Archive for the ‘Exercise possibilities’ Category

Help your baby; gain less during pregnancy

Friday, August 13th, 2010

A health-conscious blogger friend from Australia, Liana Werner-Gray, was gracious enough to feature this post recently on her own blog, The Earth Diet. Liana’s blog was suggested to me by my local friend, Pat Stoltey, an author of two wonderful mystery novels.

Original post Aug 13,2010:
I read an article in “The Wall Street Journal” on August 6th that was a long ways away from my usual areas of interest. But in this case, it caught my attention enough to track back to an article published in “The Lancet” the day befores week and another one an Epidemiology journal from nine years ago.The synopsis of the two articles is that women who gain large amounts of weight during pregnancy have large babies. No surprise there. But large babies often end up as large teenagers.

Why did I do that legwork? Well I’m really concerned about our upcoming generation’s weight. Lots of youngsters are overweight; too many are obese and heading for trouble, medical-problem-type trouble, down the line. We can blame TV, lack of exercise, fast foods, fat and sugar-laden processed foods, families that let kids decide what they’ll eat from early on…all the usual suspects. But here was an idea I hadn’t paid much attention to, do some kids start life with an obesity strike or two against them.

My caveat is this really isn’t my turf; I’m an Internal Medicine subspecialist. I’ve delivered fifty babies, but that’s old history. Nonetheless, I wanted to see the data and decide if it stood the test of time.

The 2001 piece was a Finnish study that looked at nearly 4,400 sixteen-year-old twins and tracked their progress from birth. Not surprisingly, adolescents who were tall at birth and had tall parents, were often tall at age sixteen. The group I focused on were those who were of normal birth length, but high birth weight.

That group was much more likely to be overweight at age 16. That fits with a number of other studies that didn’t focus on twins.

So there’s been some good data indicating high birth weight increases chances of high adolescent weight; the same is true for high adolescent weight foreshadowing high adult weight.

Now how much is nature and how much is nurture isn’t clear to me. What makes sense if to re-emphasize to young women that gaining average amounts of weight during pregnancy is important. Too much gained increases the chance of heavy babies, heavy teenagers and, eventually heavy adults.

Our youngsters have enough factors that can contribute to their becoming obese adults; why add one more?

If you’re a young person planning to have a baby, discuss this one with your own doctor. The life you improve may be your child’s.

More on “What to Eat”

Friday, July 23rd, 2010

I finished Dr. Marion Nestle’s book, “What to Eat” some time ago, but got distracted by several other books and articles in various publications I read. Now I’d like to return to her superb volume and make a blanket statement to begin with. I’ve been concentrating on books, articles and online sources, in the wide field of food, nutrition and dieting for well over a year now and have found and read a number of excellent publications . If you were limited to reading only one book in the area, I’d strongly suggest this one.

That being said, I’d like to devote a few posts to the book and my reactions to it.

Nestle expanded my concept of who benefits from our having an overabundance of food available, and eating much more of it then we should (remember two thirds of Americans are overweight. and half of that group, one third of our total population is obese). So of course the food industry, in all its manifestations, food production, sit-down restaurants and the plethora of fast-food outlets, benefits directly from our overeating.

What I hadn’t thought of as collateral beneficiaries were the whole diet industry, our expanding number of health clubs, our pharmaceutical firms and even my colleagues in medicine.

Then there’s the stock market angle. A number of those entities I’ve listed (a list I’ve obtained from reading Nestle’s book) are actually publicly owned and have shares traded on the stock market. As such, my take is they need to demonstrate constant growth, or at least a pattern of growth, to maintain share value.

Nestle also emphasizes changes, over the last thirty years or so, in our eating patterns. We are encouraged to snack from an early age and most of those snacks, unlike my occasional piece of fruit, are empty calories. More calories ingested equals more weight, unless you’re also burning more calories.

I’m now six and a half weeks out from back surgery and won’t be able to return to our own health club for another ten days. So for now I’m walking, and going a little further each day. Today I walked for seventy-five minutes. I wasn’t moving very rapidly and I didn’t calculate how many calories I burned. I didn’t care really; it was a beautiful morning (I started at 7:45 AM) and I enjoyed the walk. I chose a different route than I’ve taken in past days and saw some different scenery.

A major part of losing weight is to think about what you’re doing when you shop, when you eat and when you chose how to spend your time. I may watch a TV show from time to time, but I’d rather spend the same amount of time exercising.

How about you? What choices do you make in these areas?

Protecting your arteries

Saturday, June 5th, 2010

I read an article in the “Wall Street Journal” dated June 1, 2010. The subtitle was “How to Turn Back
the Clock when your blood vessels grow old before you do” and that really caught my eye. Most of the article wasn’t anything new; you can prevent or lessen damage to your arteries by some combination of eating a healthy diet, controlling your weight, sticking the meds your physician gives you for heart or blood pressure and not smoking.

Okay, so I already knew all that and so should you, whether you actually “walk the walk” or just talk about doing so as so many of us do. Over the years I’ve quit smoking (when I was a third year medical student and saw a cancer patient smoking through his tracheoestomy), decided, progressively,to lose weight (I’m now under 150 pounds consistently, allowing myself to bounce up and down a few pounds; my max weight, many years ago was 218), eaten a more healthy diet (just got a notice from our local CSA that our weekly “couples veggie share” and “fruit share” will start on the 14th and made sure my blood pressure was controlled

The striking data here appeared in the journal “Circulation” last August, co-authored by a professor of preventive cardiology at Northwestern. Men and women, in his study, who followed the precepts I’ve mentioned above, could have arteries that were equivalent to those of people 14 to 21 years younger. The flip side was certainly true also. A 35-year-old man who does the exact opposite (smokes, doesn’t exercise, has diabetes (probably Type 2 and obesity related) and abnormal cholesterol levels), may have arteries equivalent to those of a 76-year-old.

Your heart, if your resting heart rate is ~70, beats about 100,000 times a day; every time it does so it exposes your arteries to wear and tear. So I had an EKG done last week. My resting heart rate is 53, down from higher levels before I started to exercise regularly. There were no signs of heart damage on the cardiogram and my own personal physician said a while back, “Peter, you’ve gradually increased your exercise level over the years; now you’re doing the equivalent of a stress test every day.”

I think I’m on the right track, but I spent time yesterday with a friend whose belly overflowed his belt buckle. I mentioned that I thought he might want to read my blog and he said, “I weighed 174 in high school and I’m only at 185 now.”

The problem is where the weight is distributed. Many of us had more muscle mass and less belly fat in high school. We may weigh the same, or nearly so, but still be at considerable risk for heart disease and other blood vessel problems.

I’ve taken four and a half inches off my waist measurement; is it time for you to do the same?

Paying more for your soft drinks?

Friday, May 28th, 2010

I read two articles on the topic of new taxes recently, in this case taxes on soft drinks, teas and sports drinks.  The lawmakers are, of course, not just interested in our health; they need to “plug budget gaps,” as one of the newspapers commented, or pay for new programs, including health initiatives. About thirty states are taxing sodas already, including my home state (for the past eleven years as of the 31st) of Colorado.

As expected the makers and sellers of these beverages don’t think it’s a good idea at all and the sum the American beverage Association spent on lobbying went from $668,000 in 2008 to $18.9 million in 2009 to $5.4 million in the first quarter of 2010. A large part of that went toward fighting off the new taxes.

I drink one diet soda a day and don’t mind paying the extra two cents on twelve ounces that has been proposed. I see youngsters in our health club chugging down large amounts of sports drinks every day (I’m there six or seven days a week) and frequently mixing in “muscle-building” powders.

I’ve looked back over some of the medical literature on my diet soda and there’s a controversy as to adverse effects even there. But the question is clearly unresolved, so for now I’ll stick to my one-a-day routine.

Otherwise I have a great idea for you: drink water, preferably not from small plastic bottles, maybe filtered if your local water is of concern. I just bought a half-dozen limes (oh my, the price has gone up!) and used my lime squeezer to make a one-quart glass of lime water. It was sitting on a coaster beside my mouse pad as I wrote this. I use the past tense because I just finished the glassful.

I don’t think the sports drinks, the muscle-building powders, the sugary sodas make much sense, especially when they come in potentially (and I say that without a great deal of data to support the statement) hazardous little plastic bottles that won’t compost or disintegrate for many centuries. I’d prefer to hydrate the old fashioned way, with water.

Now for a period of five years when I headed a section of our largest Air Force hospital, the section that interfaced with the base itself and, among other things, had a troop clinic for basic trainees and others to get their first-line medical care, I really liked a particular sports drink. When kids from the north came to Texas in the summer for Air Force Basic training, the frequently got dehydated, lost not only water in their swaet, but electrolytes as well. Those young folk did very well with a sports drink as a first step in rehydration. But even they acclimated after a short time (three to four weeks) and water sufficed thereafter.

So my bottom line is here’s one tax I’m in favor of.  If you’re working hard in hot weather you may need some electrolyte-containing fluid, for a while. Otherwise, drink more water.

Getting help in remembering to exercise

Tuesday, May 18th, 2010

I read an interesting article this morning. A study conducted by researchers at Stanford using subjects averaging in their mid 50s and previously inactive showed the importance of social support in helping people develop and maintain an exercise regime. The project followed adults, with an average age in their mid 50s, for a year and showed that people who got phone calls, even monthly ones,  from a health educator markedly increased their time spent exercising. That’s compared to a group who only got initial health education classes. Even automated phone calls work, but a human touch was best. Those new and improved health habits held at the 18-month followup.

There were other bits of information I gl.eaned: the majority of people, like me, prefer to exercise alone. My wife participates in four exercise classes a week; I don’t join her in any of those. I often think my way through issues as I exercise (especially during the 65 minutes I spend almost every dayon a recumbent bike), zoning out and working through issues or just allowing thoughts to come up as they will.

The Stanford lead investigator, Dr. Abby King is a PhD professor of Epidemiology and Medicine at Stanford’s Prevention School of Medicine Research whose major research study relates to the role of physical activity as it links to other healthy behaviors and promotes improvements in life-coping mechanisms. She herself usually is a loner when it comes to exercise, but sometimes drips out for a period of weeks and then tends to join a small class to get back into her usual pattern.

What I take from this is if you don’t find it easy to get into a pattern of regular exercise, find a buddy who will call you from time to time. Most of us will never end up in a formal research project like Dr. King’s; almost all of us could help a friend and be helped in return.

Lynnette was just on the phone calling her another woman who is in the twice-weekly “Strong Women, Strong Bones” class she takes. She’s developed a brand new, close friendship through this class, frequently has a cup of coffee afterward with her exercise buddy and the two of us, from time to time, go to dinner with her friend and that woman’s husband.

As we age, I think social support is crucial and, if friends can help us stay in shape, maybe lose a few pounds or keep those off we’ve lost already, they have even more value in our lives.

So find an exercise buddy or even someone who’ll help you keep working out, whether you walk together, go to a gym together or just make phone calls to support each other’s good habits.


How much do I need to exercise?

Friday, April 30th, 2010

I keep running across short articles on exercise and its resultant health improvements; they vary a lot! One, taken from USA Today and published in the Journal of the American medical Society, reported on a long-term study done by researchers at Boston’s Brigham and Women’s Hospital and Harvard Medical School. This was a huge project, following 34,000 women for thirteen years. The group’s average age was 54 when the project began and the women were eating a regular diet and not trying to lose weight. Over the extended period of the study the average weight gain was six pounds. Not very surprisingly, those who exercised more gained less than those who were relatively inactive. But notice they weren’t dieting, just exercising.

A second article included multiple takes on excercise. A cardiologist from the Mayo Clinic in Rochester mentioned an overweight patient who started to consume a better diet and got moderate exercise. He lost weight and clearly improved his lipid panel results (the surprise ending to that story was he was his own patient in this instance).

Comments made at the yearly meeting of the American College of Cardiology supported the moderate exercise concept, with a number of studies showing more aggressive approach to preventing heart disease were no more effective than moderate ones. Other studies showed that adding multiple drugs to lower lipids didn’t seem to offer additional benefit and a large NIH study concluded that aggressively lowering systolic blood pressure (that’s the upper number your doc looks at when you have, for example a blood pressure of 145 over 95) wasn’t more effective in preventing strokes or heart attacks in a group of over 4,700 diabetic patients.

What does this all translate into for you. At least my approach is to eat well, keep my weight down and get some exercise as often as possible, sometimes by going to the gym and sometimes by walking up and down the stairs to my second-floor office. I’ve stayed away from using lots of meds for minimal changes in my lipids and don’t have a blood panel done very often (The last time I had one, all my results were okay). Of course I’ve worked hard at losing the roll around my middle (I’ve gone from a 37-38 inch waist to 33-34 inches in the past year) and cut my weight 25+ pounds. The dose of my blood pressure medicine was cut in half when I did so.

Listen to what your own doc tells you, but I strongly suggest you take some steps yourself to improve your health. They don’t always have to be huge ones, but, in the final essence, you’re the person who can do the most to extend your lifespan. Start by doing some walking; think about small things you can do arround the house that burn calories (like my extra stair climbing), ask your doc if you’re okay to do more strenuous exercise and if you do so, very gradually increases in your workout pattern make sense to me).

But whatever you do, don’t just sit there and let the pounds accumulate, especially pounds around your waist.

So what should I weigh?

Tuesday, April 27th, 2010

I’ve been reading some of the background material  from one of the articles that appeared in The Wall Street Journal 4-27-2010, in the “Personal Journal” section which today featured Health and Wellness. There were several controversies in other articles: I scanned two: chocolate as a potential antidepressant vs. chocolate being consumed more by those who are depressed; sun-lovers and benefits from sun exposure vs. shade-seekers and harmful effects from excess sun exposure.

The one I was most interested in was titled ”A Case for Those Extra 10 Pounds.” This one seemed aimed at those who are carrying a little extra in the hips and thighs, rather than the belly. It quoted lots of medical data suggesting there might even be some benefit to a “few extra pounds,” an increase in estrogen production  and an accompanying decrease in osteoporosis risk; a Dermatology article was quoted as saying that women who are overweight appear younger than those who are of normal weight or underweight.

So let’s go back to basics. One third of all adult Americans are frankly obese, not just a few pounds overweight. They clearly have a higher risk of a number of serious diseases. Many of those in the middle ground between normal weight and obesity, i.e., those who are termed “overweight,” carry excess belly fat as well as extra poundage in the thighs and buttocks. I see this all the time in the men’s locker room at our gym; my wife says she also notes the same in women. Those folk are also at risk of cardiovascular disease, high blood pressure and, according to some sources, even some types of cancer.

On the other hand, in general, it’s not healthy to be underweight People who are underweight may be so because of underlying diseases such as cancer. I should, of course, note that some people who are very slender may be perfectly healthy and are thin because of lifelong exercise (long distance runners come to mind).

We all tend to look for excuses and to rationalize our issues away. So if you’re lean around the midsection and carry a little extra elsewhere, perhaps you are okay. But I’d suggest you should take a good hard look at your waistline before concluding that you’re one of the folk who can safely carry some excess pounds or not.

Subtle messages

Wednesday, April 7th, 2010

I was leafing through The Wall Street Journal this morning, quickly, as I got up late, will read a book for my men’s book club most of the morning and then go to Loveland, eight miles south, to lunch at a restaurant I’ve never eaten at before. I’m going there to meet a writer friend whose book I’ve been proofreading.  I saw the headlines in the front section of the paper and will return to them later, but was struck by an article in the last section, the one called “Personal Journal.”

The article’s title was “What Your TV is Telling You to Do.” That caught my attention so I read the whole thing. It’s about NBC’s use of the technique of “behavior placement.” Instead of trying to sell you a specific product by having the star of a show drink, eat or use it, this idea is to show you a kind of behavior you may then decide, consciously or unconsciously, to emulate.

The thing that’s different here is that some NBC’s shows are now sending you messages, or rather signals, to recycle, exercise and eat right. Presumably they’re not just doing this because it’s the right thing, but, in part in least, because it will help them sell ads. TV has enormous power to get huge numbers of viewers to do something, because their favorite character does it.

In this case the stars of various shows will be exercising or eating healthy food choices. I’m going to wait and see what the outcome is and maintain a goodly amount of skepticism, but the overall concept is one I love.

For years we’ve been sold, via ads (which I mute and many who use Tivo skip), products that by no stretch of the imagination could be termed healthy choices. Now, finally, someone is going to try to influence us to make better choices. I’m all for it.

Finally, I’m back home with a lesson learned

Friday, March 26th, 2010

We’ve been on the road for thirteen days, driving to Phoenix and back for my wife’s Integrative Mental Health meeting. The trip covered nearly 2,000 miles and we got a chance to visit six sets of old friends. I weighed myself this morning, expecting to be way up, but I’m only at the top of my acceptable limit, three pounds over my current goal weight. That didn’t make sense at first as we’ve eaten out a lot and had home-cooked meals in three places; those were delicious, but not what I’ve been eating while I’m dieting. I had also spent four days in the car and several more with friends who didn’t exercise regularly.

Then I realized I still got a fair amount of exercise along the way, snowshoeing in Angel Fire and walking four miles a day in Phoenix while Lynnette was in her meeting.

My central focus in losing weight has been eating less, but when we’re home I’m in the gym six or seven days a week. I’ve said before the vast majority of people have to modify their intake of calories to lose weight, but I don’t think you can keep it off without exercising.

So I pulled out an article I picked up at a hotel we stayed at on the trip (we spent three nights there and two more on Air Force bases). This on was from USA Today and focused on “older women.” It came at the issue from a different slant, that of normal-weight women who want to avoid weight gain as they age. A group of Harvard researchers followed a large group (34,000 participants)of women over an extended time frame (13 years). These women were healthy, didn’t need to lose weight initially and eat a normal diet.

The conclusions fit with my premise; the relatively small cohort (13%) who never gained more than five pounds during the entire length of the study regularly did an hour a day of moderate-intensity exercise. The researchers didn’t extend their findings to men or younger women (or kids), but I firmly believe the way to keep weight off for all of us is through some kind of exertion. Whether you chose to walk for an hour (at least five days a week) or do something more strenuous for shorter time periods, get off your couch and find a form of exercise that fits with your age, health condition and inclinations. Even shorter periods or exercise will convey at least some health benefits. You’ll be ahead of most of your fellow countrymen and women if you do so.

And Back Down Again

Tuesday, February 9th, 2010

We got home from our East Coast trip last Friday. We made it to three of our four planned stops (the oncoming snowstorm heading toward the DC area truncated the trip). I ate far more than I have been for the past eight months and gained 4.8 pounds.

But I had pre-dieted and left at 149.4, well under my current goal weight. And when I got home I went back on the stricter version of my diet and the weight melted off. I also snowshoed for an hour on Sunday and worked hard at the gym yesterday

We even went to a party last night, a fund-raiser for the Symphony Guild. It was titled “My Curry Valentine,” and featured four curries: beef, lamb, chicken and shrimp, three kinds of rice, pappadums (Indian flat bread), a variety of topping for the curries, salad, a variety of wines (or Fat Tire beer, a local favorite) and cookies plus three choices of sorbet for dessert.

I drank a lot of water, took small helpings of each curry, didn’t have seconds (that’s not quite true; I did have several pappadums), some salad, a few of the toppings, ate one cookie, had one small helping of one of the three sorbets, and one half-glass of Reisling.

Today I weigh 149.6 pounds, only two tenths up from my pre-trip weight and well under what I’ve been terming my final goal weight. I’m thinking of re-setting that to 149 as I’ve recently gotten lots of compliments on how I’ve slimmed down; nobody has said, “You’re too thin).

So overall I had a short and temporary hiatus from my diet, but had prepared well for our trip and went back to dieting as soon as we returned. I didn’t let the short-term weight gain throw me off my overall plan. Concentration on my long-term goal helped a lot as did the exercise and the past eight months experience with a successful approach to eating sensibly.