If you think you are getting all the essential vitamins and nutrients you need from food, try keeping a diet record for a few days and having a dietitian look over it. I’m willing to bet there’s something missing.  It’s not because you haven’t been diligent, trust me, even the most well rounded diets are falling short on something. Why? Because there are just some nutrients that are not very prevalent in commonly eaten foods.

According to nationwide data from the National Health and Nutrition Examination Surveys, here are the essential nutrients that are most often missing from our diets:

• Fiber – most Americans get about ½ of the fiber they need everyday to prevent constipation, enhance satiety (that feeling of fullness that comes from a variety of factors including “bulk” in our diet) and keep cholesterol levels down.

How can you get more? - load up on fruits and vegetables. Have at least one serving at every meal (preferably more than one when it comes to vegetables).

• Phosphorus – we need phosphorus for healthy bones and teeth, growth, maintenance and repair of cells and tissues and energy production.

How can you get more? - concentrate on meat and milk, the two best sources of phosphorus.

• Magnesium – is vital for over 300 biochemical reactions in the body including bone health, muscle and nerve functioning.

How can you get more? - the top sources of magnesium are halibut, almonds, cashews, soybeans and spinach followed by mixed nuts, cereal, peanuts, peanut butter and potatoes.

• Calcium – is vital for more than just bone health. It is important for muscle, nerve and blood system functioning.

How can you get more? - dairy is your best bet for calcium. If you avoid dairy for some reason (and remember, even people with lactose intolerance can tolerate some dairy), opt for calcium and vitamin D fortified orange juice, soy or rice milk and take a calcium and vitamin D supplement (or other fortified products such as whey protein powder).

• Vitamin D – is vital for bone health and joint health as well as many other functions in the body (vitamin D receptors are found throughout the body).

How to get more?  - for sources of vitamin D choose fortified milk, salmon, mackerel, tuna fish, fortified yogurt or orange juice, mushrooms exposed to UV light.  However, getting enough vitamin D from just food alone or the sun is difficult.  Taking a liquid vitamin D supplement is a great way to make sure you get enough each and every day.

The best advice of all is to vary your diet. Dietitians often advocate variety because the more foods and beverages you choose from, the more likely you will be to consume an array of essential nutrients (and get at least some of these key ones that are often missing).

 

Summer is the perfect time to eat lots of fresh produce!

Most people know that fruits and vegetables are loaded with nutrients and essential vitamins, fiber and water. But, produce contains much more than that – every piece of produce also contains an array of antioxidants that are beneficial for good health.

You know it’s good for you, but how do you get more in? People say you need to sneak produce into your diet by using the pureed form in casseroles and other dishes. And, this is a viable option to increasing your intake of fruits and vegetables. However, I encourage people to dig in with gusto and actually try new fruits and veggies without soaking them in dressing or sauces. Why? Because I think it’s important to taste real food versus the kind that is overcooked and loaded with sauce.

I can’t count how many times I’ve heard people say “I don’t like {insert food here}” And then my next question is, “Have you tried {named food}?” Fruits and vegetables have a ton of taste and a wide variety of tastes and textures. I assure you that you will indeed find something that tastes good.  Follow the steps below to adding more produce in your diet:

1. Try one new type of produce every week for 12 weeks. If you are looking for inspirational ideas on preparing or cooking a specific fruit or vegetable, just Google the name of the fruit or veggie and “preparing” or “recipe”.
    
2. Add produce to at least 2 meals and 1 snack a day. If you are already doing this, add it to all 3 meals and 2 snacks.
    
3. Find Fresh. Yesterday a 34 year old woman told me she had never tried blueberries before because they looked funny. Then last week her friend convinced her to go to an organic blueberry patch. They had a great time and, she found out she loved blueberries! 
    
4. Think Cost Savings. If you are willing to chop and prepare fruits and veggies and eat what is in season, you’ll save some cash.
    
5. Don’t Waste. If you don’t know how to handle or store a particular fruit or vegetable, visit this website on the fruit nutrition and vegetable nutrition databases where you can look up each individual piece of produce http://www.fruitsandveggiesmorematters.org/?page_id=164.
    
6.  If you don't have a garden yourself, visit your local farmers market for fresh produce.  They are a great resource for whatever is in season.  Be sure to try something new!!
    
7.  Eating fresh fruits and vegetables along with taking nutritional supplements, is an important part of a healthy diet and for managing arthritis and bone and immune health.
   
   
    

Too hot to workout?  Try a water workout!

Water has been a longstanding workout medium for those with joint limitations or pain from injuries and conditions like osteoarthritis. Water exercise allows for total body muscle activation with controlled resistance through full range of motion and 80 to 90% of the body is supported due to buoyancy; making it a great ‘no pain’ way to train. Numerous studies have supported the use of water exercise to combat the pain of osteoarthritis. 

One such study done by British researchers (Health Technology Assessment, August 2005) involved 312 adults with knee or hip osteoarthritis (OA). One hour long water exercise classes were held twice a week for a year. Each class focused on exercises and/or swimming to improve strength, range of motion, flexibility, cardiovascular fitness, balance and coordination. The result: Water exercise over the course of a year resulted in a modest reduction in OA pain and improved physical function. (T. Cochrane et al. Health Technology Assessment. August 2005, vol. 9, no. 31, Executive Summary.)

So where do you start…

First a few safety guidelines:
• Always get your doctors approval before you start any new exercise program.
• Begin in chest height water working your way up to deeper water levels with the use of a support device such as a pool noodle, belt or other floatation device.
• Always spend 5 to 10 minutes warming up the body with gentle fluid movements like walking in place with shoulder rolls or circles.
• Start slowly with 10 or 12 minutes of movement building up to 60 minutes.
• Use a balanced combination of upper and lower body movements. (see suggestions below).
• Progress slowly by increasing the duration of your workout, depth of water workout or adding resistance devises. (e.g. http://www.recreonics.com/aquatic_exercise_equipment.htm).
• Never perform a movement that causes extreme pain or discomfort.
• Follow the 2 hour post exercise pain rule: reduce your exercise intensity and /or duration if you experience an increase in normal/resting levels of joint pain two hours after your exercise session.

Start up moves:

4-point torso press: (chest height water depth) stand with your arms out at your sides, feet about hip distance apart and knees slightly bent. Slowly press your chest forward and back extending and flexing your spine 2 to 4 inches (8 to 12 reps in each direction), then press your ribcage downward in a 2 to 4 inch side to side motion (8 to 12 reps in each direction). Your feet stay planted on the surface throughout the torso motions.
 
Leg swings: (waist or chest height water depth) while standing on one leg, bend the opposite knee and swing the leg fluidly forward and back, out and in and in a circular pattern (8 to 12 reps in each direction).  Repeat with the standing leg.  Feel free to support yourself by holding onto the side of the pool or a floatation device if needed.
 
Arm flutters: (chest height) march or tread water with lower body as you make small flutter movements with the arms outstretched to your sides (up/down and front/back).  Slow the motion down while you increase the range as far as possible and/or comfortable.

Walk and pull: (chest height water depth) walk the length of the shallow end of the pool and back while pulling the arms in an alternating fashion (similar to a cross country ski movement).

Remember to start gently and slowly.  You may also want to invest in a flotation device if you are new to water exercise.  There are belts and cuffs specifically designed to support water exercise or you can try a simple pool noodle, small inflatable raft or kick board. 

Have fun and remember that the right exercise plus good nutritional support can do wonders for our bones and joints.  Try a liquid glucosamine and chondroitin supplement to help keep your joints healthy and flexible all summer long!  Liquid supplements are faster absorbing and easier to swallow than pills or tablets and you only have to take it once per day.  Mix it in your favorite smoothie or juice and you are good to go!

Happy Summer!
 

Looking for new ways to stay in shape this summer?  If so, why not give water workouts a try.  Cool off as you tone muscles, burn calories and splash yourself fit.

Water exercise has many benefits:
 

• Healthier on your bodies cooling system during the hot summer months.
• Works your cardio vascular system by elevating your heart rate with minimal ground force impact.
• Builds strength and tone due to the added resistance offered to every move  (up to 15 times more resistance than air).
• Improves balance and flexibility as the water supports your body allowing for a wide range of movements.
• Joint friendly since the water can support up to 90% of your body weight.
• Burns up to 700 calories in an hour  (depending on the move) making it similar to running at a fast pace.
• Easy to progress with very inexpensive props like a pool noodle or lightweight rubber ball.
• And last but certainly not least, can be fun to do.

If your trying to burn maximum calories for weight loss purposes, keep your body moving with minimal breaks.  Three great full body moves include the water jack, cross-country shuffle and joggers tread.  The water jack and cross country shuffle should both be done standing in chest height water.  This will allow you to add some spring to your move as you bound off the bottom surface of the pool, lake or ocean. Remember the goal is to keep moving and stay upright with your core muscles fully engaged. 

• The water jack is just like a traditional jumping jack except you push off from the bottom on both the opening and closing movement of the legs. 
• In the cross-country movement press one leg back as the opposite arm punches forward in a gliding fashion. Alternate sides with this motion while keeping the torso upright and tight.  To intensify this move bound off the bottom as you alternate in a scissoring action.
• The joggers tread move should be done in the deep so that you maximize the muscles used. Make a rapid jogging motion with your lower body as you use various flutter patterns with the arms (front/ back, up/down, and small circles).

If weight loss is your primary goal take note that evidence from a study done at the University of Florida indicates that water temperature can have an effect on calorie intake after exercise. In the study those participants who exercised in extremely cold water temperatures (20 degrees Celsius) burned the same amount of calories as those in a more neutral temperature, but ate 44% more calories post workout than the neutral water group (White, L.J., Dressendorfer, R.H., Holland, E., McCoy, S.C., & Ferguson, M.A., Int J Sport Nutr Exerc Metab. 2005 Feb; 15(1):38-47.).

The point to take away is that regardless of exercise or environment good nutrition with caloric control is a must if you are trying to lose weight.  On that note, don’t forget the importance of nutritional support for your workouts….add appropriate supplements.

Water exercises are great for anyone with painful joints as it puts much less strain and pressure on them.  It is a way for anyone to exercise who otherwise could not due to painful knees or hips.  This along with taking your liquid glucosamine and chondroitin supplement will help keep your joints strong and flexible.

 

Hats off to those of you who have raced in a fund raising effort to fight cancer! 
 

As many of you know cancer is the second leading cause of death in America right behind heart disease (www.cdc.gov/men/lcod/index.htm). The good news is that research continues to support the very exercise you are performing in those races as a way to help fight cancer for others as well as yourself.

Studies show that exercise (in particular exercise the helps people maintain a healthy weight and reduce stress) can decrease the risk of certain cancers. Nearly 170 observational epidemiological studies of physical activity and cancer risk at a number of specific cancer sites have been conducted. The evidence for decreased risk with increased physical activity is classified as convincing for breast and colon cancers, probable for prostate cancer as well as possible for lung and endometrial cancers (Friedenreich, C., Orenstein, M. 2002, Physical Activity and Cancer Prevention: Etiologic Evidence and Biological Mechanisms. The American Society for Nutritional Sciences J. Nutr. 132:3456S-3464S, November 2002).

The American Cancer Society recommends getting at least 30 minutes of moderate to vigorous paced exercise five or more days per week.  Scientists are not exactly sure how physical activity prevents cancer but suspect it relates to body mass, hormone levels, metabolism and stress reduction.  Exercise can help reduce obesity, which has been shown to increase the risk of several cancers. It can also change the body's hormone levels, which might also have a favorable effect.

The increase in metabolism caused by exercise is thought to speed up the passage of indigestible foods, reducing the time that the colon lining is in contact with certain carcinogenic agents.  And last but not least numerous studies have linked unhealthy stress levels and lack of proper sleep habits to immune deficiencies and certain types of cancer. In fact, a recent study presented at the American Association for Cancer Research's Seventh Annual International Conference on Frontiers in Cancer Prevention Research suggests that regular physical activity can lower a woman's overall risk of cancer – but only if she gets a good night's sleep. Otherwise, lack of sleep can undermine exercise's cancer prevention benefits.
Source: http://www.sciencedaily.com/releases/2008/11/081117153154.htm

So what exercise tops my list of cancer fighting workouts?  Well that is easy; walking! Why? Because it does it all….

• Can be done by almost anybody, anywhere
• Burns plenty of calories
• Helps you clear your mind and reduce mental stress
• Offers an opportunity to get in touch with nature (when done outdoors)
• Allows for talk time with a friend or loved one
• Trains your heart and lungs without exhausting you for the rest of your day
• Acts as natural tranquilizer leading to a better nights sleep
 
Although most research has focused on physical activity in cancer prevention, evidence is increasing that exercise also influences other aspects of cancer survival, including cancer detection, coping and rehabilitation after diagnosis.

Join the Walking Challenge Today  and start on your way to a healthier you!

Don’t forget the important roll proper nutrition and supplementation can also play in a healthy cancer free lifestyle.  Calcium has been found to play a crucial role in breast health and vitamin D for colon health.  Try a liquid calcium and vitamin D supplement for optimal absorption.  Liquid supplements have been found to to be more easily absorbed than pills or tablet form. 

The term Workplace CSA was recently brought to my attention.  A Workplace CSA takes the traditional model of a CSA one step further by delivering a normal CSA farm share to a group drop off site, such as a workplace, for employees to conveniently pick up. The farmer can deliver them all at once to the workplace saving the employees from driving to the farm to pick them up each week. I had personally been involved in CSA’s before and understood the value to both the end consumer and the farmer. It is a win-win model supporting local agriculture.

The Workplace CSA concept excited me. We could provide healthy produce to our employees and support our local agriculture right here from our workplace. I set out with the goal to gain management support and a monetary contribution to start a program. With a management contribution we could make it even more cost effective for our employees to participate in this program – contributing to their health and wellness while supporting our company’s sustainability goals.

A brief PowerPoint proposal was created to present to our CEO for approval. Included in the proposal was a brief summary of what a Workplace CSA was, how it benefited our company and employees, how it supported our sustainability goals, and the potential cost for employees per week for the average 20 week CSA Share. The proposal closed with a call to action. The company was asked for 1. A company contribution to each share and 2. For the company to initially pay out the cost of shares and then allow employees to have the amount deducted from their paychecks during the time period of the CSA program. Our CEO liked the Workplace CSA concept and was on board to contribute to the program.  After we reviewed the cost per week for the most popular options, he offered up a very generous contribution to each share that an employee signed up for. The proposal went onto the management team for their support. We had approval for our first Workplace CSA program.

Sending out an all company email announcing our first Workplace CSA program supported by our company was an exciting moment. The program was explained and included an easy chart showing the cost per employee per week for the two most popular CSA share options; sign-up sheet and a date to turn it in were included. Immediately emails started coming in and my phone began to ring. The excitement level was contagious. I had coworkers thanking me over for getting this program going. I had managers thanking me for getting this going and for what they saw the excitement doing for their staff.  The company contribution helped motivate employees to get involved but on a deeper level it gave the employees pride that they worked for a company that cared about their health and supporting local agriculture.

We now have 50 percent of our employees signed up to receive Workplace CSA shares this year. As coordinator of this project I am excited to see what the season has to offer and hope we can offer this as a yearly program going forward. I am delighted to support our local Whatcom County Farms. I hope other business will follow and add the option of Workplace CSA’s. All it takes is one passionate person in an organization to do the legwork and get a program going.

Lori McKnight is PR Manager for Wellesse Liquid Nutritional Supplements, a Health & Wellness Enthusiast and passionate about sustainability and local community. Her free moments are spent enjoying the wonders of Whatcom County with her husband and daughter. Contact Lori at MomforHealth@gmail.com.

Research has shown that one of the best ways to build strong bones is to start in your youth (www.ncsf.org/pdf/ceu/Establishing-Peak-Bone-Mass.pdf). 

Young athletes that participated in strength and weight bearing and impact activities had higher peak bone density in their mid to late twenties (which is when we hit our peak) and thus had a higher base to fall back on (no pun intended) as they aged.  Bone density is primarily the amount of calcium measured in a specific region of the bone, such as the vertebrae in the spine. A higher bond density means a higher overall bone mass and stronger bones.

Loss of Bone Density
As we age there is a natural attrition in bone mass and density.  The cells that build new bone can no longer keep up with those that break it down and reabsorb it into the body.  When this condition accelerates due to hormonal changes (i.e. menopause), unhealthy lifestyle choices (i.e. smoking and heavy drinking), inactivity and inadequate nutrition it can lead to condition known as osteoporosis, which literally means brittle, porous bone.  This silent but serious condition can lead to bone degeneration and breaks which may be difficult to recover from.  Falls and the related bone breaks are a leading cause of hospitalization in the elderly.  

Multiple studies have shown that aerobics, weight bearing, and resistance exercises can all help maintain or increase BMD in postmenopausal women (Bonaiuti D, Shea B, Iovine R, et al. (2002). "Exercise for preventing and treating osteoporosis in postmenopausal women". Cochrane database of systematic reviews (Online) (3): CD000333). Some of the studies are mixed on whether a person can increase bone density once they have hit their later years, but there is substantial evidence that we can slow down and possibly halt the loss of additional bone mass with proper exercise, diet and supplementation at any age.  *

Lets start with exercise!
As mentioned earlier, it is key to introduce weight bearing, impact and muscle contracting activities to the body early on and try to maintain a sensible exercise and strength training program throughout your life. The pull and tug of the muscles on your bones is what helps to stimulate the bone building cells to go to work.  By weight bearing activities I mean those that force your muscles to support and control your skeletal system against the pull of gravity such as walking, jogging, stair climbing. Stronger muscles also act as a cushioning for falls later in life and can help prevent falls by making it easier to control your body when moving, lifting or doing activities that challenge balance.  

Nutrition
Nutritionally you will need to maintain a balanced diet including enough calories and nutrients to supply bone and muscle tissue for proper growth and repair.  We also know that it is important to have plenty of fruits, vegetables, whole grain and milk products to insure the proper amount of important nutrients for bone health such as calcium, phosphorus and vitamin C.  

Nutritional Supplements
Supplementation of calcium and vitamin D or medications such as antiresorptive or bone anabolic agents may be necessary even with the best of diets and lifestyle practices. Calcium has been a suggested supplement for bone health for many years and more recently vitamin D has become an important recommendation to aid in the absorption of calcium in your body as well as for the overall health and strength of your bones.

For bone healthy supplements check out the Wellesse liquid calcium and vitamin D product line.    When all is said and done our choices and habits can make a huge difference to our bone health and it is never too early or late too get started.
 

'The Vitamin D Solution'

A 3-step strategy to cure our most common health-care problem

What do obesity, heart disease, depression, diabetes, and fibromyalgia have in common? The answer is vitamin D deficiency. More than 200 million Americans lack this essential vitamin and as a result suffer from a host of daily annoyances, chronic conditions, and even life-threatening illnesses. In the landmark book THE VITAMIN D SOLUTION: A 3-Step Strategy to Cure Our Most Common Health Problem (Penguin/Hudson Street Press; April 1, 2010) Dr. Michael F. Holick identifies the causes of vitamin D deficiency, outlines why it is essential to our health, and provides a 3-step program to attain optimal levels of Vitamin D in our bodies.

The leading expert worldwide, Dr. Holick has studied Vitamin D for more than 30 years. Through his research, we now know that every body cell has a receptor for vitamin D and it goes much further beyond bone health. Increasing levels of vitamin D can treat, prevent, and even reverse a remarkable number of daily ailments, from high blood pressure to back pain; lessen the symptoms of chronic conditions such as diabetes and arthritis; and actually prevent infectious diseases, including H1N1 and cancer. Dr. Holick also credits vitamin D with improving infertility, weight control, memory and mood.

Vitamin D is called the "Sunshine Vitamin" for a reason, but surprisingly to many, it is not actually a vitamin but a hormone – unique because it is made in the skin as a result of exposure to sunlight. It is also possible to receive vitamin D from certain foods like milk or mushrooms, the only item in the produce aisle to contain vitamin D. Dr. Holick also recommends supplements to ensure people have optimal levels of this crucial vitamin.

THE VITAMIN D SOLUTION combines cutting-edge research from around the world, an insightful historical perspective, and a simple plan for rebuilding and maintaining an optimal level of vitamin D which combines a sensible amount of sun exposure, vitamin D supplements and foods rich in vitamin D.

Michael F. Holick, M.D., Ph.D., is a professor of medicine, physiology and biophysics at Boston University Medical Center. Additionally a BUMC, Dr. Holick serves as the director of the General Clinical Research Unit, the Bone Health Clinic, and the Heliotherapy Light and Skin Research Center. A recipient of the prestigious Linus Paulding Institute Prize in health research and the DSM Nutrition Award, Dr. Holick has authored more than three hundred peer-reviewed research articles, coedited eleven books in academia, written two books for a general audience, and currently serves on the editorial board for a number of medical publications. Dr. Holick has been featured in numerous popular media, included The New York Times, Forbes, Time Magazine, Newsweek, Men's Health, and Scientific American. He lives in Massachusetts with his family.

To schedule an interview with Dr. Holick, please contact: Alexandra Ramstrum; Alexandra.ramstrum@gmail.com / 530-219-2045

Contact: Alexandra Ramstrum
alexandra.ramstrum@gmail.com
530-219-2045
Penguin Group USA


Source:  http://www.eurekalert.org/pub_releases/2010-04/pgu-tvd040110.php

 

Yes!  You can exercise before and after Gastric Bypass Surgery - learn why & how to do it safely.

Asking a severely obese person (more than 100 pounds overweight) to exercise can be like suggesting a spicy meal to someone with a stomachache.  Obesity takes a toll on almost every system in the body from your heart and blood vessels to your organs, bones and joints.  This often leads to a vicious cycle of sedentary behavior; the less you move the more you gain ...the more you gain the less you feel like moving. When you spend years being inactive you lose important physical abilities and muscle properties that allow you to stay active for life. More and more people are turning to gastric bypass surgery as a solution when traditional diet and exercise are not working. This medical intervention can offer a fresh, new start but won’t be the full solution unless coupled with a healthier lifestyle, including proper nutritional and exercise habits. 

Research studies on obesity and weight loss continue to support exercise as a key component to weight loss maintenance. A recent study done out of Brown Alpert Medical School and Miriam Hospital in Providence, Rhode Island found that of 199 patients who underwent gastric bypass, those who became more active after surgery lost more weight over one year than those who remained relatively inactive. (Bond DS, Phelan S, Wolfe LG, Evans RK, Meador JG, Kellum JM, Maher JW, Wing RR. Becoming physically active after bariatric surgery is associated with improved weight loss and quality of life. Obesity 2009;17:78-83.(2009).

Below is a three-phase approach to exercise for those considering or recovering from a gastric bypass surgery.

Phase 1: Pre surgery (ideally 4 weeks)
Assuming you are currently inactive, the first step is to prepare for surgery by performing a pre-op ‘no sweat’ exercise program.  Now don’t let this phase scare you off, because I really mean ‘no sweat’.  This phase is simply to establish the ‘activity’ dream that lives deep down inside of your genes.  It is the preparation phase to the exercise program you will follow after surgery.  The main goal is to help you establish an exercise habit.  It starts with simply setting aside the time to exercise. It is ideal if you start this phase a month before surgery, but any amount of time will benefit you. 

Start with 10 minutes a day (most if not everyday of the week).  During those 10 minutes you can do whatever activity feels comfortable.  This might include limbering movements, light stretching, breathing exercise, chair exercise, contract and release muscle exercise, or simple closing your eyes and picturing yourself doing exercise. The key is to schedule the time like an important appointment and stick to your schedule.  It is not about the movement or exercise during this phase, it is about the commitment which will evolve into a new exercise habit in your post surgery lifestyle.  The more seriously you take this phase prior to surgery, the easier it will be to build upon it after surgery. 

Phase 2: Post Surgery (typically 4 to 6 weeks)
You will be taking in far fewer calories directly following surgery, which can sometimes cause the body to react as you were on a starvation diet. This can signal the body to burn muscle instead of fat. This is the last thing we want in the long run because it leads to a downward turn in ones natural metabolism (ability to burn calories). Regular exercise alters the metabolism so that the body burns fat instead of muscle. This is why you want to get back to regular exercise as soon as possible. Initially post surgery you can get right back to your pre-surgery ‘no sweat’ workout commitment and only perform those movements or exercises that are easy to do without interrupting the healing process. This may be limited to light stretching, deep breathing and simple contract/relax exercises in your bed.

Once you have your doctor’s permission to exercise a bit out of bed you will want to add in some light walking on level surfaces. Start off slow and easy building up to 10 minutes non-stop. You may need to wait a good four to six weeks before you can get a bit more aggressive with your cardio routine.  Always check in with your physician for approval before increasing your workout intensity.  At this point you want to focus on extending your scheduled exercise time from 10 minutes to 30. Choose activities you like that will exercise your heart and lungs while burning additional calories.  Walking and non-jarring stationary equipment like a recumbent bike or elliptical trainer will feel the most comfortable. Water exercise may also be a good option but only after all incisions have heeled completely.

Phase 3: Beyond Recovery  (a life-time commitment)
Once you have been given the green light to engage in a more complete training program you will want to include some muscle strengthening work to your cardio routine.  This is one of the best ways to insure your body maintains it’s lean mass.  When you train your muscles they get the stimulation and nutrients they need to thrive. This contributes to stronger, healthier bones and joints.  An increase in muscle strength and mass will make all of the activities you do seem easier.  This in turn will increase your ability and desire to work harder.

So during phase 3 you will want to add muscle strengthening to your weekly workouts. You can continue with your 30 minutes of cardio, most if not all days of the week and simply add in the strength training exercises on 2 to 3 of the days (non-consecutive) extending those workouts to about 50 or 60 minutes; or you can alternate your workouts and spend 30- 45 minutes everyday in either a cardio or strength routine.  Below is a sample of a balanced strength routine:

Perform 8 to 15 reps of the following exercises (choosing a resistance that allows you to sense fatigue within the final few reps)  

1. Bench chest press
2. Bent over row or seated row 
3. Overhead press
4. Biceps curls
5. Triceps kick backs 
6. Squats
7. Hamstring/leg curls
8. Calf/heel Raises
(Perform 2 to 3 sets of exercise 1- 8)
9. Supine Abdominal (compression) press into the floor – avoid traditional abdominal curls until given doctors approval – see picture A below
10. Prone opposite arm and leg reach  – see picture B below

A. Hold for 3 to 5 breaths, repeating several times
 

B. Hold for 3 to 5 breaths, repeating several times one each side 
 

• Note: To maximize muscle growth be sure to include a nutrient dense diet with enough calories, calcium and protein to support muscle development – check with a physician or dietitian familiar with your condition for specific recommendations. 

During a weight loss-training program you may find you occasionally hit a weight loss plateau.  To break a plateau try increasing the time you spend in each cardio session (moving towards 60 minutes) or increasing the intensity (moderate to vigorous). You can also choose to do a bit of both. 

• Note extending your cardio workout time and or intensity will encourage faster weight loss.  If doing so be sure to stay properly hydrated by drinking a minimum of 4 oz. of water for every 20 minutes of vigorous exercise.

The good news is that the body is a miraculous machine when in comes to damage control. Given proper nutrition and physical motion it will rebuild itself. The damaged systems can become strong and vital again. 

You will need to take certain vitamin and mineral supplements for the rest of your life because your body will have a tough time absorbing certain nutrients.  Doctors recommend that you take a multivitamin-mineral supplement and calcium, iron, vitamin B-12 and vitamin D.  For example, when it comes to calcium and vitamin D supplements, these are typically quite big in pill form.  By opting for a liquid supplement, you can take them at any time during the day (just a few teaspoons worth at most).  Many physicians recommend liquid supplements for these reasons – they are convenient and much easier for your digestive tract to handle.

When choosing a calcium supplement, make sure it has calcium citrate and not calcium carbonate.  After weight loss surgery, the body cannot absorb calcium carbonate.  Calcium citrate is water soluble and can be easily absorbed, especially in liquid form.

Liquid supplements  are easier to swallow and fast absorbing.  The stomach does not have to "dissolve" the tablet or pill, making it a perfect choice for anyone who has had weight loss surgery or who has trouble swallowing pills.  Try a liquid calcium with vitamin D3 and take the liquid vitamin D3 for additional nutrition.  Doctors are now recommending 2,000 IU of vitamin D3 per day.


If you have had gastric bypass surgery or are planning to, please tell us your story and how it has affected your life. 

 

source: http://www.nutraingredients.com/Product-Categories/Vitamins-premixes/Vitamin-D-levels-not-enough-for-winter-Study

Current recommended intake for vitamin D during winter months and need to be at increased by five, says a new study from California.

You may be surprised how much milk or cheese it actually takes to get 1000 mg of the calcium you need each day from diet alone.  It takes 3 ½ cups of milk or 3 yogurts to reach 1000 mg.  Here are some great ideas and tips for strong bones and teeth and to help prevent osteoporosis.

Ways to get more Calcium for bone health: (from eatsmart.org (Washington State Dairy Council)

These ideas will help you think about and plan ways to get enough calcium. Choose one or two changes that you can easily make for optimal bone health.


- Concerned about fat? Remember that lower-fat dairy products have all the calcium of regular dairy products.
- Select milk as a beverage when eating out.
- Stir-fry broccoli, kale or bok choy and sprinkle with toasted almonds.
- Use yogurt or tahini as a dip, garnish, spread or dressing.
- Stock up on canned salmon for use in sandwiches, salads and casseroles.
- Make soups with milk instead of water.
- Try tofu burgers or lasagna.
- Make your coffee choice a caffe latte.
- Add cheese or chickpeas to salads and sandwiches.
- Select milk desserts such as custards, puddings, yogurt and ice cream.
- Add skim milk powder to mashed potatoes, cooked cereals, casseroles, hamburger patties, omelettes, etc.
- Try some whole or refried beans in a wrap.
- Sprinkle parmesan cheese on cooked broccoli.
- Try flavored milk if you don’t like plain.
- Snack on almonds once in a while.
- Try calcium-enriched milk or yogurt. Each portion has an extra 100 mg of calcium.
- Take a liquid calcium supplement with vitamin D such as Wellesse Calcium & Vitamin D Liquid.  Liquid supplements absorb better than pills and are easier to swallow.

Other tips to take for strong bones:
- Stop smoking
- Take a brisk walk every day. Walking is a good weight bearing exercise.
- Do muscle strengthening exercises.
- Eat five or more fruits and vegetables every day.  Good nutrition for healthy bones
- Keep alcohol consumption to a minimum.
- Cut back on salty foods, caffeine and soda.
- Do balance training exercises to help prevent falls.  Exercise for healthy bones
- Get a bone density test.


What You Need to Know about Osteoarthritis

Eating Right

• Yogurt contain probiotics that help support the immune system
• Garlic contains allicin, a potent bacteria fighter
• Black Tea or Green Tea to help produce more interferon, a protein that battles cold and flu infections
• Mushrooms such as shiitake, maitake and reishi contain immune-boosting chemicals
• Fatty fish like salmon, mackerel and herring contain omega-3 fatty acids and vitamin D and selenium that benefit the immune system

• Wash hands often and well with soap and water for at least one minute or use a hand sanitizer gel if no sink is available, like at the grocery store.
• Don't share toothpaste tubes with anyone
• Use paper towels instead of cloth towels at home in the kitchen and bathrooms
• Spray or wipe disinfectant everywhere - phone, keyboard, desktop, door handles, weights, remote controls, etc.
• Use gloves if possible when pressing buttons on ATM machines and the like
• Keep a 5 feet away from anyone who is coughing or sneezing

• Omega-3 fatty acids, especially if you do not like fatty fish
• Vitamin D3 supplement - people who took 2,000 IU of vitamin D daily had 70% fewer colds and flu, according to a 3 year study published in Epidemiology and Infection.  This time of year its almost impossible to get enough vitamin D from the sun and food just doesn't have enough.
• Vitamin C
• Echinacea
• Zinc taken at the very start of a cold may help shorten the duration

• 20 or 30 minutes of moderate exercise a day will help increase blood flow, which speeds nutrient absorption and decreases stress hormones, which dampen immune response.
• Get at least 7 hours of sleep every night.  Lake of sleep depresses the immune system making your more susceptible to bacteria that causes viruses
• Try Yoga or Tai chi for relaxation and exercise.
• Don't hide out - be social.  People who are socially active get fewer colds because they tend to be more positive and happier which also strengthen immunity. 

As a continuation on my series of blog posts on healthy digestion, I'd like to talk about Prebiotics and how they affect digestion.

Overview
If you’ve ever seen inulin, oligofructose or fructooligosaccharides on product packages, you are probably wondering what on earth these food ingredients are and why they are were added to your food or supplements. Inulin, oligofructose and fructooligosaccharides are all prebiotics – food ingredients that are not digested by the human body but boost the growth and/or activity of the friendly bacteria in our gut, especially bifidobacteria and lactobacilli. Most prebiotics are a type of soluble fiber.

Prebiotics are added to foods to enhance the nutrition profile of the food and improve certain characteristics of the food. Inulin can replace some of the sugar in food while adding sweetness, replace fat, improve mouth feel and texture of certain foods.

Inulin for Good Health
Inulin is a versatile non-digestible prebiotic fiber. In other words, it is an ingredient added to food or dietary supplements to boost your health. The form of inulin (inulin-type fructans) used in food and supplements is not digested or absorbed to any extent. Inulin-type fructans are metabolized by bacteria in the colon, increasing the growth of the healthy bacteria – bifidobacteria.

Unlike other types of carbohydrate, inulin does not raise triglycerides and has a minimal effect on blood sugar. And, a thorough look through the research by a team of scientists at the University of Parma in Italy found that inulin-type fructans can reduce serum triglycerides. Inulin can cause gas and bloating in people who are not accustomed to eating a high fiber diet or inulin. These effects should go away after becoming accustomed to inulin (most Americans eat far below the dietary recommendations for fiber – 14 grams for every 1,000 calories consumed).

Prebiotics and Nutrient Absorption
Some prebiotics may improve the absorption of some minerals by changing the environment in the colon and transferring water into the large bowel thereby increasing the volume of fluid minerals can dissolve in. In human studies, inulin and oligofructose have been found to increase the absorption of calcium.  Rat studies have found these prebiotic fibers increase the absorption of calcium, magnesium and zinc.

Why is this important? Results from the largest national nutrition examination survey (NHANES 2005-2006) show that as we age, we are less likely to take in enough calcium.  Just 58% of men aged 31-50 years of age are meeting their calcium needs. And, a mere 26% of men aged 51-70 and 14% of men over 71 years of age are taking in adequate amounts of calcium.  These numbers are even more dismal for women!  Thirty-three percent of women ages 31-50, 8% of women 51-70 and 7% of women over the age of 71 are taking in enough dietary calcium needed for bone health.

A liquid calcium supplement with 1000 mg of Calcium and 1000 IU of Vitamin D3 is a great way to get the calcium needed each day to help prevent and in managing osteoporosis.
 

• Thanksgiving shouldn’t be synonymous with “all you can eat Buffet.” Keep the primary focus on the company around you and the football games on TV.
• Remember that pumpkin pie, fat-backed greens, gravy and stuffing are available year-round in this country so you don’t need to stuff yourself in one day.
• Eat breakfast on Thanksgiving Day. If you skip out on eating in the morning to “save calories” for your evening meal, you are setting yourself up for a binge.
• Eat slowly and stop when you are full. Does another bite of pie really matter or did you already experience that taste and mouth-feel you were looking for?
• Drink water throughout the day especially if you are drinking alcoholic beverages, alternate them with water.
• Instead of cutting out certain foods or denying yourself dessert, concentrate on portion control. By allowing yourself to have small portions of your favorite holiday foods, you will not feel like you are being deprived (try using a smaller plate for your main meal – a salad plate for instance).
• Eat slowly and savor every bite. Really experience the flavors, textures and smell of each food you are eating.
• Skip the seconds or wait until others have gone up for seconds. By waiting, more of the fattening foods are likely to be finished already.

Managing arthritis can be difficult during the holidays.  As you start to decorate and do lots of shopping, make sure to not over exert yourself.  It can be easy to get caught up in the excitement and do too much.  Don't forget to take your nutritional supplements even when you go shopping at 4 am on Black Friday!

Have a Happy, Healthy Thanksgiving!

Let's focus on the legs!

How are your treads holding up?  As you pick up the pace or mileage of your walking program you may find that your legs need a bit of a tune up.  It is not uncommon to feel some pain or discomfort in the muscles of your lower leg when you get more aggressive with your walking technique.  Let’s take a look at why this happens as well as how to prevent and recover from this potential performance barrier. 

In order to pick up your fitness walking pace it takes a more exaggerated ankle action and forward body lean. This technique creates a greater demand on the muscles of the lower leg.  The front of the lower leg or anterior tibialis muscle group must dorsi flex your ankle (which mean pulling the forefoot up closer to the shin) on the forward heel strike.  Then the back of your lower leg or gastrocnemius muscle group must plantar flex your ankle (which means pushing your forefoot away from your shin) to propel you forward and into the next step.  The greater the action the faster you walk.  This increase in ankle action can takes its toll on the lower leg muscles and their attachments, causing a general sense of pain in the shin, calf and ankle areas.  This is especially true when you first start a more aggressive walking program.  In most cases the muscle pain you sense is due to a condition know as DOMS or delayed onset muscle soreness. 

DOMS is your muscles way of telling you that you have introduced it to something new and challenging.  It is nature’s way of slowing you down so that the muscle tissues can progressively get stronger without getting injured.  Keep in mind that any pain that results in swelling or bruising or lasts for more than a week, should be checked out by the appropriate medical professional. 

So what can you do to avoid or treat DOMS in the lower leg muscles? 

Let’s start with a list of ways to minimize or avoid DOMS:
1. Make sure you have proper, supportive footwear.
2. Progress into your program goals gradually.
3. Warm up properly before your walk, including lower leg movements that mimic the positions your ankle will travel through (i.e. walking on your toes then heels for approximately 30 seconds each).
4. Stretch the muscles of the ankle after the walk, holding each stretch for at least 20 seconds (i.e. ankle circles, and calf stretches).
5. Keep the muscles of your ankle strong by doing lower leg condition exercises (i.e. calf raises and dorsi flexion with foot resistance).

 

Now what can be done once you are feeling a bit of lower leg DOMS:
1. Take a few days off from your walk and if possible cross train by doing an activity that does not use the same foot pattern (i.e. swimming or cycling).
2. Massage and stretch the front and rear leg muscles daily.
3. Ice the affected areas.
4. Stay well hydrated and keep your joint lubrication up with the appropriate joint supportive nutritional supplements such as a glucosamine and chondroitin liquid supplement that's easy to take and fast absorbing.

Have a great Walking Challenge!
 

This is a repeat of a previous post, but with the increasing importance of vitamin D, I thought it would be appropriate to post again.

When it comes to nutrition, the media often finds an ingredient, supplement or product that steals the spotlight for a period of time.  Sometimes the ingredient is lambased to the point where it becomes an outcast at warp speed, this happened with partially hydrogenated oils (man made trans fats).  Other times, the news is good.   And this is what has happened with vitamin D.  This vitamin has gone from the kid at the back of the class to center stage in a short period of time. 

Vitamin D
When it comes to bone health, many of us automatically think of calcium and milk/dairy.  However, calcium alone can't do its job without adequate vitamin D.  Think of vitamin D as the gatekeeper to bone tissue, it aids in the absorption of calcium.  Vitamin D may also decrease our risk for certain types of cancer.  Most notably, colon, prostate and breast cancer.  And, a deficiency in vitamin D can lead to osteopenia, osteoporosis, chronic pain, muscle weakness, fractures and autoimmune diseases.
 
Vitamin D is manufactured in the skin upon exposure to sunlight.  Past recommendations have indicated that just a little exposure - say 15 minutes a day, will give us all the sunlight we need to make vitamin D.  However, recent studies have shown that many of us fall short.  Even people living in climates sunny throughout the year like southern Arizona.  How can this be the case?  Individuals with darker skin and older individuals just don't produce vitamin D as well as fair-skinned, younger people do.  And, people who live in less than sunny climates simply aren't exposed to the sun's rays often enough.  Lastly, many people have had skin cancer (basal and squamous cell carcinoma is on the rise) and are avid sun block users and therefore don't manufacture adequate vitamin D.
 
Calcium
Now, on to calcium. Aside from its role in bone health, calcium also aids in:  muscle contraction, blood vessel contraction and expansion, hormone secretion, heartbeat regulation, conducting nerve impulses and blot clotting.  And, all of these functions are considered more vital than keeping our bones strong.  So, when we fall short on our calcium intake our body leaches it from our bones. If this process occurs frequently, over time we end up with weak, porous bones, osteopenia and osteoporosis.
 
How to Get It
It's clear we need to take in adequate levels of calcium and vitamin D daily.  Calcium is more easily obtained from foods, especially dairy foods.  Greens like spinach are often noted for their calcium but, this calcium is bound to the oxalic acid present in these greens and therefore, not readily absorbed.  The same thing goes for calcium that is fortified into grain products - it is bound to phytic acid and not easily absorbed in the body.  Vitamin D is a bit harder to find in foods.  Salmon, mackerel, canned tuna, canned sardines, and milk are your best options.  If you don't drink 4 glasses of milk a day or a combination of other dairy and the fish mentioned above, try a liquid calcium and vitamin D supplement.

 

BELFAST, Northern Ireland—Pregnant women, even those who use nutritional supplements, have insufficient levels of vitamin D, according to a new study (Br J Nutr. 2009 Sep;102(6):876-81).

Researchers at Queen's University compared vitamin D levels in 99 Caucasian pregnant women at 12, 20 and 35 weeks of gestation to 38 non-pregnant women. Vitamin D levels were lower in the pregnant women with 96 percent classified as insufficient at 12 and 20 weeks, and 75 percent classified insufficient at 35 weeks.

Women who took multivitamins had higher levels of vitamin D than those who did not take a supplement, but levels were still classified as too low.

The researchers recommend pregnant women take higher dose vitamin D supplements  in order to avoid rickets, schizophrenia and type 1 diabetes in their children.

 

Vitamin D is mainly found in foods of animal origin, though typically in small amounts.  Some species of fish including salmon, mackerel, tuna fish and sardines contain a decent amount of vitamin D in just one 3.5 oz serving.  Fortified milk, margarine, fortified cereals and infant formulas also contain vitamin D.  See chart  http://vitamind.wellesse.com/servings.asp

According to What We Eat in America, NHANES 2005 – 2006* here are the percentage of people that meet the adequate intake (AI) for vitamin D:

As you can tell from this chart, females from 14 – 50 years old are less likely than males in the same age bracket to meet their vitamin D needs.  And, very few people over the age of 50 (regardless of whether they are male or female) meet their vitamin D needs, which is so important for bone health.

Can you meet your vitamin D needs through food?  Certainly.  But, to do so you better be very diligent about taking in foods rich in vitamin D several times a day.  That's why many experts suggest taking a Vitamin D3 supplement of at least 1,000 IU per day, especially during the winter months when its impossible to get any from the sun.  Liquid supplements make it easy for everyone to take, including children, who have difficulty swallowing pills.

*The National Health and Nutrition Examination Survey is designed to assess the health and nutritional status of adults and children in the U.S.