Sunday, October 30, 2011

Decrease in Calories Burned: Weight? Efficiency? Age?

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I started spinning about seven years ago because the brochure promised that some people could burn as much as 400 calories in one session. As someone who is always watching calories and the scale that sounded really appealing. So I signed up. Looking back at my training records, the first year or so, I did burn an average of 400 calories per session. The calorie count is reasonably accurate because I use a heart rate monitor that takes my fitness level, weight, height and age into consideration.

But something’s happened. Fast forward six years. Now my average calorie burn per class for 10 classes is 312. The class lasts an average of 8 minutes more and is harder. (I call my instructor Leo the Maniac – with 4 speed drills and other harder maneuvers throughout the session). And my statistics show it’s harder, because my average training load (a measure of exertion based on heart rate and duration of exercise) is 97.4), whereas six years ago it was 91.5. So what’s going on here?

Is it weight? You burn more calories if you weight more. Well, I don’t have records of exactly how much I weighed six years ago, but I have records for several years around then and know I could have only been about 10 pounds heavier. I don’t feel like doing the math, but somehow I don’t feel even if I was 10 pounds heavier, it could have made that much difference, and looking at the records, it’s likely I was only five pounds heavier.

Is it an increase in efficiency? Some experts claim that your body gets used to an exercise and becomes more efficient, and therefore burns fewer calories. I’ve reviewed several articles and it’s doubtful that I have gained enough efficiency over the past six years to account for the difference. One article states Lance Armstrong, training over six hours a day, only increased efficiency by 1% a year.

Is it age? I’m six years older and VO2 max (an indicator of oxygen intake which indicates physical fitness) decreases with age. I’m not sure of the connection between VO2 max and efficiency, but logic tells me if you are less efficient, you’d have to work harder (burn more calories?). Any experts out there care to help us understand this?

Whatever the reason for the decreasing calorie burn, it stinks! That’s 88 calories fewer a session, and assuming I exercise only four times a week (I actually exercise six times a week), over a year that’s 18,304 calories fewer per year, or 5.23* pounds a year! No wonder I have to eat less and exercise more to maintain my weight at 15 pounds more than I weighed in my 30s.

On the brighter side, at least that keeps me jumping, and spinning, and jogging which will hopefully keep me enjoying the finer things in life for many years to come.

PS – this week I go on Medicare – that sort of makes me feel old. But if you took a soft focus picture of me (to hide the wrinkles) in my exercise clothes, you might mistake me for one of those 30 somethings! And I can keep up with them in spinning. Just don’t ask me for my 5K time. So all the hard work does have its benefits.

So keep your exercise program up, even if you do burn fewer calories!

* Calcuation for pounds per year based on 88 fewer calories per exercise session: (88 calories * 4 days/week * 52 weeks/year = calories in a year / 3500 calories per pound) = 5.23

Sunday, October 23, 2011

National Chocolate Day - Enjoy this Guilty Pleasure!

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October 28 is National Chocolate Day, so what better time to extol the benefits of chocolate.  As a hard core dark chocolate lover, today’s blog is not going to go into excruciating details about all the health benefits. Instead, I’ll just wax poetic about the joy of chocolate, list the benefits, and provide references for those who want details.
I’m sure you won’t be able to tangibly notice the many health benefits researchers are starting to credit chocolate with, but one benefit you will notice. Many women have known it for years, even before the scientific research on chocolate. Chocolate is one of the best mood enhancers there is!
To show you how to get the maximum benefit from this mood-enhancing substance, I’ll go out on a limb and share my daily chocolate ritual. It’s one the most relaxing, yet mood enhancing times of my day. My favorite chocolate is a Ghirardelli Twilight 72% dark chocolate square. If you don’t like dark chocolate, choose your own favorite chocolate and imagine this ritual in your mind; or better yet, get your favorite chocolate and join me. Do this ritual slowly, so you can savor every second. 
I slowly unwrap the chocolate square. I listen to the crinkle of the plastic wrap, which starts to fortify my senses with anticipation.  I break off about ¼ of the square. I hold it to my nose and take a deep breath, smelling it’s chocolaty goodness. Then I lay it on my tongue,  close my eyes and let the chocolate soften and melt. I slowly move it along my tongue to make sure the sweet, creamy, chocolaty  flavor fills my entire mouth.  I concentrate solely on the taste, smell and feel of the chocolate. My breathing slows and deepens as I savor every last flavinoid. When the flavor disappears, I pop the next piece in my mouth and repeat the ritual. After the last piece has melted, I still savor the dwindling flavor and the absolute joy and peacefulness from my chocolate ritual.
That leads me to the second major benefit of chocolate. That 60 calorie chocolate square is much lower in calories other deserts, well, maybe not Jell-O, but which would you rather have? And, in an earlier blog, Five Tips to Reduce Eating, chocolate can be the key factor in two of the five tips. First, the fat in chocolate can stimulate your “I’m full” hormones. Second, you can use chocolate as a symbol to end your meal, signaling your mind and body that after you eat the chocolate, you are done eating.
Finally, even with all the benefits of chocolate, go ahead and still consider it your guilty pleasure. That might even enhance the pleasure of your daily chocolate ritual.
Benefits and references
 Mood enhancer (this one doesn’t need references, does it?)

Sunday, October 16, 2011

Acid Reflux - Find What Works for You

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I’ve suffered with Acid Reflux (GERD, Gastro-esophageal Reflux Disease) most of my adult life.  This week’s blog won’t give you medical details, I’ll just share some observations. These are obviously not scientific research, but I’ve found that in many chronic medical conditions, a person has to listen to medical advice, but also has to listen to their own body, and the results of medical tests, to determine what works for them. 
What’s worked for me
In the past two years, I’ve been relatively free of symptoms, which is excellent because I am taking Fosamax, known to create heartburn problems.  I only occasionally need an over-the-counter antacid (Pepcid-AC is my favorite). The previous ten years, I had persistent problems. but I didn’t follow all the dietary recommendations (e.g., I drank caffeinated coffee).  The biggest changes that seem to have worked for me is that I lost 20 pounds and stopped drinking caffeinated coffee.  If I had to guess, I’d say the weight loss contributed more, because I strictly watch my diet and portion control to maintain my weight. Portion control helps because eating smaller meals reduces GERD symptoms.  But I also don’t drink caffeinated drinks.
Everybody had different triggers
In talking to many of my friends who have acid reflux, we all have different triggers. So it pays to be an observer. For some unknown reason, bagels trigger my heartburn.  Only 1/3 of those larger bagels makes my stomach very unhappy . Fats also seem to trigger the heartburn. I still remember my very first severe heartburn incident came from eating a croissant. Orange juice and Champaign are totally off my list. Anti-inflammatory drugs can also trigger heartburn.
I am not particularly bothered by spicy or hot foods (unless I really overdo it), certain wines (red or white), and I confess, I eat 1-2 Chocolate squares each night after dinner. I’ve read somewhere that the caffeine in chocolate is different (that’s my story and I’m sticking to it). I do seem to be able to tolerate tomatoes, spaghetti sauce, V8, and vinegar, although I don’t eat these foods in excess. Other people I’ve talked to can’t eat tomatoes or drink wine, but fats don’t seem to be a problem.
Delayed reaction
When I was having heartburn problems and drinking caffeinated coffee, I didn’t notice an immediate reaction to coffee, as I did other foods. I may have incorrectly assumed caffeine wasn’t a problem.  So before you decide a food is ok for you, I’d say stop eating that food for several weeks to see if your heartburn improves.
Warning – Bone Density and Proton Pump Inhibitors
To manage my GERD, I was on Nexium for two years. My bone density was already low, and it dropped 5% in two years, where it hadn’t dropped in the previous eight years.  So be very careful if you have lower-than normal bone density and  work with your doctor to manage both conditions.
Have you found something successful in managing your GERD?  Share it with us.
GERD resources
MedicineNet.com – an excellent article covering all aspects of GERD

Sunday, October 2, 2011

A Change of Focus to Start Healthy Eating

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Many medical insurers are adopting wellness programs to save themselves and participants money.  My insurer’s wellness program consists mostly of printed materials and webinars.  Does education work? Anyone who owns a TV must have head that a diet high in saturated fats and sugars bad for you. So why, with all the knowledge we have about health, are people in the United States becoming fatter and less healthy?
With my decades of training and organizational change background, I know that education or information alone isn’t enough to bring about change.
Psychologists and change agents sometimes say that it takes a major shock, like a heart attack, to push people to new behavior. Yet many people don’t change their behavior even after a stroke or triple bypass surgery. But why do some people who have never had a major shock switch to more healthy lifestyles?
It’s a really complex problem. I certainly don’t have the answer. And despite all the experts, self-help books and programs out there, there doesn’t seem to be a major shift in our wellness.  So I’ve wondered, just why is it that we don’t change and what might help shift our behaviors?
Some reasons why we continue unhealthy behaviors
The feeling of being deprived of pleasure. Let’s face it. Our body likes the taste of fats and sugars. We associate these tastes with comfort. And once we’ve become accustomed to the taste of certain fats and sugars, it’s hard to give them up or switch to their healthier counterparts (e.g., from saturated fats to unsaturated; from high processed sugars to natural sugars in fruits).
It seems too hard.  It does take a considerable amount of effort to adopt a healthier eating style, especially initially. If you fix your own food, you have to experiment with new recipes and change your way of shopping and cooking. If you buy prepared food or eat out, you also have to invest a lot of time and energy in finding new foods and/or restaurants.
Medicine will fix me.  Since medicine seems to have a fix for most of our unhealthy behaviors (pills for high cholesterol or diabetes, procedures for opening clogged arteries), we figure we can continue with our bad behaviors and medicine will fix it.
One Possible Solution – A Change of Focus
I’m working on a coaching class right now. One of the coaching principles to help people improve their performance is to help them change their focus to help them achieve more. People focus on the wrong things and that blocks them from achieving goals. So what does that mean in terms of changing to healthy eating behaviors?
Perhaps if we change our focus on the three examples above, we can move to healthier behaviors or help our loved ones move to healthier behaviors.
Instead of focusing on the craving for animal fats and refined sugars, focus the taste or experience of the healthier food. When buying or using olive oil, imagine you are on a Greek Island, eating like the Greeks or in Rome or , eating in an Italian restaurant. Choose sweeter, juicier fruits instead of sugared desserts and focus on bright colors and sweet juicy taste as you eat them.  When you enter the produce section, take a minute to focus on the artistry of the section. The bright colors and beautifully arranged fruits and veggies can look as pretty and inviting as an impressionist painting. Much prettier than a bunch of boxes in the freezer compartment. Do the same with your plate. A plate filled with a variety of colors from fruits and vegetables and be much prettier than a plate of only browns and whites from only meat and potatoes.
Instead of focusing on how hard it is to do all the things you need to do to switch eating habits, focus on making healthy eating an enjoyable family activity to experiment and learn about new things. Spread out healthy recipes on the table and have the family vote for a new one to try. Pick a fruit or vegetable you normally don’t eat and have everyone in the family search for a healthy recipe that everyone might like.  Competitive families can even make it a contest to see who finds the best new recipe each week.
Instead of focusing on the fact that pills might make some of you medical tests get better numbers, focus on your overall health and well being.  Cholesterol reducing drugs have some side effect such as reducing the absorption of fat-soluble vitamins (e.g., A and E). In addition, unsaturated fats have a lot of other health benefits such as eliminating belly fat, reducing the risk for certain forms of cancer. So just taking the drug alone does not have the health benefit of switching to unsaturated fats.
In my first blog, I talked about the NLP Swish technique to replace unwanted thoughts. The Swish technique can be used as a tool to change your focus and help you and your family on the way to healthier eating.

Sunday, September 25, 2011

Sixteen Recipes for Brown-Baggers

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In last week’s blog, I talked about how brining your own food to work can help you manage what you eat and also save you money. I gave four ideas on how to make it easier to take your own food for lunch. I tend to pack the same thing most days, but my husband likes lots of variety, so he prefers that we make foods ahead and he can pack them in his lunch. For those of you who like variety, here’s a list of recipes for brown bagging. Enjoy, and let us know your favorite fix-ahead brown-bag recipes.

Sandwiches
Fajita Turkey Burger – Ingredients: tomatillo salsa, avocado, cilantro, red & green bell pepper, fajita seasoning, tomato paste, egg white, salt.
Blue Cheese and Beef Roll-ups. I don’t mind these cold, but if you’d like, keep the ingredients separate and heat the beef at lunch and make the rollups. The recipe has you make your own  beef strips to eliminate the salt of deli-roast beef.  Ingredients: fat-free mayonnaise, blue cheese, horseradish, black pepper, round tip steak strips, salt, romaine lettuce, grape tomatoes, red onion, reduced fat tortillas.
Peanut Butter Plus Sandwiches. I’m happy with just natural peanut butter, but this recipe add adds honey, banana, raisins, sunflower seed kernels. It uses whole wheat bread, but I’ve switched to whole grain sandwich thins.
Pesto Chicken Salad – Ingredients: low-fat mayonnaise, fat-free yogurt, commercial pesto (or make it yourself!), lemon juice, salt, chicken breast, celery, walnuts, red bell peppers.
Sheryl Crow’s Tuna Salad – Ingredients:  tuna, green apple, diced celery, veganaise (or low-fat mayonnaise), parsley, lemon juice, black pepper.
Casseroles. These can be made ahead and frozen in one-portion sizes.
Sausage and Pepper Calzones –This recipe has you make your own dough, but read the comments for other suggestions. Ingredients: red bell pepper, onion, garlic, apple sausage (some people substituted turkey Italian sausage), mozzarella cheese, tomato sauce, low-fat cottage cheese, Parmesan cheese, oregano, salt, pepper.
Mousakka – this is the light version. Ingredients: olive oil, garlic, ground lean lamb, tomato paste, red wine, bulgur or cracked wheat, oregano, salt, pepper, cinnamon, low-fat milk, cornstarch, nutmeg, egg substitute, Parmesan cheese.
Chicken-Ham Lasagna – Ingredients: low-sodium chicken broth, chicken breast, low-fat milk, flour, Parmesan cheese, parsley, lasagna noodles, ham, parsley.
Black Beans and Rice with Cheese – This is high in sodium, most likely from the black beans – so I use low-sodium black beans. Ingredients: Olive oil, red bell pepper, garlic, onions, chili powder, cumin, oregano, ground coriander, red pepper, black beans, reduced fat sharp cheddar cheese.
Chicken Tamale Casserole – Ingredients: Mexican blend cheese, skim milk, egg substitute, red pepper, cream-style corn, muffin mix, green chiles, red enchilada sauce, chicken breast, fat-free sour cream
Shredded Beef and Mushroom Ragu -  Ingredients: porcini mushrooms,  short ribs, salt, pepper, flour, olive oil, cremini mushrooms, onion, tomato paste, thyme, garlic, red wine, less-sodium beef broth
Snacks
Cheddar-Parmesan Biscotti – Ingredients: flour, reduced-fat sharp cheddar cheese, Parmesan cheese, sun-dried tomato pieces, corn meal, pine nuts, baking powder, salt,  dried basil, fat-free milk, olive oil, eggs,
Homemade Granola Bar – Much healthier than the store-bought kind. Ingredients: rolled oats, almonds, cashews, coconut, dark brown sugar, maple syrup, vegetable oil, raisins
Breakfast Fig and Nut Cookies – Ingredients: brown sugar, butter, eggs, dried figs, dried cranberries, vanilla extract, all-purpose and wheat flour, bran, baking soda, cinnamon, allspice, almonds, sugar.
Roasted Rosemary Almonds – Ingredients: rosemary, olive oil, chili powder, salt, ground red pepper, almonds
Spicy Chickpea Nuts – Ingredients: chick peas, olive oil, cumin, marjoram, allspice, salt

Sunday, September 18, 2011

Easy Brown Bagging for Healthier (and Cheaper) Lunches

For years, I’ve brought my lunch to work. I do it to keep from being tempted by the cafeteria smells of less healthy food (fried chicken and pizza) or the sights of my fellow diners eating cheeseburgers and fries. I don’t do it to save money, but I estimate I save about $10-$15 a day. My take-to-work bag includes my morning coffee, mid-morning snack, lunch with home-brewed green tea and afternoon snack.  The snacks (fruit, black bean brownies or home-made granola bar) keep me from visiting the vending machines when I get hungry between meals. This week, I’ll cover tips to make it easier to pack your food. Next week, I’ll have a round-up of great recipes for lunch packers.

Grill ahead.  Buy super value packs of chicken breasts and grill them on the weekend. You can use different seasonings for variety (e.g., Greek with olive oil and oregano, a Cajun rub, a barbecue rub, oriental with soy sauce and ginger).  A friend grills peppered-chicken and cuts it in strips to top the salad greens he brings for lunch. You’re not limited to chicken. You can also grill other lean meats such as flank steak or pork tenderloin.

After the meat has cooled, wrap or pack it individually and freeze it or keep it in the refrigerator if you will use it in the next couple of days. To reheat the meat, I thaw frozen meat in the refrigerator. If I have time, I like to take it out of the refrigerator to reach room temperature before heating it in the microwave. I heat it at 60% or 70% power for a slightly longer time so it doesn’t get tough.

You can even grill vegetables for great, healthy sides. Brush them with Italian dressing or balsamic vinegar and oil or Google grilled vegetables.

Bake ahead. Instead of that giant, high-calorie, high-fat muffin in the morning, bake your own muffins  using cake mix and applesauce or canned pumpkin in place of the eggs and oil.  My favorites are spice cake or chocolate cake. They are amazingly moist and have fewer than 200 calories, whereas many store-bought muffins weigh in at 400-600 calories.  Other suggestions include snacks such as Rocco Dispirito’s black bean brownies or home-made granola bars. I put serving sizes of these baked goodies in l containers and freeze them or keep them in the refrigerator.

Cook ahead.  Make two or three servings of your dinner and store the leftovers in containers.  Pastas, soups, stews and casseroles are perfect for preparing in bulk and splitting for lunches or week-night meals.

Pack ahead.  I pack my lunch bag in the evening and put it in the refrigerator.  If I am packing a frozen item, I’ll put a sticky-note on the bag to remind myself to get the item out of the freezer before I leave for work.  I make a gallon of sun tea on the weekend and pour it into saved 20 ounce bottles, store them in the refrigerator and toss one into my lunch bag when I’m packing it.

Sites with suggestions for Brown Bagging

Sunday, September 11, 2011

Damage Control When Eating Out

. In many restaurants, most appetizers are fat-laden and have no nutritional value.  Desserts are usually both fat and sugar-laden.  I’m usually very hungry when we arrive at a restaurant, so I use the Dr. Oz trick of drinking a glass of water and eating an apple or 6 walnuts before I leave the house so I won’t be as hungry when I arrived at the restaurant. A chocolate square kept in your purse or glove box could substituted for desert, or order a low-calorie option such as a scoop of ice cream  or sorbet and split it with your dining partner.
Look at the menu and decide before you go.  Many restaurants have their menu on line. If so, look at the menu before you go to the restaurant and pick a healthier, lower-fat  entrée. This works because you won’t be tempted by the sights and smells of fattening foods being carried to other tables.  Also, I’m the type that gets swayed by what other people order. If I’ve decided what I want before I go to the restaurant, I’m much less likely to order the chicken-fried steak or pizza.  When I was invited to a pizza restaurant for a birthday party, went online and picked a nice salad before I went. The guests were willing to share a small piece of pizza with me so I didn’t feel deprived.

Substitute for appetizers and desserts or skip them altogether

Eat a lower-calorie, healthy salad before your meal. Eating a healthy salad before  the entrée can fill you so you don’t eat as much of the entrée. Just make sure the salad isn’t loaded with fattening things such as cheese, bacon, croutons, nuts (especially the candied nuts that are popular today). An order a healthy dressing on the side.

Pick the healthier food preparation. When you are given the option on meat preparation between fried, broiled or sautéed, choose the broiled option of ask that the meat be sautéed in olive oil instead of butter. If there isn’t

Avoid creamed sauces. Alfredo or creamed sauces can add hundreds of calories and saturated fat to your meal.  Avoid them altogether or ask if the chef can prepare the entrée with a more healthy option such as marinara.

Don’t eat everything on your plate.  We all know this one.  I’ve seen a tip to immediately ask for a take-home carton and cut your entrée in half before you even start eating. Another tip – if your order includes a fattening side such as French fries, ask the waiter to leave them off your plate or for a better substitute, such as a vegetable.

What's your tip for damage control when eating out?

Sunday, September 4, 2011

Four Thoughts for Resisting Unhealthy Behaviors

We say a lot of things to ourselves that get in our way of being healthy.  “It’s hard!”, “It won’t matter,” “I’m tired, maybe tomorrow.”  Shad Helmstetter, Ph.D. and behavioral researcher, calls this “the negative wall of self talk.”

When I find myself guilty of listening to this negative wall of self-talk, I’ve learned to change it using some of the inspirational sayings or thought-changing tricks in today’s blog.  These have worked well for me to keep me exercising and avoiding a slip back into frequent unhealthy eating. I hope some of them work for you.  If you have any great sayings that work for you, please share them with us.

  1. It  all comes down to the moment that alarm goes off in the morning. Every single day you can wake up and it’s what you decide to do that’s going to define who you are.” (Chris Powell,  Extreme Makeover: Weight Loss Edition ). One of my most challenging times is weekday mornings when the alarm clock rings. I’m not one of those people who wakes up with energy.  When the alarm clock rings, and I’d rather roll over and go back to sleep, I repeat this phrase and it helps me get out of bed.    
  2. The urge to XXX will go away whether you XXX or not.  You can substitute just about any unhealthy behavior for the XXX.  It’s really true. The urge does go away. This was one of the most powerful aids from Smoke Enders that helped me quit smoking. They gave us a card to carry with us. When I had the urge to smoke, I’d look at the card, repeat the saying, take a few deep breaths and start to think about something else. This phrase still works for me now on other things; the urge for that cake will go away whether I eat the cake or not.   
  3. Saying “My Choice is XXX.”  Saying this makes you aware that you are making a conscious choice.  This only makes me more mindful of making possibly unhealthy choices, but also helps me modify my choices. For example, at the beauty salon yesterday I got a cup of coffee and next to the coffee was a platter of chocolate chip cookies. I was going to reach for two, but I said to myself,” no, I’m choosing to have only one chocolate chip cookie” and walked away.  In Choices: Discover Your 100 Most Important Life Choices,”  Shad Helmstetter outlines the four steps of Choices.
    1.       Ask “is this a choice?”
    2.       If yes, say immediately “This Choice is Mine.”
    3.       After thinking about the choice, say “My choice is…”
    4.       Be aware at a conscious level you made the choice. “The reason I made this choice is….”
  4. I might not feel like exercising now, but I’ll feel energized when I’m done and for the rest of the day.”  Newton was right. A body at rest tends to stay at rest. Sometimes my body just doesn’t want to get moving. To break that inertia, I frequently have to coax myself into moving by remembering how good I’ll feel after I exercise and reminding myself that when I exercise, not only does that great exercise buzz stay with me all day, but it also puts me in a much better mood.
Just remember to  keep some health-inspiring thought in your back pocket to counter the excuses your brain comes up with for not choosing a healthy path.  James Allen, As a Man Thinketh,” says “They themselves are the makers of themselves, by virtue of the thoughts which they choose and encourage, the mind is the master weaver.”  

What thoughts can make you weave a healthier life?

Sunday, August 28, 2011

Eggs - Yolk or No Yolk!

For decades we were warned against eating egg yolks because of the cholesterol in the yolk. Now doctors are saying that eating an egg a day is healthy.  The yolk contains many helpful  nutrients that can lower heart disease, including protein, vitamins B12 and D, riboflavin, and folate.  In addition, the yolks contain the antioxidant lutein as well as other antioxidants which can help protect you from inflammation, which researchers are beginning to see is a big factor in heart disease.  So when you use only the whites, you are losing a lot of great nutrients, as well as the fat that can keep you from getting hungry throughout the day.
Eggs got a bad rap in the 60s when cholesterol in the blood stream was linked with heart disease. However, recent research has shown that for most people there is only a very weak link between the cholesterol  they eat and blood cholesterol levels. (Harvard School of Public Health, National Institute of Health,  Harvard Study, Harvard Study (2). Your body actually creates cholesterol from other fats you eat, not from the cholesterol you eat. Heredity accounts for about 85% or more of a person’s tendency for high cholesterol.
Saturated Fat versus Cholesterol in our Diets
Research is beginning to show that, for most people, the amount of cholesterol in our diets has much less effect on our blood cholesterol than the amount of saturated fat we eat.  Saturated fat in our diet stimulates the liver to make more cholesterol. Saturated fat is animal fat that is solid at room temperature.
Caveat
A few people, called “responders,” do have blood cholesterol levels that rise very strongly in relation to the amount of cholesterol eaten.  These people should avoid cholesterol-rich foods. Unfortunately, at this point there is no way other than by trial and error to identify responders from non-responders to dietary cholesterol (Harvard School of Public Health).
Cage-Free, Organic Eggs – The Good eggs
If you are going to eat eggs, I’m a strong proponent of eggs from free-range (cage-free), hormone-free chickens. Yes, you pay more. But eggs are such a cheap protein and meal source, even these higher-priced eggs are a bargain. And they have a much higher vitamin and mineral levels and a much better Omega-3 to Omega-6 fatty acid ratio. American diets tend to have a much higher Omega-6 to Omega-3 ration, which can promote disease. (The Importance of the ratio of Omega-3 to Omega-6 essential fatty acids, National Institute of Health). Omega-3 fatty acids are found in fish, eggs, walnuts, flax seed, canola or soybean oil).
So, unless you are a responder, don’t feel guilty about eating your daily egg. Just make sure you accompany it with whole grains and fruit instead of bacon and white toast!

Saturday, August 20, 2011

The Hidden, Under Diagnosed Health Risk for Women

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Did you know that In women over 45 years of age, osteoporosis accounts for more days spent in hospital than many other diseases, including diabetes, myocardial infarction and breast cancer?  That’s just one of the sobering osteoporosis statistics and facts on the International Osteoporosis Foundation’s (IOF) website.

You may think you are ok, but unfortunately, many internists don’t seem to be as concerned about  bone density as other major health issues. The IOF notes that many women who sustain a fragility fracture are not appropriately diagnosed and treated for probable osteoporosis. Another sobering statistic from the IOF – the great majority of individuals at high risk (possibly 80%), who have already had at least one osteoporotic fracture, are neither identified nor treated. So What Do You Do?

Have Your Bone Density Checked
There are several types of bone density tests. The IOF describes the different kinds of Bone Density tests. They are all simple and painless. If  you have any of the risk factors below, you should get a Bone Mineral Density (BMD) scan to determine your bone density.  
  • being female
  • being thin and having a small frame
  • a family history of osteoporosis
  • estrogen deficiency as a result of menopause
  • low testosterone levels in men
  • over 65
  •  under 65 postmenopausal women who have one or more additional risk factors for fracture
  • being Caucasian or Asian (although other ethnic groups can also be at risk)
  • lifestyle factors such as smoking, infrequent exercise, having several alcohol drinks or caffeinated beverages a day or amenorrhea (absence of menstrual cycles caused by low body fat or medications)
  • a "highly athletic lifestyle." Bill Rogers, four time winner of both the Boston Marathon and the New York City Marathon, was diagnosed with osteoporosis. (Running Times)

How Often to Have a BMD
Medicine.net says that monitoring bone density at one- to two year intervals may not be useful.  repeat DEXA scans cannot distinguish between a "real" change in bone density or a variation in measurement from the machine itself.  Changes of less than 2%-4% in the vertebrae and 3%-6% at the hip from test to test can be due to the precision error of the method.

Medications Can Cause Osteoporosis
You should also be aware of things that might make matters worse.  Certain medical conditions and medications, completely unrelated to osteoporosis, can have the effect of causing osteoporosis. This is called secondary osteoporosis. Prior to treating the osteoporosis, it is essential to manage the underlying cause.  Doctors can give other forms of treatment based on the contributing factors. See the Osteoporosis Research Center (ORC) Newsletter for more details on the Secondary Causes of Osteoporosis  listed below:

Heartburn Medications. Recently studies were released that show an increased risk of spine or hip factors from use of proton pump inhibitor (PPI) heartburn medications  as Prilosec®, Prevacid® and Nexium®.   Drugs known as H2-receptor antagonists or H2 blockers, which includes brand names such as Zantac® and Pepcid®, were not significantly linked to fracture risk. (Health Day News, May 9)

Steroids. Steroids (corticosteroids or glucocorticoids) taken for conditions such as multiple sclerosis, lupus, emphysema, asthma, and rheumatoid arthritis, psoriasis, etc., can cause secondary osteoporosis. Physicians are well aware of this risk and try to prescribe the lowest dose possible of steroids while still maintaining symptom control.

Heparin/Coumadin®  are brand-name blood thinners that affect the bone if taken for a long time.

Anticonvulsant medications taken for seizure disorders affect the bone by interfering with vitamin D metabolism.

It’s important you understand your potential risks and factors that contribute to osteoporosis and to have a BMD if you have the risk factors mentioned above. The websites listed below have a wealth of information on osteoporosis risk factors and treatments.

Resources