Marie has worked as a spokesperson, consultant to several nutrition, supplement and PR companies, and freelance writer.  She has written for many popular press magazines, trade publications and websites, in addition to three book chapters. She has also helped hundreds of individuals achieve competitive success in their respective sporting endeavors by tweaking their dietary intake.

Ms. Spano holds an MS in Nutrition from the University of Georgia where she worked as a graduate assistant in the athletic department and a BS degree is in Exercise and Sports Science from the University of North Carolina, Greensboro where she ran cross country. 

The conditions known as osteoporosis as osteopenia (“osteo” means bone) indicate that bones have become weaker. Often, both conditions are “silent” and without warning signs until you experience a bone fracture, neck or low back pain, bone pain or tenderness or stooped posture. 

According to the World Health Organization, osteopenia means bone tissue has lost minerals that make it hard and is therefore less dense and weaker (as measured by DEXA scan - dual energy x-ray absorptiometry, a test that uses a low dose x-ray to measure bone mineral content). Osteoporosis is a disease that happens when significant bone density is lost and bones therefore become weak and prone to breaking even from a minor fall or bump. Osteopenia refers to bone mineral density (BMD) that is lower than normal peak BMD but not low enough to be classified as osteoporosis.

How can you prevent osteopenia and osteoporosis? Talk to your physician to see if you should get a DEXA scan and blood test for vitamin D. Also, be sure to meet the Recommended Dietary Allowance for calcium for your age group. If you are between 19-50 years old you need 1,000 mg per day. Men ages 51-70 also need 1,000 mg per day whereas women over the age of 51 need 1,200 mg calcium per day. How do your foods stack up for calcium content? Check out the calcium content of foods here. Adults ages 19 - 70 need 600 IU vitamin D per day those over 70 years old need 800 IU per day. Few foods have vitamin D in them. Check out a list of vitamin D rich foods here.

Treatment for osteopenia and osteoporosis often includes calcium and vitamin D supplements, weight bearing exercise (see a related article here Improve Bone Health with Liquid Calcium Supplements) and possibly taking prescription medications for bone density.

References

Rev Endocr Metab Disord 2010;11:237-51.

In some ways medicine seems so advanced. In other ways, medical science is still in the beginning stages of discovering the big picture of how our body uses nutrients and how they all interact in our bodies. There are so many little components and processes that haven’t been completely explored, and many that cannot be directly observed.

Nothing works in isolation in our body. Identifying all of the processes one antioxidant or nutrient is part of or responsible for is an incredibly difficult task. Add to that the physiological differences in every unique human body and we are left making healthy decisions using general guidelines and recommendations rather than hard numbers.

To figure out what levels of any nutrient, dietary supplement or food may be best for you given your health status, activity level, current dietary intake and goals, it is important to sit down with a registered dietitian (RD) who specializes in your area of need or type of goal. If you want to lose weight, go to someone who specializes in this, if you have Type 1 diabetes and you are an athlete, go to a RD who works with diabetic athletes. There really is no substitute for a thorough analysis, including laboratory tests of existing nutrient levels that can then be integrated into a specific diet and supplement plan to get you on the right track to a balanced, nutrient-rich body.

 

Following the general guidelines is a good place to start, if you don’t feel a full nutrient-by-nutrient workup is in order. Recommended Daily Intake values for common vitamins and minerals are in most retail brands.  Be sure to check the brand out thoroughly though, so you know you’ve picked a quality brand that uses quality ingredients.

 

 

 

As always, the type of supplement you choose should depend on personal preference and compliance – what will you continue to take on a regular basis. Because, after all, if you don’t continue taking it regularly, there’s really no point in buying it to begin with!  If you are tired of swallowing yet another pill, try taking liquid supplements instead.  It does make taking your essential supplements each day a little easier, and the quality of ingredients tends to be higher grade in order to make them work well in liquid form.  Plus, they’re easy to mix into protein shakes, morning smoothies, or to take as a straight shot!

Are you of the age or meet the criteria to need a bone mineral density test? Read further to see if you should be investigating this critical test with your primary care physician.

Bone mineral density (BMD) tests examine bone health and can help determine a person’s risk for fractures and identify osteoporosis. The most common and accurate test used to measure BMD is the dual-energy x-ray absorptiometry machine (DEXA or DXA), which compares the bone density in your hip and spine against established norms. DEXA uses a small amount of radiation though experts indicate the radiation risk is very low.

Who should get tested?

The U.S. Preventive Services Task Force recommends all women over age 65 and those who are under 65 but have a high risk of developing fractures get tested. In addition the NIH recommends bone density testing be considered in people with medical conditions putting them at high risk of fractures due to low bone density and those who have taken glucocorticoid medications for 2 months or more.

Why get tested?

BMD testing will determine if you have low bone mass thereby helping your physician determine preventative care and treatment options if necessary.

If you have any questions about bone density testing, talk to your primary care physician, and you can decide between you if a BMD test is right for you now or possibly in the future.

References:

NIH Osteoporosis and Related Bone Diseases National Resource Center.

 

Though you may think your bones are just a hard and dormant support structure for your body, they are actually  dynamic, growing tissue with new bone constantly replacing old bone. How can you keep your bones strong over time?   Feed them the right nutrients and engage in regular weight bearing physical activity.  Strong bones help protect your organs from injury, allow your body to move and support good posture. 

 Several vitamins and minerals are important for bone health. However, the top two that provide the most impact  are calcium and vitamin D. Calcium, the primary mineral found in bone, contributes to the strength and hardness of bone tissue. Over time, inadequate calcium intake can lead to weak, porous bones.

National survey data shows that many Americans are not getting enough calcium in their diet.  In women ages 19-30 and 31-50 only 28% and 33% are getting above the Recommended Dietary Intake (RDI) set for calcium. The best dietary sources of calcium are dairy foods and fortified nutritional foods such as protein shakes. Green leafy veggies also contain calcium but in very small quantities. For instance, 1 cup of broccoli contains only one-sixteenth of the recommended intake for the average adult aged 19-50!   So eat broccoli too, but be aware of the proportion of calcium coming from it versus other foods and take a calcium and vitamin D supplement if your doctor recommends it. Click here for an additional article about the benefits of calcium and vitamin D supplementation.

 Vitamin D helps your body absorb the calcium you consume. Most of us aren’t getting enough vitamin D either, which has set the stage for a vitamin D insufficiency and deficiency epidemic in this country. Few foods contain vitamin D. Most milk is fortified with it and it is also fortified in some brands of orange juice, yogurt and breakfast cereal. Egg yolks, liver and some types of fish naturally contain vitamin D. 

 In addition to eating a nutritious diet packed with calcium and vitamin D, everyone needs regular physical activity including resistance training (strength training) and weight bearing exercise. Lifting weights, rock climbing, gymnastics, running and walking are examples of activities that help build bone strength. If you choose to run or walk, be sure to lift weights for your upper body too so you build those bones as well.

 References:

Calcium and Bones. NIH.

What We Eat in America, NHANES 2005-2006.

 

Spring has sprung! This hopefully means you’ll be outdoors more, walking, gardening, biking and all the things good weather and longer days bring.  Though your focus has turned to enjoying outdoor opportunities for healthy exercise and soaking in the spring sunshine, don’t forget about things like osteoporosis prevention, or management if you’ve already been diagnosed.  It's never too late to start getting adequate calcium and vitamin D, as well as strengthening bones with exercise.

Best form of Calcium?  Calcium Citrate
Calcium citrate has been shown to be the best form of calcium to supplement your intake. The citrate form absorbs faster and more thoroughly than calcium carbonate, and can be taken with, or without food, making compliance much easier. Look for one with 1000 mg of calcium and 1000 IU of vitamin D included in the formula. The combination aids your body’s use of calcium even further, which is all the better for your bones.

Vitamin D is also Important
Though we can manufacture vitamin D in our body when our skin is exposed to sunlight, many of us still don’t manufacture enough.  Sunscreen, darker skin, clothing and advanced age can all minimize how much vitamin D we produce.  That’s why it is important to ensure you are still getting enough vitamin D through food and/or supplements. The best form to take is vitamin D3, which is the form your body produces from sunlight.

Nutrient Rich Foods
What else can you do to ensure you are maintaining your bone mass?   Eat foods rich in soy.  Soy beans, tofu and soy protein shakes may all help build your bones.  You can also incorporate magnesium-rich foods in your diet.  Like calcium, magnesium is a mineral stored in bone tissue, and is important to maintaining bone strength.  Eating nuts, spinach, oatmeal, potatoes, beans, wheat germ and avocado are all great ways to boost your magnesium intake. 

Bone Strengthening Exercise

Weight-bearing Exercises. Any exercises where your legs and feet support your weight qualify as weight-bearing.  These exercises work directly on the bones in your legs, hips and lower spine to slow mineral loss.  If you have osteoporosis, you should avoid high-impact activities such as running, jumping, or jogging.  For example:

• Walking
• Dancing
• Gardening
• Hiking
• Low-impact aerobics 

Resistance Exercises. Any activity that uses muscular strength to improve muscle mass, strengthen bones and reduce mineral loss is considered resistance exercise or strength training.  Compression fractures resulting from osteoporosis often lead to a stooped posture and increase pressure along your spine, resulting in even more compression fractures. Exercises that gently stretch your upper back, improve your posture and focus on strengthening the muscles between your shoulder blades can all help to reduce stress on your bones and maintain bone density.  Try these: 

• Free weights
• Weight machines
• Resistance bands
• Water exercises (water acts as the resistance) 

Flexibility Exercises. Stretching is always very important as part of an overall fitness program.  It’s important for joint and bone health by reducing pain and stiffness, and supporting good posture.  It is best to do stretching once your muscles are warmed up to prevent injury, at the end of your workout for example.  Always stretch slowly and gently, without bouncing.  

There has always been a lot of buzz surrounding antioxidants. Antioxidants are compounds that can potentially protect the body from free radical induced cell damage, compounds that are produced in the body when we eat, when we are exposed to UV rays, cigarette smoke and pollution for instance. And though free radicals aren’t always bad, free radical damage  contributes to aging and may impact the development or progression of body system malfunctions.

But, antioxidants do much more than just protect the body from free radicals, they can also tame inflammation in the body, act as cell-signaling agents, and some even up or down regulate gene expression.

It is clear that antioxidants are vital to a healthy body but where can you find them and how do you know if you are getting enough? Antioxidants are found in a variety of foods including fruits, vegetables, nuts, seeds, whole grains and some meats and fish.

And though there are thousands of different antioxidants that exist in nature, scientists don’t know the exact mechanisms of action of many of these. Therefore, the best advice is to eat a diet rich in a variety of spices, vegetables, fruits, nuts, seeds and whole grains to ensure a diverse intake of antioxidants. And, consider food first, as opposed to popping antioxidant supplements (though some specific ones may help decrease the progression of certain ailments as is the case with lutein and zeaxanthin and age related macular degeneration). There may be a synergistic effect among antioxidants or antioxidants and other compounds in food. Because scientists don’t know the exact “dose” of antioxidants that may help decrease aging, the best advice for now is to do the best you can to eat a wide variety of foods naturally rich in antioxidants at each meal, and take a general multivitamin to bolster your diet with antioxidant vitamins A, C, and E.

For years we’ve been told to get an annual physical exam to rule out any warning signals that could identify poor health or disease. And, this seems like a smart approach, after all who wouldn’t want a seal of approval of good health or knowing if something is wrong before it could get worse? Despite sound logic, recent research is questioning if we really need annual exams.

 

 

Review Revealed Few Benefits

In a meta-analysis that examined 14 well-conducted studies, which compared those who went for their health check against those who did not, researchers found that general health checks did not provide any beneficial effects on morbidity, hospitalization, disability, worry, additional physician visits or absence from work. However, one out of the 14 studies did find that health checks led to a 20% increase in new diagnoses per participant over a six-year period compared to those who didn’t get health checks. And, a few other studies also found small beneficial effects on self-reported health from getting health checks.     

Those who got health checks were not necessarily those who needed them the most

But, despite the surprising findings of this meta-analysis, most of the studies were old and used now outdated treatments. In addition, some of the cutoff values signaling treatment is necessary have been updated. Also, the participants who voluntarily get regular health checks are not necessarily those who need treatment the most. And finally, physicians may screen patients at other times for specific diseases such as cardiovascular disease and catch a disease prior to a scheduled health check.

Talk with your physician

So should you or shouldn’t you? While you ponder annual health exams, talk to your physician about when you need to be seen and consider screening tests recommended by NIH. Specific screening tests can catch some diseases early so treatment is started right away. Screening tests recommended by the U.S. Preventative Services Task Force and NIH can be found by clicking here.  Also, in some cases, your health insurance may be cheaper if you follow their guidelines for health screenings so be sure to check with them as well.  

Also, click on the links below for recommended age specific health screening tests:

Men ages 40 – 64

Men over 64

Women ages 40 – 64

Women over 64

 

Learn how to snack in a healthy way!

Snacking can help keep hunger pangs at bay and contribute to your overall nutrition intake if you choose wisely. Think of a snack as a “mini-meal,” a smaller portion of something you might have at mealtime. By doing this you are likely to think of healthier foods versus “snack foods” like chips, cookies and less than healthy baked goods.

Though there are many health snack ideas, here are my top 5:

• Nuts – nuts contain heart healthy fats, fiber and an array of vitamins and minerals.

* Keep in mind that children under 3 should not eat nuts or nut butters due to the potential for food allergies. By age 3 you can introduce nuts slowly one type at a time (check with your pediatrician). Never give small kids whole nuts as they can choke on them.

• Cereal –high fiber, low sugar cereal is a great snack option for kids and adults alike. It’s portable and filled with vitamins, minerals, fiber and antioxidants. Plus, you can eat it by the handful or put it in a bowl and add some milk or vitamin D and calcium fortified milk alternative such as a higher protein soy milk.
   
• Fruit – fruit is packed with vitamins, minerals, fiber and antioxidants. Try topping cereal or yogurt with berries, serve slices of apples topped with cheese and try in season fruit like watermelon to stay cool and hydrated on hot summer days.
   
• Vegetables – start your little ones on vegetables early and they’ll develop a lifelong taste for produce. If plain veggies sound boring, add a little natural peanut butter or dip veggies in hummus or guacamole for a delicious snack.
   
• Dairy – add string cheese, yogurt and cottage cheese to your snack list and you’ll be doing your bones a favor. Dairy foods are packed with bone building calcium and some yogurts and cottage cheeses also contain vitamin D (check the label). This is especially important for growing kids who are not only growing upward but are also building bone density (we build bone density up until our early 30s).

If you are preparing snacks for kids, let them pick out a new fruit or new vegetable to try. By giving them a choice, they are more likely to dig in. Also, set a snack spot aside in the refrigerator and cupboard. Keep healthy snacks at eye level and put the less than healthy ones behind other foods in the back your cabinets and refrigerator – doing this will encourage you to reach for better options. 

Moveable joints, where bones come together and help us move, like our knees, hips and shoulders can become damaged over time due to wear and tear, disease, excess body weight and injuries. As a result, your joints may feel stiff, painful and become swollen. But, there are several steps you can take to prevent wear and tear on joint tissue.

STAY PHYSICALLY ACTIVE. Though some forms of physical activity – playing football in the NFL for years for instance, can add to wear and tear on joint tissue, normal levels of regular physical activity can help keep joints healthy by improving or maintaining bone density, muscle strength, joint flexibility and balance. Just be sure to protect your joints with protective pads when necessary and stop if they hurt more than tollerable discomfort from the exercise itself.  Swimming is great exercise and is particularly low-impact on joints. See more on joint-related exercise do's and don'ts here.

EAT HEALTHY.  Doing so will do more than just keep your weight within normal limits (being overweight puts stress on joints), but, it will also provide a variety of nutrients necessary for strong bones and muscles. In particular, adequate levels of vitamin D and calcium are necessary for bone health while protein is essential for building and maintaining muscle strength.  Having strong muscles around joints helps support the joint structure itself.

TAKE SUPPLEMENTS. And finally, the dietary supplements glucosamine and chondroitin sulfate can reduce moderate to severe knee pain in some people. Chondroitin helps absorb water in cartilage and both chondroitin sulfate and glucosamine block the enzymes that break down cartilage and some studies suggest they may also help build new cartilage tissue. Click the "recipe" link to read about a great recipe for a fun, refreshing way to take this supplement!

The blues are something everyone experiences at one point in time or another. And though you may feel like you are stuck or blah for an extended period of time, you can change your outlook and feel better by training your mind with these 3 steps.  However, actual depression is an illness and should be treated by a health professional.

1. Keep Healthy Company - Stay Away from Negative People
   Complaining is contagious. If you hang around complainers or negative people, it will rub off on you. Sometimes we have no choice but to keep company with those who are down and out on life such as family members or coworkers. And, you have two choices with these people – engage minimally by walking away or tuning out when they complain (let them know you are going to do this – the less you listen the less they’ll start ranting in front of you) or spend less time around them overall (if possible). Aside from keeping negativity at arms length, be sure to seek people who have a positive outlook on life and spend more time with them.
    
2. Speak Positively - Fake It Until You Make It!
   You’ve probably heard the phrase “if you think you’ve lost, you have.” And there is quite a bit of truth to that simple saying. What you think and the words you speak have the power of prediction. If you keep thinking you aren’t qualified for a particular job for instance, you’ll probably never bother applying for it. And even if you do apply and interview, the interviewer will be able to tell how confident you are in your ability to fulfill the job responsibilities. If you walk through a field looking for weeds you will probably never see the beautiful wild flowers. Likewise, if you are looking for people to be mean to you or expecting nothing to change at your workplace and instead for your job to suck and your boss to give you bad reviews, well, that will likely happen.  
   
   In addition to training your brain to refocus on something good or positive when thoughts of something bad or negative take over your mental energy, also intentionally speak positive affirmations. Fake it until you make it! Tell yourself you will get a new and much better job, you will get over an illness or your son will straighten himself out. Talk yourself into believing that good things are in your future and they may just happen!
    
3. Don’t Look Back - You Can't Change the Past
   The fiasco Manti T’eo has been going through (regardless of what you believe about it) should teach us at least one very valuable lesson: put the past in the past. Everyone makes mistakes and the more you focus on them the harder it will be to focus on your future. Whatever it is, get over it and spend your thoughts, time and energy on the future.

 

The Link between Feeling Blue and Low Levels of Vitamin D

Studies show low vitamin D levels may be associated with depressive symptoms in those with a history of depression. And though the exact relationship between vitamin D and mental disorders isn’t clearly understood at this time, it may explain why light therapy is an effective treatment option for seasonal affective disorder.  Sun lamps provide UV rays that can stimulate vitamin D production in the human body.  Ever wonder why you feel better after being outside in the sunshine?  It may be because of the vitamin D being absorbed through your skin!

If you suffer from depression, first speak to your treatment team about your options and ask your physician if you need to be tested for vitamin D deficiency. Vitamin D deficiency and insufficiency are rampant in the U.S. because it is found in few foods and use of sunscreen, shade and cloud cover limit UV exposure and darker skin pigment provides natural protection from UV rays. Also, many people don’t readily absorb vitamin D or manufacture it in their body, especially older and obese individuals. Vitamin D is not a miracle cure for symptoms of depression but treating low or deficient levels may help.

 

References:

Issues Ment Health Nurs 2010;31: 385-93.

Mayo Clin Proc 2011;86:1050-5.

There are 8 different vitamins in the B-Complex family. Though each has it’s own functions within the body, all help your body convert the food you consume into usable energy. In addition, the B vitamins work together as a team.

1. Thiamine or B1 - helps in the conversion of carbohydrates into energy reserves
2. Riboflavin or B2 - precursor to coenzymes involved in the growth and repair of skin and tissues lining the gastro-intestinal tract, as well as the synthesis of amino acids
3. Niacin - necessary for normal breakdown of fats and fatty acids, and energy release from carbohydrates
4. Vitamin B6 - converted into the main enzyme responsible for amino acids & protein metabolism
5. Folic Acid - essential especially for pregnant women for baby's development
6. Vitamin B12 - plays a role in entire nervous system, promotes energy metabolism and support healthy heart function
7. Biotin or B7 - supports the metabolism of carbohydrates, fats and proteins for energy and often associated with hair, skin and nail health
8. Pantothenic Acid or B5 - converts to Coenzyme A in the body, which is important for many reactions involving energy metabolism

B vitamins from Diet

B vitamins are found in a wide range of foods from dairy products and eggs to meat, grains, vegetables and beans; therefore, a deficiency in any B vitamin is rare. However, some individuals may consume lower amounts of specific B vitamins than they need for optimal health. In particular, those who are dieting or cutting out specific food groups, individuals with a limited food intake such as those who have had bariatric surgery, vegetarians, vegans, gluten free, alcohol-dependent individuals and those with malabsorption issues all have an increased risk of falling short on their nutrient needs.

Vitamin B-12 Deficiency More Common

One of the more common B vitamin deficiencies is B-12, which affects from 1.5 – 15% of the population. Some of the symptoms of B12 deficiency include weakness, fatigue, constipation, appetite loss, weight loss and tingling in the hands and feet. Those most at risk for B12 deficiency include older adults, people with gastrointestinal disorders such as celiac disease or Crohn’s disease, individuals who have had weight loss surgery and vegans.  B12 becomes increasingly important with age with risk of decreased absorption which can lead to deficiencies in both B12 and Folic Acid.

Vitamin B12 is involved with energy metabolism, heart health and nervous system function. 

B Vitamins for Energy

B vitamins work together in the body to convert food into energy metabolism, support mental focus and reduce the effects of stress. Because they are water soluble and not stored in the body, they must be replenished daily to maintain optimal health.  Many energy drinks on the market contain B vitamins for the energy they provide.  However, most energy drinks also contain sugar and/or caffeine so are not considered a good source.

Vitamin B Supplements - Do you need them?

If you are deficient in one or more B vitamins or your intake is suboptimal, it is possible to improve your overall health if you consume more foods rich in B vitamins or take a dietary supplement. But, always talk to your health care professional first prior to taking any new supplement.

 

References:

JAMA. 2002 Jun 19;287(23):3116-26.

Dietary Supplement Fact Sheet: Vitamin B12. Office of Dietary Supplements, NIH.

Is there such a thing as fats that are good for your heart?

Through the years dietary fats have been scrutinized like no other ingredient. They went from bad to worse in the 1990s when everything was “fat free”. But then, logic set in and scientists combed through the research carefully to change their recommendations. Fat wasn’t the problem but the type of fats people were commonly consuming was. Fried foods, trans fat laden desserts and main dishes made with an artery clogging combination of shortening and butter led to an obese and unhealthy nation. But, you shouldn’t fear all fats, just cut down on the ones that are bad for you while increasing healthier fats.

Monounsaturated and Polyunsaturated Fats Should Replace Saturated:

• Nut oils (soybean oil, canola oil, etc.),
• fatty fish (salmon, mackerel, herring, halibut and lake trout for instance),
• nuts and seeds
• Olive Oil
• Avocados and Olives 

These fats are either healthy for your heart or neutral meaning that they won’t harm heart health (unless of course you are over consuming calories). In particular, fatty fish are associated with improvements to blood fats (triglycerides), slight improvements in blood pressure and better cholesterol levels.  For these reasons the American Heart Association recommends two servings of fatty fish per week.

Stay Away From Harmful Fats - Especially Partially Hydrogenated Oil

Harmful fats are those that are solid at room temperature particularly saturated and trans fats. Saturated fats are the kind found in full fat dairy products and the fat on marbled meat and are LCFA - Long Chain Fatty Acid Check the Nutrition Facts panel of your favorite foods. Many processed and packaged foods contain high levels of saturated fats. But, what’s worse than these? Man-made trans fats (aka partially hydrogenated oils). These lurk in baked goods and candies as well as some deep fried foods. Take a look at the ingredients list and if a food says “partially hydrogenated oil,” steer clear of it!

Coconut Oil is a Good Saturated Fat - MCFA - Medium Chain Fatty Acid

One saturated fat that can be good for you is coconut oil.  Coconut oil comes from coconuts, which have been shown to be one of the richest single food sources of vitamins, minerals, and amino acids.  Coconuts are loaded with many of the amino acids your body needs to manufacture protein, as well as important minerals such as calcium, magnesium, phosphorus, and potassium. It is also an excellent source of vitamin C and vitamin B2 (riboflavin). All of these same nutrients are also contained in coconut oil. Plus coconut oil is actually a great natural energy source making it a great addition to any weight loss program. MCFAs are stored in the liver, where they get converted into a readily available source of energy.

Your heart is the most important muscle in your body. Keep it healthy and keep all of your cardiovascular system healthy by opting for the right fats in your diet. 

 

photo source: fda.gov

 

Let this year be the year you achieve Resolution Success!

Many people yo-yo with their goals and resolutions for years on end. They clearly identify what they want and even voice it out loud repetitively like a 2 year old reciting lines from their favorite book: “I want to finish my college degree” or “I want to lose 50 pounds.” However, they remain stuck for years on end in the same position, complaining yet not making progress. Fear of change, lack of confidence or an inability to see the light at the end of the tunnel keeps them still, yet comfortable, in their current familiar circumstance: a miserable job, relationship, excess body fat or smoking packs per day. If you want to make your way out of the maize for good and reach your goal, there are three steps you must take:
 

1) Give up the idea of perfection.

There is no perfect spouse, ideal body or perfect job. Now, I’m not saying you shouldn’t reach for what is right for you but throw away the idea of perfection and figure out what is essential and what you can bend on. Looking for a physician assistant degree but the thought of taking out a six-figure loan on top of your current school debt gives you a stomachache? Settle for a less expensive school even if it isn’t the one you really, really want to go to. Take the best alternative and make what you want out of it.

2) Listen to your intuition.

If you think back about things you wish you had never done, you’ll realize you had warning signs or a gut feeling that you ignored. Commit to paying attention to these signs in the future without trying to rationalize a reason for dismissing them. So let’s say your career goal involves living in California and working in TV there. Along the way you are offered a job in Alabama, one that can build your resume but gives you a sense of uneasiness because it isn’t in the TV business and isn’t where you want to live. It doesn’t “feel right” though your family is pushing you to be closer to home and the job is just 2 hours from them. Think about how the job offer makes you feel – happy, excited and generally good or sad, disappointed and stuck? You may not know exactly what you want to do in TV or every detail of your goal and life plan but you can certainly tell what makes you feel good and what feels bad along the way.

3) Make small changes.

Just a few days ago a client asked, “How much body fat can I lose in one month?” Granted, it can be done if you have a solid, immediate reason the weight absolutely must come off by that time – you are trying to avoid weight loss surgery or make weight for a job (military or the NFL for example). In these instances the repercussions of not making weight by a certain date will cost you more then just a few photos at a high school reunion or having to buy new suits for work. But even when you make that weight you have to go back and change the patterns of behavior that led to excess weight gain to begin with. Start with breaking each bad habit that contributed to the weight gain. If your goal isn’t weight loss but say, finishing that college degree, figure out exactly what you need to do and map out a reasonable timeline.

Make small changes. Commit to cleaning one room at a time and at some point your entire house will be clean. Save $100 a month and at some point you’ll have enough money to buy a car free and clear with no loan. Sure it may take a while but you will reach your goal. Which brings me to my last point – make the time. Committing to something new takes time. And that means clearing your schedule and making room for more important priorities. You may need to give up your regular dinner date with your best friend in order to re-write your resume and reach out to contacts on LinkedIn or take some time off work to figure out a detailed plan for obtaining that college degree.

Whatever you need to do, put a time stamp on it and clear your schedule for your most important priorities.   Then reward yourself as you reach each small goal!

Those who develop Type 2 diabetes usually had prediabetes at some point - where blood glucose levels are higher than normal.  The good news is there are steps you can take to prevent or delay it progressing to Type 2.

If we pay close attention to our bodies and schedule regular checkups, like a yellow light signaling caution, warning signals will appear. And prediabetes alerts us when our blood sugar is higher than normal though not high enough to be diagnosed with Type 2 diabetes. However, those with prediabetes are more likely to develop Type 2 diabetes and may already have some of the problems associated with the disease. Therefore, it is very important to recognize the symptoms that may be associated with prediabetes:

Symptoms of Prediabetes:

• Frequent thirst
• Frequent urination
• Blurred vision
• Extreme fatigue
• Frequent infections
• Cuts/bruises that are slow to heal
• Tingling/numbness in the hands/feet
• Recurring skin, gum or bladder infections

Get Tested!

It can be easy to ignore these symptoms, especially if they develop gradually. Therefore, if you have any of the risk factors outlined below you should ask your physician about getting tested. Doctors will use a fasting plasma glucose test, oral glucose tolerance test or an A1C test or combination of tests.

Risk factors for prediabetes and diabetes include:

• High blood pressure
• Low HDL cholesterol and high triglycerides
• A family history of diabetes
• A history of gestational diabetes or giving birth to a baby weighing 9 lbs or more

In addition to taking a look at the risk factors and symptoms, the American Diabetes Association offers this risk factor test you can take to determine if you may have an increased risk: Type 2 Diabetes Risk Test

Preventing Progression to Type 2 Diabetes - Lose Weight and Exercise!

How can you prevent Type 2 diabetes? The two single most important preventative steps you can take today include losing weight and exercising. In fact, research shows that you can lower your risk by an astounding 58% by losing 7% of your body weight and exercising moderately for 30 minutes per day, 5 days per week.

Get Your Z's

In addition to losing weight (by eating a healthy diet) and exercising regularly, sound sleep is essential. Research shows that regular sleep deprivation can contribute to insulin resistance and therefore, higher blood sugar levels. Plus, sleep lost stresses the body and makes losing weight more difficult. Aim for at least 7 hours of quality sleep per night (this means the time you are actually asleep, not from the time you get into your bed until the time you get out).

The National Diabetes Education Program has designed a national awareness campaign to target people at risk for type 2 diabetes. The campaign will create awareness that type 2 diabetes can be prevented through modest lifestyle changes and losing about 5 to 7 percent of body weight. More about Small Steps on Diabetes.org. 

During the winter months it can be especially difficult to have nice skin.  Did you know there are certain foods and supplements that can help?

Have you tried anti-aging serums, BB creams, masks that dry out pimples and just about anything else with pretty packaging and believable claims to improve your skin? If you’ve spent quality time in Sephora or Ulta looking for the Fountain of Youth and Acne/Blotchiness/Rosacea - Free skin, it is now time to pay closer attention to what you eat, drink and the dietary supplements you take. Because topical products will not do enough to slow down the effects of skin, hair and nail aging.

What you put in your body will affect your skin, hair and nails on a cellular level and support your immune system defenses against environmental stresses that damage skin and lead to premature aging.

Your skin is the largest organ in the human body (yes it is an organ!). And it has a natural defense system that protects your body from bacteria, viruses, environmental pollutants and more. And, several substances help your skin work as a protective barrier.

Antioxidants

Antioxidants protect against cellular damage and aging due to free radicals (though they do much, much more in the body). And, carotenoids are one of the major categories of antioxidants that are vital for skin health. Carotenoids such as lycopene, lutein, zeaxanthin, beta and alpha-carotene, offer some protection against skin damage due to the sun’s UV rays (they help prevent red, irritated skin) yet their ability to protect is directly related to their accumulation in the skin (meaning that you must consume enough carotenoids frequently so they accumulate). Carotenoids may also boost collagen and prevent DNA damage, which contributes to skin aging. This category of compounds is found in yellow, orange and red pigments in plants making them easy to find if you look for fruits and vegetables in those colors.

Antioxidants - Flavonoids

Another category of antioxidants, flavonoids, which are found in green and black tea, onions, citrus fruits, berries and many other foods, also play an important role in maintaining healthy collagen and elastin (structural components of your skin), protecting against free radicals and DNA damage and aging. In addition to these food components, vitamin D is critical for skin integrity and keeping inflammation and wrinkles at bay yet vitamin D is found naturally in very few foods (the bones in fish for instance). Vitamin C is necessary for healthy collagen and biotin, aka the “skin, hair and nails” supplement enhances the strength and durability of fingernails. And finally, the omega-3 fatty acids DHA and EPA found in fatty fish, have important anti-inflammatory functions within the body and also help decrease wrinkling. Skimp on dietary fat overall and your skin will look rough and dry.

A Beautifying Diet

So, how can you put all of this information together and consume a beautifying diet? Eat a diet rich in red, yellow and orange produce. Cook your tomatoes and add a little olive oil so the lycopene is better absorbed (cooking enhances the bioavailability of this carotenoid and fat is necessary for optimal absorption). Also, be sure to eat beans, seeds, fatty fish and take a multivitamin supplement daily. No matter how good your diet is, chances are you fall short on certain vitamins or minerals.

Though topical products (especially sunscreens!) can improve skin health and prevent photo damage from the sun, they typically do not penetrate the deep layers of the skin. However, food and dietary supplements affect beauty from within. Therefore, if you want drastic changes in skin health, combine cosmetic products with a sound diet and skin specific dietary supplements.

I’m hearing about Irritable Bowel Syndrome (IBS) more now than ever before which affects over 58 million Americans.

IBS leads to changes in how the gastrointestinal tract works. The GI tract doesn’t become damaged, however, IBS is characterized by a collection of symptoms that can interfere with normal daily life. And though symptoms can vary from person to person, the most commonly reported ones include abdominal pain or discomfort, fullness, gas and bloating. However, other disorders and some diseases may have similar symptoms, and therefore, it is important to see a gastroenterologist for an accurate diagnosis.

Not sure if you have IBS?  Take this quiz to find out if you need to see a doctor concerning your symptoms.  http://www.webmd.com/ibs/ibs-symptoms-quiz

It's unsure as to exactly what causes IBS, which affects about 1 in 6 people in the U.S. and can occur at any age and is much more common in women then men. It’s also a chronic condition that may come and go.  But, there are several non-pharmaceutical drugs treatment options that may help relieve some IBS symptoms:

• Monitor your symptoms to see if certain foods aggravate them and avoid foods that may stimulate your intestines (caffeine, sorbitol, lactose, wheat, fructose and alcohol are common culprits)
• Eat smaller meals; avoid large meals
• Increase intake of dietary fiber if you have constipation
• Drink plenty of liquids
• Relax more – stress is a major contributor to IBS

In addition, those with IBS may want to consider prebiotics, which stimulate the growth of good bacteria in the intestines and may therefore, decrease one’s risk for and severity of inflammation and infection. Some studies suggest that people with IBS have a decrease in good bacteria in their guts, which may lead to or exacerbate some of their symptoms. Specific strains of probiotics, which can positively alter the makeup of gut bacteria, may also be beneficial for symptom relief.

If you suffer from IBS:

1. Keep a detailed food and symptom log that you can share with your physician.
2. You should soon notice some patterns and foods that aggravate your symptoms to stay away from.
3. Making needed changes in your diet is critical to managing IBS symptoms.
4. Always be sure to talk with your physician first before taking over-the-counter medications or making any drastic changes to your diet.
5. Try a prebiotic or probiotic supplement for at least 30 days to see if it improves your symptoms
6. Add more fiber to your diet gradually
7. Find ways to relieve your stress - talk to a professional if needed.

 

References:

National Digestive Diseases Information Clearinghouse, NIH

National Library of Medicine, NIH

If you are caught between looking forward to Thanksgiving dinner and being concerned about an expanding waistline, you shouldn’t be.

Media reports about holiday weight gain are often grossly exaggerated because the “shock” value drives readers and viewers to click on a link or stay glued to the TV with their eyes wide open and jaw a few inches lower. And, that unnecessary fear will oftentimes take the enjoyment out of this time of year or lead people to believe they are destined to gain weight so they might as well overindulge. But, research shows the average weight gain is just one pound (those who are overweight or obese tend to gain more then people who are normal weight).

So, relax, and enjoy this national holiday while keeping these sensible, healthy eating tips in mind:

• Eat a higher protein breakfast

Studies show eating a higher protein breakfast will keep your stomach satisfied for a longer period of time so you aren’t as hungry during the day. Don’t skimp on calories in the morning to “save up” for dinner because this approach will likely backfire causing you to overeat.

• Eggs
• High protein cereal
• Protein shake or smoothie
• peanut butter
• yogurt
   
• Put a few new players in the game

Make healthier ingredient substitutions that don’t sacrifice the taste of your dish:

• Use chicken broth (regular or low sodium) or skim milk + low fat sour cream instead of butter to flavor mashed potatoes. Keep soft spread out and regular butter and let your guests decide which to use.
• Eat turkey, white or dark meat, but toss the skin! If you deep-fry your turkey, keep the temperature high at all times so your turkey absorbs less fat from the oil.
• Choose a bread-based stuffing over corn stuffing and cook it separately from the turkey or it will soak up the turkey fat (and actually draw moisture away from your turkey). Try cooking stuffing in chicken broth for flavor and add chopped celery and onions for more flavor and less fat.

 

• Choose your dinnerware size wisely

Grab a salad plate for your main meal. Doing this ensures that you you will eat a reasonable portion of each dish.  Dish up more of the vegetables like salad, carrots, squash and sweet potatoes than the higher calorie dishes.

• Make a plate to go

If you are overwhelmed with the sheer number of food options and find that you are tempted to try everything, go ahead and make a plate to go. You’ll still get the opportunity to try each delicious dish but you won’t have to stuff it all in on one day.

• Focus on the company

Thanksgiving should be about friends and family. Grab your meal then move away from the serving line and focus on catching up with everyone. Soon you’ll forget about going back for seconds.

• Take a Walk

Either before or after the meal try to make time to take a walk or do some kind of physical activity instead of just sitting in front the the TV.  How about a game of touch football?

 

Happy Healthy Thanksgiving!

Most of us know someone personally that is fighting or coping with the realities of breast cancer or has in the past.   Since October is National Breast Cancer Awareness Month, it's a great time to be even more diligent about taking charge of your own health to help prevent breast cancer for yourself and loved ones.

Have you had your mammogram yet this year?

Aside from making good decisions every day about diet, exercise, not smoking and moderating your alcohol consumption, the single best thing you can do for your health is go to your doctor for an annual physical and get regular health screenings. For a list of the screenings you need, click here if you are a man and here if you are a woman.

Every October is a good reminder about breast cancer awareness. Women are you getting your annual breast exam and a mammogram if recommended by your ob/gyn? You can lower your modifiable risk factors for breast cancer by:

1. Maintaining a healthy weight. Your risk of breast cancer and breast cancer reoccurrence is higher if you are overweight or obese, particularly after menopause.
    
2. Staying active. Women are not physical active may have a higher risk of developing breast cancer. And of course, physical activity will help keep excess weight off.
    
3. Cutting your alcohol intake. Though you may have seen reports that alcohol might actually have some health benefits, research shows that the more alcohol a woman drinks the higher her risk of breast cancer.

Vitamin D Deficiency May be a Risk Factor

In addition to these risk factors, scientists are also studying a number of other potential risk factors possibly related to breast cancer. In particular, vitamin D deficiency has been linked to a worse prognosis in at least one study in breast cancer patients. And though the data is conflicting and not clear right now, scientists agree that vitamin D deficiency should be corrected for a number of health reasons.

For more information about breast cancer awareness and what you can do to participate, check out the National Breast Cancer Awareness Month website.

References:

Oncologist 2011; 16(9): 1215–1227.

If you don’t seem to have the time, or desire, to go to the gym everyday or hit a zumba class, why not get in a little extra calorie-burning cardio while also crossing tasks off your to-do list?

There are plenty of chores that can help you with your weight loss goals. For example, for an average 175 lb person, you’ll burn:

• 398 calories per hour with gardening (not simple gardening but actually getting out there and working at it)
• 358 calories per hour washing your car
• 199 calories per hour sweeping
• 318 calories per hour raking leaves (bonus, leaf piles you can jump in!)

Anything you “do” vs. sitting will help you move closer to your weight loss goal. In fact, a recent study found obese people tend to watch an average of 27 minutes more of TV per day than those of normal weight. So get up, turn the TV off and do something. Even cooking burns calories – have you seen Hell’s kitchen? They’re sweating up a storm! And, in addition to churning through some calories, getting up and getting active, even if just for 10 minutes every hour, is healthy. In fact, research shows that sitting for long periods increases ones risk of obesity, diabetes, cancer and early death, even if you exercise! That’s right, just going to the gym everyday does not fully mitigate the health risks associated with prolonged sitting.

It’s easy to keep moving once you get started:

• Set a timer if you need to but get up at least once per hour
• Do something, move around, stretch, fold some clothes
• Walk to your coworkers cubical vs. emailing her
• Walk around while on the telephone and stand and iron clothes while watching TV

Whatever you do, stay active throughout the day, not just for an hour while at the gym!

If you’ve recently heard that calcium supplements are harmful, it’s time to take a closer look at what this nutrient does and why it is critical that you consume enough on a daily basis.

 

Calcium is the most abundant mineral in the body and the primary one that supports strong, dense bones and teeth. It is stored in bone tissue and pulled out when needed to support

vascular contraction and vasodilation, muscle function, nerve transmission, intracellular signaling and hormonal secretion. However, tiny amounts are needed to support these metabolic functions.

Bone Loss Increases as We Age

But, your bone is constantly being remodeled with old bone being broken down and new bone taking its place. The process of bone breakdown rapidly exceeds formation during the later years of adulthood – especially in postmenopausal women. Have you seen older adults hunched over and unable to stand straight with their head back? Many times this may be the result of osteoporosis or possibly even osteopenia – the stage prior to osteoporosis. If you have years of inadequate calcium intake or excess calcium loss or inadequate absorption (amenorrheic women, vegans, undiagnosed celiac disease, post-bariatric surgery, lactose free diet) you are putting your bones and teeth at risk for the development of this silent disease.

Now what about the reports on calcium supplements leading to heart disease? Actually several studies have found that calcium supplements are tied to a small decrease in blood pressure. And though two recent studies found calcium supplements were tied to an increase in risk of stroke and myocardial infarction, the totality of evidence, as covered in the Institute of Medicine’s report on Dietary Reference Intakes for Calcium and Vitamin D, does not support a relationship between calcium intake and cardiovascular disease. 
 

Getting Enough Calcium from Food is Difficult - 33 Cups of Broccoli Anyone?

If you think the spinach or broccoli you are eating contains plenty of calcium, think again.

This chart provides the amounts of each of these foods you would need to consume daily to meet your calcium needs (for all adults 19-50 except pregnant and lactating women who need more; women over 50 need more calcium and all adults over 71 need more as well). 

Food	Amount you need to eat to meet your daily calcium requirement
Dairy products	3 servings per day
Chopped broccoli, fresh	33 cups
Raw spinach	30 cups
Cooked kale	5.6 cups
Large oranges	15.4
Cheerios cereal	8.2 cups

Taking a liquid calcium and vitamin D supplement each day that absorbs quickly will go along way to ensure you get these essential nutrients your body needs to stay strong.