Skip the Soda

Study Links Diet Soft Drinks With Cardiac Risk

By Ed Edelson
HealthDay Reporter,

HealthDay

Posted: 2007-07-23 16:11:02

MONDAY, July 23 (HealthDay News) -- Drinking more than one soda a day -- even if it's the sugar-free diet kind -- is associated with an increased incidence of metabolic syndrome, a cluster of risk factors linked to the development of diabetes and cardiovascular disease, a study finds.

The link to diet soda found in the study was "striking" but not entirely a surprise, said Dr. Ramachandran Vasan, study senior author and professor of medicine at Boston University School of Medicine. There had been some hints of it in earlier studies, he said.

"But this is the first study to show the association in a prospective fashion and in a large population," Vasan said.

That population consisted of more than 6,000 participants in the Framingham Heart Study, which has been following residents of a Massachusetts town since 1948. When the soda portion of the study began, all participants were free of metabolic syndrome, a collection of risk factors including high blood pressure, elevated levels of the blood fats called triglycerides, low levels of the artery-protecting HDL cholesterol, high fasting blood sugar levels and excessive waist circumference. Metabolic syndrome is the presence of three or more of these risk factors.

Over the four years of the study, people who consumed more than one soft drink of any kind a day were 44 percent more likely to develop metabolic syndrome than those who didn't drink a soda a day.

The findings are published in the July 24 issue of the journal Circulation.

A variety of explanations, none proven, have been proposed for the link between diet soft drink consumption and metabolic syndrome, Vasan said. That association was evident even when the researchers accounted for other factors, such as levels of saturated fat and fiber in the diet, total calorie intake, smoking and physical activity.

One theory is that the high sweetness of all soft drinks makes a person more prone to eat sugary, fattening foods. Another is that the caramel content of soft drinks promotes metabolic changes that lead to insulin resistance. "These are hotly debated by nutritional experts," Vasan said.

Vasan, who noted that he is not a nutritional expert, said he leans toward the theory that "this is a marker of dietary behavior" -- that people who like to drink sweet soda also like to eat the kind of foods that cardiac nutritionists warn against.

"But we cannot infer causality," Vasan said, meaning there is no proof that soda itself is the villain. "We have an association. Maybe it is a causal one or maybe it is a marker of something else."

Carefully controlled animal studies might resolve the cause-and-effect issue, he said.

Dr. Elizabeth G. Nabel, director of the U.S. National Heart, Lung, and Blood Institute, which funds the Framingham Heart Study, said in a prepared statement: "Other studies have shown that the extra calories and sugar in soft drinks contribute to weight gain, and therefore heart disease risk. This study echoes those findings by extending the link to all soft drinks and the metabolic syndrome."

Dr. Suzanne R. Steinbaum, director of Women and Heart Disease at Lenox Hill Hospital in New York City, said, "There is no safe way of eating junk food, just as we learned the lesson from trans fats and partially hydrogenated oils often found in fat-free or low-fat cookies. Diet soda does not protect us from the development of what we are trying to avoid by consuming it."

More information

Learn more about metabolic syndrome at the American Heart Association.

SOURCES: Ramachandran Vasan, M.D., professor of medicine, Boston University; Suzanne R. Steinbaum, M.D., director, Women and Heart Disease, Lenox Hill Hospital, New York City; July 24, 2007, Circulation

Fitness and Parenting

All Child-Play and No Workouts Make Dad an Unfit Boy

Below is an excerpt for a great article in the NYTimes, which explores how becoming a parent can affect a person's workouts and fitness routines. Click here for the whole article.

THEY count among their ranks former marathoners and Ironmen, beached surfers and scuba divers. They lay off red meat and trans fats. They stay current on annual physicals and take their medications as prescribed.

And yet, this group of the once-fit finds itself at risk of becoming unhealthy and stacking on the pounds, because of one threat to their physical fitness: children.

...

Too many Americans have an all-or-nothing mentality toward fitness, said Dr. Harvey B. Simon, an associate professor at Harvard Medical School. If they can’t find a 45-minute window to bike, they don’t substitute by strapping on a BabyBjörn and taking a stroll.

“There is a very common misconception, one that is shared by physicians as well as by the public, that exercise requires a set amount of time and a formal program,” said Dr. Simon, who has two grown daughters. “I’m fond of saying that the aerobic exercise movement inspired the few and discouraged the many.”

Heart-healthy exercise can take many forms (gardening, car washing, stair climbing) and needn’t be done in continuous chunks to be beneficial, said Dr. Simon, the author of “The No Sweat Exercise Plan.”

Having three and a half hours of exercise to lose puts the study’s participants well above the norm, said Janet Fulton, an epidemiologist in the division of nutrition and physical activity at the Centers for Disease Control. After all, three-quarters of Americans don’t meet the minimum requirement of two and a half hours a week, she said.

Still, cutting back on exercise as a new parent has hidden costs. “Reducing their activity in this critical period of time is probably not going to help their adjustment in terms of a new person in their house,” Dr. Fulton said. “The long-term stuff, the chronic-disease risk reduction, is great, but immediately, they’re not getting the mental-health benefit.”

For those parents who can’t stomach exercise, however, their children serve as a bulletproof cop-out. When single or childless people say they have no time to exercise, it can ring hollow. But a mother of three? Watch those heads nod in sympathy.

Reluctant exercisers use parenthood as “an excuse to not do it at all,” said Dana Wood, a mother and the health and beauty director for Cookie, a parenting magazine.

Can You Pinch More than an Inch?

The scale may say that you're slim, but your frame may still be carrying too much body fat, says Michele Olson, Ph.D., a professor of exercise science at Auburn University. "Women with little muscle tone may not be overweight but still have unhealthy levels of body fat," she explains. A new Italian study found that normal weight women with higher than 30% body fat are at greater risk for heart disease. To learn you fat level, try one of two tests available at many gyms: calipers, which assess skin thickness at key areas, and bioimpedance devices, which send an undetectable electrical current through the body to read the ratio of fat to other tissue. Both are reasonably accurate when used by a trained professional.

Healthy Recipe: Braised Salmon with Soy and Ginger

Ingredients:
16 ounces salmon fillet
2 tablespoons extra-virgin olive oil
1 tablespoon minced ginger
1/4 cup mirin (a Japanese cooking wine found in ethnic stores and most Whole Foods)
2 tablespoons soy sauce
2 tablespoons vodka
1 tablespoon butter
2 scallions, white parts only, chopped
3-4 sprigs cilantro

Directions:
Cut the salmon into 1" squares. Heat the oil in at 12" nonstick pan over medium-high heat and add the salmon cubes and ginger. Sear together for about 1 minute, then pour the mirin, soy sauce, and vodka over the salmon. Turn the heat to medium and cook for about 3 minutes, until the fish turns pale. Add the butter and turn off the heat. Spoon the salmon onto a serving plate and top with the scallion and cilantro.
Makes 4 servings.
Nutritional Information, per serving: 359 calories 24 grams protein 6 grams carbohydrates 22 grams fat 1 gram fiber

The Benefits of Interval Training

from the NYTimes, May 3, 2007 http://www.nytimes.com/2007/05/03/fashion/03Fitness.html?ei=5070&en=9e74e98f3732c066&ex=1180065600&pagewanted=all

SOME gymgoers are tortoises. They prefer to take their sweet time, leisurely pedaling or ambling along on a treadmill. Others are hares, impatiently racing through miles at high intensity.

Each approach offers similar health benefits: lower risk of heart disease, protection against Type 2 diabetes, and weight loss.

But new findings suggest that for at least one workout a week it pays to be both tortoise and hare — alternating short bursts of high-intensity exercise with easy-does-it recovery.

Weight watchers, prediabetics and those who simply want to increase their fitness all stand to gain.

This alternating fast-slow technique, called interval training, is hardly new. For decades, serious athletes have used it to improve performance.

But new evidence suggests that a workout with steep peaks and valleys can dramatically improve cardiovascular fitness and raise the body’s potential to burn fat.

Best of all, the benefits become evident in a matter of weeks.

“There’s definitely renewed interest in interval training,” said Ed Coyle, the director of the human performance laboratory at the University of Texas at Austin.

A 2005 study published in the Journal of Applied Physiology found that after just two weeks of interval training, six of the eight college-age men and women doubled their endurance, or the amount of time they could ride a bicycle at moderate intensity before exhaustion.

Eight volunteers in a control group, who did not do any interval training, showed no improvement in endurance.

Researchers at McMaster University in Hamilton, Ontario, had the exercisers sprint for 30 seconds, then either stop or pedal gently for four minutes.

Such a stark improvement in endurance after 15 minutes of intense cycling spread over two weeks was all the more surprising because the volunteers were already reasonably fit. They jogged, biked or did aerobic exercise two to three times a week.

Doing bursts of hard exercise not only improves cardiovascular fitness but also the body’s ability to burn fat, even during low- or moderate-intensity workouts, according to a study published this month, also in the Journal of Applied Physiology. Eight women in their early 20s cycled for 10 sets of four minutes of hard riding, followed by two minutes of rest. Over two weeks, they completed seven interval workouts.

After interval training, the amount of fat burned in an hour of continuous moderate cycling increased by 36 percent, said Jason L. Talanian, the lead author of the study and an exercise scientist at the University of Guelph in Ontario. Cardiovascular fitness — the ability of the heart and lungs to supply oxygen to working muscles — improved by 13 percent.

It didn’t matter how fit the subjects were before. Borderline sedentary subjects and the college athletes had similar increases in fitness and fat burning. “Even when interval training was added on top of other exercise they were doing, they still saw a significant improvement,” Mr. Talanian said.

That said, this was a small study that lacked a control group, so more research would be needed to confirm that interval training was responsible.

Interval training isn’t for everyone. “Pushing your heart rate up very high with intensive interval training can put a strain on the cardiovascular system, provoking a heart attack or stroke in people at risk,” said Walter R. Thompson, professor of exercise science at Georgia State University in Atlanta.

For anyone with heart disease or high blood pressure — or who has joint problems such as arthritis or is older than 60 — experts say to consult a doctor before starting interval training.

Still, anyone in good health might consider doing interval training once or twice a week. Joggers can alternate walking and sprints. Swimmers can complete a couple of fast laps, then four more slowly.

There is no single accepted formula for the ratio between hard work and a moderate pace or resting. In fact, many coaches recommend varying the duration of activity and rest.

But some guidelines apply. The high-intensity phase should be long and strenuous enough that a person is out of breath — typically one to four minutes of exercise at 80 to 85 percent of their maximum heart rate. Recovery periods should not last long enough for their pulse to return to its resting rate.

Also people should remember to adequately warm up before the first interval. Coaches advise that, ideally, people should not do interval work on consecutive days. More than 24 hours between such taxing sessions will allow the body to recover and help them avoid burnout.

What is so special about interval training? One advantage is that it allows exercisers to spend more time doing high-intensity activity than they could in a single sustained effort. “The rest period in interval training gives the body time to remove some of the waste products of working muscles,” said Barry A. Franklin, the director of the cardiac rehabilitation and exercise laboratories at the William Beaumont Hospital in Royal Oak, Mich.

To go hard, the body must use new muscle fibers. Once these recent recruits are trained, they are available to burn fuel even during easy-does-it workouts. “Any form of exercise that recruits new muscle fibers is going to enhance the body’s ability to metabolize carbohydrates and fat,” Dr. Coyle said.

Interval training also stimulates change in mitochondria, where fuel is converted to energy, causing them to burn fat first — even during low- and moderate-intensity workouts, Mr. Talanian said.

Improved fat burning means endurance athletes can go further before tapping into carbohydrate stores. It is also welcome news to anyone trying to lose weight or avoid gaining it.

Unfortunately, many people aren’t active enough to keep muscles healthy. At the sedentary extreme, one result can be what Dr. Coyle calls “metabolic stalling” — carbohydrates in the form of blood glucose and fat particles in the form of triglycerides sit in the blood. That, he suspects, could be a contributing factor to metabolic syndrome, the combination of obesity, insulin resistance, high cholesterol and elevated triglycerides that increases the risk of heart disease and diabetes.

By recruiting new muscle fibers and increasing the body’s ability to use fuel, interval training could potentially lower the risk of metabolic syndrome.

Interval training does amount to hard work, but the sessions can be short. Best of all, a workout that combines tortoise and hare leaves little time for boredom.

Tip: Metabolism Booster

GO LONG! LONGER!
Research shows that the longer your cardio sessions go, the longer your RMR (resting metabolic rate) will stay boosted after the workout.

from Hers Muscle and Fitness, June 2007

My Philosophy: Not a New Year's Resolution, a New Life Resolution/Revolution

Part 1
Because I am slim and fit, a lot of my clients and friends ask me if I diet. I don't believe the word "diet" should be a verb (as in, "Are you dieting?"). I'm a strong believer that one's diet should be a way of life. I don't believe in good foods or bad foods (chocolate cake=bad, rice cake= good). It should be noted that I do not consider highly processed foods, most fast foods, and foods containing certain artificial ingredients (hydrogenated oils, artificial sweeteners, &c.) real food that is fit for consumption. Few things in life are black and white, so why should we expect what we eat to be so simple and binary?

My philosophy is that we should listen to what our bodies are telling us. If we are gaining weight, are becoming hypertensive, if our cholesterol levels are high, if we're always hungry/stuffed, we should take a good, unbiased look at what we eat, when we eat, why we eat, and how we eat, and we should modify those things until we are healthy. What we consume should not negatively affect us, and if it does and we do not change our eating habits, we only have ourselves to blame. We don't have to diet (ie. deprive) we need to adjust our diet (how, how much, and what we eat).

Losing Weight

To effectively lose weight, one needs to adjust their diet as well as their activity level. Doing one without the other probably won't have much of a lasting effect. Think of it as a lifestyle change that will give you a changed body, a healthier body. Our bodies are amazing things. They will do only what we ask of them. If you want the strong, lean body of an active, healthy person, you are going to have to embark on the process of becoming a strong, active, healthy person. You won't get a strong, lean body by watching 20 hours of tv a week and substituting rice cakes for potato chips. If you're willing to accept that your lifestyle as it is now is not giving you the physique you want and committed to altering your lifestyle and adopting a healthier diet and more physical activity, your body will listen. It may grumble, it may ache and complain, but it will listen.

A good friend of mine is always saying, you are the master of your own destiny. You are the master of your body as well.

Change Your Diet, Change Perspective

It's common for many people to improve the quality of their food, make healthier choices, and still find they are not losing weight. Portion size is very important. It is crucial. American meals, especially the ones served at restaurants, have lost all sense of proportion. Our dinner plates are huge. Our spoons are huge. We need to relearn what a real portion size is and accept that. As long as we believe that a steak should be 24 ounces (as opposed to 4-6 ounces), we are not going to get the bodies we want.
At home, use smaller plates and fill them mostly with brightly colored vegetables. Keep your protein portion about the size of a deck of cards and your starch about 1/2 cup (think of a baseball cut in half). Still hungry? Have some more steamed string beans, some more beets, another helping of broccoli.
When you are actively trying to change your diet, to nurture your palate to accept and enjoy healthier real flavors, and to lose weight, you may want to step away from the desserts for a while. You should probably cut out alcohol, which is high in calories. This does not mean that you will forever forgo these items, but just know that for the time being, you are taking a break and resetting your palate and your body. If you must, savor just a bite of some high quality sweet instead of having a whole dessert or candy bar.
When you achieve your goal weight, remember that you can have anything you want occasionally and in moderation.

Exercise

The healthiest way to lose weight is to adopt a healthy diet and exercise. We should all be getting 45 minutes a day of exercise. At least. Our bodies are designed to be active. Unfortunately, our jobs often require we sit still for long periods of time. This starts a vicious circle of fatigue and inflexibility. This vicious circle continues even when we first start working out. It can last a few weeks, but slowly, surely, your body will wake up and rise to the occasion. It will do what you ask of it; it will get stronger, more flexible, healthier. You will feel stronger, healthier. You'll have more energy. As you come into your body, you'll be amazed at how good it feels to be more active, to be stronger. Your body is meant to be strong and healthy and your hard work and exercise will be rewarded. Your body is a part of you. Don't neglect it.

Math

While I don't believe we should be wed to the scale, there are some important numbers to consider. 3500 is the number of calories in a pound. If over the span of a month, you consume 7000 extra calories, you will gain two pounds of fat. Likewise, if over the span of a week, if you decrease your calorie consumption by 200 calories a day (that's about equal to a slice of cheese and a can of soda) while increasing your energy expenditure (exercise) by about 300 calories every day, you can expect to lose a pound.
What about all those diets you read about that tell you to cut out carbs and you'll lose 10 pounds in a week.... well, most of that is water. It is safe and reasonable for most people to lose between 1-2 lbs a week. Unless you have an excessive amount of weight to lose, dropping more than 1-2 lbs a week usually indicates you are dehydrated (a side effect of ketosis, the state your body goes into when it's deprived of carbohydrates).
Going back to what I wrote earlier about being wed to the scale... you should use how you look, how you feel, how your clothes fit, as better indicators of your progress. Muscle weighs more than fat. How much more? A pound of fat is about the size of a large grapefruit. A pound of muscle is about the size of a small orange or tangerine. So if you are losing fat and gaining muscle, the numbers on the scale might not be moving very much. If the jeans you banished to the back of your closet or some other "thin clothes" are telling you you lost weight but your scale is telling you otherwise, rest assured that you may not have lost "weight" but you certainly lost fat.

Walking for your Health

Walking Cure from Women's Health, December 2006

Eating a meal high in saturated fat could do immediate harm to your blood vessels. But if you just polished off a pint of Edy's Chocolate Fudge Chunk, don't panic: A study in the European Journal of Applied Physiology suggests that going for a walk after a high-fat meal may reduce the food's effect on your arteries. Researchers compared the heart health of eight 25-year olds after three scenarios: eating a low-fat breakfast; eating a high-fat breakfast; and eating a high-fat breakfast and then going for a 45-minute walk. While the arteries narrowed in the nonexercisers who ate the fatty meal, the arteries in the exercisers dilated (even more than in the low-fat eaters). So take a walk after a holiday pig-out, but avoid regular binge-and-walk sessions.

New Study: Effects of Aerobics on the Brain

NewsTrack - Science
Study: aerobics fights brain shrinkage

URBANA, Ill., Nov. 16 (UPI) -- A University of Illinois-Urbana study suggests aerobic exercise can help reverse the brain shrinkage that begins around age 40.

The researchers said patients who engaged in three or more hours of aerobic exercise weekly experienced increases in their brains' volume of gray and white matter, The Wall Street Journal reported Thursday.

The team studied 59 adults, age 60 to 79, in three groups: one group that received aerobic training, one that engaged in non-aerobic stretching-and-toning training and a group that did not exercise.

The non-aerobic exercise group and the group that did not exercise did not experience any change in their brains, but "the aerobic group showed a substantial increase in brain volume," Illinois' Arthur Kramer told The Journal.

"After only three months," Kramer said, "the people who exercised had the brain volumes of people three years younger."

Kramer said the subjects who exercised aerobically had better working memories, better abilities to switch between mental tasks and were more adept at screening out distractions than those who did not exercise.