UPDATE: Omega-3 Fatty Acids

First the good news: Omega-3 fatty acids reduce post-partum depression by as much as 50 percent. This seems to indicate that the post-partum depression is, at least in part, a nutritional deficiency. While pregnant and nursing, the infant gets priority use of any omega-3 fats in the mother's diet. Since most Americans are deficient in this essential fat anyway, consuming more will help the baby to grow a large, well-functioning brain and keep the mother from becoming deficient and depressed.

Now the bad news: omega-3 fats do not seem to offer any protection against cancer, at least not in the latest meta-study.

Researchers examined data from 38 studies that tracked patients for up to 30 years, and said most showed there is no cancer protection from omega-3 fatty acids. Although a few studies found some risk reduction for cancers of the breast, prostate and lung, those studies were relatively small and not definitive, said Dr. Catherine MacLean, the lead author and a researcher at the Rand Corp. and Greater Los Angeles Veterans Affairs Healthcare System.

"It doesn't mean that omega-3 fatty acids don't have other health benefits — it's just that reducing cancer risk isn't one of them," MacLean said.

However, the review is unlikely to be the last word on the issue. Diet is known to play a role in cancer and the researchers evaluated observational studies, which provide mostly circumstantial evidence.

The reviewed studies examined the effects of fish oil — in both pill form and as food — on 11 kinds of cancer, mostly tumors of the breast, colon, lung or prostate.

Emphasis added. You still need to be getting omega-3 fats in your diet for a myriad of health reasons.

More on Choosing a Personal Trainer

Here is a new ABC News article on the benefits of working with a trainer--and how to choose one.

Jan. 27, 2006— So you made your usual New Year's resolution to get in shape. But studies show that by late January most of us have already strayed. (We didn't need a fancy study to figure that out, did we?) Maybe what you need to do is outsource your willpower. My best workout success has been with a personal trainer. But beware! The government doesn't regulate personal trainers, so anybody can become one.

"I am a personal trainer." Saying it is all you have to do to make it so. You don't need a degree. You don't need a certification. For that matter, the government doesn't regulate the organizations that provide certification. About 15 different groups do so
nationally — some respected, others not. Several organizations certify people as trainers after one weekend of classes. Others require simply an open-book test. When I investigated personal trainers, I even found a group that was willing to certify me by mail if I sent a videotape of myself exercising!

Personal training costs $50 to $100 an hour and up, so it ought to be a weighty decision. If you get the wrong trainer, you'll lose money and you won't lose weight. You could also seriously injure yourself. Don't choose a trainer just because he or she has a great body. Choose somebody who can help you achieve your fitness goals. Finding a good trainer should wear you out a little bit — just like a good workout.

Try to find a personal trainer who has a college degree in a relevant field like kinesiology, biomechanics, exercise physiology or health and fitness plus a credible certification. The American College of Sports Medicine and the National Strength and Conditioning Association are the most respected certifying organizations. Knowing who trained the trainer is really the key.

Here are some tips to becoming a savvy consumer when it comes to hiring a personal trainer:

• If a trainer claims to be certified by a national agency, ask for the agency's name, number and Web site so you can confirm.
  
• Check to see that the trainer keeps up with continuing education.
  
• Many certifying organizations keep grievance records, so you can find out if the trainer's background is clean.
  
• Some trainers carry liability insurance, and that's another thing you may want to look in to.
  
• Check the trainer's references and make sure his or her fitness philosophy is a good match for you.
  
• Make sure your trainer is capable of performing CPR.
  
• Get the trainer's cancellation policy in writing before you start working with him or her. (My trainer requires 24 hours' notice or I have to pay. Sounds strict, but I actually like it because it motivates me to stick with my workouts unless I have a good reason.)
  
• If a trainer suggests you use herbal supplements, resist. Personal trainers are not qualified to advise on supplements, and many are risky.
  
• If a trainer pushes you to do exercises that hurt or make you uncomfortable, say no until you can get a second opinion.

This is all good advice, although herbal supplements are often better than prescription medications--and safer. The medical establishment, of which writer Elisabeth Leamy is a part, denigrates any supplement not produced by a drug company paying them kickbacks, so beware the "magic pill" your doctor prescribes.

Other good certifications include the ISSA (International Sports Sciences Association) and the ACE (American Council on Exercise).

Type-II Diabetes Is Preventable, But There's No Money in That

The Nation has a good article on how the diabetes epidemic is being completely ignored by the medical community because there is much more money to be made treating the complications of diabetes than in preventing it.

The article also looks at how the food industry is making the problem worse.

This is a disease of low- and middle-income people. They are the ones who live off factory-made food loaded with the grease and sugar from which American people are sickening at an ever younger age.

At home and at school children are habituated to eating what will kill them. There is profit in poisoning the population, and lethal food peddling, unlike lethal drug peddling, is legal. A go-getting, job-creating ad agency entrepreneur can make a hell of a lot of money teaching children how to grow fat and kill themselves.

These two issues are prime examples of why we need an Integral fitness solution, not another diet plan or exercise program. If we do not look at the cultural values around food and health and the the societal support (economic, in particular) for getting sick from diabetes (as shown in this article), we'll never solve the problem.

The problem is not simply weak people who eat too much of the wrong foods. When the food industry is contributing to the problem in every way possible and the medical community cuts diabetes prevention programs because there is more money to be made on dialysis and amputations than on preventing the disease in the first place, it's the society that helps create and support the problem.

To solve the problem of obesity and diabetes, we must also look at how our economy supports these diseases. We need an integral approach to the problem.

Soy Does Not Live Up to Health Claims

The American Heart Association now claims that soy has no effect on heart disease and does not lower cholesterol. The evidence has always been sketchy on this claim, so it's good news that they've clarifed the issue with new research.

The report also noted that soy isoflavones provide no benefits in preventing breast, uterine, or prostate cancer. Soy and its isoflavones have no impact on menopausal "hot flashes," either.

I suspect that continued research will find that soy actually increases cancer risk in some people.

From the ABC News story:

An American Heart Association committee reviewed a decade of studies on soy's benefits and came up with results that are now casting doubt on the health claim that soy-based foods and supplements significantly lower cholesterol.

The findings could lead the Food and Drug Administration to re-evaluate rules that currently allow companies to tout a cholestorol-lowering benefit on the labels of soy-based food.

The panel also found that neither soy nor the soy component isoflavone reduced symptoms of menopause, such as "hot flashes," and that isoflavones don't help prevent breast, uterine or prostate cancer. Results were mixed on whether soy prevented postmenopausal bone loss.

Based on its findings, the committee said it would not recommend using isoflavone supplements in food or pills. It concluded that soy-containing foods and supplements did not significantly lower cholesterol, and it said so in a statement recently published in the journal Circulation.

Read the rest here.

For Women, Larger Waistline Equals Greater Heart Disease Risk

Some people reject the idea that being obese is unhealthy, but the evidence keeps piling up.

From UPI:

A New York Presbyterian Hospital study says women with waistlines of 35 inches or more are at greater risk of heart disease than thinner women.

The research, jointly done with Sister to Sister: Everyone Has a Heart Foundation Inc., and published in Thursday's issue of the Journal of Women's Health, studied more than 6,000 women without known heart disease.

It found 90 percent had at least one major risk factor for heart disease, and one-third had three or more. The risk factors included high cholesterol and high blood pressure.

Increased waist circumference was also correlated with a woman's 10-year chance of having a heart attack or dying of heart disease.

"Measuring waist circumference may be a simple method that women can identify themselves as being at increased heart-attack risk and empower them to seek further evaluation and possible treatment from their doctors," says lead author Dr. Lori Mosca.

T-Nation Interview With Paul Chek

T-Nation interviews Paul Chek, very cool. Chek is a bit of a maverick in the fitness world. While most trainers only look at the physical mechanisms involved in losing fat or building muscle, Chek includes emotions, the mind, subtle energies, and the soul. It's these last two that often get him in trouble with the establishment--and make him important to the integral world.

From the introduction to the interview:

I'd been assigned to interview Paul Chek, I'd been on the phone with him for close to four hours, and I didn't understand a single goddamn thing he was saying.

How was I going to transcribe this? How was I supposed to cut it down to 5000 words for an article? How was I supposed to get info out of this guy when every question I asked about protein and training garnered me an hour long diatribe about magnetic poles, chi, God, the planets, "cosmic consciousness," and the soul?

Shit.

Was this interview a bust? Had I wasted his time and mine?

No, I didn't think so. Because in the back of my mind, I knew that Chek was one of the best in the world in his field: corrective and high-performance exercise kinesiology. In fact, with his holistic approach, he's practically reinvented the field. I knew that, at 44 years old, Chek could outperform a lot pro-athletes in their twenties. (In his own words, he can "hammer the shit out of them in the gym." And he really can.) And his physique is pretty damn impressive too. There was something to learn here. Maybe a lot.

I also knew that while a lot of Chek's ideas were "out there," all really innovative and powerful concepts sound a little crazy at first... Or hell, maybe he's just a nutcase. I'll leave that for you to decide.

Read the rest here.

FitBit's News You Can Use

Here's the December update from Exercise ETC.

FitBits
December 31, 2005
Exercise ETC’s Review of Exercise Related Research
Compiled by Jeannie Patton, MS, CSCS

Testosterone Supplementation Greatly Increases Muscle Size in Elderly Men

Many older adults experience a loss of muscle mass and strength due to deconditioning, illness, injury or major surgery. The purpose of this study was to determine the benefit of progressive resistance training and testosterone administration to improve muscle strength and cross-sectional area for elderly men.

Seventy-one males with an average age of 78 served as subjects and were randomly placed into one of four exercise groups. The groups consisted of low-intensity resistance training (20% of the one repetition maximum) with injections of either testosterone or a placebo and high-intensity resistance training (80% 1RM) with injections of either testosterone or a placebo. Each subject received training and injections for 12 weeks.

Strength improved in all 4 groups, but was statistically greater in the high-intensity training group. Subjects who had the testosterone injections saw significantly greater increases in cross-sectional area than the placebo group, but not significant gains in strength. Interestingly, no protocol resulted in significant increases in functional
capacity.

The results of this study indicate that high-intensity strength training produces greater gains in muscle strength, but that the addition of testosterone significantly increased cross-sectional area. This study indicates that Fitness Professionals have a range of program design options in designing training programs to meet their clients’ goals. In addition, trainers should remember that gains in muscle strength and size do not necessarily parallel gains in function.

Sullivan, Dennis, H. et al. Effects of muscle strength training and testosterone in frail elderly males. Medicine & Science in Sports & Exercise. 2005: 37(10), 1664-1672.

Can I get a "Well, no shit?" It should not even require a study to determine that if you give testosterone-deficient older men some of the magic T, they will increase their muscle mass and strength, especially with higher intensity training. Who gives away money for such dumbass studies? And how do I get some?

On the other hand, there are still doctors who do not believe that steroids have any use whatsoever. For them, I guess these studies are necessary.

Post-rehab Exercise Critical To Restore Strength After Knee Replacement

The first few months after knee replacement surgery are critical to restore the function of the knee extensors (quadriceps). The purpose of this study was to document quadriceps strength before knee replacement and to compare it to results at 30 and 60 days following unilateral knee replacement surgery.

Thirty-eight men and women with an average age of 72 served as subjects. Force production of the knee extensors was assessed before surgery and at 30 and 60 days after surgery.

The study demonstrated a significant reduction in force production in the involved limb after the surgery: Force production was at its lowest level 30 days following surgery. By 60 days after the surgery, strength had improved and approached pre-surgical levels.

The results of this study clearly document the necessity for rehabilitation to continue for at least 60 days, which is when many physical therapy programs cease. Keep in mind, though that this only brings the strength up to pre-surgical levels which were deficient (compared to the uninvolved limb) to begin with. This study documents the necessity for post-rehabilitation and/or home exercise programs past the 60-day period.

Rossi, Mark, D. et al. Early strength response of the knee extensors during eight weeks of resistive training after unilateral total knee arthroplasty. Journal of Strength & Conditioning Research. 2005, 19(4), 944-949.

Having worked with several joint replacement clients, I can personally attest to the necessity of post-rehab training. Further, personal training for the first six months should be covered by insurance--that's how important it is for the patient.

As a side note: the better condition the patient is in going into surgery, the faster and more completely s/he will recover. All joint replacement patients should be encouraged to build as much functional strength as possible prior to surgery. And doctors should use glutamine and branched chain amino acids as part of the IV drip during and after surgery, as well as prescribing these supplements post surgery to maintain as much muscle mass and strength as possible until rehab can begin. It's the little things, people.

Kevin Trudeau's "Natural Cures They Don't Want You to Know About" Is Crap

Kevin Trudeau is the most recognizable face in the infomercial realm. He has been promoting and selling scam programs and cures for more than fifteen years. He is the only person ever banned from selling products on television.

The Federal Trade Commission said that Trudeau falsely claimed that a coral calcium product could cure cancer and other serious diseases and that a product called Biotape could cure or relieve severe pain.

"This ban is meant to shut down an infomercial empire that has misled American consumers for years," said Lydia Parnes from the FTC's Bureau of Consumer Protection. "Other habitual false advertisers should take a lesson: mend your ways or face serious consequences."

Trudeau can sell his scam of a book under First Amendment protections. But he was forced to pay $2 million in "customer redress" for the coral calcium scam, as well being banned from:

appearing in, producing or disseminating future infomercials that advertise any type of product, service or program to the public, except for truthful infomercials for informational publications.

"In addition, Trudeau cannot make disease or health benefits claims for any type of product, service or program in any advertising, including print, radio, Internet, television and direct mail solicitations, regardless of the format and duration."

Trudeau spins it that the government dropped the charges (since he was never convicted of anything). He claims the government was just trying to silence him for exposing their secret agenda to keep Americans sick.

From the ABC Nightline story:

Instead of products such as Coral Calcium, Trudeau now hits the airwaves to sell his book, which promises magical natural cures. But not all of them are in the book. "Natural Cures" often refers readers to his Web site, which requires lifetime membership at a price of approximately $500.

But in the book or on the Web site, many doctors have expressed serious concerns about Trudeau's cures, saying his advice is not only misleading, it could actually hurt people.

"Stop taking nonprescription and prescription drugs," the book instructs. "Remember, drugs are poisons. This includes vaccines."

Trudeau says drugs are only OK in exceptional circumstances — such as trauma or in surgery. His book makes other outrageous claims.

Trudeau writes in his book — which has sold more than 5 million copies and will be listed as No. 1 on this Sunday's New York Times best-seller list for hardcover "advice" books — that "the sun does not cause cancer. Sun block has been shown to cause cancer. The ingredients in sun block are now strongly believed to be the number one cause of skin cancer." He says "antiperspirants and deodorants contain deadly poisons," and that AIDS is "one of the greatest hoaxes and deceptions ever perpetrated on the American public."

The government and the pharmaceutical companies conspire to keep natural cures from you, he insists, to make money by selling medicine.

"It's so profitable to the companies that sell it," he says. "Chemotherapy kills more people than cancer itself."

Trudeau has no medical training and no particular health expertise.

But wait, if you order now, there's even more life-threatening "information" in his book:

Asked for his "natural cure" for diabetes, Trudeau continually cites a study from the University of Calgary, which he says "has 25 years of research" of a natural way to make it so "diabetes can be, if not completely cured and wiped out in America, dramatically reduced by this herbal combination."

But when asked, the University of Calgary told ABC News that "there is no scientific evidence that any herbal remedy can cure any form of diabetes. In our review of the claims made by Kevin Trudeau's book, we have established that there have been no human studies conducted at the University of Calgary in the past 20 years on herbal remedies for diabetes."

Trudeau responded that he was "shocked and amazed" and that he would send us documentation he was referring to. We never did receive that documentation.

The book also claims: "All of the author's royalties on the sale of this book are being used to help fund the mission of educating people about natural health care and exposing corporate and government corruption."

But that "mission of educating people" includes paying for Trudeau's flights and luxury hotel stays as he jets around the country for interviews, he acknowledges.

My guess is that most of the claims in his book are wrong and could endanger lives. He needs to be ignored, and perhaps banned from all television appearances.

Americans Are Starting to Accept Their Fat

We used to look at bodyfat as something almost as evil as, well, lobbyists. But in recent years, Americans have began to accept the fact that they are fat and have revised their ideals of attractive bodies to reflect that new resignation.

Rising instances of obesity have led to Americans being more accepting of excess weight in others and themselves, a survey by market research firm NPD Group has found. The survey, which tracked the changing attitudes of 1,900 people that represent the American population, found that only 24 per cent of Americans found a person carrying excess weight unattractive, as against the 55 per cent that did so two decades earlier.

The irony is that many people still claim that they need to lose at least 20 pounds. I suspect--and the article also mentions this--that the results of the study might have more to do with the fact that 65 percent of the population is overweight. It becomes much harder to reject extra bodyweight when you have some, too.

Many remain skeptical and argue that the findings might stem from the subjects themselves being overweight. Kelly Brownell of Rudd Center for Food Policy and Obesity at Yale University felt that the results reflect the resigned attitude of overweight people.

“These studies don't pick up on implicit, unconscious bias. It's like if you asked people around the country if they had racial bias. There's a difference between what people say and what actually happens,” Brownell said.

The fact that the survey also found that overweight youngsters are 50 per cent less likely to go on dates than their normal body counterparts reinforces Brownell's contention.

National Association to Advance Fat Acceptance's Marilyn Wann said that fat people are often at the receiving end of jokes, mainly because consumerism has brought in the concept of physical perfection. “Everyone thinks it's okay to make fun of fatties,” she said.

It's never okay to make fun of someone who is heavy. You have no idea how much pain I see in my clients as a result of their weight and the self-esteem loss they suffer due to other people judging them. I have been guilty in the past of thinking obesity was a self-control issue--often, it's not. There are deeper issues at work--issues which require some emotional self-exploration.

On a related topic, there are some who believe that the health risks of being overweight are exaggerated and that the pharmaceutical industry is behind it. I never trust big pharma, but I'm skeptical of their claims. Read this article and judge for yourself.

A History of Fad Diets

ABC News has an amusing story on the history of fad diets. Take home message: choose an eating plan that you can stick with for life. The weight might come off more slowly than if you use the "cabbage soup diet" or William the Conqueror's approach (alcohol only), but you'll be able to keep the wieght off instead of doing the yo-yo thing.

Being Overweight at Midlife Kills

A lot of people think that if their cholesterol is not too high and they don't have high blood pressure, they are not at risk for heart disease. It seems they are quite wrong--which is not news to most of us.

Northwestern University researchers tracked 17,643 patients for three decades and found that being overweight in mid-life substantially increased the risk of dying of heart disease later in life — even in people who began the study with healthy blood pressure and cholesterol levels.

High blood pressure and cholesterol are strong risk factors for heart disease. Both are common in people who are too fat, and often are thought to explain why overweight people are more prone to heart disease.

But there is a growing body of science suggesting that excess weight alone is an independent risk factor for heart attacks, strokes and diabetes.

The new study fits with that evolving school of thought and contrasts with a controversial government study published last year that suggested excess weight might not be as deadly as previously thought.

"The take-home message would be pay more attention to your weight even if you don't have an unhealthy risk factor profile yet," said lead author Lijing Yan, a researcher at Northwestern and Peking University.

The study appears in Wednesday's Journal of the American Medical Association.

Participants were Chicago-area men and women in their mid-40s on average who had no heart disease or diabetes when the study began. They were followed for an average of 32 years. The researchers tracked deaths from cardiovascular disease and diabetes, and hospitalizations for those conditions, starting at age 65.

A total of 1,594 heart disease deaths occurred, 31 of them in people who started the study with normal blood pressure and cholesterol.

Among participants with normal blood pressure and cholesterol at the start, those who were obese — or grossly overweight — were 43 percent more likely than normal-weight participants to die of heart disease later on. They were also four times as likely to be hospitalized for heart disease.

Participants who were modestly overweight but had normal blood pressure and cholesterol still ran a higher risk than the normal-weight people.

A total of 1,187 participants — 494 of them overweight or obese — had normal blood pressure (120 over 80 or lower) and cholesterol levels (under 200) at the outset. Standard body-mass index categories were used to define weight — BMIs of 25 to 29 were considered overweight and 30 and above was obese.

Yan said it is possible that some overweight participants developed high blood pressure and cholesterol problems during the study, which could have contributed to their deaths. But she said researchers increasingly believe that being too fat causes other cardiovascular problems, too.

Fat tissue "is not like an inert storage depot — it's a very dynamic organ that is actually producing hormones and chemical messengers," said Dr. JoAnn Manson, chief of preventive medicine at Harvard's Brigham and Women's Hospital. These substances can damage blood vessels, increase the risk of blood clots and cause insulin resistance that makes people prone to diabetes — all without elevating blood pressure or cholesterol, said Manson, who was not involved in the Northwestern study.

Read the whole AP article here.

Product Recommendations

I want to start recommending products that I find useful in a healthy diet and as part of a fat loss program. These companies don't know that I am promoting their products and aren't paying me anything, so don't think I have any ulterior motives. This information is presented for the use of my clients and readers of this blog.

Naturally More Peanut Butter: I generally don't recommend peanut butter due to the extreme imbalance of omega-3 to omega-6 fatty acids (PB is high in the omega-6, which we already get too much of in our diets). But this new product includes flax oil and flaxseed to balance the fat profile. But even better, it includes egg whites to add a complete protein and wheatgerm and flaxseed to add some fiber.

So far, I've only found this product in Sunflower Markets, but I suspect that Wild Oats, Whole Foods, and Trader Joe's should carry it as well.

Nutrition Profile:
Serving: 2 tbsp
Calories: 169
Total Fat: 11 g
Saturated Fat: 2g
Omega-3: 4.1g
Omega-6: 1.2g
Total Carb:8g
Dietary Fiber: 4g
Sugars: 2g (from honey)
Protein: 10g


La Tortilla Factory Whole Wheat Low-Carb/Low-Fat Tortillas (Large): A whole wheat, high-fiber burrito shell that tastes good. Perfect for breakfast burritos with eggs, or with grilled chicken and veggies, and so on. One thing to note is that the calorie count on the packaging is wrong. They only count what they call "effective carbs," a response to the Feds cracking down on the useless and misleading term "impact carbs." Even with the deceptive labeling, this is still a good product.

These are available at many health food stores (Sunflower Markets, Trader Joe's) and Safeway. Likely available in most other major grocery chains.

Nutrition Profile (as listed/actual):
Serving: 1 tortilla (8 per package)
Calories: 80 listed/135 actual
Total Fat: 3g
Polyunsaturated Fat: 1g
Monounsaturated Fat: 2g
Total Carbs: 19g
Dietary Fiber: 14g
Sugars: 1 gram
Protein: 8g

Obesity Increases Risk of Prostate Cancer

The Tucson Daily Star has this report from the AP. My comments are below the quote.

The study surveyed medical records of some 1,400 men diagnosed with cancer whose prostates were surgically removed from 1998 to 2004 at Veteran's Administration hospitals in California and Georgia and at the San Diego Naval Hospital.

Prostate cancer is the second- most-common cancer afflicting American men. In its most recent estimates, the American Cancer Society projected that 232,000 American men would be diagnosed with the disease and 30,000 would die from it in 2005.

Previous studies have shown that obese men diagnosed with prostate cancer were 20 percent to 35 percent more likely to die from it than men of normal weight. Obesity is based on a height and weight formula; a 6-foot man would be obese if he weighed 222 pounds or more.

Prostates removed from the patients in the study were weighed. The 245 men in the sample who were moderately obese had an average prostate weight of 1.4 ounces. Normal-sized prostate glands weigh half to three-fourths as much.

Dr. Durado Brooks, the American Cancer Society's prostate cancer specialist, said the study helps deepen the understanding of the link between obesity and prostate cancer.

Here's what the article doesn't mention: prostate cancer is estrogen-related. Bodyfat produces more estrogen and has more estrogen receptors. The fatter a man is, the more estrogen in his system, the higher the risk for all cancers--but especially prostate cancer.

Doctors often blame high testosterone levels for prostate cancer, which is partly true--kind of like blaming the sky for clouds. High testosterone, especially in the obese, is converted to estrogen, a normal process that becomes abnormal in the overweight or in those who use steroids (thus the need for steroid users to also use anti-estrogen drugs).

With the increase in environmental estrogens over the past 40 years, the problems will only get worse. All forms of cancer will increase in occurrence.

Even Moderate Exercise Reduces Disability from Arthritis

A study in Arthritis & Rheumatism (December 15, 2005), as reported by Yahoo News, suggests that even small amounts of exercise can reduce the disability associated with osteoarthritis ("the wear-and-tear form of arthritis in which the cartilage cushioning the joints breaks down over time, leading to pain, stiffness and, often, limited mobility").

The study featured 3,554 adults ages 53 to 63 who had osteoarthritis.

Study participants who got some exercise -- but less than 30 minutes per day of moderate activity or less than 20 minutes of vigorous exercise -- were still less likely than inactive arthritis sufferers to show functional decline over time.

However, that doesn't mean there's no benefit to getting more exercise, noted Feinglass, a research associate professor at Northwestern University Medical School in Chicago.

He told Reuters Health that he and his colleagues have found, in this same study group, that vigorous exercise lowered the risk of type 2 diabetes -- a major risk factor for such ills as heart attack and stroke -- while modest activity did not.

Still, even lower levels of exercise may be enough where arthritis disability is concerned. Other studies, Feinglass said, have found that walking may be a good form of exercise for people with the joint disease.

In their study, he and his colleagues divided participants up into three groups based on their reported leisure-time activities at the start of the study: an inactive group, an insufficiently active group, and a group that got the recommended level of exercise for adults - at least 30 minutes of moderate activity like walking or gardening on most days of the week, or 20 minutes of vigorous exercise like running or swimming.

Overall, adults in this latter group were 41 percent less likely to show functional decline over the next 2 years than their inactive peers were. The risk reduction was almost as great for those who exercised at a less-than-ideal level.

"Given the high prevalence of arthritis," Feinglass and his colleagues write, "even modest increases in rates of lifestyle physical activity among older adults could make a substantial contribution to disability-free life expectancy."

It is always a good idea, Feinglass noted, for sedentary people with arthritis to consult their doctor before taking up any activity.

Baltimore Named Fittest City, Chicago Is the Fattest

Men's Fitness has released its annual list of the fittest cities, but the list looks a little "off" to some of us.

Men's Fitness editor Neal Boulton is quick to point out that the survey is far from scientific, and he says it took additional factors into account this year that worked in Baltimore's favor.

Among them: the amount of public park space, access to health care, air quality, the relatively small number of fast-food restaurants and the leadership of Mayor Martin O'Malley. Boulton says Baltimore has become safer, more prosperous and more conducive to fitness.

Last year's fittest city (Seattle) fell to number 8 this year. Tucson, where I live, has risen to number 4. I have to shake my head on that ranking. Maybe the Men's Fitness staff didn't get any further into Tucson than the barely-dressed young women at the University of Arizona.

Here are the best and worst cities:

The fittest and fattest cities in America in the annual survey by Men's Fitness magazine, with cities in order of ranking, and 2005 rankings in parentheses. Some were on the opposite list:

TOP 25 FITTEST CITIES:
1. Baltimore (25 fattest)
2. Honolulu (2)
3. Virginia Beach, Va. (12)
4. Tucson, Ariz. (8)
5. Milwaukee (15)
6. Colorado Springs, Colo. (3)
7. San Francisco (4)
8. Seattle (1)
9. Louisville-Jefferson, Ky. (not ranked)
10. Boston (11)
11. Sacramento, Calif. (7)
12. Nashville-Davidson, Tenn. (25)
13. Albuquerque (10)
14. Tulsa, Okla. (22 fattest)
15. Phoenix (12 fattest)
16. Atlanta (23 fattest)
17. Portland, Ore. (6)
18. Washington (23)
19. Oakland, Calif. (20)
20. Denver (5)
21. Minneapolis (13)
22. Arlington, Texas (22)
23. Austin, Texas (19)
24. Jacksonville, Fla. (18)
25. Omaha, Neb. (16)

TOP 25 FATTEST CITIES:
1. Chicago (5)
2. Las Vegas (9)
3. Los Angeles (21 fittest)
4. Dallas (6)
5. Houston (1)
6. Memphis, Tenn. (4)
7. Long Beach, Calif. (20)
8. El Paso, Texas (11)
9. Kansas City, Mo. (18)
10. Mesa, Ariz. (15)
11. Indianapolis (13)
12. San Antonio (10)
13. Fort Worth, Texas (14)
14. Miami (19)
15. Detroit (3)
16. Columbus, Ohio (16)
17. Oklahoma City (21)
18. Cleveland (24 fittest)
19. Wichita, Kan. (17)
20. Charlotte, N.C. (24)
21. San Diego (9 fittest)
22. Fresno, Calif. (14 fittest)
23. Philadelphia (2)
24. San Jose, Calif. (17 fittest)
25. New York (8)

Coffee Cuts Breast Cancer Risk in Some Women

I LOVE coffee. Although I drink too much of this manna, I rationalize it by remembering that it reduces risk for Parkinson's Disease and liver cancer. Now, if I had breasts and was Jewish, I could add prevention of breast cancer to my list of rationalizations.

As posted on Yahoo News:

Women with a particular gene mutation may reduce their risk of breast cancer by a startling amount simply by drinking coffee, according to new Canadian research.

The study, published in the January edition of the International Journal of Cancer, found that women with the so-called BRCA1 mutation, who have about an 80 percent risk of developing breast cancer before their 70th birthday, benefited from heavy coffee consumption.

"Those women who drank six or more cups of coffee a day on average had about a 75-percent reduction (sic) in the risk of breast cancer," University of Toronto professor and principal study author, Steven Narod, told broadcaster CTV.

Narod is a leading cancer researcher who helped isolate BRCA1 and BRCA2 mutations a decade ago in women primarily of Ashkenazi (Eastern European) Jewish heritage.

The results of the study indicate that women who drank one to three cups of coffee per day reduced their risk of breast cancer by 10 percent. The risk is further reduced, by 25 percent, if women drink four to five cups, and up to 69 percent beyond five cups.

Only women who drank caffeinated coffee derived any benefit, however.

"Estrogen is metabolized by different pathways, and one pathway yields to good estrogen, the other to bad estrogen ... Women who have more good estrogen compared to bad have been shown to have a lower risk of cancer. It's like a marker of risk," team researcher Joanne Kotsopoulos told AFP.

"Caffeine affects the enzyme that increases the good estrogen production," she said.

Other foods such as broccoli, Brussels sprouts and soy, and supplements such as the broccoli extract DIM or Diindolylmethane, sold in pill form, may offer similar cancer protection.

But, Andre Nkondjoka, an epidemiologist at the University of Montreal hospital and study co-author, noted that coffee contains other elements, notably antioxidants.

"I'm personally convinced that the combination of all these ingredients play a role," he said.

Nkondjoka recalled a recent US study which showed drinking coffee produced fewer side-effects than generally expected, while reducing hypertension.

T-Nation's 2005 Testes Awards

Be warned: this is definitely a guy thing--and not at all politically correct. That said, enjoy.

My personal favorite was the athlete of the year.

New Year's Resolutions

The gym has been hopping this week with new members who have resolved to get in shape for 2006. Most of the regulars tolerate the crowds with the full knowledge that next month things will get back to normal. Some studies have indicated that nearly 80 percent of those who join a gym this month won't be using that membership by March.

The NPD group, one of the biggest polling companies in the nation, has released a new study that supports the idea that few of these new members will last. This study indicates that most people won't try the diet approach until June, when bathing suit season looms on the horizon.

Harry Balzer, vp-The NPD Group, says,

"People start thinking in January that exercise will melt away the pounds but realize by March that it's much easier to change their food intake than exercise the weight away.

The annual "Eating Patterns in America" and "Dieting Monitor" studies found that typically, only 23% of adults are on diets in January versus 26% in March.

The study, a leading indicator of consumer eating/dieting patterns used by food marketers and restaurant operators in the U.S., also found that while 62% of Americans are overweight, some 60% agreed with the statement, "I would like to lose 20 pounds," and seem to be more tolerant of their battle with the bulge.

Clearly the diet OR exercise approach isn't working. Two-thirds of Americans are overweight and 20 percent of those are obese. The solution is diet AND exercise. They work hand in hand, and one without the other is sure to fail.

Even more than that, there needs to be the recognition that health is a lifestyle, not something you do for two or three months until the weight comes off. As a trainer, I try to teach my clients to adopt habits that they can stick with for the rest of their lives.

Here a few tips to help make the resolution to be healthy last past this month.

1. Clean out ALL of the junk from your refrigerator, your cabinets, your desk drawer at work, or wherever else you hide junk food. This means most boxed cereal, all white bread, white rice, anything made with white flour, candy, baked goods, chips, cookies, ice cream, regular soda, most fruit juices, and anything else that you know isn't good for you.

2. Go to the store and buy vegetables (go for a variety of colors, not just green), lean meats (chicken, turkey, fish), nuts (almonds, cashews, walnuts, pumpkin seeds), olive oil, fruit, low-fat cheese, sugar-free yogurt, low-fat cottage cheese, whole wheat/high fiber wraps, whole wheat bread, oatmeal (not instant), and some spices and sauces (be sure they are low or no sugar).

3. Join a gym. Look for one close to where you live, or on the way home from work. If you have to go out of your way to get there, it's likely you won't. If you aren't sure about the gym, do a month-to-month membership--it'll cost a little more but you won't be locked in for three years. If you like the place, you can always upgrade the contract.

4. Get friends or family members to do it with you. It's much easier with teamwork and accountability.

5. Look at the reasons you eat badly. There is likely to be at least one emotional trigger that causes you to give up the healthy stuff and go for the junk. For some it's anger or sadness, for others it's boredom or fatigue. If you eat when you are bored, look at why you are bored. With all the options available to us, there is no reason to ever be bored--most likely there is something else going on.

6. Be clear that is this is a lifetime choice, not a quick fix. You should not do any diet that you don't want to do for the rest of your life. That said, avoid fad diets and simply make healthy choices each day, one day at a time.

7. Cut out some pictures from magazines of bodies that you admire. Post these pictures on the fridge, on the bathroom mirror, and above your nightstand. Use these images to motivate you. Imagine yourself, each night before falling asleep, with the body and the health you have always wanted. Visualization sounds woo-woo, but it works.

Good luck.

Choosing a Personal Trainer

For many, a personal trainer seems like a luxury that is out of reach. However, if you want to begin a weight-training program and you have little or no experience, a good trainer can make the difference between success and failure--or worse, injury.

Expect to pay between $35 and $75 a session depending on the trainer, the gym, and the city. Packages of multiple sessions will always be cheaper than single sessions. If you are just looking for help with form and training ideas, look for a package of 3 to 6 sessions. Be clear with the trainer about what you want. If you want guidance for a longer period of time, invest in the bigger package but ask for payment options. It helps to understand that it takes at least six weeks to see changes in the mirror, so look for a package that will give you eight weeks of training.

So, how do you find a good trainer?

A recommendation from a friend or family member is always a good option. Even then, meet the trainer, ask for a free workout to see if you like his/her style, and ask questions related to your goals.

Most major health clubs will have a staff of trainers (some good or great, some not so good). Ask the PT Director for a recommendation based on your needs and goals, especially if you have special needs (injuries, diabetes, joint replacement, and so on). Ask for a free session.

ALWAYS ask for certifications. There are five top-notch companies you should be looking for, although a good trainer might still have a different certification. The top certifications are:

American College of Sports Medicine
National Academy of Sports Medicine
International Sports Science Association
National Strength and Conditioning Association Certification Commission
American Council on Exercise

The last one on this list is the biggest and best-known, but the other four are better, in general. If you are not yet a club member, contact one of the organizations above and ask for some names of trainers in your area who hold these certifications.

For more information on choosing a trainer, check out the following sites:
Healthclubs.com
Exercise at About.com
ShapeFit

Tips for a Healthy 2006

I posted this last year, and the advice is still valid. Happy New Year.

[More good diet info here, here, and here.]


Top Ten Tips for a Healthy 2006

Many people dread the holiday season and the weight gain that is usually followed by a New Year’s resolution to lose weight and live a healthier life. Gym enrollment is always highest in January, but few of those people stick with their plan to get healthy.

The following are my top ten tips for living a healthier life in 2005 - and beyond. The best part of this plan is that gym membership is optional. Everyone can do the things on this list - all it takes is commitment. To make it even easier, you don’t even need to do them all at once. For January, pick one item on the list and change your lifestyle accordingly. The next month, choose another item on the list. By November of next year, you will have added all ten things to your daily life and will already be feeling the positive results.

In the spirit of David Letterman, we will start with number 10. Please keep in mind, however, that these are in order of importance, from one to ten. Even so, start where you can, and make your first few choices ones you can stick with long-term. Building a record of success is an important part of changing behavior patterns.

10. Eat Organic. Starting with your vegetables and fruit, eat organic as much as you can. Organic foods cost a little more, and the fruit isn’t as pretty, but the health benefits over the course of a lifetime will be significant. Corporate agriculture uses a variety of pesticides and fertilizers that are highly toxic. The pesticides, in particular, are very alarming. Most pesticides are filled with synthetic estrogens, which have been linked to a variety of cancers, early onset of puberty in girls (down from 11 years of age as a standard to 9.7 for Caucasian girls and 8.1 for African-American girls), and male infertility. Many of these chemicals saturate the produce we eat, especially apples, peaches, winter squashes, spinach, green beans, strawberries, and grapes.

For those of us who eat a lot of meat, we should eat grain-fed beef, free-range chicken, and open-ocean fish (especially salmon). Besides evading all the chemicals used in the meat industry, organic meat has a much healthier fat profile, often containing the ideal ratio of omega-6 to omega-3 fatty acids (2:1).

9. Take Creatine. Creatine is without question the most successful and most highly studied sports supplement in history. What began as a supplement for athletes and "muscle heads" has become a supplement with potential benefits in a vast range of human health concerns. This simple amino acid has been clearly proven to aid in muscle growth and sports performance, but has also been shown to have the following benefits:

· Decreased risk for neurological diseases, such as Huntington’s Chorea, Parkinson’s disease, and Lou Gehrig’s disease. Oral creatine seems to help prevent and slow the progression of these diseases.
· Oral creatine has been shown to improve memory function and intellectual capabilities.
· Oral creatine reduces homocysteine levels, which has been implicated in atherosclerosis and heart disease.
· Evidence suggests that creatine use inhibits replication of the herpes virus, both I and II, which reduces the frequency and duration of outbreaks.
· Creatine use reduces physical and mental fatigue.

The recommended dose is five grams a day. There is no need to follow the "loading" instructions or to take it with high-glycemic carbohydrates. Just add five grams to some water and drink it with a protein and carbohydrate meal. Many studies currently underway are seeking to ascertain other possible benefits of creatine use.

8. Take a Good Multivitamin. Look for a brand that uses capsules, not tablets. Also, avoid brands that have high (more than 10 percent of daily allowance) levels of calcium. The calcium will block absorption of other minerals. Men should also choose a brand without iron, as should postmenopausal women. Our foods just don’t contain the nutrients we need to achieve optimal health, due to agricultural practices, factory meat production, and an over reliance on nutrient-deficient junk foods.

7. Eat Berries. Studies have shown that dark berries are filled with beneficial anti-oxidants. In particular, blueberries, blackberries, boysenberries, and raspberries have been shown to contain phytochemicals that can prevent cancer and strengthen the immune system. Berries make a great low-glycemic snack instead of chips or cookies, and they add flavor to protein drinks or oatmeal. Always try to buy organically grown berries, which are often available in the freezer section of large grocery chains, as well as in natural foods stores.

6. Eat Garlic. Or at the very least, take a daily garlic supplement (which may be better for your social life). Garlic has been shown to reduce cholesterol, improve insulin sensitivity, strengthen the immune system, fight some forms of cancer, reduce body fat, increase testosterone levels, and offer a host of other benefits. [My lengthy post on the miracle of garlic is available here.]

5. Increase Your Fiber Intake. We all should be eating about 25 to 35 grams of fiber a day, but most of us aren’t. One of the best ways to increase fiber intake is to eat more cruciferous vegetables (including broccoli, cauliflower, cabbage, and their relatives). Even on a low-carb diet, these vegetables are a healthy choice. If you can’t eat enough veggies to get your fiber, other good choices are ground flax seed, whole oats, apples, and whole wheat. As a last resort, fiber supplements are cheap and easy.

A diet rich in fiber has been shown to reduce cholesterol, reduce the risk of colon cancer, and improve insulin sensitivity due to its ability to slow gastric emptying. In fact, two heaping tablespoons of a fiber supplement can minimize the insulin released when drinking a high-sugar beverage.

4. Eat More Protein. Yes, Dr. Atkins was correct. However, you don’t need to follow the Atkins diet or any similar diet to reap the benefits of higher protein intake. In general, in the absence of kidney disease, a person should eat about one gram of protein per pound of body weight each day - and more is not bad. Replacing some carbohydrate foods with protein foods will increase your metabolism, provide more even and sustained energy, reduce body fat, provide greater feelings of satiety following a meal, and improve muscle strength if you are working out. There are many other benefits as well, all of which can be found by reading articles by John Berardi (www.johnberardi.com).

3. Eat Healthy Fats. Most Americans get too much saturated fat and too many trans-fatty acids (TFAs) from fried foods and hydrogenated oils, both of which are linked to heart disease, diabetes, and high cholesterol. TFAs have also been linked to some forms of cancer. We all should be including flax oil or ground flaxseed in our diets. The omega-3 fatty acids in flax have many health benefits, including reduced cholesterol, improved insulin sensitivity, reduced inflammation (for both rheumatoid and osteoarthritis), and a reduced risk for some forms of cancer. Omega-3 fatty acids also reduce the negative impact of saturated fats and TFAs. Other healthy fat choices include fish oil (several grams a day), GLA from evening primrose oil or borage oil, olive oil, almonds, walnuts, cashews, pumpkin seeds, and hemp seeds.

2. Begin a Weight Training Program. Even as little as one day a week of weight training will have profound effects on health. The earlier in life you begin to lift weights, the greater the benefit later in life, but you are never too old to begin. You don’t need to lift heavy weights, or build a lot of muscle, but you need to lift weights. Weight training has been shown to improve insulin sensitivity, reduce body fat, increase collagen density in joints, reduce cholesterol, improve heart health, improve bone density in postmenopausal women, and the list goes on.

If you’ve never worked with weights, hire a trainer to teach you the basic exercises and good form. Weight training is good for your health, but if your form is bad, you can injure yourself or aggravate existing problems. You don’t need to work with a trainer for the rest of your life, but for several weeks at the beginning, or for new ideas or exercises, a qualified trainer can be very helpful. Ask about certifications and interview trainers as you would a doctor or a lawyer. It’s important to find a person you feel comfortable with and who is knowledgeable.

And now, the number one tip for a healthy 2006 is . . .

1. Exercise! It doesn’t matter if you walk the dog for half an hour a day or train to compete in your favorite sport, get off the couch and move your body. You already know that exercise will help you lose weight, reduce the risk of diabetes, lower your cholesterol, improve your heart health, and make you stronger, so we can skip the basic facts.

What you may not know is that exercise improves mood in depressed people as effectively as some prescription drugs. Or that exercise can revive a lagging libido in both men and women. Or that exercise can improve self-esteem and the sense of control over one’s life. These psychological effects may not get much press, but they are as important as the physical benefits.

So, those are my top ten tips for a healthy 2006. Choose one item on the list and add it to your life each month. Start easy if you need to, maybe with eating berries instead of junk food for snacks, but stick to each change, one at a time. By 2007 you will be healthier and thinner, and will feel more control in your life. Make 2006 the year you change your life - the year you’ll look back on as the point in your life when you made the commitment to growing older in optimal health.

News You Can Use: More Research Updates

Here are some more research summaries from Exercise Etc.

FitBits
December 15, 2005
Exercise ETC's Review of Exercise Related Research
Compiled by Jeannie Patton, MS, CSCS

Running Faster Does Not Necessarily Result in Increased Fat Burning Rates

Low intensity endurance training is often recommended to ensure compliance and enhance fat burning, but If the goal is weight loss, theoretically the caloric cost of the activity should be as high as possible. The purpose of this study was to determine if there was a difference between energy expenditure and substrate use running the same distance at a high versus lower intensity.

Ten males and 4 females that were moderately endurance trained served as subjects. On separate days. Each subject performed a five-mile run at 70% and 95% of their individual anaerobic threshold. Energy expenditure was significantly greater during the higher intensity run, but there was no significant difference in the absolute amount of fat that was used, although the higher intensity trial used a statistically significantly greater amount of carbohydrates.

The results of this study indicate that both high and low intensity endurance exercises are effective for weight loss and fat loss. If caloric expenditure is the goal, then the time needed to reach that goal will be less with high intensity exercise versus low intensity exercise, but Fitness Professionals need to consider several other aspects when interpreting these results. The motivation of the client must be considered when recommending high intensity exercise. Clients working at higher intensities may perceive the exercise as uncomfortable and punishing, which could have an impact on adherence.

Rosenberger, Friederike. Et al. Running 8000m fast or slow: Are there differences in energy cost and fat metabolism? Medicine & Science in Sports & Exercise. 2005: 37(10), 1789-1793.


More Evidence That Strength Training Is A Viable Choice for Weight Loss

The American College of Sports Medicine and the Centers for Disease Control and Prevention recommend 30 minutes of moderate intensity physical activity at least 4 days per week. Moderate intensity is defined as physical activity that is performed at an intensity of 3-6 metabolic equivalents (METs) with an energy expenditure of 150 to 200 calories within those 30 minutes. The purpose of this study was to compare the calories burned during cardiovascular and strength training at moderate resistance.

Ten trained men performed 30 minutes of intermittent free-weight squatting at 70% of 1 repetition maximum and continuous cycling at 70% of VO2 Max. Measurements included VO2, caloric expenditure, heart rate, respiratory exchange ratio, work and rating of perceived exertion.

The researchers found that average caloric expenditure was 442 calories for the cycling activity versus 269 for the resistance activity. The subjects had a higher average VO2 for the cycling activity, and the total work was also higher for cycling than squatting. (Interestingly, perceived exertion was higher during squatting , although heart rates were identical for both cycling and squatting.)

On the surface, it appears that continuous aerobic activity results in a higher caloric expenditure than strength training for the same amount of time, but several factors must be considered: The 30 minutes of resistance training consisted of both work and rest periods so the actual time spent in work was only about 6 minutes compared to 30 minutes of continuous cycling. The work output per actual minute of exercise was almost double for the squatting exercise versus the cycling exercise. Fitness Professionals must also consider the effect of excess post-exercise oxygen consumption (EPOC,) which increases lean mass and metabolic rate and is associated with resistance exercise. When these factors are considered it appears that resistance training is a viable mode of exercise for weight management and can be used to fulfill the minimum amounts of recommended physical activity for Americans.

Bloomer, Richard. Energy cost of moderate-duration resistance and aerobic exercise. Journal of Strength & Conditioning Research. 2005, 19(4), 878-882.


Americans Living Longer Despite Increases in Obesity, Hypertension

The Associated Press reports that American life expectancy is at an all time high: 77.6 years. This is in spite of statistics that show that half of middle aged Americans have high blood pressure, 28% report "recent" low back pain, and 40% are obese. One reason for the increase in life expectancy, despite the increases in hypertension and obesity, are major advances in health care that allow people to live longer despite unhealthy lifestyles. Thanks to the increased use of cholesterol lowering drugs, cholesterol levels actually decreased, even as obesity increased. This study focused on Americans age 55 to 64, since these "near elderly" citizens represent a huge potential influence on the American Health care system. For example, in 2004 there were 29 million Americans in this age group; by 2014 there will be 40 million near-elderly Americans, thanks to the aging of the Baby Boomers.

Life Expectancy Hits All-Time High: Health Officials Say Obesity and High Blood Pressure Are Trouble Spots As reported by MSN. Mike Stobbe. AP 12-08-05 15:28 EST