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!

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

International Osteoporosis Foundation

Osteoporosis Research Center

Womenshealthpractice.com

Sodium in Your Food - Risks and Remedies

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In a previous post, I said I log my food intake (see Comparison of Food and Exercise Logging Sites). It didn’t take long to notice my sodium intake was above recommended values. I was surprised. I thought my diet was healthy.

How much sodium is recommended?

The 2010 Dietary Guidelines for Americans recommend limiting sodium to less than 2,300 mg a day or 1,500 mg if you're age 51 or older, or if you are black, or if you have high blood pressure, diabetes or chronic kidney disease.  

What impact does too much sodium have?

It’s not only your blood pressure that’s at risk. According to American Bone Health, excess sodium in the diet can result in bone loss (see explanation).  The National Institute of Health points to a limited study that showed that salt intake was responsible for a significant change in bone calcium balance, from positive to negative, as salt intake is increased (Sodium and Bone Health). Another side effect of too much salt is swelling of the extremities and possibly fluid retention around the heart.

Steps to reduce sodium

Monitor your sodium for a week. Even if you don’t want to log all the food you eat, keep a small notebook or card with you. Write down the sodium content of the foods you eat each day and total it.  You might be surprised how much sodium you are getting.  I certainly was.  Once you know if you are getting too much sodium, you can decide the best way to reduce it.

Check the label. A CDC study found that 80% of the average American’s sodium intake comes from packaged and restaurant foods. That’s why it’s so important to read the label. And when a restaurant provides nutritional information, look at it.  You may be surprised how much sodium some of the foods contain. Many of the soups at one hamburger chain contained more sodium than the daily allowance for persons over 51 or those who are hypertensive, and over ½ that allowed for everyone else.

I’ve noticed even some products labeled low sodium can have fairly high sodium. One brands’s low sodium black beans actually had as much sodium as the organic brand which was not labeled low sodium.

Avoid foods that are high in sodium. The biggest culprits are:

·         Soups

·         Packaged and Restaurant foods

·         Soy sauce, salad dressings

·         Salami, bacon, cured meats

·         Sun dried tomatoes

·         Cheese

·         Snack foods – chips, pretzels, popcorn)

·         Frozen dinners

·         Canned foods

Don’t add salt during cooking. It’s not necessary to add salt to boiling water for pasta (read the explanation for this myth). Also, studies have shown that you use less salt if you sprinkle it on the food after it’s cooked than adding salt to the dish while it’s cooking.  And of course, follow the rule, “don’t salt food until you’ve tasted it.”

Make Simple Swaps. Take one higher sodium food in your diet and replace it with a food that has low sodium. I replaced my veggie burger (350mg sodium) with natural peanut butter (only 90 mg sodium). That saved me 260mg of sodium a day. If you love soups, make your own (see Allrecipies.com Low-Sodium Soups).  

Become vocal. OK. You might not want to go this far, but the more people complain about the sodium in their food, the more likely manufactures will be to reduce sodium.  It can be very easy. I sent an email to the  burger chain with high sodium soups. I was particularly troubled because the listed it as a healthy choice (probably based on calories alone). I did get a response that they were working on trying to reduce the sodium.

Other tips for reducing sodium can be found at:

• National Heart, Lung and Blood Institute Your Guide to Lowering High Blood Pressure, Reduce Salt and Sodium in Your Diet
• Mayoclinic.com  Sodium: How to tame your salt habit now

Squeezing Exercises into Your Busy Schedule

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I’ve got my cardio workout schedule down pat. I get up early to do my cardio before I go to work, so always get it done. Many days I don’t have a solid extra 30 minutes in my day to doing the other exercises I should do, like weights and physical therapy exercises, so they don’t get done.

 I needed to come up with a way I wouldn’t skip those exercises, so I experimented blending them in with my day.  The key to making sure you get the exercise done is to trigger the exercises by picking a specific event and time that is always part of your schedule. That way you don’t forget.

Doing the exercises throughout the day has the added bonus of boosting my metabolism several times a day. Below is my plan. I have physical therapy exercises I’m trying to squeeze in, but you can substitute the exercises in my plan with the exercises you want to squeeze in.

Match the exercise to a daily activity

• If you take the stairs at the same time everyday (e.g., to go to the cafeteria), you can do step-ups,  dips,  or side-step-ups.  Note: you can do these on the stairs without weights.
• When you first arrive at work in the morning or leave at night, before you sit down, do squats.
• Use your washroom trips to sneak in an exercise, e.g., corner chest stretches.

Use your breaks and lunch

• Before going for a cup of coffee, do chair dips.
• Before or after lunch, find a private place (e.g., a conference room) and do five or ten minutes of resistance exercises such as lunges,  push-ups or wall slides.

Use dead time

• Use standing wait time (e.g., grocery store lines, waiting for the bus or train) to do exercises you can do discretely, such as calf and Achilles tendon stretches (you don’t need to put your hands on the wall, as many diagrams suggest) . If you aren’t self-conscious, you can also do calf raises.  I’ve found people aren’t paying attention anyway.
• Use wait time in the car (e.g., at stoplights) to do hand and wrist exercises  (see Chicago Tribune’s 2 Moves to Strengthen your forearm and grip).

Multitask

• During a teleconference, do sitting exercises such as leg extensions. Do them without bands or take a resistance band to work.
• While on the telephone, do isometric abdominal exercises. Livestrong.com has a series of Ab Exercises You Can Do at Your Desk.
• While watching a specific program on TV (e.g., the news), do weight training or resistance exercises such as leg lifts.

Do you have tips for making sure you get your exercises done? Share them with us.