Monthly Archives: February 2016

Seven Minutes of Fitness During Unfit Weather

Winter is not an easy time, and complaints about the weather are truly justified. Dreadful cold, snow, ice, and wind are afflicting most of the country, along with unseasonable thunderstorms, torrential rains, and tornados. Even though spring (on the calendar) is about five weeks away, there is no guarantee that conditions will improve quickly by the middle of March.

One consequence of the perverseness of the weather is its effect on exercising outside. Going for a run, biking to work or for recreation, snowshoeing or skating, playing golf or tennis become almost impossible when temperatures and wind chill cause frost bite, or the heavy rains turn sidewalks into rivers. 

Exercising inside may be possible only if one has equipment at home or as part of an apartment complex or office building. Health clubs, even a few blocks from work or home, may be impossible to reach when weather conditions are disastrous. Those whose first response to bad weather is to think longingly of going back to bed may consider the inaccessibility of a place to exercise as irrelevant.  In fact, it may be looked upon positively, i.e. “No one will nag me about working out if we are told to stay home because of weather conditions.”

But there is an alternative to becoming a weather-related couch potato: exercise apps. These are available to anyone who owns a smartphone and/or a computer, most are free, and those that have to be paid for cost considerably less than the daily cost of a gym membership.  Moreover, most require nothing more than a carpeted floor (to prevent sore elbows and knees) and perhaps a low stool. One free and popular option is the, ‘Seven Minute Workout.’ This is exactly a seven-minute combination of aerobic exercise and muscle building moves that leave the heart pounding and the lungs seeking air. The very fit can move onto the advanced version, which as described in a New York Times review is torture but only seven minutes of torture and probably not as bad as having a cavity filled without Novocain.

“Sounds easy,” I thought to myself while researching exercise options for this article as I downloaded the beginner’s version on my smartphone. Warning: If you are one of those people who read directions only after you try to turn on a computerized version of a washing machine or the audio system in your new car, don’t do the same with the exercise program. For one thing, one exercise in the beginner’s version of the seven-minute workout requires standing and stepping down from a medium height chair or stool. The one chair without wheels in the room where I was trying out the program did not look sturdy enough for bouncing up and down on it with one leg and then the other. By the time I tentatively tried it, that exercise was over. Yoga and Pilates participants will be familiar with most of the positions but for those who think a plank is a long and narrow piece of wood, being told to get into the plank position for 30 seconds may seem bizarre. And while I can do push-ups fairly easily (a long stint on crutches a few years back strengthened my upper arms), single arm push-ups were beyond me even in this beginner’s exercise routine.

But if I had read the directions before starting the program I might have fared better. There are several videos that slowly and carefully demonstrate how to do the exercises and better yet, show options for those whose fitness levels are similar to the cushions on which they usually reside. Moreover, it is important to remember, as I reminded myself, that this is not a competition and unlike doing these moves in a class where everyone else seems more adapt and fit, no one can see me.

The limitation of such a brief but intense exercise program is that the aerobic component is very short but there is no penalty for continuing running in place, for example, for longer than the 30 seconds or so on the program. Adding stair climbing or jump roping or running around the cellar with a toddler or puppy will also increase the cardio-workout component. 

But the best thing about the indoor exercise option is its brevity. You may moan and groan at some of the exercises, especially when weather enforced immobility has left you stiff and short of breath.  But by the time you decide that maybe it was a mistake to attempt to exercise, the program is over.

Seven minutes of vigorous movement each day is less than accepted standards for daily exercise. Study after study has pointed to thirty minutes of physical activity three or four times a week as being the minimal amount of movement we should be doing to keep our physical and mental health from deteriorating. On the other hand, any exercise is better than none. And the relentless pace of the seven-minute workout may increase stamina faster than a slow stroll through an indoor shopping mall or around the block.

Now if someone could adapt this program so it could be used while standing in a long line at the supermarket, on a commuter train, or during those pesky endless commercial breaks, we all will be in great shape, regardless of the weather.    

Can You Cure Obesity, Migraines and Even Depression By Drinking Carrot Juice?

Walking my dog in my neighborhood, I pass a sandwich shop specializing in Cuban sandwiches. In good weather people perch outside on stools next to high tables and happily munch on loaves of toasted bread , almost as long as my dachshund. He stands near the table hoping to catch a few drips from the sliced pork, ham, mayonnaise, melted butter, melted cheese and pickles layered between white doughy bread.  Often the diner is also munching on French fries and drinking a sugar filled soft drink. Obviously the restaurant is not exactly a testimonial to nutritional dining.

Yet yesterday a poster appeared on one of the windows advertising juices that would confer upon the diners health and maybe even longevity.  Various drinks made of different combinations of vegetables and some fruits were now available.  Celery, carrots, spinach and something leafy, maybe kale, were pictured on the sign and underneath descriptions of the remedial benefits of various vegetable combinations .Suffer from migraines? A combination of carrots, celery, spinach and ginger will take away the pain. Depressed? Drink blended spinach and carrot. Cancer will disappear after having a beverage made from apple and carrots, and if several of the sandwiches have left the diner obese?  Well the restaurant has just the beverage: grapes, apple, lemon, ginger, carrot, celery and tomato. (V-8 anyone?)

The developers of dietary guidelines will be happy to see these vegetables/fruit concoctions offered at this restaurant.  The only green vegetable available until the appearance of this vegetable juice was the pickle, and there were only three or four thin slices in a sandwich. These were hardly enough to qualify for the 5 vegetable servings we should be eating each day.  Thus customers who choose to drink liquefied vegetables will be consuming vitamins and minerals not available, obviously, in a high fructose soda.

The potent health effects of drinking  blended vegetables and fruit has been advertised  for years, and usually the list of ‘cures’ go far beyond those I have described. Most do not promise relief of baldness as one of the promised outcomes, but in a nearby juice bar, the list of therapeutic benefits takes up two columns in a wall to ceiling display.  And given the popularity of these juice bars, people must be consuming juices for more than their taste.

 But really, would anyone come into this sandwich shop or a juice bar to seek relief from a variety of serious illness? Are they mistaking the restaurant for an urgent care facility?  Is it possible that someone walking by suffering from a migraine or having been diagnosed with cancer will read the poster’s claims for the juices and says to themselves, “I must have one of those drinks.  It will make me healthy again!”

The proliferation of vegetable-fruit blended juices in such restaurants and juice shops touting health benefits does not seem to fall under the scrutiny of local public health officials, the FDA or the Federal Trade Commission. (Indeed given the limited resources of municipal public health departments, it is probably more important that inspectors check for rodent infestation than evidence that celery juice will help migraines.)   Usually government agencies such as the  FDA become involved in the claims made for products only when national sales of a product are great enough to  affect a large number of buyers and/or the product contains ingredients with dangerous side effects .

Drinking blended juices does confer health benefits just not the ones touted on the posters in restaurants and juice bars.  Carrots and spinach are a good source of vitamin A, a vitamin necessary for the retina, cornea, and membranes of the eye to function optimally.  Folic acid works with another vitamin B12 in the production of red blood cells and is critically important in preventing a neurological defect, spina bifida, in the developing fetus.  Juices that contain broccoli, Brussel sprouts, spinach, peas, asparagus, or liver will be excellent sources of this vitamin.  (You don’t have to drink the liver.)

Vitamin B3, or niacin, a critically important vitamin for metabolic functions, is best found in white or sweet baked potatoes, but those are rarely blended or mashed into a drink.  Jerusalem artichokes and shiitake mushrooms are also good sources, but not likely to be eaten on a daily, or even monthly schedule. Peaches, oranges, and grapefruit are also good sources and happily, these fruits do make their way into blended drinks.

Vitamin C is usually abundant in blended juices because citrus fruits, strawberries, papaya, spinach, broccoli, and blueberries contain this vitamin. This vitamin multi-tasks in the body as it is involved in the production of collagen, helps the body absorb iron, participates in wound healing, and acts as an anti-oxidant. Few people are insufficient in this vitamin unless they scrupulously avoid fruits and vegetables and/or smoke; smoking cigarettes lowers vitamin C levels in the body. Going on long sea voyages with only salt pork and bread to eat also decreases vitamin C levels, but this is a scurvy joke of yore.

And there are countless other benefits to the body from drinking, or even chewing vegetables and fruits; this is why we are urged to eat several servings from a variety these food groups daily. Not doing so over several months may cause nutritional deficiencies and decrease the body’s ability to function optimally. But, and this is where science and juice poster claims part company; carrots, celery, spinach, ginger and apples are not a cure for anything except nutritional deficiencies. An apple a day is not going to keep the doctor away if one is suffering from depression or migraines or cancer. On the other hand, eating perfectly ripe sweet strawberries or handfuls of sun-warmed blueberries can be a joyous experience, and its memory may be able to beat back the depression from a cold, gray winter day. 

 

Shrinking Into Obesity

A close friend came back from her annual physical agitated and anxious.

“I’m fat!” she wailed. “According to the doctor, my BMI is 29!”

“Wait a minute,” I remonstrated, “How can that be? You told me only a few days ago that you rarely go clothes shopping since you are wearing the clothes you bought years ago, because you like them more than the clothes in the stores these days. How can you fit into these same clothes if you are suddenly fat?”

“But that is what the chart said. And if my BMI increases, I am going to be morbidly obese.”

I looked at her. I have known her for years, and her size has always been the same with one difference: I was looking down at her, and she used to be taller than me.

“Uh, did your doctor tell you how the BMI is calculated?” I asked.

“It has something to do about my height and weight. I was so upset, I didn’t pay much attention.”

“OK. I think I know why your BMI is in the fat range.” I told her. “Did the doctor measure your height? Have you shrunk?”

I was right. She lost two inches from her 5’4″ height over the past 18 months, a considerable loss, but not unusual for a woman of over 70.

“Open the calculator on your phone so you can figure out your BMI yourself. You will see why your height is making it appear as if you are fat.”

She weighed 131lbs and her height in inches was 62. She calculated her BMI by:

1. Squaring her height in inches (multiplying her height 62 by itself);
2. Dividing her weight, 131 lbs, by 3844, her height squared; and then
3. Multiplying that number by 703.

Her BMI was 23.9.

“You are not in the fat category,” I told her after checking BMI charts on several internet sites. “You would have to have a BMI of 25 to be considered obese. But anyway, that is not the point. Your BMI went up because of changes in your height, not weight. You may have to have your clothes shortened, but certainly not widened.”

After she left, feeling a little lighter in spirit (pun intended), it occurred to me that the BMI is certainly an unreliable measurement for people whose height changes due to age, or orthopedic problems that cause that they be bent over, or have spinal fusion. Shrinking into obesity is not the same as gaining weight without losing height.

Should measures other than the BMI be used to determine obesity?

Another common measurement of obesity is the waist/hip ratio. This is considered to be a good indicator of fat, especially around the mid-section and should not be affected by loss of height. I emailed my friend these instructions:

1. Measure your waist circumference. Locate your upper hipbone and put a tape measure (cloth, not metal) around your bare stomach just above the bone. Don’t squeeze the skin and breathe out while measuring.

2. Measure your hip circumference. This requires looking in the mirror and locating the widest part of your hips. Put the tape measure at this point and measure around your body.

3. Divide the waist circumference by the hip measurement.

I sent her the chart of waist-to-hip ratio data for men and women, in case her husband was curious about his own measurements.

The chart is simple. A 0.95 or below waist-to-hip ratio for men, and 0.80 or below for women, is considered normal and low risk for obesity-related disease like diabetes.
A ratio of 0.96-1.0 for men and 0.81-0.85 for women is considered a moderate risk. Above that, individuals are at high risk.

She did the calculations and was pleased to note that she was at a low risk but her husband was starting a diet.

The anxiety and concern my friend experienced when told she was obese (according to her BMI) could have been avoided by asking some obvious questions: Has your weight and clothing size increased during the past year? Certainly if the answer had been yes, then the BMI chart or waist-hip ratio measurements would have been useful to see whether she was hovering close to the obesity line.

Moreover, if her weight had decreased (so it appeared that it compensated for her diminished height), it would have been an oversight to ignore the reasons for the lower weight. She might have lost it dieting or through increased exercise. But what if she had lost weight due to a loss of muscle mass and not fat? The BMI chart would show her in a healthy weight category but a shrinking muscle mass would put her at risk for osteoporosis and falling due to lack of muscular strength. Models, for example, whom are forced to live on semi-starvation rations to look two-dimensional in photographs, may have envious BMI scores. But these scores do not reflect their scrawny muscles and fragile bones.

Lesson learned? Charts are useful, but should never replace common sense and simple observation.

“Oprah, I Told You So!”

She wouldn’t remember. Why would she? It was at least 15 years ago since I appeared as the only guest on her afternoon television program, discussing the benefits of carbohydrates on mood and controlling appetite. After I wrote a book on how nutrients can influence mental performance and mood, one of her many producers asked me to be on her show. We discussed our mutual craving for carbohydrates in the afternoon, and when asked for snack suggestions that would be diet appropriate, I mentioned baked sweet potatoes, popcorn, and toast and jam. The sweet potatoes and bread appealed to her. She understood immediately the connection between eating carbohydrates, increased serotonin levels in the brain, a better mood and decreased appetite. (She is a very smart woman.)

But alas, my advice to her was soon lost, smothered under a steamroller marketing campaign to promote high-protein, low-carbohydrate diets.  A movement to tarnish carbohydrates as the cause of obesity, and extolling the virtues of eating only protein and fat as the path to thinness nirvana, started around that time with Dr. Atkins. (His high-fat, high-protein diet caused him to exit the world not too long afterward.) Soon the low-carbohydrate South Beach diet (with mouth-watering pictures of low carbohydrate foods) followed, and the nation was hooked on eliminating carbs from their diet. (Interestingly, despite the popularity of the South Beach diet elsewhere, South Beach itself is  filled  with  Italian restaurants serving pasta and pizza; an Italian bakery selling gigantic loaves of freshly baked, crusty bread is so crowded it is often hard to get in the door!) 

Soon after it became popular in our culture, not eating carbohydrates was praised as a way of returning to the pre-Stone Age menu of raw meat, occasional berries, and edible twigs known as the Paleolithic Diet. Fear that eating a piece of bread would turn one into a look-alike Tubby the Tuba, eliminated bread baskets from the kitchen table, and recipes for sandwiches using lettuce wraps rather than bread became popular.  It did not matter that eliminating bread, potatoes, rice and pasta in favor of beef, chicken, fish, and cheese drained the brain of serotonin, and left the dieter with a personality that ranged from grumpy to Attila the Hun. No matter that the satiety-producing effects of serotonin no longer could turn off appetite, and serotonin’s soothing aura could no longer help people to fall asleep naturally without sleep aids. No credence was paid to that after a low-carb diet, weight was gained quickly and efficiently as the brain pummeled the ex-dieter into now overeating carbohydrates in an attempt to replenish serotonin stores. No matter that the previous Weight Watchers point system was rigged against carbohydrates except fruit, which does not increase serotonin levels.

Now, finally, Oprah has squashed the bread phobia.  Certainly the instant increase in the worth of her stock in Weight Watchers, after she announced her 26 pound weight loss eating bread on their new diet plan, must convince some that their portfolio, if not their scale, will benefit from a return to carbohydrates.   

It is unclear whether those in the Weight Watchers organization understand the relationship between eating carbohydrates, an increase in brain serotonin, a decrease in appetite and an improvement in mood. Dieters are deliberately given few limitations on what foods to eat and avoid. (However, the new Smart Point System does allow food choices to be more flexible and less directed.)  Moreover, it is unlikely that information about how to eat carbohydrates in order to harness the power of serotonin is conveyed. Unless the carbohydrate snack such as rice cakes, popcorn, pretzels or baked potato is eaten with very little protein and fat, i.e. five or fewer grams of each… no serotonin will be made. Weight Watcher dieters are probably unaware that two pieces of bread stuffed with protein foods like turkey or tuna will not produce the satisfying satiety of eating carbohydrates alone. The program likely does not inform them that protein interferes with the synthesis of serotonin, nor tells them to eat carbohydrates at least 30 minutes before protein is eaten, or two-to-three hours afterwards. They may not be able to translate the small amount of carbohydrate necessary to turn on serotonin synthesis, about 25 grams, into Smart Points.  

No matter.  They will listen to Oprah. She is someone whose pronouncements change people’s lives, almost always, for the better. Her cry of, “I love bread!” may be one of those pronouncements.  If she can convince the carbohydrate-avoiders to start eating foods that produce the calming, soothing, mellowing, and appetite-reducing effects of serotonin, then who knows? Maybe the rest of us will be thinner and happier.