Monthly Archives: November 2016

Strolling: Good for the Mind as Well as the Body

Walking has become the default mode of exercise. If going outside to walk is not convenient, then a walking treadmill is available for year-round use. You will get nowhere, but you will use up calories. We are exhorted to walk to lose weight, to avoid gaining weight, to refresh our minds, to unstiffen our muscles.  As someone whose steps per day are counted by an app on my cell phone, I am pleased when my daily walking miles increase. “Look at all the calories I am using up!“ I think when a congratulatory computer-generated message appears on the phone.

But before walking was reserved for burning calories, it used to be the predominant way of reaching a destination. Those who still depend on walking, rather than a car or public transportation, often find it a more efficient and cost-effective way of getting somewhere.  When the roads are clogged with traffic, it is a delight to realize that walking to a destination is faster than driving.  And in some situations like a mall, museum or zoo, walking is the only option other than a wheelchair. Tour buses get drive a sightseeing group to the ancient castle or botanical garden, but seeing it requires legs not wheels.

However, there is an aspect to walking that seems to have been forgotten or disregarded in an attempt to make more people move more. Walking is good for the mind, for thinking, daydreaming, and becoming aware of the details of our environment.  Indeed, those who meditate sometimes do a walking meditation in which the body, breathing, and mind become one. Usually too impatient to contemplate anything but a robust pace while walking, recently I have been forced to slow down because of my dog. He is almost blind due to a genetic problem associated with his breed. Fortunately, his hound genes allow him to sniff his way through the world as if there are eyes at the end of his nose; but his pace is about 90% slower than when he could see.  As I am at the other end of the leash, I too have slowed down my pace. 

Our walks have now become a stroll, a leisurely perambulation around the neighborhood. But as the number of miles we used to cover diminishes to a few blocks, moving slowly has the positive effect of increasing my awareness of the surroundings: There are fewer ducks in the pond today; the yellow leaves of the birch tree highlighted by the sun look painted; that trash can needs to be emptied; the moon is almost full tonight; the leaves on the sidewalk crunch delightfully when I scuff through them. Casual conversations with other walkers occur frequently, as I stop to allow the dog to smell his way to the next tree. But the best aspect of these leisurely strolls is giving me the time and privacy to think, to indulge in memories, even to daydream.     

A constant complaint of our over-committed lives is the absence of time to restore and renew ourselves.  We must always get to the next thing on our list. One of my friends jokingly told me that as she is lowered into her grave, she will toss out her ‘to -do’ list. Strolling gives us permission to forget the list, to stop temporarily multi-tasking and strategizing about how much we can accomplish over the next 24 hours. Ambling gives us the respite from the constant demands upon us. It gives us time to indulge in our private selves without having to worry about how we present ourselves to the world.  Strolling, if we think about it, should even make us aware and grateful that we can walk and see and hear.

Exercise is important; indeed, it is essential to good mental and physical health. But as my dog has taught me, sometimes a gentle walk can truly enhance our well-being.    

Lactose Intolerance: Can It Cause Weight Gain and Weak Bones?

I hadn’t seen my neighbor for several weeks, but we’d just met again while walking our dogs.  When I commented on how well she looked, she patted her mid-section and said, ”I finally got rid of my big stomach.” (that she had a large stomach was not apparent in our previous encounters.)  When I murmured something to that effect, she went into a long discourse on how she managed to vanquish her perceived girth by radically changing her diet.  She told me, “I cut out all dairy and carbohydrates, and I eat only protein and vegetables. But it’s strange. I haven’t lost any weight. I just lost the bloating.”

My nutritional antennae went up when she mentioned her dietary changes.  Further questioning revealed that she really hadn’t stopped eating carbohydrates, and had enjoyed an excellent pasta dish the previous night at a local restaurant.  But no dairy products had been eaten for weeks. “And as soon as I stopped putting milk on my cereal, and cut out yogurt and cottage cheese, my bloating stopped,” she proclaimed, patting her flatter stomach. “So obviously the dairy products were making me fat.”

As our dogs settled down on the grass, we continued talking. “ So maybe you have lactose intolerance,” I suggested. “That would account for the bloating after you eat dairy. “

She was unaware that as people age, the enzyme lactase that breaks down lactose, the sugar naturally found in milk, disappears or becomes much less active. Consuming milk and sometimes other dairy products such as ice cream, yogurt, cottage cheese, cheese and even butter (it contains milk solids) causes gas, bloating and diarrhea. This is due to bacteria in the intestine interacting with the undigested milk sugar. The intestinal discomfort is accompanied by cosmetic discomfort; skirts or pants strain to fit over a bloated stomach, and the abdomen may not retract to a flatter shape until all the lactose has been expelled.

“You can get lactose-free dairy products,” I told her. “Also, often the bacteria in yogurt have already broken down some of the sugar, so regular yogurt may not cause bloating. And you can take pills that contain the enzyme lactase. You chew them right before eating any dairy products. “

“Well, maybe I do have lactose intolerance… but it doesn’t matter,” she responded. “Why go back to eating dairy? I drink almond milk and eat broccoli. “ She bent down to pick up her dog who was eating grass. “I get all the calcium I need. “

I felt as if I was making a nutritional nuisance out of myself, but asked anyway, “ Didn’t your doctor tell you a few months ago that you may be developing osteoporosis? You were worried that calcium in supplements was not being absorbed as well as calcium in food. Are you sure you are getting enough calcium now?”  Her dog started barking, and she looked as if she was going to bark at me so, letting our dogs pull us in opposite directions, we parted company. But as I walked home, I wondered whether she could get enough calcium from almond milk and broccoli. She needed to get about 1200 mg of calcium daily.

She was right about the almond milk. Eight ounces of calcium-fortified milk contains as much of this mineral as cow’s milk: 300 mg.  But would she drink 4 glasses a day?  Yogurt has 400 mg of calcium, but because eating it supposedly made her fat, it was not on her allowable food list.  What else could or would she eat? Canned salmon or sardines with bones? Probably not, or only rarely. Vegetables? She said she ate broccoli.  Could vegetables provide the calcium she needed?

Broccoli is not a good option, unless she eats a bucket full.  A cup contains at most about 65 mg of calcium. Steamed kale, bok choy, turnip greens, and spinach are good sources (a relative term as they contain only about 100 g per cup of calcium) but there is a problem. These dark leafy vegetables have a pesky substance called oxalic acid that attaches to the calcium, and prevents the mineral from being absorbed from the intestine into the circulation. In fact, oxalic acid can even prevent the calcium in milk or yogurt from getting into the blood stream if these dairy products are eaten along with dark leafy vegetables.

What about orange juice? Calcium-fortified OJ is as good a source of calcium as milk, and has about the same number of calories as whole milk. But will my friend, worried about the size of her tummy, fret about the calories?

Maybe she could swallow 2 tablespoons of blackstrap molasses every day (400 mg). And she could eat chickpeas, black-eyed peas, soybeans, tofu processed with calcium sulfate, figs, and instant oatmeal fortified with calcium.

Bones are an excellent calcium source, but I suspect only her dog chewed on those. (These cook down in the canning process of sardines and salmon to boost calcium.)

So it seems that dairy products are the best natural sources of this essential mineral. But will my friend be willing to try lactose-free dairy products and/or the lactase containing pills so she can consume them? Maybe so, if her stomach remains flat.  Perhaps it will require another   walk with our dogs to convince her.

If We Celebrated Thanksgiving in July, Would We Gain Less Weight?

Weight gain season has started: first Halloween, then Thanksgiving, and finally the Christmas/New Year holidays. The trick-or-treat candy has been barely put away (in our stomachs) when the recipes for Thanksgiving dinner are pulled from the drawers, or torn out of the November magazines. Even those among us who rarely cook begin to fantasize about a perfectly cooked turkey, moist dressing, gooey sweet potato casserole (will last year’s marshmallows still be edible?) and pies…How many pies should we bake? Surely not just one. What will our guests think? And as the days grow colder, wetter, windier, and darker, we fantasize about spending an entire day focused on eating. No need to exercise. The gyms are closed on Thanksgiving anyway (at least most of them), and who wants to go outside for a walk when it is so cold and/or so dark?

So begins the season of real weight gain.

What makes Thanksgiving so fraught with weight-gaining potential is its position on the calendar. Presumably when President Lincoln picked the fourth Thursday in November as a day of national Thanksgiving, he could not have known that the holiday would be altered into a day of national overeating due, to some extent, it being plopped in one of the darkest months of the year. It wasn’t until more than a hundred years later that scientists linked the short days of late fall with a winter depression causing significant overeating. Nor was President Lincoln concerned, skinny as he was, that the feasting on Thanksgiving was a prelude to weeks of overeating associated with December holidays. Indeed, for a country in the middle of a civil war, obesity was not something anyone worried about, nor was anyone in the position to spend much time in festive parties.

But just consider the impact on our food intake and weight if Thanksgiving were moved to the warmer, sunnier months like June, July or August. The benefits are obvious:

1. Menus would not be filled with butter and cream-infused carbohydrate dishes like mashed potatoes and creamed onions;
2. Stuffing soaked in the melted fat of the turkey would be incompatible with the warm temperatures of a late June afternoon;
3. Vegetables might come from the farmer’s market and reflect what was harvested that day, rather than limited to what was harvested weeks earlier, or shipped from a country a continent away;
4. Desserts could include really fresh fruit whose tastes do not have to be enhanced by large amounts of sugar, or baked in piecrust made with copious amounts of butter or lard;
5. Long hours of daylight would allow outdoor activities before and after the meal, such as a lengthy walk after dinner instead of lying on a couch; and
6. Wearing bulky clothes to disguise large figures would not be possible, thus adding a bit of restraint to indulging in more than two servings.

Were Thanksgiving moved to another date not bookended by holidays characterized by overeating, there would be time to diet or exercise off the pounds that might be added by the meal. But coming as it does at the time of the year when we think wistfully of the joys of overeating and then hibernating until spring, it seems easier to ‘go with the flow’ and continue to overeat until January ads for diet programs make us get on a scale.

When the Pilgrims celebrated the first Thanksgiving in October (by the way), they did feast for three days on foods provided mainly by their Native Americans neighbors. They did not have to worry about overindulging a couple of months later at Christmas, as they did not celebrate this holiday. Moreover, they were worried that their food supply would not last through the winter, and so were very careful about how much they were eating. Death from hunger, not obesity, was their constant worry.

It is unlikely that Thanksgiving will be moved to another time of the year, regardless of the benefits that would confer on those of us struggling to maintain our weight. But if we, like Governor Bradford and President Lincoln, focus on the reasons for the holiday rather than the recipes, we might emerge with our weight intact.

 

Are You Losing More Than Weight on a High Protein Diet?

Adherents of high-protein/low-or no-carbohydrate diets have, to some extent, hijacked the discussion of whether we should still be eating carbohydrates. Indeed, for some militant followers, carbs are seen as leading only to brain and body decay, and are to be avoided at all costs. Well, maybe it is time to reconsider this attitude.

Avoiding carbohydrates seemed like the logical response to poor insulin activity. Obesity often causes a decreased responsiveness to insulin and may result in Type 2 diabetes. But before the diabetes is confirmed, there are signs that the body requires more than normal amounts of insulin to push glucose in the cells. This is called insulin resistance or decreased insulin activity. “Well,” say the high-protein folk, “stop eating carbohydrates! No carbs, no glucose? No problem getting the glucose into your cells.”

What these high-protein adherents fail to mention is that the body can make its own glucose and only by following an exceedingly stringent no-carbohydrate diet does the body switch from its natural use of glucose to using fat for energy.  There are many side effects that come with a fat- burning (ketotic) diet:  dreadful breath, foggy brains and bad moods. But so what if one’s breath will kill mosquitoes? It is worth it so one does not have to worry about insulin and carbohydrates?  Eliminating fruits, vegetables, fiber, and dairy products, in short the foods that our bodies require for their nutrient contents, on such diet shouldn’t be a problem according to the non-carbohydrate folk.  Just take lots and lots of vitamin/mineral/fiber supplements.

There was only one problem with this approach. It apparently did not work.

A few weeks ago, researchers from Washington University in St. Louis published a study that is challenging the relationship between high protein and better insulin responsiveness. Bettina Mittendorfer and her colleagues divided 34 obese post-menopausal women into three groups: a non-dieting group, a dieting group that ate only the recommended daily amount of protein, and a third dieting group who followed a high-protein diet.

If the ‘high protein diet to improve insulin sensitivity’ proponents were correct, the women on the high protein diet should have shown the most benefit. They didn’t. In fact, there was no improvement among this group. Only the group whose diet contained carbohydrate showed improvement in insulin sensitivity; it increased by about 25-30%. And a side benefit assumed to be conferred by eating lots of protein while on a diet, i.e., no muscle loss? This did not happen either.

This study generated headlines, albeit brief about these unexpected results. However, Sargrad, Mozzoli and Boden reported similar results in the April 2005 journal American Dietetic Association. They found no improvement in fasting glucose levels or insulin sensitivity among dieters on a high-protein diet. Those on a high-carbohydrate diet did improve.

The absence of improvement of insulin sensitivity among the obese women on a high-protein diet is worrisome because they are already at risk for developing Type 2 diabetes. To bring glucose levels in the blood to normal levels, their beta cells in the pancreas have to produce abnormally high levels of insulin. Eventually diabetes can result.

What is also worrisome is that blunted insulin response affects the ability of a critical amino acid, tryptophan, to get into the brain. Tryptophan is the essential component of serotonin; too little or too inactive serotonin may result in depression, anxiety, inability to focus, or even fatigue. Insulin removes other amino acids from the blood that interfere with the ability of tryptophan to get into the brain. High-protein diets fill the blood with these interfering amino acids so that with such a diet, tryptophan levels in the brain may be lower than normal. Consequently, serotonin levels are lower. This may be one reason why there is a strong relationship between diabetes and depression.

The results of the Washington University study seem unfair. High-protein diets are no fun. The dieter can’t eat starchy carbs like popcorn, rice, or bread and must limit fruits and starchy vegetables like winter squash or potatoes. But this deprivation seems worthwhile if the result was an improvement in insulin sensitivity. But of course this did not happen.

The better option it seems is the natural one: Eat the amount of protein that corresponds to what the body needs but no more. Eat a variety of healthy fruits, vegetables, grains, and low-fat dairy products. And finally do physical activity, which in itself helps insulin shunt glucose into the cells so the body can use it for energy.

Not terribly exciting, nor the focus of television health talk shows or dinner table conversation….But it works.