Exercise and The Common Cold

Prevent The Common Cold This Season With Exercise!

Cough, hack, sneeze…. Yep it’s that time of year; you are probably getting a cold. It’s called “The Common Cold” and seems to be as much part of the winter season as the cold weather from which it derived its name. According to the CDC there are over 425 million colds and flus that occur annually in the US at the expense of $2.5 billion dollars. An adult on average will experience 2-3 colds per year while children may have up to 7. Contrary to popular belief, colds are not enhanced by damp or cold weather. It’s actually the effect of the weather that brings people indoors where they can spread the virus through close contact with each other.

While there are an endless number of cold remedies on the market, none of them can prevent or cure the common cold. Colds are caused by viruses so antibiotics won’t help. That leaves our bodies to fight off these nasty virus particles on our own. To kill a virus we need a strong immune system. Some of these cells, called Natural Killer cells, attack the virus on site. Other cells called B-cells create antibodies that sense the invader and attach to it signaling the attack. T-cells help to organize the attack by coordinating the other cells to perform their role. Some T-cells also attack infected cells directly but can’t get to the virus directly once it enters the host cell.

Recently, a completely new mechanism has been discovered at Cambridge University. It has always been assumed that once the virus entered the host cell, the game was over. Now we know that these antibodies follow the virus into the cell where they attract a protein called TRIM21 which in turn signals a waste disposal cell called a proteasome to dismantle the virus piece by piece before the virus can cause harm to the host. Have a look at this video: http://www.youtube.com/watch?v=dHBZCxtQz0g

So where does exercise fit in? Well we know that exercise has the effect of boosting the immune system, especially Killer cells and T-cells. One study showed that exercise increased the number of killer cells by as much as 300%. Another study found that in 65 year olds that exercised regularly, the number of T-cells was as high as those in people in their 30s. A study reported in the British Journal of Sports Medicine showed that people who felt fit and were physically active cut the risk of having a cold by about 50%. Not only did they have fewer days suffering from a cold, but they suffered less with their symptoms when they had a cold.

The American College of Sports Medicine describes several studies linking exercise to cold prevention. In one study 61% of 700 recreational runners reported fewer colds since beginning to run. Two other well-controlled studies on young and elderly women showed that walking briskly 35-40 minutes five days a week cut the number of cold days in half compared to sedentary women.

So remember, this is the time of year when you need your immune system working at peak performance. That means eat well, sleep well, hydrate well, and above all exercise well. Those nasty cold viruses will never see it coming.

http://www.webmd.com/cold-and-flu/cold-guide/exercise-when-you-have-cold

http://www.acsm.org/docs/current-comments/exerciseandcommoncold.pdf

http://lancastria.net/blog/common-cold-cure-on-the-horizon.html

http://www.cbsnews.com/8301-504763_162-20021435-10391704/preventing-the-common-cold-and-a-cure-looming-/

http://www.bbc.co.uk/news/mobile/health-11664660

http://www.livescience.com/817-natural-body-guards-killer-cells-motivated.html

http://www.youtube.com/watch?v=dHBZCxtQz0g

5 Things you need to do to get through the holidays

Well, Thanksgiving has come and gone and you know what that means… The holiday season is upon us.  For some, that can put a new meaning on the term “Black Friday”. All that work we have put into losing those 5 lbs. is could be negated by Eggnog and Candy canes. The evening walk that helped your body and mind during the summer and fall becomes more difficult in the dark and the cold.  According to research, this can be the most stressful time of the year. It is also when cold and flu season is really getting cranked up. The holidays are a wonderful time of the year, but they could be full of pitfalls that can turn it into a nightmare before Christmas. In the spirit of the holidays, we have come up with 5 remedies to the holiday blues.

1.       Hydrate: Hydration becomes more difficult during the winter due to the dryness that accompanies the colder weather. Twenty percent of our hydration comes from food, however winter foods have less natural water in them than the summer fruits and vegetables. Alcohol and caffeine can actually add to the dehydration. This can lead to impairment in cognitive skills and make you more tired and lethargic. Hydration allows our bodies to rid themselves of toxins and waste products that can lead to illness and disease. So remember the rule of 8’s (eight servings of eight ounces of water a day).

2.       Sleep: It seems nobody gets enough sleep these days but this becomes worse around the holidays. Shopping, partying, and year end projects can take their toll on your sleep pattern. The stresses associated with these activities can make it harder to fall asleep and stay asleep. Being rundown is the last thing you need at this time of year. For one thing it will make you more susceptible to illness. Try to avoid late night eating, drinking, or partying. The body needs some time to slow down and prepare for sleep. Food, alcohol, and activity just before retiring tends to keep your body’s metabolism revved thus disrupting sleep. Try reading a book instead of watching TV as studies have shown that TV stimulates parts of the brain that can prevent sleep. If you can’t get stressful thoughts out of your head try concentrating on a peaceful or pleasurable thought. Take yourself to a place or time that brings you happiness and stay there until you fall asleep.

3.       Exercise: The holiday season can take a real toll on your exercise routine. Why do you see so many ads for exercise clubs and equipment right after the New Year? It might be the cold or the dark or the myriad of seasonal activities that disrupt our activity level. If you have a regular workout time stay with it and if you don’t have one this is a great time to start. Remember, all you need is 30-40 minutes three times a week. Even walking counts so bundle up and get outside. Try skiing or snowshoeing if you want an extra challenge. If you can’t find 30-40 minutes to free up, you can get the same result from three or four 10 minute segments. This will help you have more energy, sleep better, and prevent illness.

4.       Try to limit over-indulgence: Here’s where those extra pounds really add up. We tend to eat more and consume more alcohol than at any other time of the year. Late night parties especially can lead to gaining weight and losing sleep. So in order to keep indulgences in check, have a healthy snack before you go to the party. Use a salad plate to keep the portions smaller. Discipline yourself to have a glass of water in between each alcoholic drink. Try to stick to the healthier party foods such as fruits, vegetables, or shrimp. In particular go easy on the desserts and high calorie snacks. And above all, pace yourself. Have a small snack and then engage someone in conversation. That way you won’t leave the party feeling overly stuffed. You will probably also have a better time meeting new people or catching up with old friends.

5.       Have more Fun: Seems like a simple concept so why is it so elusive some times? Sometimes the stress that goes with this time of year can take the fun right out of it. Remember when you were growing up and the excitement of the holiday season? It is still there, you just have to find a way to get it back. In the end it’s not about presents and parties, it’s about friends and family. Try to come up with activities that will rejuvenate those relationships. Take some family walks or just hop in the car, grab some hot chocolate, and go see the Christmas lights. Organize a game night or invite your favorite friends over and prepare a dinner together instead of going out. Work out together or take you partner ice skating. Make the memory of the holidays more about what you did together than what you had under the tree.

The holidays are a magical time of the year where for a few short weeks we can escape back to another time, a time where the wonders of childhood can emerge and fill us with joy. But underneath the magic are pitfalls that can turn the season into a time of stress and disappointment. You can avoid these problems with five simple solutions. Follow these suggestions and when New Year’s comes around you won’t have to worry about resolutions, you will have already made them.

 Happy Holidays from MDFitness!

MDFitness Tip~

Healthy eating starts with your shopping cart. Learn which foods to grab that’ll keep you on track towards better health. One of our primary principals is to:

 Eat More Fruits and Vegetables

We love carbs as much as the next person and a juicy steak is hard to beat. But research shows that eating a rainbow of fruits and veggies provides countless benefits, including protection against cancer, heart disease, and the effects of aging!  SO we strive to load up on fruits and veggies as a principle of a great diet!

Ultimately, the FDA recommends a total of nine to thirteen servings of fruits and vegetables daily. That really is not as difficult as it seems since a serving size is only a ½ cup for most fruits and veggies.  However, if that still seems daunting, rather than fixate on a specific amount, make sure to have just one vegetable or fruit with each meal. Whether that means adding a banana to your morning cereal or putting tomato and lettuce on your lunchtime turkey sandwich, it's an easy way to get your veggies in without keeping a tally sheet.

 At dinner we practice the 50 percent rule: we aim to have half of our plate covered in veggies. Not only will this help you get your nutrition fix in, but you'll also likely shed some weight. Each bite of vegetable has 3 to 4 times fewer calories than any other bite of food on your plate.  In addition the fiber in the veggies will fill you up FAST. 

National Eating Healthy Day

Did you know that today, November 6, is National Eating Healthy Day? Most people don’t. So what is the big deal and why should we designate a day to get people to eat more healthy foods? What if I told you that over 144 million adult Americans are overweight or obese? How about the fact that over a third of our children share the same problem? Did you know that for the first time in the history of our country the next generation isn’t expected to live as long as their parents despite advances in treatment for cancer and other diseases? One major reason for this obesity epidemic is the increase in meals eaten out, presently one in five or about 4.2 meals a week. Eating out means larger portions and more calories. As we go into the holiday season the problem becomes worse than ever, making this a perfect time to make a pledge to change our eating habits and live a longer healthier life. It’s really not that hard. Just follow these simple guidelines and you are on your way.

When you go to the super market look for these healthy items:

• Colorful fruits and vegetables 
• Beans and other legumes 
• Brown rice or whole grain pasta 
• Whole wheat or whole grain bread 
• Lean grass fed meat 
• Free range poultry and eggs 
• Low fat dairy products including yogurt 
• Olive and Canola oil 
• Almonds, walnuts, pistachios, and other nuts 
• Berries especially blueberries, raspberries, and strawberries 

Look for these same ingredients when you eat out and try to eat half the meal and take the other half home.

Remember the difference between a serving and a portion. A serving is a specific measured amount of food. A portion is the actual amount you put on your plate. The closer your portion size is to a serving, the more you control your weight. Try to remember what a serving size means. For instance:

• A serving of meat is about the size of a deck of cards 
• A serving of fish is about the size of a checkbook 
• A serving of fruit is about the size of a baseball 
• A serving of leafy vegetables is about the size of a small fist 
• A serving of bread is one slice 
• A serving of rice, pasta, or cereal is about the size of a baseball 
• A serving of cheese is about the size of 4 stacked dice 

Go easy on the salt. Most people consume over twice the recommended limit of 2/3 teaspoon a day.

So come on and make the pledge today. Don’t put is off until tomorrow or next week or next year. Let’s all strive for a healthier future for ourselves, for our family, for our country. It might just save your life.

November is Diabetes Awareness Month… What you need to know!

So it’s your birthday and here comes the cake. You blow out the candles (harder to do than last year) and lick some of the icing (yum). You tell yourself that you are only going to have a small piece but it tastes so good you find yourself craving for more. 400 calories later you still want more. As you started to chew the first bite your body was already breaking down the carbohydrates to glucose and fructose, the major basic sugars. The sugars are rapidly absorbed into the bloodstream resulting in a condition called hyperglycemia. The accelerated spike is largely due to the lack of fiber in the highly processed flour used to prepare the cake. Fiber helps to slow the absorption of sugars in the intestines allowing the body to adjust to the rise in blood sugar more naturally. Your body responds to the rise in blood glucose by releasing insulin from the pancreas. 

Too much glucose in the blood is toxic to the body just as too little deprives the body of needed fuel to the brain, muscles, intestines, and other organs. Insulin helps maintain the right level by allowing the liver and other organs to absorb the sugar where it can be burned as fuel or stored as fat like a battery storing electrical power. When the system is overwhelmed by the excessive surge of sugar and insulin, the liver has to release some of the excess into the blood stream. The fat or triglyceride ends up being stored as visceral or belly fat. The glucose released by the liver creates a vicious cycle by stimulating the pancreas to release more insulin putting more stress on the liver. Over time the pancreas wears out and the liver becomes insensitive to the insulin resulting in a condition called “metabolic syndrome.” This in turn leads to Type 2 Diabetes.

Fructose, unlike glucose, does not stimulate production of insulin. In the liver fructose is converted triglycerides which are deposited in the belly leading to obesity. Fructose increases our hunger, and deprives us of energy. This creates a vicious cycle of sugar intake leading to fat deposition leading to insulin resistance with increased craving for sugar accompanied by less energy to burn the calories. In the end this can lead to massive obesity.

Between 1975 and 2005 the incidence of Type 2 Diabetes has increased over sevenfold. Interestingly this corresponds perfectly with the development of high-fructose corn syrup (HFCS) in 1971. By the 1980s HFCS was the most common sweetener in the U.S.  Humans are clearly not designed for the lifestyle of today. The combination of inactivity and a diet high in refined carbohydrates is largely responsible for this deadly epidemic. Type 2 Diabetes is deadly because it leads to cardiovascular disease, increasing the risk of death by heart attack or stroke.

So how do we prevent it?

1. Avoiding fructose especially HFCS may be the most important step. 
2. Adding fiber to your diet and limiting the amount of processed carbohydrates allows the body to absorb the sugar more slowly preventing the spike in insulin that overloads the liver. 
3. Exercise has been shown to make the liver and other organs more sensitive to insulin while simultaneously lessening the amount of visceral fat. 

Remember: 

We can treat the symptoms of Diabetes but there is no cure. That is why it is so important to prevent the condition from developing in the first place!

Delayed Onset Muscle Soreness

So you have finally decided to get back in shape and lose those 10 pounds you gained during the last year. You hit the gym with a vengeance forgetting that a few years have passed since you were in top condition and now you wake up and you can’t move without pain. It’s in your hips and knees and muscles. Just getting out of bed hurts. You walk like a robot, and forget about bending over. What in the world is going on and more importantly - what do you do about it?

The condition is called DOMS which stands for Delayed Onset Muscle Soreness. It is extremely common and generally goes away in a few days. Some feel it is caused by micro injury to the muscles and connective tissue due to over-stressing when a new and strenuous exercise is attempted. This leads to inflammation and the two major symptoms, pain and stiffness.

So the big question is this: Do you stop exercising or press on? Well you definitely don’t want to stop exercising but you do want to lessen the intensity a bit until the symptoms subside. Try lowering the weights if you are weight training, or instead of running try fast walking. If you are performing an eccentric exercise like lunges which are particularly prone to this condition, try doing it part way. You might also want to add a non-steroidal anti-inflammatory (NSAID) such as Motrin or Advil to help lessen the inflammation. As the symptoms subside over the next few days you can increase the intensity until you are back in action. If the pain is not subsiding however you may be dealing with a true injury in which case you will have to back off exercising the injured area until it heals and speak with your medical provider for guidance. Even an injury should not keep you from exercising completely. In most cases you can simply work around the injured area and keep going. Remember the axiom: “Use it or lose it”.

Breast Cancer and Exercise

October is a month of beauty and change. The vibrant colors display nature at its finest. It’s a wonderful time to get outside and enjoy the spectacular show. It is a great time to take a walk and get in some exercise. Ironically it is a perfect month to be designated as “Breast Cancer Awareness Month.” Exciting new research has given women more reasons than ever to add walking to their daily routine.

There are over 70 studies worldwide that have found an association between exercise and breast cancer. These studies have demonstrated an average of 25% risk reduction in physically active women compared to inactive women. The latest study published in Cancer Epidemiology Biomarkers & Prevention showed that even moderate aerobic activity such as walking 7 hours or more a week could lower the cancer risk by 14%. While that may seem like a lot of time, remember some simple tricks to help pile up the hours:

1. Swear off elevators and always use the stairs
2. Try walking part or all of the way to work
3. Park on the far side of the Mall
4. If you need to talk to a colleague, walk down the hall instead of using email
5. Plan your next vacation around walking, hiking, or biking

The association between exercise and breast cancer is an inverse one meaning that the more one exercises, the greater the benefit. The importance of this study is that it clearly demonstrates a benefit in even a modest amount of activity that anyone can perform without a gym or exercise equipment. 

So let's all celebrate October, Life, and Breast Cancer Awareness by getting outside and walking.  It might just save your life!

¹ http://www.ncbi.nlm.nih.gov/pubmed/23652373
² http://well.blogs.nytimes.com/2013/10/09/how-walking-may-lower-breast-cancer-risk/?_r=0

³ http://cebp.aacrjournals.org/content/22/10/1906.short

⁴ http://abcnews.go.com/Health/story?id=116923

⁵ http://www.forbes.com/sites/melaniehaiken/2013/10/11/5-things-you-can-do-now-to-prevent-breast-cancer/

⁶ http://www.cbsnews.com/8301-204_162-57606064/walking-seven-hours-a-week-may-lower-breast-cancer-risk/

⁷ http://www.ncbi.nlm.nih.gov/pubmed/21113759

Twelve Easy Ways to Improve Your Health

Big changes are HARD to make and even harder to stick with, which is why so many of us struggle with our weight and overall health. This is why we suggest small changes you can easily adapt into your life. Choose one easy change each month and this time next year you will have made a BIG impact in your health.

1. Eat fish twice per week. Look for choices that are high in Omega 3 fatty acids when you can. 
2. Choose low sodium versions of canned vegetables, tomatoes and soups. 
3. Limit yourself to eating only half of your restaurant meal and take the other half home for another meal. 
4. Read the labels of the foods you are buying and if you can’t pronounce anything on the label, PUT it BACK. 
5. Eliminate one sugary or artificially sweetened drink each day and replace it with water. 
6. Cut 100 calories from your diet each day and in a year you’ll lose 10 lbs! 
7. Commit to some activity each and every day. It can be as simple as taking a walk or 10 minutes of abdominal exercises. Every bit counts. 
8. Replace your dessert with a healthier option such as fruit. 
9. Focus on stress reduction. Think about what relaxes you, take a deep breath and live in the moment. 
10. Sleep no less than 6 hours and no more than 8 hours. Both have been shown to result in an increased appetite and weight gain. 
11. Get a checkup… See your dentist every 6 months and doctor every 12 months for a routine examination. 
12. Have at least one serving of vegetables or fruit with every meal.   

Commit to these simple changes and in no time you will significantly improve your health. Studies also show that success breeds success, meaning that when people see that making small health changes has a positive impact, they are motivated to make more changes and stick with them. Start today for a healthier tomorrow.

How to Combat Seasonal Weight Gain

The days are a little cooler, the leaves are beginning to show their brilliant colors, it’s Autumn in New England, my favorite time of the year. It’s time for football games and the World Series. Halloween is just around the corner and before long it will be the holidays with Thanksgiving dinner and Christmas treats. What’s not to love about this time of year? It’s the extra 5 lbs. of weight gain, that’s what’s not to love! Come New Year’s, it’s resolution time, the time to get rid of the extra weight. 

So what is behind this seasonal phenomenon? Some people blame it on darkness, some on cold, and others on SAD (Seasonal Affective Disorder). Seasonal changes have been demonstrated in levels of Melatonin, Serotonin, Tryptophan, and Vitamin D all of which may play a role in tilting the balance of “calories in” over “calories out” - the driving force behind weight gain. Whatever the underlying causes, the end result is less exercise and more food consumption - especially carbohydrates. Cookies, cakes, and pies are loaded with carbohydrates, so is alcohol. Tired of having to loosen your belt? So am I. So this year, let’s try something different. Let’s not gain those extra lbs.

Here are five easy ways to prevent seasonal weight gain:

1. Let’s talk about food. We know carbohydrates lead to obesity and in the fall we seem to crave them more and there are plenty more of them around than at other times of the year. So try to eat more protein, whole grains, fruits, and vegetables especially early in the day. A healthy breakfast will keep you satisfied all morning and help prevent weight gain. For an afternoon snack, try an apple, they are in season this time of year and they are both healthy and delicious. If pasta is calling you for dinner, try a whole grain brand such as Barilla Plus and make a sauce with more olive oil and less sugar.
2. Exercise or lack thereof is perhaps the biggest cause of seasonal weight gain and therefore the solution. When you get out of work and it is cold and dark all you want to do is snuggle up with a blanket and some comfort food but you can resist this if you are proactive and establish a routine. Just insert 30-40 minutes at least 3 times a week to strength training and fill in the rest with some cardio and problem solved. Strength training increases muscle mass, which bumps up the metabolism and burns more calories. 
3. Change your routine to burn more calories. Try taking a fast walk at lunch that will get you outside and exposed to more sunlight. Use the stairs instead of the elevator. Park your car on the far side of the mall parking lot. Go for a stroll after dinner. Every little bit counts. Remember, an extra 100 calories burned or saved each day will result in 10 lbs. of weight loss in a year. 
4. Let’s talk about alcohol. A glass or two of wine, especially red wine is considered healthy but after that it just piles on the calories. If you normally drink two glasses a day try to nurse one glass longer. That will give you that 100 calories all by itself. When you are tailgating or attending a holiday party, have a glass of water in between cocktails. It will help you to pace yourself. 
5. Embrace the outdoors. There is so much to do in spite of the cold and the dark. Bundle yourself up and head for the hills and mountains. Hiking, skiing, and snowshoeing will invigorate you and burn calories. Most ski areas now have night skiing under the lights or buy a headlight and off you go. Find someone you care about to join you. There is nothing more romantic than a moonlit walk on freshly fallen snow. 

Try these five tips and you will be amazed at how great you look and feel. Remember, the choice is yours: get heavy or get healthy!

6 Reasons to Lift Weights NOW!

Lifting weights can improve your health, no matter your age or gender. In fact we are constantly learning new benefits of weightlifting. And you don’t have to bench press 350 pounds to see those benefits. You can see results in lifting a 5 pound dumbbell! 

 

Weight training will:

1.) Help you lose more fat… even at rest. Muscles burn more calories than fat. So even at rest you are burning more calories to help you keep the weight off for good.

2.) Your clothes will fit better. One pound of fat takes up more space than one pound of muscle (18-20%)… so even though pound for pound muscle weighs more, it’s lean, tight and takes up less space!

3.) Curb the effects of Sarcopenia ( age related muscle loss) and help protect your heart while also preventing type 2 diabetes!

4.) Improve your balance… you may not notice it… but as you age you start to lose your balance and it is largely related to muscle loss. Gaining back muscle strength means you are less likely to fall and injure yourself.

5.) It will strengthen your bones. All adults, but especially women need to protect their bones from osteoporosis. Exercising with weights is one of the best ways to maintain strong healthy bones.

6.) Improve your self-confidence and motivation. You can see results in just a few weeks which can impact your self-image and motivate you to get in shape and stay in shape.

Weight training 2-3x per week on alternating days is all it takes to see real results. Even light weights will have a dramatic impact on how you look and feel! So grab some dumb bells today and get started. What are you waiting for?

Is skipping breakfast killing you?

Remember your mother telling you not to skip breakfast? Mine did. It turns out that she was right. In fact, recent evidence shows that people who skip breakfast have a 27% higher risk of heart attack or dying from cardiovascular disease.¹ How can that be you may ask? It probably comes down to the effect of breakfast on how the body functions - also known as metabolism. In short, eating a good breakfast jump starts your metabolism while stabilizing blood sugar. This lowers the risk for obesity, diabetes, and heart disease. There is also evidence that eating breakfast has a positive effect on the mind, improving cognitive skills, memory, and mood.

One recent study involved overweight women who were all put on a 1400 calorie diet with half of the women being told to make breakfast the larger meal and half to make it the smallest meal.² The group that made breakfast the larger meal lost an average of 20 lbs compared to the other group who lost an average of 8 lbs. This group also lost twice the waist circumference and showed a greater improvement in blood cholesterol, glucose, and triglyceride levels, despite consuming the same total number of calories. 

In spite of some of the recent theories that propose breakfast is not so important, I believe it is clear that breakfast is an important meal, it is equally clear that some foods are better than others and some are downright unhealthy. Remember, the food should be high in protein and nutrients and low in sugar and refined carbohydrates. The term glycemic index is often used to describe the relative effect of the food on insulin and resulting blood sugar. The calorie amount is also important especially if they are what are called “empty calories” - meaning that there are little or no nutrients to offset the calories.

The most healthy breakfast foods include: 

• Oatmeal
• Eggs
• Coffee
• Non-fat greek yogurt
• Peanut butter
• Low fat cottage cheese
• Low sugar whole grain cereal
• Whole grain bread
• Fruit ( especially grapefruit, blueberries, strawberries, and bananas) 

These foods offer protein, vitamins, minerals, and antioxidants with little or no sugar.

On the unhealthy side are foods high in sugar and refined carbohydrates. 

The most unhealthy breakfast foods to avoid:

• Donuts
• Pastries
• Sugared cereal
• Bagels
• Sausage
• Biscuits
• Pancakes
• Flavored non-dairy creamers 

These high glycemic index foods cause spikes in insulin and glucose that can lead to obesity, diabetes, and heart disease. 

As you can see, there are many popular food items in both the healthy and unhealthy groups. The key is to eat breakfast regularly and stick to foods in the healthy category. This will lessen your urge to snack during the morning and lower the total calories consumed during the day. More importantly, you might just live longer.



1. Journal: Circulation; 
Prospective Study of Breakfast Eating and Incident Coronary Heart Disease in a Cohort of Male US Health Professionals
Leah E. Cahill, PhD; Stephanie E. Chiuve, ScD; Rania A. Mekary, PhD; Majken K. Jensen, PhD; Alan J. Flint, MD, DrPh; Frank B. Hu, MD, PhD; Eric B. Rimm, ScD

2. Journal: The Journal of Obesity
High Caloric intake at breakfast vs. dinner differentially influences weight loss of overweight and obese women
Daniela Jakubowicz, Maayan Barnea, Julio Wainstein, Oren Froy

Exercise Tips for Beginners

Remember, the only workout you will ever regret is the one you talked yourself out of.

To learn more visit: http://www.youtube.com/watch?v=LDkeTJBN3a0

Is Physical Fitness Inherited?

New Study shows physical fitness is an inherited trait…. So if you won’t exercise for yourself, will you do it for your future kids?

A recent study in Sweden titled A Six Months Exercise Intervention Influences the Genome-wide DNA Methylation Pattern in Human Adipose Tissue has shed some light on this almost science-fiction like concept. It is all part of an area in biology called Epigenetics. Epigenetics is the study of how genes are expressed. It tries to explain why identical twins become less identical as they grow up. They are born with exactly identical DNA down to the last gene but how those genes function will depend on several factors including diet, environment, and behavior such as smoking. Remember, every type of tissue has all of the bodies genes imbedded in its cells but something has to tell it to be a bone cell or a nerve cell or a blond hair as opposed to a brown hair. Certain periods of life such as puberty or pregnancy also result in changes in how the genes are expressed. Think of it like the Genes are the computer hardware and the Epigenome is the software that tells the computer what to do. Methylation is the mechanism of one way the gene function or expression can be altered. Scientist believe this is how some cancers are created and there is now a whole new area of cancer research based on altering the epigenome of the cancer cell rather than killing it. What is even more fascinating is that there is evidence that not only are genes passed on to offspring but also some epigenes as well. In other words not only are you what you eat but your children and grandchildren are also what you eat. And now comes a study that shows that exercise can dramatically change the epigenome in fat cells particularly parts of the cells that have to do with obesity and Type II diabetes. While it was already well known that exercise has a beneficial effect on these two health problems, now they are gaining insight into how it occurs on a molecular level. And that brings me back to my original statement. Based on what we know about Epigenetics it may well be possible that the beneficial changes that occur with exercise can be passed on to our children and grandchildren. And those changes can occur in as little as six months. So if you won’t do it for yourself, do it for your kids.

http://www.plosgenetics.org/article/info:doi/10.1371/journal.pgen.1003572

http://well.blogs.nytimes.com/2013/07/31/how-exercise-changes-fat-and-muscle-cells/?_r=0

http://www.evolutionnews.org/2013/08/are_our_genes_a075111.html

http://www.pbs.org/wgbh/nova/body/epigenetics.html

Health is All Around Us

We all want to be healthy. So why do we constantly fail at diets and extreme workouts? If you are like me, you are a creature of habit. That means change doesn’t come easily. We get energized and excited to make a move to become more fit or lose that nagging 10 pounds but somehow we just can’t stick with it. Sometimes we get fooled by promises of overnight success but when it doesn’t happen we tend to go back to “business as usual”. But you know what? The true secret to adapting a healthy lifestyle is all about taking small steps. Look for some tiny changes you can adapt to and make them part of your “business as usual”. It’s pretty easy to cut 100 calories a day from your diet or burn an extra 100 calories and before you know it you will lose that 10 lbs and feel amazing. It’s all around you; you just have to look for it. 

Here are my 10 favorites:

1. Take the stairs and not the elevator. 
2. Switch from a large coffee with cream and sugar to a small latte lite or just put nonfat milk in your coffee instead of cream 
3. Replace your dinner carb (i.e. potato, rice or pasta) with a second side of veggies 
4. Use cooking spray instead of oil and butter can cut 100 calories or more from your dish 
5. Replace the diet sodas and artificially sweetened drinks with water! True these have few or no calories but have been shown to cause you to crave more sweet foods and lead you to unhealthy eating. 
6. Bring your lunch to work. You will eat healthier foods and better manage your portions than eating out. 
7. Keep healthy snacks nearby… Keep an apple on your desk. It might be the last snack you’d normally choose… but if you are hungry and busy… it’s amazing how good and filling that apple is. 
8. Take a walk during your lunch break…. Walking 20-30minutes will burn 100 calories or more! 
9. Do The Doctors Workout 3 days and week…. and burn 250-300 calories per session… plus build lean muscle that will keep you burning more fat even at rest! 
10. Gaining more strength, energy and endurance will entice you to try new physical activities. You will find that you seek out more activities that are physical in nature and develop a more active lifestyle! Take up hiking, biking, or canoeing. And don’t forget to invite a friend or loved one. It’s a great way to build a better relationship. 

So come on and give it a try! What do you have to lose? Remember, it’s the small steps that will stay with you on your way to a better, healthier life and they are all around you.

The Wolverine Workout and Other Extreme Workout Programs:

It seems every day there is an actor or celebrity getting “ripped” with a new extreme workout. First Jake Gyllenhaal and now Hugh Jackman are highlighted as results of these extreme workouts. So I guess you have to ask yourself: Am I trying to star in the next blockbuster movie or am I just trying to create a better quality of life? Out of interest, I decided to look into the Wolverine workout to see what made it so different from other workouts. What I found was a program that had some marked similarities to “the doctor’s workout” with a few important differences.

First the similarities:

1. Both workouts include a warm-up session with some cardio 
2. Both use fundamental training principals with core strengthening 
3. Both compound and isolation exercises are emphasized 
4. Many of the exercises are the same such as squats, dead lifts, and presses 
5. Weights are lifted slowly and to fatigue 

Now the differences:

1. Longer sessions (1 – 1 1/2 hours vs. 40 minutes) 
2. Heavier weights 
3. Sessions are split between muscle groups using “Super sets” 
4. The exercises are mixed up changing angle, tempo, weight, time, and rest 
5. Hugh uses a very expensive trainer 
6. Dietary supplements are probably employed 

If you take away the hype and the glamour, basically you see more similarities than differences especially in the basic principles of the two workouts. An important difference is that “the doctor’s workout” is designed for real people living real lives not movie stars living fantasy lives. You won’t end up with a six-pack of abs but you will have more strength, better balance, greater endurance, and overall a better quality of life. And best of all, you won’t have to kill yourself to keep it going.

What is more important, Diet or exercise?

Patients ask me all the time, when it comes to getting healthy, which matters most - diet or exercise?

The answer is that they are both equally important but for different reasons. 

Here’s why:

For initial weight loss dieting is the best method but over time most people put the weight back on. Why? The answer is related to a hormone called Leptin. Leptin has been called “the fat hormone” because it is made by fat cells but it should really be called “the starvation hormone” because it helps to regulate the hunger response during starvation. As the fat stores go down during dieting or starvation, the Leptin levels go down causing hunger. That’s why people tend to regain the weight they lose when dieting. Adding exercise to dieting helps to regulate Leptin allowing for sustained weight loss.

So how about exercise alone. Exercise has been shown to be the most effective way to boost energy, improve mood, and prevent diabetes. A number of studies have shown however that exercise alone usually fails to achieve significant weight loss. It may even result in weight gain. Why is this? To answer the question a group of anthropologists did a study on a tribe of hunting and gathering natives from Tanzania. They were amazed to find that despite an average 7 miles a day walking, their metabolic rate was no different than the more sedentary life style of Westerners. Other research studies have come to similar findings. It is nearly impossible to exercise away the effects of a bad diet.

In one study diet and exercise were tested by initiating diet first, exercise first, or both at the same time. The best results were achieved by initiating both at the same time. When exercise was initiated first followed by diet changes, the goals were still achieved, however when diet was initiated first and exercise later were unable to achieve the exercise goals.

When it comes to cardiovascular disease both exercise and diet are effective separately or especially together. The same is true for Cancer prevention, especially breast and colon cancer.

Therefore if your goal is achieve and maintain the healthiest lifestyle, ideal weight, and best quality of life, consider a two pronged approach of a regular exercise program ( which includes cardio and weight training) and a nutritious low glycemic index diet focusing on fish, nuts, fruits, vegetables, and whole grains. Also limit your intake of refined sugar, bread, and pasta.

Chia – The Ultimate Super Food

Who isn’t looking for easy ways to incorporate healthy food choices into your diet without making HUGE changes? I look for items that are easy to add to your diet, have numerous health benefits and are tasty. This is how Chia Seeds stack up: 

What is a Super Food:

• Is rich in vitamins, mineral, and nutrients 
• Low in calories 
• Require little to no processing 
• Can be added easily to other foods 
• Have special health benefits 

Remarkable Health benefits:

• Increased Energy… Chia can provide you stamina and energy over time 
• Fights cardiovascular disease (Omega-3 and Omega-6 fatty acids) 
• Controls Cholesterol and Blood pressure (alpha-linoleic acid) 
• Aids in management of Osteoporosis (High Calcium content and helps you absorb calcium better from other sources) 
• Great for your digestive health and conditions such as Diverticulitis (High Fiber content) 
• Anti-Aging properties (Anti-oxidants)… good for your hair, nails and skin. 
• Obesity especially belly fat (slowing of metabolism in stomach) 
• Brain function (fatty acids) improving mood, memory and concentration 
• Aids Sleep (Tryptophan) 
• Blood thinning properties 
• Improved Liver health 
• Helps you stay hydrated 

Basic Nutritional Profile (1 oz/ 2 tablespoons):

• 139 calories 
• 4 grams of protein 
• 12 grams of carbohydrate 
• 9 grams of fat 
• 11 grams of fiber (42% of our daily requirement!) 

How does is stack up against other superfoods:

• More Omega-3 ounce of ounce than Salmon 
• More Calcium than skim milk (18% daily value) 
• More Potassium than Bananas 
• More Iron than Spinach 
• More Antioxidants than Blueberries

The World’s Most Perfect Food – The Egg

Once condemned as a heart attack in the making due to it’s cholesterol content, the humble egg has undergone a renaissance as recent studies have shown eating cholesterol doesn’t raise blood cholesterol.

• Myths concerning Eggs 
•  Eating eggs will raise blood cholesterol: This is the oldest myth and is very misleading. Eating cholesterol from eggs will not raise your bad cholesterol (LDL) but will increase your good cholesterol (HDL) 
• Eating eggs raw may preserve the most nutrients but runs the risk of Salmonella poisoning. On the other hand, there is evidence that cooked eggs especially soft boiled and poached preserve the nutrients and prevent Salmonella poisoning. Scrambling eggs has the least benefit as the proteins are denatured by the direct heat. 

• Health Benefits of Eggs 

• The Antioxidant Carotenoids lutein and zeaxanthin help prevent macular degeneration and cataracts both of which are the leading causes of adult blindness 
• Choline helps regulate the brain and nervous system improving memory and mood 
• Sulfur helps promote healthier hair and nails 
• One of the only foods that contain naturally occurring Vitamin D which helps build stronger bones 
• Eggs have been shown to help prevent Breast Cancer 
•  Tryptophan helps prevent Cardiovascular disease and Cancer as well as helps to induce sleep and regulate mood 

•  Nutritional Summary 

• 6 grams of Protein plus all 9 essential amino acids 
•  5 grams of Fat most of which is good unsaturated Fat 
• 185 mg of Cholesterol (which does not raise your blood cholesterol) 
•  Only 70 Calories in a large Egg 
•  Two raw eggs have twice the Antioxidant content as found in an Apple 

There are an unlimited number of ways to prepare and enjoy this marvelous food. Eggs can be served as an appetizer, entrée, dessert, or beverage. No wonder eggs are the perfect food!

The Sneaky Facts about Snacks

The U.S. Department of Agriculture released new standards for nutrition in the schools this week. Titled “Smart Snacks in School” the goal is to provide healthier snack options in the vending machines at our schools. 

The real problem is childhood obesity affects at least 17% of school children today and is increasing like a runaway train. “Little Johnny” is no longer little, he has become “Big Johnny” seemingly overnight. 

Childhood obesity develops into adult obesity with all of the associated problems such as cardiovascular disease and diabetes. The time to solve the problem is before it becomes a problem and that means helping children develop better eating habits that are both tasty and nutritious. 

If you look at the most popular vending machine snacks, they include Snickers, Peanut M&Ms, Cheetos, Doritos, Twix, Pop Tarts, and of course the always popular potato chips. While these treats rank high on the tasty scale they are loaded with the three biggest contributors to early health problems, namely, sugar, fat, and salt. 

The sneaky part about these ingredients is that the more you eat, the more you want. But don’t be fooled by snacks that claim to be healthy but in fact aren’t what they seem. Take granola bars for instance. If you dissect them out, you often find a high percentage of processed carbohydrates, and very little fiber. Between the dried fruit and the honey used to hold it all together, they have as many sugar calories as there are in a Twix bar. But the good news is that taste buds can be trained to be satisfied by snacks that are truly healthy such as nuts, whole grain chips such as Sun Chips, Fig Newtons, Baked Chips, Pretzels, and yes even Popcorn without the trans-fat. The changes won’t happen overnight, but if we all try just a little bit each day to encourage our children and grandchildren to make better snack choices, we will be helping them to become healthier happier adults.

http://www.wmur.com/news/health/New-rules-require-better-school-snacks/-/9857712/20735792/-/9msao6z/-/index.html

Tom Kleeman, MD Marks the Passing of Gandolfini

“The sudden passing of actor James Gandolfini saddens all of us who appreciated the artist that he was,” said Tom Kleeman, MD. “Although we don’t know the cause of his death, the media reports and his relatively young age are a stark reminder to all about the importance of maintaining a healthy, active lifestyle.”

Consider that:

•  35% of heart attacks that lead to death are due to inactivity

•  Only 22% of Americans exercise regularly

http://www.foxnews.com/entertainment/2013/06/20/actor-james-gandolfini-sopranos-dies-at-51/

Cardiorespiratory Fitness and Cancer Risk

Lakoski SG, et al "Cardiorespiratory fitness and risk of cancer incidence and cause-specific mortality following a cancer diagnosis in men: The Cooper Center longitudinal study" ASCO 2013; Abstract 1520.

The risk of developing and dying from two types of cancer was recently shown to be reduced by high levels of cardiovascular fitness in a study presented at a press conference prior to the 2013 American Society of clinical oncology annual meeting. The study conducted by Susan Lakoski, M.D. involved more than 17,000 men over a 20 year span with a mean age of 50 years. A comparison was made between different levels of cardiovascular fitness. Comparing the men with the highest level of fitness compared to those with the lowest level of fitness the risk of lung cancer was reduced by 68%. For colorectal cancer the risk reduction was 38%. Even a small improvement in fitness level resulted in a 14% reduction in the risk of death by cancer and a 23% reduction in risk of dying from cardiovascular disease. While the study could not establish a cause-and-effect between fitness and cancer risk, the association between the two was unmistakable.

http://www.nbcnews.com/id/51910901/t/fitness-protects-you-cancer-even-years-later/

http://www.pbs.org/newshour/rundown/2013/05/the-link-between-fitness-and-cancer-1.html

http://www.medpagetoday.com/MeetingCoverage/ASCO/39172

http://health.usnews.com/health-news/news/articles/2013/05/16/fitness-in-middle-age-may-help-shield-men-from-cancer-later

Cardiovascular Disease Prevention with a Mediterranean Diet

N Engl J Med. 2013 Apr 4;368(14):1279-90. doi: 10.1056/NEJMoa1200303. Epub 2013 Feb 25.

Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Martínez-González MA; PREDIMED Study Investigators.

A very impressive study was recently published in the February issue of The New England Journal of Medicine. The lead author Ramon Estruch M.D., PhD reported on the effect of the Mediterranean diet on heart attack and stroke. Using diet alone they were able to reduce the incidence of death from heart attacks and strokes by 30%. The study involved over 7000 people in Spain who were overweight, smokers, diabetics, or had other risk factors for heart disease. The study was originally designed to compare a low-fat diet with two variations of the Mediterranean diet. One of the Mediterranean diet groups was instructed to use at least 4 tablespoons of extra-virgin olive oil a day, the other group received a combination of walnuts almonds and hazelnuts and was asked to consume an ounce of the mix each day. One of the problems with the study was that the low-fat diet group were unable to adhere to the diet and were therefore allowed to eat their regular diet. This study therefore is not a fair comparison between the Mediterranean diet and the low-fat diet but the results are nonetheless compelling. One of the advantages of the Mediterranean diet over the low fat diet is that the food is more palatable and it's a program that is easier to maintain.

http://www.nejm.org/doi/full/10.1056/NEJMoa1200303

http://www.nytimes.com/2013/02/26/health/mediterranean-diet-can-cut-heart-disease-study-finds.html?pagewanted=all&_r=0

http://www.sciencedaily.com/releases/2013/02/130225181536.htm