Friday, July 25, 2008

wellness weekly

Stupid Exerciser Spot: I think I should start a regular column here to note the people I see doing a good thing in a dumb way. It is obvious that I love running and runners. I still want people to be sensible. The last time I mentioned this it was the pretty overweight out of shape guy at Siesta Key, this time it was a regular weight guy in Sarasota. He was running down the sidewalk, also in the hottest mid day sun. I emphasize side walk , but it should really read, unshaded sidewalk. His stupidness was that he was dressed all in black and had no hydration evident. The thing is the t shirt. It was not a singlet or a dry fit shirt, but a regular beefy man T-shirt. Crazy.

Hydration: To reiterate. Hyponatremia(very low sodium) is possible if too much water is consumed. Usually hydration is needed when workouts approach or exceed the hour mark. It is good to gauge your hydration by the color of your urine with pale yellow being ideal. Experts, exercise physiologists, will recommend that a person weighs himself before and after the strenuous workout to determine how many ounces of fluid has been lost. My concern is that the only way to do that accurately is to not hydrate during the workout, in my case a long run. That is not healthy in my opinion. If you are able to do it however, you would drink as many ounces as pounds, i.e 1 pound is 16 ounces.

Cell Phones: This is another issue (like plastic, Teflon and aspartame) that gains life and momentum through the internet only to be quelled with FDA repudiation or a quick search on until the whole process starts anew. So to recap, previous studies have found no conclusive evidence of cancer risk related to cell phone use and radiation, nor have they concluded that there is no risk. This latest study suggests that there is a problem and though it cannot be duplicated by a clinical trial or experiment (that would be unethical) it is still an issue that should be addressed with alerts and precautions. On the University of Pittsburgh Cancer Institute website this week and on NPR and in other print, a researcher and an expert panel have recommended at least 10 things one should do or not do with regards to cell phones. I found the information important. I learned that there is a legal limit on the Specific Absorption Rate and that my cell phone was in the top ten of the worst ones, practically at the limit of 1.6. I have upgraded my phone because of this, the day that I read this, so yesterday. You can read the report, get info about SAR and check your phone here:

Childhood Obesity Reccs: Oh my gosh. I read the AMA expert panel recommendations on this week as part of a CME activity and was just stunned. Though only suggestions that may take years to become standard care, I was surprised by the extent and seriousness of the attention. The panel is recommending that physicians not only address weight but gauge the readiness of change in the child and or parents. They are referring to the Stages of Change or Transtheroetical Model of behavior change, pre contemplation, contemplation, action, maintenance and termination. The panel recommends that docs tell parents to limit TV, to push 60 minutes of exercise a day, avoid eating out and to increase consumption of fruits and vegetables while limiting sweetened drinks. Treatment for children aged 2-19 is encouraged any time the BMI is at the 85th percentile or above. In other words if your child weighs more than 85% of other children that age.

Fast Food:
If one takes the AMA seriously, then Los Angeles’ idea regarding fast food restaurants might not seem so radical. A council member is proposing a ban on new fast food restaurants in a certain geographical area where there are already 40 such restaurants. It is specifically based on the type of food they sell, not the building being an eyesore or anything like that. They are also looking into calorie content law similar to that of NYC. The restaurant industry is up in arms(and court) about these calorie laws. This makes me think we must need them even more.

Oh. I’ve got a Pill for that: The only problem with drugs that are gender specific is that they are gender specific and THUS, the sale potential is limited. So what would a drug company need to do ? Well, find a way to make the drug work for the opposite sex of course. Think Gardisil and Viagra for example. The maker ofViagra (pfizer)is on it. They have been running clinical trials to see if women who take Viagra, the erectile dysfunction drug for men, will have increased libido. No luck so far, except….. a certain class of women. Women who are clinically depressed and taking antidepressants are having a response to t he Viagra. BTW, psychotropics are rife with side effect warnings. Anyway, what is one more pill. Remember however, ED is about blood flow and blood flow is effected by diabetes and hypertension and those illnesses are effected by>>>>>>>>>>>>>> all together now, diet and exercise!

Lastly, a WSJ style article tells us that slips are no longer being worn by women. In fact, an office poll found that the only member who wore one was over 40. In honor of this, I sit here now in a skirt without a slip! Do NOT tell my mom.

Wishing You Wellness

Friday, July 18, 2008

Wellness Weekly

A Colorful Plate: A great article passed on to me from my sister and written by S. Squires reminds us that fruits and vegetables contain health promoting compounds that can obviate the need for poly pharmacotherapy as we age. In other words, eating well and in moderation coupled with near daily exercise can prevent illness and loss of physical and mental vigor while increasing well being. So choose bright and myriad colors for your plate at every meal and no white is not really a color nor is it bright. I.e. The sweet potato trumps the white.

Diets: Hate ‘em. Most will work for as long as you work them. Bottom line is that as long as you cut your calories and maintain or increase your amount of physical activity you will lose weight. Are all diets going to provide you with the nutrients you need to be well? No, but they can all lower your weight. Best that you pick one that you can live with forever, i.e. financially, mentally and physically because when you stop doing whatever it is your doing, the weight will come back. Many news sources this week reported on a study out of Israel and published in the New England Journal of Medicine. Please note the subjects were predominately male (over 80%) AND the version of the Atkins diet or low carb diet, used in the study was mostly vegetarian. Vegetarian? How Atkins is that? Two of the diets were calorie controlled at 1800 and 1500 (male to female). They were the AHA and the Mediterranean. All of the diets were free of processed or simple carbs, free of TFAs; two were low fat and high in fruits and vegetables. All persons lost weight. Now if you are a fan of Atkins and you read from this that Atkins is good, please note, this was a modified version it is not a classic Atkins diet.

EXERCISE: I want to put on my old personal trainer hat for a moment, while still wearing my health educator one, of course. After two people mentioned their exercise plans to me this week, I recalled an important message that needs to be repeated. Adding or changing an exercise routine is a lifestyle modification that should be made with some thought for the long run. It is important that one not go gang busters into their exercise program. For example, if one is not walking at all, they should not begin by walking every day. This is important for several reasons. One is that going too fast, too strong, can lead to burn out and or injury, two it is unnecessary and three it may lead to an early plateau. When the body is not used to doing an activity, for me it is swimming, starting with two or three times a week is the best. A month or so later you can add minutes (or laps) and or days. It should take you a year to get to five plus days a week. You will initially burn plenty of calories at your three day 30 minute walking or elliptical activity, etc. When your body gets used to it, THEN add minutes or days. When you get to a high level, like me and my running, then you have to add INTENSITY. All things in their time and you will have continued benefit and a nice lifelong habit of physical activity.

NYC: A friend forwarded an MSNBC article to me this week. It reports on the response to the NYC law on calorie content labeling in chain restaurants. It seems that the citizens of this glamorous city have gotten a few surprises with regard to their favorite foods. The article was very interesting and indeed, people are reconsidering their choices. The restaurant owners have noted that some of the low calorie items they have are selling out because more people are ordering them. Because of this change in consumer behavior, the restaurants will have incentive to either reduce calorie content or serving size. This law can be an effective tool for changing the environment that has contributed to this worldwide obesity epidemic. Wait, if it’s worldwide, does that make it a pandemic.

Kids Part 1: Physical activity. A study that lasted approximately six years and which was reported in JAMA this week shows that on average, 9 year olds are physically active for about three hours a day while 15 year olds are so for less than an hour a day. Why? Perhaps the social climate doesn’t promote it as fun, necessary or normal. The consequence is that around 33% of children are overweight. Many of these kids will later be classified as one of the 66% of overweight adults.

Kids Part2: Marketing. It isn’t just lack of activity but over consumption that adversely affects our kids. Another study, this one from Canada, discusses the marketing of high calorie foods to children. The researchers analyzed 367 products that were targeted to kids (i.e. cartoons, movies, etc) and found that only 11% of the foods advertised to children actually provided good nutrition. The standard for kids relates to maximum amounts of fat, sugar, salt and calories according to our Center for Science in the Public Interest. Rather shameful especially because the industry has said it did not need to be policed that it would take care of this itself. It was also noted in the study that some of the products falsely claimed that they were health promoting.

Tilapia: Well, I have read more about the study that is out of Wake Forest University regarding the adverse effects that can occur from the consumption of tilapia, specifically. The problem relates to the ratio of omega 3 fatty acids to omega 6. Though both are considered essential fatty acids, there is some debate over the omega 6 type being helpful. Salmon and trout are high in 3 and are the better fish. Tilapia is a low fat, low calorie, low mercury fish, but the risk for aggravation of inflammatory illnesses from consumption of this fish is evident. Heart disease is associated with inflammation. Oh the irony of that. Eat fish it will reduce your risk of heart disease, oh except when it increases it. Give me a break. And I loved tilapia. As do many people and that is the problem. Increased consumption of this fish was not what the health experts had in mind when they started advising us to eat more fish. In fact, someone quoted about this said that the tilapia was no worse than a hamburger, well, geez, that isn’t saying its healthy now is it. I am quite frustrated with this because I thought the good fish bad fish problem was related mercury and pcbs.

Be well and uh, don’t eat tilapia!

Friday, July 11, 2008

Wellness Weekly

The news I reviewed, read, was sent or heard about this week mostly related to the country’s problem with overweight and obesity. Happily, I also registered to attend the 9th annual conference on obesity in Orlando, Fl but that is in September. The problem of being overweight begins early in life now days as never before and has an impact on ones quality and length of life.

Children: Two articles addressed children. One reporter (L. Tanner AP) noted the American Academy of Pediatricians new recommendations on treating high cholesterol in children, especially in the presence of low HDL cholesterol, the kind most associated with sufficient amounts of exercise. The advisory suggests medicating children at the early age of 8. In this same report came a suggestion that children, especially overweight ones, be started on low fat milk at age one instead of the current standard of age 2. Some people are concerned about a lack of saturated fat in the diets of the young whose brains are still developing. However, the children must be getting enough of that fat from other food sources to warrant both of the aforementioned strategies. I find it far more discomfiting to put elementary school kids on medications for chronic illness then to take toddlers off full fat milk.

the American Heart Association has also come out with a statement this month. Its concern on the consequences of obesity was part of Medscape’s recent bulletin and CME activity. In essence, the AHA is urging its cardiologists to become proactive, well active even, in advising patients to eat well and exercise and to do so by advocating for policy changes. It is like the tobacco movement and I expect it will be met with some of the same resistance. Doctors seem “in general” to be quite reluctant to tell people that their weight is putting them at risk for serious medical complications, even more so than they are uncomfortable telling them the same thing about cigarette smoking. I love the recommendations none the less. I especially like the idea of making poor food choices a non issue by not making unhealthy foods so readily available (i.e. school and work, snack machines and by limiting the portion size at restaurants)

Prevention: In a joint statement the AHA, American Cancer Society and the American Diabetic Societies advise us all to change our lifestyles in order to add about 14 years to our lives. Actually people who are fat, sedentary and smoke lose about 14 years. If we adopt several healthy habits we could gain 1 plus years. Now hold on a minute… Drug companies, especially those who work on terminal illnesses such as many cancers, sell drugs for over 10,000 a dose to give a person three months more to live and at not so high a quality existence. You could have another healthy active year pretty much for free. Do me a favor; humor me, if you will. Go and get a pen and paper. Now think back to July 2007 and write down things you have seen, done, experienced, accomplished, things and people gained and lost, smiles and tears, love and heartache, etc. One YEAR< can be a lifetime.

Odds and Ends:
A friend (Ellen) was on vacation when she called me. Ellen is a fellow runner and a health conscious person. She told me on the phone that her host for the weekend was following Weight Watchers so at least she was able to eat healthy while away from home. This is important to note. Sometimes people do not want you to serve them food that is high in fat and calories but instead appreciate a healthy meal. Also this week, the ever entertaining and educational Jim Cramer (CNBC) was discussing stock to buy in the health care field and noted a company that made artificial hips and knees. He suggested that the stocks would be good, that the company was poised to do well because we were a “weight gaining, aging population.” Lastly, the number one killer of Americans is heart disease. There are several risk factors for this disease and they include being overweight, sedentary, genetics, high blood pressure, high cholesterol and what one eats. Heart attacks, at least in the past, were more often seen in the fifty something overweight white male. So last Saturday at around 1pm, in high sun at Siesta Key Florida I was aghast to see this. A white man of about 40 to 50 years old, overweight by at least 30 pounds was JOGGING down the road in the 90 degree heat. He did not have on a visor and was not carrying any hydration. His grey sweat shirt was plastered to his protruding stomach. I thought, there you go, the next heart attack victim who will give running another black mark. Running is NOT just for thin people, but ALL people must be mindful of the heat and it might be better to lose some weight before starting such a strenuous program for both the heart and the joints. That sounds rather cruel and I don’t mean it to, but I really thought the man did not look well. So in closing, one more story, according to an article that ran in the Winston Salem Journal this week, there may be a problem with tilapia, a popular low mercury fish, which though low in Omega 3 may be high in Omega 6 in a not so good way. I am hoping that this is just a headline based on one small research study that has yet to be replicated, so hold tight on that one.

Wishing you Wellness

Friday, July 4, 2008

Wellness Weekly

Today I ran on the beach as opposed to the street near the beach. It was a nice way to start a weekend, a vacation. Afterwards I sat on the beach reading a book, eating yogurt and fruit, watching families and basking in my utter good fortune to be healthy, active and self sufficient. I wanted to start this week’s blog then saying that I am grateful to the “powers that are” for my life. Even on the worst ever days, I am glad to be alive and the important thing is, though I don’t know why exactly, my life is good and I never want to take that for granted.

Now back to blogging:

BIG? Gonna cost you extra: At least one airline has come out and said that they will charge more for overweight passengers and I think that it makes sense (cents). It is extra weight that increases fuel costs and it is excess weights that can reduce the number of persons that can fly on a plane, yes. So if the airline bills by ticket and now its 150 tickets per plane instead of 200 because we really have, as a nation (world) gotten THAT fat, well, what choice do they have. Last week, Parade magazine reported on this story and had a survey afterwards regarding obese persons paying for two seats.
At this time, more have said yes than no. However, what got me going last week was talk of whether or not people were being discriminated against for this disability. Well I have to tell you, I have had enough with everyone claiming disability. There are disabled people and it is an affront to them to say low back pain, bad knees, allergies and obesity are disabilities. It is a disservice to the low back pain sufferer to categorize him as disabled and end his productive working career. As well, obesity is NOT a disability it is an illness. Obesity is the body’s reaction to improper nutrition which does lead to system changes. It requires much effort and even medical intervention to reverse, but it is NOT a disability. One can avoid becoming overweight, genes be damned. One must eat the right amount of food for their output and even their metabolism and sometimes it is down right unfair to have a precondition that means you really have to watch what you eat much more than the average person. The consequences of living ones life with constant excess weight is significant and worth avoiding. We are eating ourselves to premature death, in general, and it has to stop. [Serious medical and psychological conditions are not the focus of this diatribe]

Knees: I have said time and again, though maybe not in the blog, that knee injuries and subsequent surgeries are most often the result of sports injuries OR overweight OR lack of use. In other words, the common thought that runners have bad knees is rarely played out in the real world. Hence, my utter shock at having a spongy knee a week or so ago. All I could think and say to myself was, “it’s not your knee, it’s not your knee, you do not have bad knees.” Turns out, it wasn’t my knee but my IT band. Runner’s World had some IT band stretches to try, I did,, I am fine. Last Sunday’s 15 mile run went without a hitch, well, okay, the toe nail…………,7120,s6-241-285--11555-0,00.html

Weight Watchers: I have an appreciation for this program as indicated in one of my side links because they now talk about eating well for life and have a strong message about dining out WELL. Also, my sister is going and I get to hear what they tell her and many, many times it is something I have said or something I too believe. OK, a little side note. The funny thing is, my sister doesn’t listen to me! I told her, hey, if you want to pay me 10$ for advice, if that is what it takes, by all means, pay up. Anywho, I am not the only one that is impressed by this more science based Weight Watchers, so is the renowned Cleveland Clinic. But oh there is so much more. The Cleveland Clinic and also it’s Florida program are setting an example for us all. They have banned trans fats from work menus and no longer hire smokers! Now they are offering the Weight Watchers program as an employee benefit. Employees will also have access to a fitness center and stop smoking programs FREE. The Clinic cares about its bottom line in regards to insurance costs and costs due to lost productivity of unhealthy employers, and that is not a selfish thing. I don’t care why they do it, what an awesome place to work. And they are a health center for goodness sakes, they must BE the change they hope to make.

Water: We have been over the whole water thing (8 by 8) in past blogs, but now the Wall St Journal chimed in, so I thought, ok, let’s review the latest. After reading Melinda Beck’s article I do not think anything much has changed since the last time I addressed this. In other words, there are two or three ‘camps’ out there. I fall into the yes you can drink too much water and yes, it needs to be individualized. Some believe drinking water really helps with weight loss, well of course it does, especially if you are drinking water instead of taking in calories. Some people think you should drink when you are thirsty, others warn that it is far too dangerous to wait until you are thirsty to drink. I say, um, definitely if you are thirsty, you should drink something. If you drink too much, you can get hyponatremia; sodium way too low. If you drink too little you can get constipated, etc etc. I say, fluids in other items count. I say that diet sodas don’t make you gain weight unless you EAT more, which some people do. I say, if your urine is a pale yellow you seem to be on the right track. I say, if you are wetting your panties during gym class…… TOO MUCH WATER.

Happy 4th