to drinking a regular soda or eating some sweets after working out. It is natural to always rationalize our intake. There is definitely psychological implications for choosing a diet/low calorie beverage but are there metabolic ramifications?
A study from Purdue University was published in the journal Behavioural Neuroscience that investigated the role of sweeteners versus real sugar in calorie consumption. The researchers determined that sucrose (real sugar) trained rats that were given a high-calorie chocolate pudding treat made them eat less afterwards whereas the saccharine (artificial sweetener) trained rats showed less restraint in what they ate next. The rational behind this difference is that our body uses the combination of calories and sweetness to regulate intake and when the two do not match up we tend to look for extra calories. Basically, diet beverages are sweet but don't match up in calories so our body sends us on a search to match up the calories with the sweetness until we feel full. Therefore, it seems that drinking a diet beverage by itself will tempt us to eat a high caloric food in conjunction.
Despite all these great new options to hydrate our bodies it seems that the good old fashioned H2O is the best. In addition to being the best way to remain hydrated it also is useful in maintaining calorie consumption within normal range. Many times when we feel hungry it is actually thirst. A natural response to dehydration is for our body to crave salty foods since excess salt causes the body to retain fluid. Therefore, when I have felt hungry on these long 12 hour shifts in the mid afternoon I have been drinking a bottle of water (thinking I am most likely dehydrated) and this has been satisfying.
To conclude I will quote from an email comparing water and coke that I received last week.
Water:
75% of Americans are chronically dehydrated/even mild dehydration will slow metabolism by 3%/lack of water is the number one trigger for daytime fatigue.
Coke: highway patrol carries 2 gallons of coke in the trunk to remove blood from the highway after a car accident/put a T bone steak in a bowl of coke and it will be gone in 2 days/to loosen a rusted bolt apply a cloth of coke for several minutes/the active ingredient in coke is phosphoric acid which can dissolve a nail in 4 days and is one of the leading contributors to osteoporosis.
I have basically eliminated soda from my daily routine for the last 6 months. Not sure if that has made me feel better but when I take a sip of a soda now it doesn't taste as good as it use to. Give it a shot.
Monday, February 1, 2010
Cycle for Survival
Cycle for Survival is a fundraising event to raise money for rare cancer research through Memorial Sloan Kettering. My sister-in-law put together a team to participate in this amazing event since she has battled a rare cancer called sarcoma (thankfully she is doing great!) and fortunately I was a member of this team. A special thanks to Laurie for her effort and passion in building our team of Laurie's Laughter. Our team raised about $7,000 and the total NY event raised $2.2 million. The event took place at Equinox gym and was a 4 hour event consisting of 4 spin sessions. With the music pumping throughout we all pushed ourselves physically to represent either ourselves or our love ones who have battled one of these diseases. In essence, I guess these fundraising events that are based on a strenuous physical task are to symbolize the battle many people fight to rid the cancer from their body. I was thinking about all the different fundraising events such as AIDS walk, the breast cancer runs, walk for mental health, etc. and wondering why all these events were based on a physical tasks. As I was becoming physically exhausted as I cycled against the resistance to reach the top of the metaphorical hill the symbolism became clear. In life, when we face any struggles with health there are both physical and emotional barriers that challenge us. At times it may be easier to give up but I think most people really find the passion to fight which is admirable. In the end, no matter how many people we have behind us, our health is a personal issue.
When I completed my portion of the cycle event I walked into the cheering area. I use the word walk but it was more of a drag, my legs felt like jello. Anyway, the cheering area was filled with all types of food and beverages. There were your classic foot long sandwiches, bins of yogurt, sports protein bars, bottles of water, sports drinks, etc. Of course, as a nutrition blogger (ha!) I began thinking about what are the best types of food to eat before and after exercise. Since I wasn't entirely sure of the correct answer I reviewed some literature when I got home and learned some of the following information.
Prior to exercise it is best to eat/drink carbohydrates (fruit, juice, pasta, crackers...). This is because the body digests carbohydrates much faster than protein and prefers to use carbs as fuel. If you are going to eat protein prior to exercise it is advisable to wait at least a few hours to allow the body time to digest. If you exercise prior to the majority of the digestion process you are likely to experience cramps since blood will rush to the GI system for digestion rather than the muscles that need them during exercise. For some reason I use to think that working out on an empty stomach was better, however, this makes little sense since the body needs fuel for physical activity. Additionally, working out on an empty stomach can cause nausea and lightheadedness due to hypoglycemia (low blood sugar). Another important factor in preparation for exercise is hydration. It is crucial that the body has enough water stores during exercise to prevent hypotension (low blood pressure-with severe dehydration), cramping, lightheadedness, headaches. The body needs volume to perfuse the tissues and if this volume is low, as with dehydration, side effects will occur. I would recommend drinking about 16 oz. of water prior to exercise and sipping water throughout. I did this prior to the event yesterday and I think it definitely helped while I was "climbing that mountain" on the stationary bike.
As far as after the work out, back to the cheering area. After exercise a meal with a balanced mix of carbs, protein and fat is optimal. Carbs are useful to replace the energy stores (glycogen) that had been depleted during exercise. Protein is important to help rebuild muscle. The best beverage remains water unless the work out was more than 1 hour at which point a sports drink is useful to replete electrolytes. Based on these points a whole wheat foot long turkey sandwich would have been a great thing for me to eat. However, while I was there I figured this would have been less than optimal. Oh well, next year! Sports bars are also good post exercise but make sure to check the calories. The sports bars they had were more like a meal replacement, 440 calories, so unless you are actually using it as a meal replacement I think I would go with something with less calories.
I have thoroughly enjoyed the process of writing this blog for the last week or so. I have learned a lot by thinking about these various nutrition related issues. I have become more vigilant in my daily life as I search for new and hopefully interesting topics. I hope you as readers are learning and enjoying these entries. Please continue to pass the link on to your friends and family if they may be interested. Also, encourage them to sign up for email updates and as "followers." You can also comment at the bottom of each entry.
When I completed my portion of the cycle event I walked into the cheering area. I use the word walk but it was more of a drag, my legs felt like jello. Anyway, the cheering area was filled with all types of food and beverages. There were your classic foot long sandwiches, bins of yogurt, sports protein bars, bottles of water, sports drinks, etc. Of course, as a nutrition blogger (ha!) I began thinking about what are the best types of food to eat before and after exercise. Since I wasn't entirely sure of the correct answer I reviewed some literature when I got home and learned some of the following information.
Prior to exercise it is best to eat/drink carbohydrates (fruit, juice, pasta, crackers...). This is because the body digests carbohydrates much faster than protein and prefers to use carbs as fuel. If you are going to eat protein prior to exercise it is advisable to wait at least a few hours to allow the body time to digest. If you exercise prior to the majority of the digestion process you are likely to experience cramps since blood will rush to the GI system for digestion rather than the muscles that need them during exercise. For some reason I use to think that working out on an empty stomach was better, however, this makes little sense since the body needs fuel for physical activity. Additionally, working out on an empty stomach can cause nausea and lightheadedness due to hypoglycemia (low blood sugar). Another important factor in preparation for exercise is hydration. It is crucial that the body has enough water stores during exercise to prevent hypotension (low blood pressure-with severe dehydration), cramping, lightheadedness, headaches. The body needs volume to perfuse the tissues and if this volume is low, as with dehydration, side effects will occur. I would recommend drinking about 16 oz. of water prior to exercise and sipping water throughout. I did this prior to the event yesterday and I think it definitely helped while I was "climbing that mountain" on the stationary bike.
As far as after the work out, back to the cheering area. After exercise a meal with a balanced mix of carbs, protein and fat is optimal. Carbs are useful to replace the energy stores (glycogen) that had been depleted during exercise. Protein is important to help rebuild muscle. The best beverage remains water unless the work out was more than 1 hour at which point a sports drink is useful to replete electrolytes. Based on these points a whole wheat foot long turkey sandwich would have been a great thing for me to eat. However, while I was there I figured this would have been less than optimal. Oh well, next year! Sports bars are also good post exercise but make sure to check the calories. The sports bars they had were more like a meal replacement, 440 calories, so unless you are actually using it as a meal replacement I think I would go with something with less calories.
I have thoroughly enjoyed the process of writing this blog for the last week or so. I have learned a lot by thinking about these various nutrition related issues. I have become more vigilant in my daily life as I search for new and hopefully interesting topics. I hope you as readers are learning and enjoying these entries. Please continue to pass the link on to your friends and family if they may be interested. Also, encourage them to sign up for email updates and as "followers." You can also comment at the bottom of each entry.
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