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Category Archives: Fitness and Nutrition

Exercise -The Unknown Warrior In The Battle Against Cancer

Cancer touches every soul in one-way or another. There are many treatments available for both the mind and the body when living with this disease but the most important treatment option can often be overlooked. With chemotherapy, radiation, surgery, medications and rehabilitation, it is easy to forget that exercise can be a cancer patient’s greatest ally.

Extreme Fatigue is one of the most common complaints heard from patients during chemotherapy treatments but there are ways to help alleviate this uncomfortable side effect without adding additional medications into their day. Numerous studies have shown the merits of exercising throughout treatment to help maintain a normal level of activity. These studies have also shown that continuing to follow an exercise program after treatment may help cancer survivors maintain a quality of life similar to that found before diagnosis.

Exercise can do more than just help reduce fatigue. It can also help many patients address the emotional issues that come with a cancer diagnosis and treatment. Issues such as weight gain, muscle loss, and postoperative healing can create a distorted body image, which may lead to depression. It is widely known that exercise can aid in weight loss and that weight bearing exercises can increase muscle mass but during exercise, the body also releases endorphins that create an elevated mood. This elevated mood could help patients see their situation in a more positive light and aid in their recovery.

Although some form of activity is recommended daily, each patient will require a different exercise program dependent on his or her disease and current treatments or if they are currently in a survivorship plan. For example, a patient receiving Mesothelioma treatment must be more cautious of activities that apply a greater strain on the heart or lungs while a patient being treated for Bone Cancer would avoid any high impact exercises that could lead to a fracture.

Because of these risks, many people choose to have a trainer help them design an appropriate exercise routine. This is a wonderful idea but it is important to remember that the trainer must understand the specific requirements of cancer patients. According to an article published on the National Cancer Institute’s website, the American Cancer Society has developed a certification program for trainers wishing to help cancer patients and survivors. This program ensures that cancer patients and survivors are receiving the best care possible.

by David Haas. David is a writer for the Mesothelioma Cancer Alliance.  Please follow David on Twitter @haasblaag.

Healthy Fruits – Healthy Vegetables:Brooke Douglas RD Tells All

Brooke Douglas RD is back with her first of the month post, this time telling us about healthy fruits and healthy vegetables.  Don’t miss a word.

Almost Everything You Ever Wanted to Know About Fruits and Vegetables

Research shows that people who eat even 2½ cups of fruits and vegetables a day have only half the cancer risk of those who eat less than one cup a day.  Hundreds of studies show that increased fruit and vegetable consumption may also help prevent heart disease, stroke, hypertension, birth defects, cataracts, diabetes, obesity and other serious conditions.

Healthy Fruits and vegetables are nutritional powerhouses which:

  • Are excellent sources of vitamins and minerals and contain disease fighting fiber
  • Contain antioxidants and phytochemicals
  • Are virtually fat-free (exceptions: coconut, olives & avocado) and cholesterol-free
  • Are helpful in weight management, due to their high-fiber, high-water, and low-fat content

Vitamins and minerals: Are essential in maintaining the health of the brain, heart, bones, teeth and nerves; making/repairing red blood cells; regulating body’s balance of fluids; and in other vital functions.

Many healthy fruits and vegetables are particularly good sources of vitamins A, C, E and K, some B vitamins, and many important minerals needed for healthy bodies.  Beta-carotene and related compounds called carotenoids are converted by the body to Vitamin A. Carotenoids are found in high concentrations in carrots and other orange and yellow vegetables and fruits such as winter squash and cantaloupes.  Dark green, leafy vegetables, such as spinach, kale, broccoli, and other members of the cabbage family, also contain high concentrations of carotenoids.

Dark green vegetables are also excellent sources of folic acid (a B vitamin needed during pregnancy to reduce the risk of neural defects in the fetus), Vitamins E and K, and minerals such as calcium, magnesium, manganese, iron, and potassium.  Many fruits are also a good source of minerals, such as chromium (grapes), iron (cherries), manganese (pineapple), and potassium (apricots, bananas, orange juice, peaches and prunes).

Citrus fruits are good sources of Vitamin C, as is the family of plants that includes tomatoes, red and green peppers, potatoes, and eggplant.  Other good sources of Vitamin C include papayas, strawberries, kiwis, cantaloupe, and the cabbage family, including broccoli, cauliflower and Brussels sprouts.

While there is overlap in the vitamins/minerals supplied by fruits and vegetables, you need a wide variety of colorful healthy fruits and vegetables to fully benefit from the various nutrients they contain.

Antioxidants: Disease-fighting compounds found in many foods, especially healthy fruits and vegetables. Antioxidants neutralize free radicals (compounds that damage cells and lead to cardiovascular disease, cancer, cataracts, premature aging, and impaired immunity.)  Antioxidants include vitamins A, C, and E; beta carotene, minerals (selenium, copper, zinc, and manganese) and some of the phytochemicals.

 

Phytochemicals: From plants, “plant chemicals” are recognized as powerful disease-fighting compounds. Fruits and vegetables contain thousands of different phytochemical compounds. Categorized as carotenoids, flavenoids (compounds that give flavor/colors to fruit/veg), and other compounds, such as allicin, indoles, lycopenes, lutein, and phenols.  Scientists studying phytochemicals are finding an impressive range of health benefits.

Color & Examples Phytochemical Examples Potential Benefits
Red: apples, cherries, strawberries, watermelon, beets, red peppers, radicchio, tomatoes Lycopene, anthocyanins Maintain memory function, heart health urinary tract health; reduce blood pressure, fight infections, and reduce risk of some cancers
Orange/yellow: apricots, mangos, oranges, peaches, pineapple, cantaloupe, carrots, corn, winter squash Carotenoids, bioflavonoids Maintain health of heart, eyes, and immune system, slow aging, and reduce risk of some cancers
Green: leafy greens, asparagus, broccoli, green beans, peas, spinach, honeydew, kiwi, avocados Lutein, indoles, carotenoids Improve vision, strengthen bones and teeth, and reduce risk of some cancers
Blue/purple: blueberries, blackberries, purple grapes, plums, eggplant, purple cabbage Anthocyanins, phenolics, resveratrol Facilitate healthier aging, enhance memory function, urinary tract health and cardiovascular health and reduce risk of some cancers
White/tan/brown: onions, garlic, cauliflower, turnips, mushrooms, potatoes, bananas, pears, dates Allicin, quercetin, sulphoraphane Improve heart health, maintain healthy cholesterol levels, and reduce risk of some cancers

 

Not all foods listed above, even within the same group, have the same health benefits.  Foods with the same phytochemicals may contain different concentrations of the phytochemicals, and the compounds may be absorbed differently.  Even different varieties of foods within the same category (such as different varieties of apples or lettuce) may contain widely varying concentrations and kinds of phytochemicals.  However, those darker in color usually contain higher concentrations.  So think “more color and more variety” in making your selections!

 

What is considered one serving of fruit?

  • • 1 medium whole fruit (apple, banana)              • ½ cup of fresh, frozen or canned fruit
  • • 6 oz. (¾ cup) 100% fruit juice                             • ¼ cup of dried fruit

What is considered one serving of vegetables?

  • • 1 cup of raw, leafy vegetables                 • ½ cup cut up fresh, frozen or canned vegetables
  • • 6 oz. (¾ cup) 100% vegetable juice         • ½ cup cooked beans, peas, or lentils

How Can I Get More…Healthy Fruits and Vegetables in My Diet?

At home:

  • • Top your hot or cold cereal with fresh fruit.
  • • Enjoy a glass of 100% real fruit or vegetable juice with breakfast.
  • • Make smoothies with fresh or frozen fruits and juices for a great breakfast or lunch choice.
  • • Choose hundred percent fruit and vegetable juices as delicious alternatives to soft drinks.
  • • At dinner, include salad/raw veggies; use low-fat or non-fat dressing to reduce fat and calories.
  • • Steamed vegetables are always a good side dish.
  • • Add vegetables to your favorite entrees, like tacos, lasagna, casseroles, and pasta dishes.
  • • Add pureed vegetables to sauces to fortify them.
  • • Try more vegetarian meals, like tofu, rice or pasta with vegetables, and Asian stir-fry dishes.
  • • For dessert, bake sweet potatoes, apples, peaches, pears, or bananas, or make fruit cobblers.
  • • Discover some of the many cookbooks that specialize in fruits and vegetable recipes.
  • • For a snack or when you’re on the go:
  • • Choose fruits and vegetables that can be eaten out of hand, like apple wedges, baby carrots, broccoli spears, or cherry tomatoes, grapes, bananas, and seasonal items like peaches and plums.
  • • In place of candy, choose dried fruit (easily packs in a bag/take on the road or eat at office.

When dining out:

  • • Order a dinner salad to begin your meal.
  • • Request an extra serving of vegetables as a side dish.
  • • Order meals that include vegetables or fruits as a major component. To keep fat and calories in check, request vegetables steamed without the addition of butter, oil or cream sauce.
  • • Ask for extra lettuce and tomato (or other vegetables) on sandwiches and burgers.
  • • Choose healthful desserts; fresh fruit, sherbet, sorbet, or angel food cake topped with fruit.
  • • Choose dishes on the nutrition charts of Healthy Dining Finder that have more servings of fruits/vegetables.
You can read more by Brooke on this health blog just look under the nutrition category.  I especially like her post on intuitive eating and eat five a day. Also check out her site at Nutrition Authority.

The Unexpected Health Benefits of Running

The Unexpected Health Benefits of Running

by Charles Boren

The ancient Greeks used running as a form of training and competition. It was a way to test personal fortitude and improve physical health. Many of the health benefits of running were known even in those ancient times. In modern times, many start running for the same reasons. They run to improve their physical endurance, lose weight and build muscle. While these common health benefits of running influence many to start running, runners are surprised to learn just how extensive the health benefits are. Running improves the quality of sleep, fights off depression and anxiety, and improves joint health and stability.

Sleep disorders affect a surprising percent of the population today. There is good news to those who suffer from them. Running can actually improve the decrease the symptoms of sleep disorders and improve the quality of sleep. It also appears to help people sleep more efficiently. That is, the amount of time spent actually sleeping while in bed increases. Running helps people fall asleep more quickly, toss-and-turn less through the night, and wake up more rested than those who do not run.

The runner’s high is a well-documented phenomenon, and major benefit, of running. This is a unique feeling often reported during long, strenuous amounts of exercise. The feeling can range from relaxed and peaceful to intensely euphoric. It is produced when endorphins flood the brain as part of a stress response to running. These endorphins are the natural drugs of the body. They reduce pain and are responsible for the happy and content feelings similar to many those produced by narcotics. While many runners experience this phenomenon, many do not realize the long-term positive effect that is has. Over time, the regular doses of endorphins to the brain can combat both anxiety and depression. In fact, many studies have shown that following a regular running program markedly reduces the symptoms of these disorders.

A common misconception is that the high-impact nature of running negatively affects the joints in the body. The truth is that running may actually improve joint health and stability. (1) This is done in a number of ways. First, running helps keep excess weight off. Just a ten-pound increase in body weight can cause a 45-pound increase in stress on the knees (2).  Second, running causes cartilage to expand and contract with the natural movements created while running. This forces nutrients and oxygen into the cartilage cells. Without this, the cells will slowly die from oxygen depletion and starvation. Third, running strengthens the tendons and ligaments that support and stabilize joints. This prevents injury in the long-term. Overall, running greatly improves joints and prevents the onset of arthritis.

Building muscle, losing weight, and strengthening the heart are the health benefits that motivate people to start running. However, it is the unspoken benefits that keep them running. As a whole, runners have better sleep, improved mental states, and healthier joints. Many runners feel that they are taking responsibility for their health by running. They physically feel better, less stressed and they have peace of mind. This is a reward all in itself.

Bio: Charles spends much of his free time running. On the side he also runs an automotive company, where he purchases vehicles.

Benefits of Resistance Exercise

In recent years it has become clear that in order to reap the full benefits of exercise that both aerobic exercise and resistance exercise is important.  The recommendation of the CDC for adults of all ages is to incorporate strength exercises into the exercise regimen at least 2 days a week. Technically resistance exercise and strength exercise are not synonymous, but for practical purposes the terms are interchangeable.  Resistance exercise is exercise where the major muscle groups exert force against a resistance.  When the goal of this type of exercise is to increase strength it is strength exercise.

So what are the benefits of resistance exercise?  Actually they are multiple, some obvious and others less obvious.

  • Resistance Exercise Builds Strength:  This is one of the obvious benefits, but some aspects may not be appreciated. One aspect that some may not fully appreciate is that this benefit does not go away with age.  One study of the elderly (average age 87) showed that an 8 week program of resistance training 3x/ week increased strength by over 100%, increased walking speed by 12%, and reduced the incidence of falls.  With the sedentary life style many jobs enforce, and the lack of outdoors physical work by many of us, resistance training can make a huge difference in the way we feel, in our functional capacity to do tasks without hurting ourselves, and in our overall functional capacity.
  • Resistance Training Builds Bone Strength:  Bones are a living tissue, constantly remodeling based on the stress loads placed upon them.  Resistance training while bearing weight can lead to increased bone strength and help prevent the fractures of osteoporosis as we age.
  • Resistance Training Helps Lower Mild Hypertension:  Aerobic exercise is the backbone of maintaining cardiovascular health, but resistance training also helps reduce blood pressure to at least some degree.
  • Resistance Training can Increase Metabolic Rate:  Aerobic exercise is again the mainstay of weight control and maintenance, but there is considerable evidence that resistance training when combined with aerobic training leads to higher metabolic rate and more weight loss than aerobic training alone.
  • Improved Self Image:  This is just my opinion and experience, but I believe that maintaining strength, physical capability and muscle mass is has a positive effect on self-image.  I know I feel better about myself when I feel strong and fit.  Resistance exercises are a key to this for me.

If you believe in the benefits of resistance exercise how should you go about setting up a program?  First be real with yourself.  Set goals that you believe are possible, sustainable and affordable.  You can go to a gym, buy free weights or machines for home, or simply do exercises using your own body weight like pushups, pull-ups, and squats.  Rubber band type resistance equipment is inexpensive and very effective.  Secondly aim for 3 days a week for resistance exercise.  Taking a day between training sessions gives the muscles exercised time to recover and grow.  Third learn from Milo of Croton in that progressive overload is the principle behind steadily increasing strength. You don’t need a calf to carry every day until it has grown.  Just start with exercises where 8-15 repetitions lead to fatigue.  Once this is easy, slightly increase the resistance.  Keep increasing the resistance as the exercise becomes easy.  Last if a certain exercise leads to persistent pain, change something rather that thinking you can work through the pain.  Often some minor change may avoid an overuse injury.

Add resistance training to your regular exercise to reap the full benefits of exercise.  Enjoy.

Thanksgiving Mistakes to Avoid

At any holiday we tend to get out of our normal routines, and from a health standpoint some people can find themselves at risk of making choices that put them at serious risk.  Here are some situations to avoid.  Most involve people with specific medical conditions, but some apply to all of us.

  1. Don’t let the holiday with the sometimes strong emotions, family discord, or memories tempt you to fall back to destructive habits like alcohol or tobacco.  I see too many patients after the holidays each year who have relapsed at this time of year.
  2. If you have congestive heart failure, don’t eat too much high sodium food. Emergency rooms see patients every holiday who consume too much hidden salt in foods at their family feasts, and decompensate.
  3. If you travel don’t forget your medications.  If you do forget, figure out a way to get needed meds.  Find out if your pharmacy can transfer your prescription to a pharmacy near where you are staying.
  4. Be aware that holidays can be emotionally challenging.  If you struggle with depression, be aware that this time of year can be difficult.  Take care to get enough sleep, enough exercise, to eat well, and just take good care of yourself.  If you feel terribly depressed, and suicide is a concern, get help.  Watch out for depression in those around you.
  5. Overeating is typical at holiday get-togethers.  Accept this, and focus on the rest of the holiday period.  Don’t let one or two meals get you out of your usual healthy eating routines.
  6. New Year’s resolutions are fine, but don’t let the anticipation of a New Year’s resolution lead you to completely overdoing it regards to eating and drinking up until Jan. 1.

If you have good ideas to add to the list, please leave a comment.

@diabetictweets

After nearly 25 years in practice as a family doctor I have accumulated a large number of patients with diabetes.  Every day I see several patients for help managing their diabetes, and realize that many of them can use a bit of extra encouragement. I have set up @diabetictweets account to allow any patients with diabetes to get frequent words of encouragement and bits of advice I hope will be helpful.  I’ll also add tweets with links to articles and posts I think may be of interest.  Feel free to pass this on to your friends, patients, and anyone you feel may be interested.

Do Women Sweat Like Men?

Research shows that women do of course sweat, and like men sweat more with exercise.  The difference is in volume of sweat.  A recent study in the Journal of Experimental Physiology found that women, whether fit or not, are less able to use sweating to get rid of body heat than men.  This is expecially true of unfit women.  An article in the NY Times by Gretchen Reynolds discusses the results of a simple but interesting study where fit and unfit men and women are evaluated for their sweat production, body temperature, and physiologic responses to exercise in a hot environment.  It shows once again that men and women are different. 

October 20, 2010, 12:01 am

Do Women Sweat Differently Than Men?

By GRETCHEN REYNOLDS

Free Radicals and Exercise

Growing up in the 1960’s I thought of radicals as people who protested Vietnam, took LSD, or burned flags or bras.  In medical school I learned about free radicals, molecules produced in our bodies as a part of metabolism that have been linked with all sorts of bad things like cell damage and atherosclerosis.  When we exercise our muscles produce lots of free radicals, and in response some people take antioxidant vitamins to try to prevent the production of free radicals from exercise.  A rule of thumb over the years has been that trying to use supplemental vitamins or other products often is less effective than we would hope, and may have consequences we didn’t plan on.   Tara Parker Pope’s Well section in the NY Times has an article informing us that we may want to “Free the Free Radicals.”  Enjoy.   

October 6, 2010, 12:01 am

Phys Ed: Free the Free Radicals

By GRETCHEN REYNOLDS

Is a Low Level of Vitamin D a Marker for Poor Health or a Cause of Disease?

A Confounding Mess

In this week’s issue of the Annals of Internal Medicine (unfortunately you need a subscription to see the article)  Dr. Andrew Gray MD, and Mark Bolland PhD write an interesting editorial called Vitamin D:  A Place in the Sun. In it they discuss the current flood of claims for health benefits of vitamin D.  When analyzing a finding such as the link between Vitamin D levels and a disease state, one of the most difficult aspects is to control for “confounding variables.”  The definition of a confounding variable in The Free Dictionary online is, “interference by a third variable so as to distort the association being studied between two other variables, because of a strong relationship with both of the other variables.”   Low vitamin D levels are associated with such potential confounding variables as obesity, sedentary lifestyle, and lack of sunlight exposure.  These conditions and others are potentially associated with depression, diabetes, and many of the other conditions for which low vitamin D levels has been suggested as a risk factor Hence the concern about confounding variables not accounted for in the association of these conditions with vitamin D.  This is elegantly stated in these authors middle paragraph of their editorial:

“Although some evidence from preclinical studies suggests that components of the vitamin D system might impact favorably on some diseases,4 it seems intuitively unlikely that a singlehormone could play a substantial role in preventing or ameliorating the diverse range of diseases that have been linked to low levels of vitamin D. A more plausible and prosaic explanation for thefindings of the observational vitamin D studies is the presence of common confounders. Vitamin D levels are directly related to sunlight exposure and physical activity, and inversely related to adiposity.5-6 It is likely that less healthy individuals, who are more likely to subsequently experience morbid events, will be heavier, less active, and more sunlight-deprived than healthier ones and therefore have lower levels of 25(OH)D. This notion is supported by previous studies7and by the study of Llewellyn et al,2 in which several indices of poor health were more commonly observed at baseline in those with lower levels of vitamin D. Thus, low vitamin D levels may simply be a marker for lower health status rather than a cause of it. Healthiness is difficult to measure and adjust for, as illustrated by the disparate results of observational studies and randomized controlled trials (RCTs) of postmenopausal hormone therapy and cardiovasculardisease or antioxidant treatment and cardiovascular disease and cancer.8-11 We should therefore treat the data from observational studies of vitamin D with caution.”

Although low vitamin D levels are associated with multiple conditions it will be interesting to see if supplementation of vitamin D lowers the risk of these conditions or whether only improving the confounding conditions, like more exercise, lower levels of obesity, more sunlight, etc. works to prevent the medical conditions.  It will sure be nice if just taking those nice small, easy to swallow yellow capsules works, but as for me I remain skeptical.

Exercise and Your Brain

Most of us who exercise believe that exercise just makes us feel better, sleep better, look better and be better.  In today’s NY Times is a very nice article on  exercise and brain regeneration and growth.  Enjoy:

July 7, 2010, 12:01 am

Your Brain on Exercise   originally from the NY Times

By GRETCHEN REYNOLDS

What goes on inside your brain when you exercise? That question has preoccupied a growing number of scientists in recent years, as well as many of us who exercise. In the late 1990s, Dr. Fred Gage and his colleagues at the Laboratory of Genetics at the Salk Institute in San Diego elegantly proved that human and animal brains produce new brain cells (a process called neurogenesis) and that exercise increases neurogenesis. The brains of mice and rats that were allowed to run on wheels pulsed with vigorous, newly born neurons, and those animals then breezed through mazes and other tests of rodent I.Q., showing that neurogenesis improves thinking.  Read the full article