Ask Dr. Janet

Is there really any nutritional value in lettuce?

2009-02-09T09:47:00.000-08:00

Q: Is there really any nutritional value in lettuce?

A: Lettuce is a leafy crunchy vegetable with substantial water content, some fiber and a negligible calorie count—all factors that are beneficial for filling up your plate and pairing down your waistline.

You should know that only certain types of lettuce are loaded with lots of vitamins, minerals and antioxidant plant chemicals, whereas others contain virtually nothing in terms of nutrition. Hence, even though all types of lettuce are low in calories, the different varieties offer different valuable sources of nutrients. For example, romaine lettuce is especially rich in vitamins A, C, and K, folate, and manganese when compared to iceberg lettuce.

When making lettuce choices, be sure to get in the power lettuces, romaine and red leaf—the darker the leaf, the greater the amount of nutrients such as vitamin A and folate. Other salad greens, such as spinach, kale, arugula and radicchio, while technically not lettuces, are among the most nutrient-dense foods available.

So when it comes to good health and weight control, be sure to pile on the dark leafy greens (an antioxidant gold mine), and leave the iceberg in the bin!

Is soda ok for my kids in moderation?

2009-02-03T10:27:00.000-08:00

Q: I let my kids drink soda with special meals (no more than two cans per week). Is this OK for them?

A: Your advice to limit the intake of soda to two cans per week is a good one. So many parents have no qualms about providing unlimited amounts of sweetened beverages such as sodas to their little ones. In fact, it’s been estimated that almost one third of parents serve this type of drink to their 12-14-month-old children and, believe it or not, this statistic increases to almost 50% of parents when children reach 19-24 months old. As a mother of three, and as a registered dietitian, I urge parents to rethink this practice due to the childhood obesity epidemic that envelopes our country.

According to the Dietary Recommendations for Children and Adolescents issued by the American Academy of Pediatrics, parents should limit their children’s intake of sugar-sweetened drinks such as soda. With the limits you’ve set in your own home, you’re teaching your children the concept of “moderation” and starting them off on the right foot by promoting a healthy lifestyle.

The most valuable tool you can use to promote good health in your kids is to be a good role model yourself. Eat healthy and exercise daily and your children will learn not so much by what you say but by what you do!!!

How do I start training for a marathon?

2009-01-26T06:48:00.000-08:00

Q: Where is a good place to start if I've never run a marathon and would like to start training?

A: Having trained for and completed four marathons, I must say that the experience of crossing the finish line of a marathon is well worth the grueling training and personal sacrifice involved in preparing both mind and body for this extraordinary accomplishment. Kudos to you for having the courage to make this commitment!

The best place to start training for a marathon is a year away from the date of the race. Start training the body with short runs, on an almost daily basis. Six months out from race day you should be able to log in at least 25 miles of running in a week, comfortably. At this point (6 months from race day), I would highly encourage you to join a running club or a charity organization that trains its runners to complete marathons such as Team In Training, the organization that raises funds to help stop leukemia, lymphoma, Hodgkin lymphoma and myeloma. A set training program with knowledgeable leaders will help you to safely and gradually increase your endurance and give you lots of training and nutrition tips that should make your first marathon an event that you will forever cherish. Good luck and best wishes . . . and remember, the goal is to cross that finish line with a smile on your face, regardless of your finish time.

What is a good rule of thumb when purchasing healthy food?

2009-01-19T07:02:00.000-08:00

Q: What is a good rule of thumb when purchasing healthy food? The fewer ingredients, the better?

A: Absolutely right! When it comes to making wise nutrition choices, the golden rule on the ingredient list is “less is better!” This is because the most nutritious foods are generally the least processed foods with the least amount of additives. The closer the food is to the way Mother Nature intended it to be, the more natural vitamins, minerals, fiber and phytonutrients the food product will contain.

For example, it’s always healthier to choose an apple over a slice of apple pie loaded with unhealthy fats, salt, spoilage retardants, refined carbohydrates and excess calories. If you peruse the frozen vegetable case, better to grab the bag of frozen peas that simply contains two ingredients—peas and salt—rather than a frozen pea product with 20 ingredients in the list. Another important tip regarding processed foods is that if you have a choice, make the food yourself (such as your own tomato sauce versus a jar of sauce). This way YOU control the ingredients and can be very judicious with adding in excess amounts of harmful ingredients such as sodium and bad fats.

Is whole grain white any different from regular whole wheat bread?

2009-01-12T11:05:00.001-08:00

Q: When it comes to choosing a healthy bread, is whole grain white any different from regular whole wheat bread?

A: The definition of “whole grain white” bread or flour is nebulous at best. It is a fairly new product that can consist of virtually anything, but generally comprises a mixture of 100% whole grain and white flour. The white wheat comes from an albino variety of wheat that differs from the traditional red wheat kernels. Furthermore, the white wheat is more heavily processed than the 100% whole grain flour to make the product taste more like its refined cousins, though the jury is still out regarding exactly how much nutrition is lost in the processing.

The product is marketed to regular consumers of white bread who want to consume more whole grains for the health benefits but just can’t quite take the plunge to eating 100% whole grain products. So, for those people, the new “white wheat” products are a better choice than refined white bread products. The bottom line is, nutrition-wise, your best bet is to routinely go for the 100% whole wheat products that have been less processed, contain all three parts of the original wheat kernel and have been shown scientifically to help prevent chronic disease.

Are Probiotic Drinks Healthy?

2009-01-05T05:38:00.000-08:00

Q: With all of the probiotic culture drinks, cheeses and other dairy products on the market, can the use (or overuse) of these products be detrimental to my digestive system?

A: Probiotics are live, “healthy” bacteria that are added to the diet and function to promote better health. They reside in the colon. Common names of these “friendly” bacteria are Lactobacilli and Bifidobacteria (this strain of healthy bacteria is included in Dannon Activia yogurt).

Why is it good for your health to increase the number of these bacteria? Probiotics ingested in the diet:

Overpower bad disease-causing bacteria.
Help boost the body’s immune system.
Help the body absorb vitamins and minerals and increase the body’s internal production of B vitamins.
May help bone health by increasing the absorption of calcium and the ability of the bones to absorb calcium.
Decrease diarrhea and diaper rash in babies.
May improve constipation in the elderly.
May reduce the conversion of bile into carcinogenic substances (decreasing risk of colon cancer).

Because probiotics are the good kind of bacteria, and promote health, they would not be detrimental to your health, regardless of the amount ingested.

What type of oatmeal is healthiest?

2008-12-29T10:21:00.000-08:00

Q: Why have I heard that rolled oats are healthier than quick oatmeal packets?

A: As you can see, there are different types of oat products out there on the market. The two kinds that you will most likely find on your supermarket shelf are “steel-cut” oats and different varieties of “rolled” oats.

Steel-cut oats (my personal favorite) are the least processed of the two varieties and so retain the greatest amount of nutrients—especially the cholesterol-lowering soluble fiber found in oats, namely beta-glucan. Because steel-cut oats are pretty much “right off the farm,” they do take much longer to cook than the rolled type, but it is well worth the extra time and effort for their superior flavor, texture and nutrient composition.

Rolled oats are what most Americans know as oatmeal and are often sold in familiar round cardboard containers. These oats have been steamed, dried, sliced and then flattened, producing the flat oatmeal shape that we have become accustomed to. There are actually three types of rolled oats: (1) old-fashioned, (2) quick-cooking, and (3) instant. The instant variety is the most processed of the three and has already been precooked—making it convenient to cook but unfortunately mushy in texture. In addition, the instant variety frequently has added sweeteners, salt and other flavorings. Your best bet is to choose the least processed type of oats such as the steel-cut or the old-fashioned varieties. If you need the time-saving convenience of instant, go for the plain instant packets and add your own sweetener—and also be sure to add a couple tablespoons of oat bran (the concentrated form of beta-glucan, much of which has been lost in the instant varieties).

Are the "healthy" menus at fast-food places really healthy?

2008-12-22T05:42:00.000-08:00

Q: Are the "healthy" menus at fast-food places really healthy?

A: In our society, everything is fast, fast, fast, including our food. The problem is, how does one follow government-advocated healthy eating guidelines recommending that we consume lots of fruits, vegetables, whole grains, nonfat (or 1%) dairy products, lean protein and healthy fats (like olive oil, avocado and nuts) when we’re on the go?
Let’s face it, finding healthy food is tough outside of your own kitchen.

In answer to your question, surprisingly some of the “healthy” menu choices now offered at fast-food restaurants are actually much healthier than their classical menu choices, though clearly not what I would call “health food.” The best advice for navigating the fast-food maze and for a fast food to be truly healthy is that it has to be low in saturated fat, cholesterol and trans fat free. It also cannot be swimming in sodium or sugar and should not provide a ridiculous amount of calories (a good goal is to keep under 500 calories for a full meal).

I decided to check out the McDonald’s Web site (http://nutrition.mcdonalds.com/bagamcmeal/nutrition_facts.html ) to see if I could concoct a “healthy lunch.” I found the following nutrition information for their Premium Asian Salad with Grilled Chicken: 320 calories, 9 grams fat (3 grams of those are saturated) and 960 mg sodium. Add in a packet of Newman’s Own Low Fat Balsamic Vinaigrette (40 calories, 3 grams fat and 730 mg sodium), a sugar-free iced tea and a fruit ’n’ yogurt parfait (160 calories, 2 grams fat and 85 mg sodium) and you can squeak out a somewhat healthy lunch for a grand total of 520 calories, 14 grams fat and a whopping 1,775 mg sodium (you should keep your total daily sodium intake under 2,300 mg/day). Not ideal, but in a pinch . . .

What's a good substitute for butter in Holiday recipes?

2008-12-15T11:19:00.000-08:00

Q: Many of my holiday recipes call for butter. What's a good substitute?

A: I like to use the tub margarines with added plant sterols such as Benecol or Promise Take Control. I also like the “light” versions that give you all the flavor with half the calories. These margarines are a nice substitute for butter not only because they have only a fraction of the artery-clogging saturated fat, and are trans fat free, but also because they give you a dose of plant sterols—the natural plant derivative that is safe and effective for lowering your “bad” LDL cholesterol. Here is a mashed potato recipe for a delicious and truly heart-healthy holiday side dish taken from my book, Cholesterol DOWN:

Mashed Potatoes with Chick Peas (Garbanzo Beans)
Yield: 6 servings (serving size: approximately 1 cup)

2 pounds baking potatoes, peeled and cut into chunks

1 can (15.5 ounces) chick peas, rinsed and drained

1 cup light soy milk

½ cup reduced sodium chicken broth

¼ cup Promise Take Control Light Margarine

1 teaspoon salt

½ teaspoon pepper

Commercial gravy, optional

Place potatoes in a large saucepan, cover with water, and bring to a boil. Reduce heat and simmer for 15 minutes or until tender. Drain and return potatoes to pan. Add in chick peas and mash using a potato masher. Add in soy milk, chicken broth, margarine and seasonings, and stir. Cook an additional 2 minutes until heated, stirring constantly. Serve warm. Top with commercial gravy if desired.

Nutritional Information Per Serving (approximately 1 cup):
Calories: 255, Fat: 5 g, Cholesterol: 0 mg, Sodium: 751 mg,
Carbohydrates: 46 g, Dietary Fiber: 5 g, Sugars: 3 g, Protein: 7 g

Recipe from: Cholesterol DOWN: 10 Simple Steps to Lower Your Cholesterol in 4 Weeks—Without Prescription Drugs by Janet Bond Brill, Ph.D., R.D., LDN.
Published by Three Rivers Press, December 2006; $13.95US/$17.95CAN; 978-0-307-33911-9.

Is exercising in the cold dangerous?

2008-12-08T05:29:00.000-08:00

Q: Do physical activities like snowshoeing or cross-country skiing in very cold temperatures have any negative effect on my body?

A: I love your question, because even though I live in a tropical climate, I have to say that snowshoeing is probably my favorite aerobic exercise! I try to travel to the high country once a year to get my fix of cold weather exercise. Strap on a pair of comfy snowshoe boots (or even a good-quality leather boot and warm, insulating socks that will work just as well), attach them to your snowshoes, throw on a few layers of clothes, gloves and a hat, and you’re off.

To me, nothing compares to hiking along snowy paths, and all the while—as your heart is pumping—taking in the magnificence of the majestic snowcapped mountains and basking in the quiet solitude of the snowy forest. As far as I’m concerned, it simply doesn’t get better than that for exercise for both the mind and the body.

Exercising in very cold temperatures is a safe and really fun way to stay physically fit, as long as you be sure to take some precautions:

Check with your doctor first before beginning any exercise program.
Layer up for cold weather and make sure to cover those extremities (head and hands). Wearing a “neck gator” to cover your nose and mouth can be tremendously helpful in frigid conditions.

Drink, drink, and drink before, during and after your workout; even if you don’t feel thirsty, you need to drink to stay hydrated.

Bring a snack because you really work up an appetite exercising in the great outdoors!

Make sure someone knows of your whereabouts before you embark on your outing—either the ranger who sold you the day pass or a friend or family member. I suggest carrying a cell phone for use as an emergency contact (although reception in the backcountry can be iffy).

To improve safety (prevent hypothermia and frostbite) and comfort, I suggest that you go to the American College of Sports Medicine website and review their recommendations for how to exercise safely in cold weather.

Is coffee a good energy boost for a workout?

2008-12-01T03:23:00.000-08:00

Q: I see people at my gym drinking coffee before they work out. Is this a good energy boost for a workout?

A: Oh, that morning cup of Joe . . . Americans just can’t seem to get enough of the most popular behavior-altering drug in this country, caffeine. Is it smart to down a cup or two of coffee before you work out or is it better to refrain until after you get your exercise in?

Caffeine is the most widely used ergogenic aid (a substance that can purportedly enhance sports performance) and has been scientifically proven to be a highly effective sports aid. Caffeine is a central nervous system stimulant that can help you perform better because it acts to increase alertness as well as lower your perception of effort during exercise—so you can exercise harder and it won’t feel as difficult. The science has shown that caffeine is most valuable for endurance-type athletes involved in sports such as cycling and long-distance running. Caffeine has been shown to increase the amount of fat floating in the bloodstream of endurance athletes, which would theoretically improve endurance performance by helping to spare muscle glycogen. When muscle glycogen runs low, endurance athletes need to slow their pace, so an ergogenic aid that enables athletes to “spare” the glycogen in favor of using the fat for fuel would be highly beneficial and potentially delay fatigue.

If you do decide to drink a cup of coffee before exercising, there are a few caveats. Caffeine is a diuretic, so if you choose to consume it before exercising in a hot, humid environment, be sure to drink extra fluids to compensate. Furthermore, many people are caffeine sensitive and can have negative side effects from consuming caffeine, such as nervousness, upset stomach and a rapid heart rate. If you are caffeine sensitive, I would suggest that you abstain.

How Do I Not Overdo It At Thanksgiving Dinner?

2008-11-24T10:13:00.000-08:00

Q: How do I not overdo it at Thanksgiving dinner while still taking part in the tradition of eating?

A: One meal will not make or break your diet or weight management goals. In fact, it’s probably very rare to find a person who doesn’t overeat at festive holiday gatherings where good food and holiday spirit abound. Keep in mind that the real damage occurs when we keep on overeating from Turkey Day all the way through January 1. We each need to be vigilant about putting the brakes on excessive calorie overload during this dangerous time of year for the battle of the bulge.

That said, how can we prevent feeling like a stuffed turkey after this year’s Thanksgiving meal? Planning ahead is the key as well as using a few calorie-cutting tricks. Lighten up your favorite holiday recipes by cutting back on fat, sugar and salt and substituting healthier ingredients. Load up on lower-calorie vegetable dishes before and on your holiday dinner plate. Use strict portion control for the higher-calorie foods and be careful about drinking your calories—nutmeg or alcoholic drinks that can easily add to your meal’s calorie overload.

The goal of this holiday season should be to avoid weight gain. Make your New Year’s resolution on Thanksgiving Day by watching your food intake and getting that exercise in—set a goal of walking away from the scale reading the same number on January 1, 2009, as it reads on November 27, 2008, and you will truly have given yourself the holiday gift of health.

How Do I Know An Antioxidant Supplement Is Working?

2008-11-17T05:44:00.000-08:00

Q: I have been taking an antioxidant supplement, but how do I know if it’s doing anything for me?

A: Scientists have proven beyond any shadow of a doubt that consuming a plant-based diet of whole foods—naturally rich in antioxidant vitamins, minerals, fiber and phytochemicals—can provide substantial health benefits such as prevention of chronic disease like diabetes, cancer and heart disease. In contrast, consuming man-made supplements of concentrated antioxidants extracted from plants, has not shown to benefit health. In fact, some studies have demonstrated that consuming certain antioxidant supplements increases risk of disease! A 2007 review article published in the Journal of the American Medical Association (G. Gjelakovic et al.) revealed that subjects taking beta-carotene, vitamin E or vitamin A supplements, either alone or in combination, actually raised their risk of dying prematurely.

So what’s the take-away message regarding whether your antioxidant supplements are doing anything for you? Swallowing pills will not buy you good health or a long life. An active lifestyle combined with eating a Mediterranean-style plant-based diet, filled with fruits, vegetables, whole grains, legumes, olive oil, nuts and a small amount of fish, is the secret to better health. This is the ultimate wellness prescription that simply cannot compare to anything that can be purchased in a bottle.

Why Is Stretching After Working Out Important?

2008-11-10T05:29:00.000-08:00

Q: Why is stretching after working out important?

A: This is a great question because it addresses the importance not only of practicing stretching but also the best and safest technique for performing this valuable type of exercise. Why stretch? Stretching increases flexibility, a key component of physical fitness that is often neglected. A greater degree of flexibility is believed to help prevent injury (and low back pain) and improve sports performance. We lose flexibility as we age, so practicing a regular program of stretching the major muscle groups can help prevent loss of flexibility and its associated negative impact on quality of life in our golden years.

Stretching properly involves a slow, steady elongation of the muscles and tendons to the point of tightness—never pain—and holding the stretch for several seconds. (Never use bouncing or ballistic-type stretching, which can cause injury.) It is best to stretch muscles that have been warmed up internally from exercise as opposed to cold muscles. In fact, stretching cold muscles can actually increase risk of injury, as a cold muscle is more prone to strains! Think of a muscle as if it were a rubber band. If you stretch cold rubber, it snaps and breaks; however, if you warm the rubber first, it stretches more elastically and fluidly, like taffy.

Stretching is different from “warming up.” A warm-up is what you do before you begin a bout of exercise and generally consists of a low-intensity version of the exercise you are planning on engaging in (such as a fast walk before a jog). A good exercise routine would be to warm up (work up a light sweat and raise the internal temperature of your muscles), followed by a series of brief stretches, then perform your exercise bout, warm down and end with another series of stretches. Practice this plan and you will have a well-rounded fitness routine.

What Foods Can Aid Constipation?

2008-11-03T04:22:00.000-08:00

Q: I have been constipated for a few months now and want to attempt to treat it through changing my diet first. What kind of a menu do you recommend?

A: The best way to treat constipation through diet is to take a two-pronged approach: bump up your dietary fiber intake and drink more fluids. Constipation is a very common problem in our society. We are nation of people who eat a diet woefully short on fiber. In fact, the average person consumes about half (14-15 grams) of the daily recommended dietary fiber (20-35 grams) for good health. The good news is higher fiber diets can effectively treat constipation as well as lower cholesterol, help control blood sugar in diabetics and even promote weight control. (High-fiber foods tend to be lower in calories and are filling.)

The best high-fiber menu includes a cornucopia of whole and unprocessed plant foods. For example, oatmeal and fruit for breakfast, fruit and nuts for snacks, whole grain bread, vegetables and beans for lunch, and more whole grains, salad, veggies and a small amount of animal protein (such as skinless poultry or fish) for dinner. However, when you do increase your fiber intake, you must also increase your fluid intake concurrently or the high-fiber menu could backfire and actually increase constipation! So make sure to get in those 8 glasses of water a day and you should have great success in treating your constipation problem without prescription medication.

On a final note, in my book, Cholesterol DOWN (Three Rivers Press), one of the 10 steps I prescribe for lowering “bad” LDL cholesterol is to take Metamucil—a powerful cholesterol-lowering fiber (psyllium seed husk), which also helps with regularity.

What's the Nutritional Impact of Halloween Treats?

2008-10-27T07:07:00.000-07:00

Q: What is the nutritional impact of sugary Halloween treats on my kids?

A: Overdosing on huge quantities of sugary, empty-calorie junk food—for the few days post-Halloween—will not harm your kids except perhaps to give them a stomach ache, reinforce poor eating habits and contribute to a few dental caries. While I certainly think it would be wiser for parents to put the brakes on the amount of Halloween candy their kids eat, a little candy excess for a day or two will not have real lasting effects.

That said, with today’s obesity epidemic among our nation’s children, parents must emphasize a healthy lifestyle, meaning teaching children the value of good eating habits and daily exercise. The best way to teach kids healthy eating habits is to provide nutritious meals and snacks in the home, and lobby for healthier foods and daily PE at schools. Sugary, high-calorie Halloween candy is not a nutritious snack food and should be limited in your child’s diet and replaced on a daily basis with healthier snack options such as low-calorie popcorn, cut up fruit and vegetables, or yogurt.

When it comes to Halloween, moderation and control are key. Parents should take charge of their kids’ candy loot. Here are some Halloween survival tips:

-Make sure you know the people who are giving your children candy.
-Once your kids bring home the candy, check that the wrapper on the candy is sealed and unbroken.
-Have your children sort out their candy, choosing only their favorites. (The rest give away or even throw away.)
-Take the candy and put it somewhere where you can control your kids’ intake.
-Allow your children a few pieces a day of their candy loot for just a few days, and then get it out of the house!
-Junk food should not be a dietary staple for kids but only an occasional treat.

Does a Morning Workout Burn More Calories?

2008-10-20T05:52:00.000-07:00

Q: Does the time of day (morning rather than evening) impact burning more calories?

A: Whenever you can burn calories—morning, evening or mid-day—is the best time of day as long as you do it! If your question is addressing weight management, then the best way to lose weight and keep it off is to spend mental and physical energy, day in and day out, eating healthy calorie-controlled meals and getting in that calorie-burning exercise. In short, balancing the calorie math. The goal for weight loss is to consume fewer calories than your body requires, creating what is termed a “calorie deficit.” A calorie deficit of 500 calories per day results in a one-pound weight loss of body fat in one week’s time.

Whichever time of day you get in a major “bout” of calorie-burning activity is up to your personal schedule. Ideally, you’ll want to get in a planned exercise bout in addition to being physically active throughout the day, such as parking farther away from the store and taking the stairs instead of the elevator. In summary, the time of day you eat or exercise does not impact calorie burning. Your best bet is to eat small, frequent, nutritious (calorie-controlled) meals throughout the day and combine that eating style with a daily exercise bout as well as making an effort to simply move around more. That is what is important for your personal calorie balance and the secret to lifelong weight control.

Do Carrots Really Help Eyesight at Night?

2008-10-13T05:22:00.000-07:00

Q: Do carrots really help my eyesight at night? Or was Mom just saying that as a way of getting me to eat carrots?

A: Yes, Mom was right! Carrots really do help your eyesight at night, or “night vision.” Carrots are an incredible vegetable. Their bright orange color is due to a plant pigment called beta-carotene, the extraordinary chemical that doubles as both a pro-vitamin (the precursor to vitamin A) and a powerful antioxidant. Carrots are one of the richest sources of beta-carotene in our diet. Beta-carotene (pro-vitamin A) is converted into the fat-soluble vitamin A (aka retinol) in the human body. Vitamin A is a crucial vitamin for eye health. In fact, the first sign of a vitamin A deficiency is night blindness, the inability to see in dim light. In developing countries, blindness is often observed in children—a result of a vitamin A deficiency.

For a mere 30 calories in one large carrot you get a whole lot of nutrition . . . imagine, almost half (~ 41%) of the daily value for vitamin A in a single carrot! High in fiber and disease-fighting plant chemicals, with zero fat and cholesterol and very little sodium, carrots are one vegetable that should be on everyone’s daily vegetable list. Thanks, Mom, for the great advice!

How Should I Get Back Into a Running Routine?

2008-10-07T14:42:00.001-07:00

Q: I used to run every day and then I had kids. Now that they’re getting older, I’m starting to run again. Should I run every day (if even for only 10-15 minutes), or should I space it out and run more each time I run (like 30 minutes every other day)?

A: I am the mother of three children, as well as an avid runner, so on a personal note . . . good for you! Kudos for having the desire to integrate this supremely beneficial habit back into your busy life. Running is such a wonderful exercise that is good not only for the body (burning calories and promoting cardiovascular health and fitness), but also for the mind (a really healthy way to burn off stress—especially the stress of mothering and performing the balancing act that so many of us moms try to do).

I am a big advocate of getting in daily aerobic exercise, so in answer to your question, I suggest aiming for running on a daily basis, even if you have to alternate walk/running at first. Because you are returning from a break in your former routine, take the time to build your endurance back up slowly. Just make sure you have medical clearance and that you get in a proper warm-up and cool-down (and stay hydrated) with each exercise bout.

Good luck and perhaps I’ll see you out on the running trail!

What Are the Health Benefits of Green Tea?

2008-09-29T18:21:00.000-07:00

Q: I know green tea is good for me, but what are the real health benefits?

A: No doubt about it, green tea can harness the power of plant protection against disease. A few cups of green tea daily can defend against a host of cancers (most notably colorectal, prostate, oral and skin cancers), provide cardiovascular protection via antioxidant and anti-inflammatory mechanisms, and even offer therapeutic benefits for people with rheumatoid arthritis.

What exactly is in green tea that wards off disease and will put you on the road to better health and longevity? Researchers believe that catechins, or powerful antioxidant plant chemicals (polyphenols), are responsible for the anti-cancer, anti-inflammatory and cardioprotective effects of green tea. Scientists have isolated one type of green tea polyphenol called epigallocatechin-3-gallate (EGCG for short), which is believed to be the major health-protective component in green tea. (Incidentally, green tea contains 40 percent more polyphenols than black tea.)

So let's get over the Boston Tea Party and borrow a nice habit from the British . . . teatime in the afternoon. But let's instead make it green tea. Bottoms up for better health!

How Can I Gain Healthy Weight and Energy?

2008-09-22T16:17:00.000-07:00

Q: I am 75 years old and my doctor has ordered me to put on about 10 pounds (I am very thin and agree I need more weight to be healthier). What are some foods I should eat to gain healthy weight and energy?

A: Gaining weight healthfully is actually trickier than you might think. The object is to make the weight gain mostly lean body mass (muscle) and not much body fat. You can accomplish this by taking in more calories than you burn, in addition to partaking in a regular aerobic exercise and muscle-strengthening exercise program. (Note that people in your age category benefit highly from a regular program of strength training.)

You will also want to gradually increase your consumption of healthy, energy-dense foods. Keep in mind that you can boost caloric intake healthfully without having to purchase expensive supplements—it just takes a little planning. What’s more, your age group tends to have a problem getting in enough protein, so you will need to be especially attuned to increasing your intake of higher-calorie (but still healthy) protein sources. To learn more about which foods are highest in “nutrient density,” you can access the USDA MyPyramid.gov site.

Here are some other suggestions for getting in extra calories:

Choose larger portions of healthy protein sources: peanut butter or other types of nut butters (a great higher-calorie source of protein and nutrients), low-fat dairy such as yogurt and cottage cheese, nuts and lean cuts of chicken, turkey and fish, such as salmon and tuna.
Choose higher-calorie juices more often, such as cranberry and pomegranate juice, as opposed to drinking calorie-free beverages like tea and coffee.
Choose a higher-calorie whole-grain cereal such as Post Grape-Nuts (208 calories in 1/2 cup serving) versus a low-calorie refined-grain cereal such as Kellogg's Special K (only 117 calories in an entire cup).
Add generous amounts of healthy fats like olive and canola oil into your day
Add in a few high calorie snacks throughout the day such as a nutritious shakes or smoothie made with real fruit, fat-free milk, sugar and some added non fat dry milk and even peanut butter to boost calories and nutrient density
Make sure to eat three meals a day, plus get in those higher-calorie snacks and you should be on your way to putting on some extra weight the healthy way!

Should We Prescibe Cholesterol Drugs For Kids?

2008-09-16T04:30:00.000-07:00

Q: There's been talk about prescribing cholesterol drugs to children. What are your thoughts on this?

A: Pediatricians are concerned with the rise of childhood obesity in our nation, as well as the fact that high cholesterol, diabetes, and high blood pressure–all major risk factors for heart disease, the leading cause of death in the U.S–are increasingly diagnosed in obese children.

The American Academy of Pediatrics has just revised its guidelines for cholesterol screening and treatment in our nation’s children. These guidelines take a more aggressive stance regarding prescription drug treatment, with the newest recommendation dropping the age of consideration for drug treatment from “older than 10” to as young as 8.

Is it wise to prescribe medication to our children to fix what used to be considered purely an adult problem? And will statin medication taken in childhood truly lower our kids’ risk of contracting early heart disease as adults?

While I agree with the push to both increase detection of high cholesterol levels in children and, more specifically, with taking aggressive action to control this major risk factor for heart disease, I question the wisdom of freely placing children as young as 8 years old on prescription statin medication to solve this problem. Isn’t this strategy almost like taking a “Band-Aid” approach?

First and foremost, we as a nation of parents must change the environment of poor nutrition and lack of physical activity that lead to obesity and high cholesterol levels in our kids. Prevention is the best strategy! That said, I believe that prescription medication should be reserved only for those children who have been aggressively treated with lifestyle changes for a long period of time and have not responded favorably.

What Is The Benefit Of "Hot" Yoga?

2008-09-08T17:16:00.000-07:00

Q: At my gym, they offer a yoga class in a special room where the temperature is turned way up, I assume to induce sweating. What is the benefit of this technique?

A: Called “hot yoga,” this particular brand of yoga is all the rage these days and basically consists of performing a series of yoga poses in a heated room. And we are talking really HOT rooms, heated to a temperature of up to 105 degrees F. The idea being that the hot room temperature helps your muscles warm up more quickly, which supposedly enables them to stretch more fluidly and to a greater degree. I have attended hot yoga classes where the instructor utilizes portable space heaters, sprinkled around the room and turned on full blast (which in hot and humid Florida is not exactly pleasurable). These hot yoga studios do induce sweating and not just a drip or two but profuse sweating!

Is there a benefit to performing yoga in heated rooms? Scientific research in the area of stretching has shown that the only effective way to truly warm up the muscles internally is to perform physical activity (such as light jogging) that increases the internal, or core body, temperature. Sitting in a sauna, for example, applies external heat and makes you sweat but is not an effective means of raising the core temperature inside the muscle cells. What’s more, heat regulation and the potential for heat illness is a concern I have because the hot yoga environment could potentially hinder the body from using its main source of heat dissipation, evaporation of sweat from the skin. Anytime we exercise in the heat, we must be cognizant of the potential for heat illness. However, if you enjoy hot yoga, then by all means continue taking classes, which are very helpful for many people in increasing flexibility and releasing stress. Just make sure to hydrate well before, during, and after exercise, acclimate to exercise in the heat and take as many precautions as you can to prevent heat illness.

How Do Energy Drinks Impact My Body?

2008-09-02T18:41:00.000-07:00

Q: What’s the deal with energy drinks like Red Bull or Full Throttle? How do they impact my body and energy?

A: We live such busy lives, is it any wonder so many of us feel tired and run-down and in need of a shot of energy to keep us going? Sadly, the recipe for good health and vigor simply can’t be bought in a single bottle of liquid. The most energetic people are those who are physically fit, and physical fitness comes from living a lifestyle that includes regular exercise, eating a healthy diet and routinely getting a good night’s sleep. Time management is also another piece of the puzzle, learning how to prioritize and leaving some time for rest, relaxation and even a quick cat-nap to reinvigorate ourselves during our long, hectic days.

What is in that energy drink that makes us feel more alert and full of pep after we down one? The answer, in a single word, is stimulants, namely caffeine and taurine. Caffeine is a stimulant drug that will result in raising your mental alertness but for many has unwanted side effects, such as jitteriness and stomach upset to name a few. And what about the “crashing” effect when it wears off? Taurine is an amino acid that is believed to augment the stimulant effect of caffeine. Some of energy drinks also contain a stiff dose of sugar, which will contribute to raising your blood sugar level (albeit short-term), giving you a nice lift but could add considerably to your waistline while it peps you up (one 8.3-fluid-ounce can of Red Bull contains 115 calories and 26 grams of sugar).

The bottom line is that no energy drink can compete with a healthy lifestyle for keeping your energy level up—the natural way.

Fat-Free Ice Cream Or Just A Smaller Size?

2008-08-25T16:52:00.001-07:00

Q: Ice cream in the summer is my passion. Is going for fat-free ice cream (not frozen yogurt) really better for me than regular ice cream? Or is it more about the portion size and how often I indulge?

A: There is one main type of artery-clogging fat that all Americans should try to cut back on to keep their hearts strong and healthy and to help prevent heart disease (the No. 1 killer of American men and women): saturated fat. We also need to watch our calorie intake, as we are a nation of overweight individuals—a situation that is associated with increased risk of disease.

Full-fat premium ice cream contains a staggering amount of saturated fat and calories—and that’s before all the toppings or the gargantuan serving sizes that so many of us opt for at the counter. We should all take note of the potential damage regular consumption of these luscious and creamy treats could take on our arteries and waistlines. I recommend delicious and satisfying fat-free or low-fat ice cream choices as your summer treat instead. Here’s a comparison of Cold Stone Creamery’s ice cream choices to drive home this point (note that these are calorie and fat comparisons of just the ice cream and not the insane amount of additional calories and fat that come along with the “extras” like waffle cones, cookies brownies, candy or whipped toppings):

1 small cup full-fat Cookie Batter Ice Cream: 380 calories, 11 grams saturated fat.
1 large cup full-fat Cookie Batter Ice Cream: 900 calories(!), 26 grams saturated fat.
1 small cup fat-free Raspberry Sorbet: 160 calories, 0 grams saturated fat.
1 large cup fat-free Raspberry Sorbet: 390 calories, 0 grams saturated fat.

So, the moral of the story is to enjoy your passion for summer ice cream treats but make your choices wisely most of the time. Go for the sorbets, fat-free and low-fat single scoops whenever possible, and your heart and waistline will surely appreciate it!

Do I Really Need A Daily Supplement?

2008-08-18T15:28:00.001-07:00

Q: Do I really need to take a daily supplement if my diet is diverse and healthy?

A: Americans love their supplements, with over half of us taking some type of dietary supplement daily. Is this a smart move? Although it is preferable to obtain all the nutrients our bodies require from consuming a healthy, balanced diet, the fact is, many of us fail to get in the 40-plus essential nutrients our bodies need on a daily basis. Therefore, as a safety net, I encourage people to eat a healthy diet first and if they so desire, to take an inexpensive multivitamin and mineral supplement containing 100% of the daily value for most vitamins and minerals.

That said, keep in mind a favorite saying among nutritionists: “A lousy diet with supplements is still a lousy diet.” No amount of vitamin popping will ensure good health unless you are eating a healthy, balanced diet. A supplement does not compensate for a poor diet and will not guarantee good health. A supplement should be just that, a supplement to a nutritious diet and a healthy lifestyle.

CARBS! It's What Fuels Michael Phelps's Olympic Fire

2008-08-15T10:32:00.000-07:00

In Wednesday’s (8/13/08) Sun-Sentinel, the reigning super Olympian and Boy Wonder Michael Phelps was asked about his dietary habits. His response was, “Lots of carbs.”
Phelps’ comment provides further evidence that carbs are truly the fuel of choice for the elite gold medal athletes among us. Which leads me to the topic at hand: that carbs have gotten a bad rap and it’s time to set the record (Olympic? world?) straight.
There are three types of macronutrients that supply energy (calories) for the human body: carbohydrates, fat, and protein. When it comes to eating for good health, it’s all in the balance, and “good” carbs should be the foundation of the diet, with a nice dose of added “healthy fats” and a smaller amount of lean protein. Carbohydrates are the most widely eaten food in the world and should comprise the bulk of any and all healthy diets, as carbs are truly the staff of life. Carbs supply quick energy for the muscles. Plus, if you eat the good whole-grain carbs, you get the added benefits of fiber, loads of vitamins and minerals, and tons of important phytonutrients (antioxidants and natural cholesterol-lowering phytosterols, for example). The best sources of “good” carbs are whole grains, fruits, vegetables, and beans.
So how much is enough? For the mere mortals among us (inactive or modestly active), carbohydrates should make up at least 50% of our total caloric intake. For the dedicated athlete (especially endurance athletes like swimmers, cyclists, and runners), carbs should make up at least 60% of their total calorie intake. Elite athletes are different. During peak training, elite endurance athletes often increase their carb intake to 70%, a necessary adjustment to give them the extra energy and nutrition required to train at an optimal level.
When my patients tell me that carbs are fattening, I always tell them to look at Lance Armstrong, who in the months leading up to the Tour de France routinely ate a 60% to 70% carbohydrate diet. If carbs make you fat, then why is he one of the leanest, fittest humans on the planet? Carbs are not fattening; too many calories, regardless of the source—excess carbs, fat, or protein—are what put on the pounds. So follow the lead of the great athletes among us: Eat a healthy higher carbohydrate, moderate fat, and protein diet and get that daily exercise in.

Does Cheese Really Bind Up Your Digestive System?

2008-08-11T16:36:00.000-07:00

Q: Do certain foods like cheese really bind up your digestive system, or is that just a story?

A: Cheese, and for that matter, dairy products, have gotten a bad rap lately with the common misconception that they “bind you up” and are generally unhealthy. The fact is, dairy is the leading source of bone-building calcium in the American diet and most Americans simply are not consuming enough dairy. This is a huge health concern, particularly for our children, because a lack of sufficient calcium in the diet during the crucial bone-building years—the teens and young adulthood—will result in failure to reach peak bone mass, which could predispose them to contracting osteoporosis later in life.

What’s more, calcium helps lower blood pressure, as shown in the famous DASH diet studies. Dairy contains lots more nutrition than just calcium. Filled with vitamin D (if fortified), vitamin A, riboflavin, B12 and protein, dairy is truly a nutrient-dense food. Most major health organizations recommend that all Americans consume three serving of dairy foods per day. I suggest going for the 1% or fat-free varieties to cut out the artery-clogging saturated fat that comes bundled up with full-fat dairy foods.

Certain people cannot consume dairy products because of a situation called “lactose intolerance.” These people either lack or have a reduced activity of the enzyme lactase, required to digest the milk sugar lactose. For these individuals, consuming dairy products can result in severe gastrointestinal symptoms. Lactose-intolerant individuals should know there are plenty of lactose-free dairy products on the market, as well as lactase supplements that would enable them to obtain nutritious dairy foods in their diet.

How Can I Get In Shape After Having A Baby?

2008-08-04T18:32:00.000-07:00

Q: How can I start to get back in shape after just having a baby?

A: One of the best ways to get back in shape after having a baby is to breast-feed. The physiological process of breast-feeding requires that a woman’s metabolic rate go into overtime as her body strives to produce milk to nurture her growing infant. This process requires an exorbitant amount of calories to sustain. If you combine breast-feeding with both a nutrient-dense, calorie-controlled diet (with enough calories to support lactation) and regular aerobic exercise (like taking the baby for long walks), you will surely be on the right track for getting back into shape and getting back your pre-pregnancy body.

If a woman decides not to breast-feed, she can still take a healthy approach to getting back into shape following the birth of her new baby. The extra fat that Mother Nature adds to a woman’s body to support her pregnancy can be taken off following the same general principles for all types of healthy weight loss: eat a healthy, balanced, calorie-controlled diet combined with regular exercise, and aim for a weight loss of no more than 1 to 2 pounds per week. There are registered dietitians who specialize in pregnancy, and I would highly recommend you consult with one to get on the right path. Go to www.eatright.org to find a registered dietitian in your area.

Supplements For More Omega-3s?

2008-07-28T18:42:00.000-07:00

Q: I don’t like fish but want to get more omega-3s. Should I look to diet or to supplements?

A: The best advice for getting in those ultra-healthy omega-3 fats is to first focus on getting them into your diet from FOOD sources. There are two types of omega-3 fats: the short-chain plant omega-3 called alpha-linolenic acid (ALA), and the long-chain varieties known as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are more physiologically active in the body. Ideally, you should aim for a daily serving of the plant omega-3 ALA and at least two servings per week of the long-chain varieties.

The best food sources of ALA include flaxseeds, walnuts, canola oil and green leafy vegetables. The best sources of EPA and DHA are fatty cold-water fish such as salmon, mackerel, halibut and herring. Since you don’t eat fish, you may want to consider taking a fish oil supplement. I would recommend discussing this with your personal physician. There is a prescription fish oil medication called Lovaza™ that I like because it is regulated by the FDA as a drug, so you know that what is described on the label is exactly what you are swallowing!

How Can I Tone Up "Fatty" Areas?

2008-07-22T17:59:00.000-07:00

Q: Since turning 50 I have noticed a fat accumulation around the inside of my knees, making my knees look "fat." I realize this may be due to my age, but I believe it doesn't have to be. Any suggestions would be greatly appreciated.

A: The bad news is that as we age, and with each passing decade, we lose more and more precious muscle mass and at the same time gain body fat. Where we gain fat tends to be genetically determined, so the fat accumulation around the inner knee happens to be one area where your particular body tends to store fat.

The good news is that there is a lot you can do to lessen the decline in muscle mass with age and tone up your inner knee area. The best type of exercise for hanging on to that nice, shapely muscle tissue is to get in regular strength training exercise—a minimum of two times per week for at least 20 minutes. A good program of muscle building exercises should include exercises that target the major muscle groups. There are plenty of muscle building and toning exercises that target the inner thigh and knee area. I suggest making an appointment with a certified personal trainer (you can find one in your area on either www.acsm.org or www.nsca-lift.org) and have them set you up with a good program. That said, you should also include a daily bout of calorie-burning aerobic exercise and combine that with a nutrient-dense, calorie-controlled diet to help you whittle away at extra body fat. Put this all together and you will be taking the best course of action for a lifetime of health and fitness.

Are Dried Fruits Just As Nutritious As Regular?

2008-07-14T17:39:00.001-07:00

Dried fruits have pros and cons associated with them. Dried fruits such as raisins are a highly nutritious and portable sweet snack. Filled with antioxidants, fiber, iron, potassium and selenium, raisins are a healthful alternative to sugary, empty calorie snacks. The downside of dried fruits is that they are dehydrated, so they have lost the bulk of water; hence, they are highly concentrated sources of calories and sugar. Considering that most of us are battling the bulge, eating the fresh fruit versus the dried is always a calorie-wise choice. Let’s make a few comparisons to drive home this point:

1 cup of grapes contains approximately 62 calories; 1 cup of raisins, 493 calories.
1 cup of blueberries contains 84 calories; 1 cup of dried blueberries, 480 calories.
1 cup of fresh pineapple chunks contains 82 calories; a 12-ounce package of dried pineapple, about 1,100 calories!

The bottom line is that dried fruits are a nutritious snack, especially if you’re on the go and need a quick source of energy. However, a piece of fresh fruit, such as an apple, is just as portable, more nutritious and a far better choice for weight control.

Is Working Out Safe For Children and Teens?

2008-07-07T17:47:00.001-07:00

Considering that being overweight or obese is now epidemic among our nation’s children, encouraging daily exercise as a means to help kids control their weight is extremely important. In fact, the American Heart Association recommends that children and teens get in at least 60 minutes of moderate to intense physical activity every single day as part of a healthy lifestyle.

If your question is specifically regarding the safety of strength training in children and teens, strength training can be a wonderful form of exercise for kids. It can provide numerous benefits such as strengthening their bones, improving their self-esteem and boosting their metabolism, to name just a few. But is it safe? The Council on Sports Medicine and Fitness recently published a policy statement in the journal Pediatrics that addresses this question (you can download the article in PDF form here). The take-away message is that children and teens can safely enjoy strength-training programs, provided they:

Have medical clearance from their personal physician.
Have strict supervision by certified personnel qualified in pediatric strength training, to ensure proper technique.
Avoid any potentially unsafe maneuvers such as maximal lifts.
Include warm-up, cool-down and proper nutrition (including hydration).
Begin with no resistance until proper technique is learned.
Follow a general strength-training regimen that addresses all the major muscle groups.

To sum things up, a strictly supervised program of strength training using lighter weights and controlled movement is a safe and beneficial recommendation for kids and teens that may just provide the fuel for a lifetime of better health and fitness.

Have medical clearance from their personal physician.
Have strict supervision by certified personnel qualified in pediatric strength training, to ensure proper technique.
Avoid any potentially unsafe maneuvers such as maximal lifts.
Include warm-up, cool-down and proper nutrition (including hydration).
Begin with no resistance until proper technique is learned.
Follow a general strength-training regimen that addresses all the major muscle groups.

What Are Prebiotics and Should I Consume More?

2008-06-30T19:15:00.001-07:00

“Prebiotics” are a food ingredient that humans are not capable of digesting (soluble fiber), yet they keep the existing strains of “friendly bacteria” in the colon healthy. Inulin is a type of plant fiber that is not digestible in the human intestine and is considered a prebiotic. Inulin is isolated from vegetables or fruits. Inulin is commonly added to low-fat foods to help promote a “fat-like” mouthfeel, providing a better taste and texture. It is fermented in the colon by friendly bacteria that produce short-chain fatty acids, which have notable health effects. Additional food sources rich in prebiotics are asparagus, oatmeal, barley and many types of beans.

Thus, prebiotics nourish the “good guys” and promote their growth and survival. Keeping the “good” bacteria healthy and well fed has beneficial effects, namely, encouraging the existing healthy bacteria to multiply so that they can overpower the “bad” disease-promoting, harmful bacteria strains.

Why, then, is it good for your health to increase the number of these bacteria (by ingesting them in food) and feed them with prebiotics to keep them happy? Because good bacteria:

Overpower bad disease-causing bacteria.
Help boost the body's immune system.
Help the body absorb vitamins and minerals and increase the body's internal production of B vitamins.
May help bone health by increasing the absorption of calcium and the ability of the bones to absorb calcium.

Note that prebiotics differ from “probiotics.” Probiotics are actual live “healthy” bacteria added to the diet, and they promote health; prebiotics feed the probiotic bacteria. Common names of these healthy probiotic bacteria that are added to foods and reside in the colon are Lactobacilli and Bifidobacteria (this strain is included in Dannon Activia® yogurt). Should you try and get both pre- and probiotics into your diet? More and more scientific evidence is emerging suggesting that ingesting the good bacteria and their food has beneficial health effects. So, eat your yogurt and your fiber and enjoy better gastrointestinal health.

Why Is Running On a Treadmill Easier?

2008-06-23T17:22:00.000-07:00

Q: Why does running on a treadmill seem easier than running on the road or on a track?

A: There are definite pros and cons that go along with using the “mill” for training.

You are right: running on a treadmill is easier (physically) than running outside because you are being propelled by the treadmill belt, a padded moving platform, and you are not running against any wind resistance. What’s more, treadmill running is weatherproof, so you can exercise in a controlled climate without concern for heat, humidity or frigidity.

While it may be easier on you physically, mentally it is a different story. Let’s face it, running like a hamster round-and-round on a wheel for long periods of time can be quite monotonous! Treadmill running is much more difficult psychologically than outdoor running due to the lack of visual distractions as well as variety in terrain. I generally recommend that those individuals training for an upcoming road race spend the bulk of their training outdoors on the road to acclimate to the environment as well as the twists and turns of the road and the variable terrain.

Is a Liquid Diet (Such as “Juicing”) Safe?

2008-06-16T18:08:00.000-07:00

Q: Is a liquid diet (such as “juicing”) safe?

A: I am not a big proponent of “juicing” or any other type of liquid diet. I especially object to the false or misleading claims that frequently accompany these unproven and potentially dangerous nutrition tactics. Oftentimes juicing regimens are linked with the concept of detoxification, or “flushing the body of toxins.” What’s more, detox diets sometimes advocate additional techniques such as laxatives and enemas to help “cleanse” the intestinal tract. The premise that toxins build up in our bodies and that we need to cleanse our bodies by resorting to fasting or juicing regimens to get rid of them provokes fear in people and is simply not supported by scientific evidence. In fact, the body has its own built-in cleansing systems—namely, the liver and kidneys—that specialize in rounding up toxins for excretion in the urine and stool.

That said, juice does have many redeeming qualities (some are loaded with vitamins, minerals and disease-fighting antioxidants) as long as they are consumed in small amounts as an addition to a healthy whole foods diet. Concord grape juice, pomegranate juice and orange juice (with added calcium and vitamin D) are a few of the highly nutritious juices out there that top my list. Just remember, though, juices concentrate the calories; one 8-ounce glass of OJ contains 110 calories and 0 grams of fiber—that’s the calorie count of two small oranges, which provide a total of 6 grams of dietary fiber! So don’t make those juice glasses a bottomless pit or you’ll pay at the scale.

The take-away message: NOTHING beats the nutritional benefits of eating a plant-based diet filled with whole fruits and vegetables, whole grains, lean protein and healthy fats. Add daily exercise to the mix and you have the secret for good health and longevity, a benefit that no liquid diet could possibly provide.

How Can I Build Muscle Tone In My Arms?

2008-06-09T20:01:00.000-07:00

Q: What can I do to build muscle tone in my arms?

A: The best thing you can do to firm up those arms and get rid of that extra underarm “jiggle” for swimsuit season is to get yourself right over to the nearest gym (or you can even do these exercises in the privacy of your own home) and start a regular program of building and toning strength-training exercises. For the arms, you will need to work on the muscles in the back of your arms (those out-of-shape triceps) and the muscles in the front (the “Popeye” muscles, or biceps). You can tone those muscle groups using gym equipment (or makeshift equipment from your own home). Some great exercises that target the triceps are triceps pushdowns, bench dips, triceps kickbacks and plain old push-ups. Exercises that target the biceps generally involve “curls,” using dumbbells, barbells or even heavy soup cans from your pantry.

That said, keep in mind that there are two separate types of tissue: fat and muscle. The best way to keep those arms looking lean and shapely is to take a two-pronged approach: lose the fat and put on and tone up the muscle. Losing body fat involves combining regular calorie-burning aerobic exercise (such as walking or running) with a calorie-controlled diet. Adding and toning muscles requires a regular program of strength-training exercises. Start putting it all together now, and before you know it you’ll be ready for summer looking healthy and fit!

How Can I Shake the Salt Habit?

2008-05-26T16:57:00.000-07:00

Q: I know too much sodium is bad for me, so are there any alternatives I can cook with that will add a similar flavor boost and be healthier for me?

A: You are absolutely right—we eat far too much sodium in this country, and cutting back on sodium intake is a wise nutrition move. In fact, the American Heart Association dietary and lifestyle recommendations suggest we keep our intake of sodium under 2,300 mg per day (that’s the amount of sodium chloride found in about 1 teaspoon of salt) and under 1,500 mg for middle-aged and older adults, African Americans and those with diagnosed hypertension. Why worry about getting in too much salt—even if your blood pressure is normal? A high sodium diet has been linked to excessive loss of calcium from bones, an increase in kidney stone formation, reduced vitamin D and an increased risk of stroke, to name but a few of the adverse health effects linked to sodium overload.

Here are a few tips to help you shake the salt habit:

Most of the salt in our diet comes not so much from the salt shaker but from processed and restaurant foods. Therefore, make an effort to choose less processed, natural whole foods. Be sure to read the nutrition facts label with the knowledge that 2,400 mg/day is your upper limit.
If you dine out frequently, order the least processed menu options and add your own seasoning at the table. A salad bar is a great way to start your meal with a splash of heart-healthy olive oil, balsamic vinegar and a touch of lemon juice . . . and practically salt-free (but beware of pre-made salad dressings—notoriously high in salt).
When cooking, learn to cook salt-free by using antioxidant-rich herbs and spices to give your food a surefire flavor boost. One of my favorite ways to flavor vegetables like broccoli or spinach is to sauté fresh garlic in extra virgin olive oil; add in the vegetable, then sprinkle with a touch of fresh lemon juice, yum! Dill is another one of my favorite herbs. I chop fresh dill and garlic, spread it on salmon and roast until done. Sprinkle with fresh lemon juice and you’ll never miss the salt!

Why Are Nuts Important In a Woman’s Diet?

2008-05-19T17:00:00.000-07:00

Q: Why are certain foods like Brazil nuts important in a woman’s diet? What are some others?

A: It is important for all women to eat a heart-healthy diet to protect themselves against heart attacks and stroke (cardiovascular disease)—the leading cause of death and disability in American women—and nuts are a highly nutritious, heart-healthy food that should be a daily addition to one’s diet. Nuts contain a treasure chest full of nutrients such as protein, fiber, antioxidants (such as vitamin E and selenium), cholesterol-lowering plant sterols, and “good” fats such as the omega-3s and monounsaturated fats.

One caveat regarding nuts is that nuts are not created equally. The FDA has allowed a heart health claim for only seven types of nuts: almonds, walnuts, hazelnuts, peanuts, pecans, pistachios and some pine nuts. This is because these nuts all contain less than 4 grams of saturated fat per 50 grams of nuts. Notice that Brazil nuts did not make the cut. Brazil nuts are a nutritious food, exceptionally high in selenium and magnesium, but are also among the types of nuts that are high in saturated fat. Saturated fat is the most potent cholesterol-raising substance in our diet, so we need to cut way back on our intake. Thus, these nuts would not be your best bet.

Just remember not to go too nuts for nuts, as they are a very concentrated source of calories (due to their high fat—albeit good fat—content). Try and get about 1.5 ounces of nuts (about a handful) daily from one of the “magnificent 7” to help keep the cardiologist away!

How Can I Prevent Cramping While Exercising?

2008-05-13T03:43:00.000-07:00

Q: How can I prevent cramping while exercising?

A: No doubt about it, muscle cramps hurt! So what are they and how can we prevent them? A muscle cramp (aka a “charlie horse” if it occurs in the leg) is an involuntary, sustained and forceful muscle contraction that can last a few seconds to what seems like a lot longer! Skeletal muscles are the type of muscles that are most likely to cramp, with calf, thigh and muscles in the arch of the foot as notoriously common spots. Although the exact cause of muscle cramping during exercise is unknown, four major contributing factors have been identified:

Dehydration.
An imbalance in the electrolyte level of the body fluids (most notably sodium and potassium).
Lack of a proper warm-up and cool-down.
Muscle fatigue.

The best way to prevent muscle cramps is to prevent the four major contributing factors:

Drink lots of fluid before, during and after your workouts. A good rule of thumb to determine how much fluid to drink during your workout is to gauge your “sweat rate” and try to match fluid loss with fluid intake. There are calculations to determine your exact sweat rate, with the average person losing roughly 25 to 50 ounces of sweat per hour. Drinking at least 8 ounces of fluid every 15 minutes would cover you if you lose approximately 32 ounces of fluid per hour.
Eat a healthy plant-based diet naturally rich in potassium (bananas, potatoes, papayas and spinach are all high-potassium foods), and do not restrict sodium in the diet directly before a long exercise bout in the heat.
Make sure to warm up before exercising by performing a slow version of the same exercise that you will be doing during your exercise bout, and cool down by decreasing intensity until your heart rate returns to normal
Follow a regular aerobic exercise training program, gradually increasing in intensity and duration from week to week, which is the best way to train your muscles to resist fatigue.

Diet or Fitness to Moderate High LDL?

2008-05-05T19:28:00.000-07:00

Q: I am in my early 30's and was told by my primary care physician that my LDL cholesterol level was a little too high, but not at risk. Should I focus more on my diet or my fitness level to moderate my LDL?

A: Great question, as this is a topic very dear to my own heart! Considering that cardiovascular disease (CVD), which includes heart disease and stroke, is far and away the leading cause of death and disability in American men and women (killing as many people each year as all forms of cancers, lung disease, diabetes and accidents combined), it would behoove all Americans, young and old, male and female, to live a heart-healthy lifestyle. This involves fine-tuning both your diet and your exercise habits, which together favorably impact your LDL, or “bad,” cholesterol level.

The first step in preventing CVD is to sit down with your personal physician and assess your risk factors. LDL cholesterol is the most established risk factor for CVD. You and your doctor will come up with your personal LDL goal, as your LDL goal really depends on your risk status: the higher your risk, the lower your goal. According to the American Heart Association, the “optimal” goal for LDL cholesterol—for the prevention of heart disease—is less than 100 mg/dL. An LDL of between 100 and 129 mg/dL is defined as “near or above optimal.”

If your LDL is too high, what should you do? Because lifestyle changes (diet and exercise) remain the foundation for cardiovascular disease prevention and cholesterol control, the answer to your excellent question is to focus on both diet and exercise to lower your LDL cholesterol level. In my book, Cholesterol DOWN, I provide a simple diet and exercise plan that includes nine “miracle foods” and 30 minutes of walking a day that can lower your LDL cholesterol by as much as 47% in just 4 weeks.

Is the Acai Berry as Good as They Say?

2008-04-28T17:08:00.000-07:00

Q: I have heard about the ORAC value of the açaí berry. Is it as high in antioxidants as they say?

A: ORAC, short for “oxygen radical absorbance capacity,” is a chemical test scientists use to measure the antioxidant potency of a particular food. There are actually a variety of tests that scientists can use to test the antioxidant capacity of foods. What must be understood, however, is that the antioxidant capacity of a specific food determined in the lab does not necessarily translate to the antioxidant capacity of that food in the human body. That said, to strengthen our body’s defenses against highly destructive free radical damage, we should try to eat a variety of plant foods (high on the ORAC scale) daily. The easiest way to do that is to consume a rainbow of colors throughout the day. In 2007, scientists at the USDA published a list of ORAC values for 277 foods. Some of the foods highest on the USDA ORAC scale include red wine, English walnuts, oregano, cocoa and gingerroot.

The açaí (pronounced ah-sigh-EE) berry is the fruit of a type of palm tree (Euterpe oleracea) that grows near the Amazon River of Brazil. Açaí is consumed in beverages and food products, and yes, it has been found to exhibit an exceptional antioxidant capacity in the lab. A recent study, published in the Journal of Agricultural and Food Chemistry (Seeram et al., 2008), ranked the antioxidant potency of several commonly consumed beverages in the United States. Pomegranate juice led the pack followed by red wine > Concord grape juice > blueberry juice > black cherry juice > açaí juice > cranberry juice > OJ, iced tea and apple juice.

The bottom line: don’t be misled by claims of one particular food’s superior antioxidant activity, which may or may not be based on accurate testing. Eating a variety of antioxidant-rich foods, on a daily basis, is your best strategy for harnessing the disease-fighting antioxidant potential of the mighty plant kingdom.

What Are Some Healthy Breakfast Ideas?

2008-04-23T17:46:00.000-07:00

Q: What would be some alternatives for a healthy breakfast rather than my regular bowl of whole-grain cereal?

A: Nothing beats a bowl of whole-grain oatmeal for breakfast, the first step in my 10-step Cholesterol DOWN plan. I would say that eating a bowl of oatmeal made with light soy milk, some ground flaxseeds and maybe some cranberries and topped off with chopped almonds is about as good as it gets for starting the day off right. That said, if you are tired of the same old whole-grain cereal for breakfast, then why not try something new? After all, variety is the spice of life! I have some excellent, heart-healthy breakfast recipes in my book, Cholesterol DOWN, that you might enjoy.

How about Mia’s veggie omelet (named after my daughter Mia)? It is made with egg whites, lots of colorful veggies and topped off with a touch of soy cheese. Serve it up with 100% whole-grain toast spread with some plant sterol-containing margarine and you have a delicious breakfast that provides you with antioxidant-rich vegetables, soy protein and whole grains—and it lowers your cholesterol, too. Another breakfast favorite of mine that I often make for my own family on Sunday mornings is almond oat pancakes. Made with oatmeal, almonds, flaxseeds and soy milk; spread with plant sterol-containing margarine; sprinkled with powdered sugar; and served with warm Vermont maple syrup . . . these pancakes are delicious, nutritious and contain 5 of the 10 cholesterol-lowering steps in my book. It doesn’t get much better than that!

How Often Should I Workout?

2008-04-14T19:13:00.000-07:00

Q: Is it better to work out more days per week for shorter intervals or fewer days per week for longer intervals?

A: The answer to your question really depends on your personal preference and the type of exercise. When patients ask me what’s the best kind of exercise, my answer is always: “Whatever type of exercise that you will do on most days of the week.” In a nation of couch potatoes, suggesting that people find whatever kind of exercise works for them is sound health advice.

Major health agencies such as the Centers for Disease Control and Prevention and the American College of Sports Medicine (ACSM) recommend that for good health and to reduce risk of chronic disease, adult Americans should participate in moderate-intensity aerobic (or cardio) exercise (such as brisk walking) for at least 30 minutes on 5 or more days of the week or vigorous-intensity cardio at least 3 days of the week. So the frequency really depends on the intensity that you choose to gauge your exercise bout. What’s more, research has shown that the 30 minutes can be cumulative, meaning it will be just as effective if you choose to divide the 30 minutes up into 10-minute bouts.

Aerobic exercise is not the only type of exercise that you need to try and fit in. The ACSM also recommends weight training exercise (8 to 10 different exercises and 9 to 12 repetitions of each exercise) 2 days a week. Weight training exercise is essential for enhancing muscular strength and endurance, helping to prevent the decline of muscle mass (and metabolic rate) that accompanies aging, and promoting bone health.

Get Active at Work

2008-04-07T16:37:00.000-07:00

Q: I work on a computer all day. Are there exercises I can do while working at my desk?

A: Unfortunately, with the advent of modern technology, and as a side effect of living in a high-tech world, comes the sad fact that this advancement comes at a price—it makes our workday conducive to a sedentary lifestyle. The danger in living a sedentary lifestyle is that it predisposes us to creating a caloric imbalance on the calorie expenditure side of the equation. If we expend too few calories on the physical activity side of the equation and overconsume too many calories (a simple task in our high-calorie, high-fat convenience food world) on the calories side, then we gain weight. The lack of enough physical activity is what many health professionals believe is partially responsible for the obesity epidemic in our nation today.

Consider that most Americans are completely sedentary throughout their day. We work sitting at a computer all day; we sit in traffic while driving to and from work and perhaps even driving through the restaurant take-out window for meals; after work we head for the couch, where we sit in front of the TV for relaxation or again at our computers; and then it’s off to sleep. Keep in mind that these are all completely sedentary activities. For better health and weight control we must combat this sedentary behavior by making an attempt to get in some calorie-burning physical activity in our day somewhere, somehow. Thus, your question is a very important one because Americans must learn to become more physically active.

Here are two suggestions for fitting in more physical activity into your day. First off, wear a pedometer (clip it on first thing in the morning and take it off last thing at night) and see how many steps you get in daily. America On the Move Foundation is a national nonprofit organization designed to improve the health and quality of life of Americans. They suggest adding in an extra 2,000 steps to your daily routine to get you on the road to health and fitness. Second, when at your computer, make it a habit to get up and stretch, walk around the room for at least 5 to 10 minutes every hour. Taking a short break and logging in 200 steps every hour would almost give you the extra 2000 steps the America On The Move Foundation recommends.

Nutritonal Value of Lettuce and Pickles

2008-04-02T03:24:00.000-07:00

Q: Is it true there is little to no nutritional value in some vegetables such as lettuce or pickles?

A: When it comes to lettuce, a little color goes a long way. It is true that iceberg lettuce is pretty low on the totem pole regarding nutrients. Let’s compare a cup of shredded iceberg lettuce to, say, 1 cup of spinach and see which one stacks up better:

Iceberg lettuce: 10 calories, 7% of the daily value (DV) for vitamin A, 3% DV for vitamin C, 2% DV for iron, 1% for calcium.
Spinach: 7 calories, 56% of the daily value (DV) for vitamin A, 14% DV for vitamin C, 5% DV iron, 3% calcium.

So you can see, spinach gives you a much greater nutrient bang for your calorie buck. This is what good nutrition choices are all about: filling your daily calorie quota with the most nutrient-dense foods.

The beauty of pickles is in regard to weight control because they are very tasty and very low in calories. However, they do pack a sky-high sodium count. One large dill pickle, for example, contains a mere 16 calories and zero fat and cholesterol BUT unfortunately will also give you half of your day’s sodium allowance (a whopping 1,181 mg) in just a few bites. According to a recent report form the World Health Organization, there is strong evidence of a link between excessive sodium intake and the development of chronic disease (especially high blood pressure, a major risk factor for heart disease, the leading cause of death in the U.S.). The report recommends that governments around the world institute guidelines to reduce sodium consumption to 2,000 mg per day, or about half of what the typical American consumes.

The Benefits of a Vegetarian Diet

2008-03-24T16:53:00.000-07:00

Q: Is there a risk to going vegetarian after 28 years of not? What about going vegan?

A: No doubt about it, going vegetarian is a smart move, as vegetarians have a reduced risk of chronic disease and are at much less risk for obesity. It’s never too late to switch over to a plant-based diet and begin to reap the phenomenal health benefits associated with this pattern of eating. According to the American Dietetic Association, “appropriately planned vegetarian diets are healthful, nutritionally adequate and provide health benefits in the prevention and treatment of certain diseases.” The key here is to note the words “appropriately planned,” for eating the vegetarian way does take some homework.

Let’s begin by defining what a vegetarian is. There are actually many different types of vegetarians. The general definition of a vegetarian is a person who does not include meat, fish or fowl in their diet. A lactovegetarian includes dairy, a lactoovovegetarian includes dairy and eggs, and a vegan abstains from eating or using all animal products and is the strictest kind of vegetarian. Newer versions of vegetarianism have evolved including flexitarians, loosely defined as individuals who eat a mostly plant-based diet but may occasionally eat small amounts of meat, fish or chicken. Then there are pesco-vegetarians (such as myself) who eat a mostly plant-based diet and choose to include a small amount of fish in their diet.

Keep in mind that since vegan diets are the most restrictive, if you choose to follow that diet, you must plan your diet carefully to include adequate amounts of protein, iron, calcium, vitamin B12 and the long-chain omega-3 fatty acids EPA and DHA. As with all types of diets, eating a large variety of whole foods, grains, fruits, vegetables, legumes, nuts and seeds is the best strategy for obtaining all the nutrients required for good health. For more sound nutrition information on eating the vegetarian way, go to the Vegetarian Resource Group (a nutrition practice group of the American Dietetic Association).

The Power of Antioxidants

2008-03-17T17:37:00.000-07:00

Q: What exactly do antioxidants do and what are some great food sources?

A: Antioxidants counter the excessive production of small, highly reactive molecules in the body called reactive oxygen species (ROS). These ROS are byproducts of normal human metabolism and include both free radicals and nonradicals. ROS are capable of damaging delicate cells, especially DNA, our cells’ genetic blueprint. When the production of ROS exceeds the body’s antioxidant capacity, premature aging and the development of chronic diseases is accelerated. Thus, a large intake of antioxidants (consumed in food) theoretically would help the body fight DNA damage and oxidative stress, factors involved in disease development.

The total antioxidant power of foods is measured by the Oxygen Radical Absorbance Capacity (ORAC). According to a study by the USDA, some of the foods highest on the ORAC scale include black and red beans, blueberries, strawberries, Granny Smith apples, pecans and cranberries.

A plant-based diet filled with colorful fruits, vegetables, nuts, legumes, beans, whole-grains and olive oil will virtually guarantee you a huge array of health-promoting antioxidants. Plant foods are not only rich in antioxidants but also vitamins, minerals, dietary fiber and polyphenols, additional factors that confer numerous health benefits, most notably protection from disease. So when it comes to antioxidants, color generally indicates concentration. Make an effort every day to harness the power of plant antioxidants by coloring your plate with dark, deep hues of green, purple, orange and blue. And remember, when it comes to antioxidants, more color = more health!