20/20 InSights

Underestimating Diabetes

2008-10-28T18:19:00Z

I came across a very interesting article today on MSN Health regarding the dangers of diabetes.

The article talks about a survey done by the Centers for Disease Control (CDC). In the survey, very few people understood the threat that diabetes posed to their health. In fact, most people feared shark bites, plane crashes, or cancer more, even though they were more likely to get diabetes.

For example, 49% of the respondents feared cancer, while only 3% feared diabetes.

This article illustrates how are fears and perceptions often don't match up with reality. While people fear shark bites more than diabetes, only 70 confirmed shark attacks occur each year around the entire world. In contrast, over 233,000 people in the U.S. died of diabetes in 2005.

Why is this?

In my opinion, this is due to the phenomena known as misleading vividness. This is where a small number of very dramatic events are taken to outweigh a significant amount of statistical evidence. In other words, an event is so dramatic that it makes quite an impression in your mind. Your fears of this event are heightened, and you develop a distorted perception of the likelihood of the event.

Misleading vividness is also known as the Volvo fallacy. Joe thinks about buying a Volvo. He hears about someone whose Volvo had a wheel fall off the highway. The car crashed and the person died. So Joe won't buy a Volvo, despite the strong safety reports.

Shark attacks are vivid, sensationalistic events, particularly if you've ever seen the movie Jaws. Plane crashes are vivid, sensationalistic events. Even dying from cancer can be a vivid event, in the sense that cancer deaths are much more heavily publicized by the media, and we are constantly reminded of the hardship of going through this disease.

Dying from diabetes, however, is not a vivid event. You rarely hear about people dying from diabetes on the news. Death from diabetes is a very slow process. It's not a headline grabber. And thus it does not make the same emotional impact on your mind that a plane crash does.

But it should. We are at a much greater risk of diabetes than we are of getting in a plane crash. And the cost of diabetes, to both our health and our finances, is staggering. The average annual medical cost for someone with diabetes is nearly $12,000. A diabetic's medical costs are at least 2.3 times that of someone without the disease. And the complications that can result from diabetes are numerous, ranging from numbness to blindness to amputation to death.

The bottom line is that we should be much more worried about diabetes than about Jaws.

Vitamin C Craziness

2008-10-21T23:10:00Z

In a past blog, I talked about how we're a bit overly crazy about vitamin C in our society. We'll take megadoses (1-2 grams per day), thinking it will help us fight aging and prevent colds and prevent cancer and everything else. I pointed out how none of this is true, and how too much vitamin C may be harmful, despite the fact that it's a water-soluble vitamin (meaning it can dissolve in fluid so that your body can excrete in the urine).

Well, more research has come out showing that vitamin C isn't all it's Cracked up to be.

A recent study found that vitamin C, when taking in megadoses, reduced the effectiveness of anticancer drugs in animals. The doses used were equivalent to about 2 grams in humans.

In the study, mice underwent chemotherapy to treat cancer. When they were given the high doses of vitamin C, the effectiveness of the chemotherapy was reduced by about 30%.

This is another piece of evidence that you can have too much of a good thing. Antioxidants, like vitamin C, are certainly healthy in moderate amounts. But when you start taking very large doses, you can get the opposite of what you want.

There's no need to be taking more than 200 milligrams of vitamin C per day, anyway. This is the amount that will maximally saturate your blood levels; anything more is excreted.

Overall, you want to stick with getting your antioxidants from your diet, and a standard multivitamin like the 20/20 multivitamin. Avoid large single doses of antioxidant nutrients like vitamin C. They won't benefit you, and in some cases may even cause harm.

Superhype Juices Part Deaux

2008-10-09T17:31:00Z

In one of my first ever blogs, I wrote about so-called "superfruit" juices and how they were super-hyped.

A study was recently published in the Journal of Alternative and Complementary Medicine showing Goji juice to improve energy levels, athletic performance, sleep quality, mental acuity, calmness, and feelings of contentment.

So does that mean there's something to the hype?

Not really.

Dr. Paul Gross, the self-proclaimed "berry doctor", came out with some heavy criticism of this study. And he's right. This study is full of problems, including:

The study was funded by Freelife International, a Goji-berry juice supplier
The study was conducted by Freelife employees
The subjects in the study were Freelife employees
There was no control for the diets or personal habits of the subjects
There was no validation of the questionnaires
There was no "positive control" in this study. This means that there was no "standard" juice to compare the Goji juice to. It's quite possible that any juice may have had a positive effect.
There were no improvements in objective measures of health, only subjective self-rated measures
The study only lasted for 14 days

The fact is, there is no plausible mechanism behind how Goji juice could have all of these miraculous effects. If it sounds too good to be true, it probably is.

Currently, there is not a shred of scientific evidence that these "superfruit" juices have any benefit beyond normal whole fruit. There's nothing magical about these fruits. The only thing magical about them is the inflated cost (a bottle of Goji juice can run you $44!!!!!).

Cancer Misconceptions

2008-10-06T18:06:00Z

I came across an interesting article on MSN about the misconceptions people have about cancer.

Researchers surveyed almost 30,000 people in various countries, asking them what they believed to affect cancer risk.

The researchers had some interesting findings. First, they found that people in high-income countries often didn't believe that alcohol intake affected cancer risk, despite the scientific evidence that cancer risk increases as alcohol intake increases. These people also thought that not eating enough fruits and vegetables was more risky than drinking alcohol, although the opposite is true.

Another interesting thing was that people were more likely to accept things they could not control (such as environmental factors, including air pollution) as risk factors for cancer, and were less likely to accept things they could control (such as body weight, which is strong risk factor for cancer).

This made me think about how our priorities are often screwed up. I've noticed people tend to "micro-manage" their bodies, worrying about whether little things like artificial ingredients or pesticides cause cancer, while ignoring the important things, such as body weight and lifestyle. People tend to dramatically over-estimate the risks caused by the little things, and under-estimate (or ignore) the risks caused by the big things.

I've seen people worry about whether the food they eat is organic or not, while ignoring whether they're getting enough fruits and vegetables in the first place.

I've seen people who don't exercise worry about the monosodium glutamate (MSG) content in their foods.

The bottom line is that we need to get our priorities straight. Rather than making mountains out of molehills, we should be worrying about if we get enough physical activity, if we are eating a healthy, balanced diet, and if we are controllling our weight. Those things will go much further into helping to lower our risk of cancer than worrying about if a food has yellow #5.

Old Wives' Tales

2008-09-30T17:45:00Z

When it comes to health and wellness, there are soooooo many old wives' tales out there. While there may be truth to some of these, the rest belong in the fiction section of your local bookstore.

MSN had a nice little summary of 5 old wives' tales that are common in health and wellness. They are:

Cell phones are dangerous to use in hospitals because they interfere with medical equipment (JURY'S OUT)
It's safe to follow the "5-second" rule for food dropped on the floor (FALSE)
Cracking your knuckles can cause arthritis (FALSE)
Cola-type soft drinks may damage your kidneys (TRUE)
"Double dipping" spreads germs from one chip to another (TRUE)

I've addressed other old wives' tales in the past, such as here. However, I'm curious to hear from you. Are there any old wives' tales out there that you've wondered about? Is there anything that you or others have tended to believe, but you wondered, "Is that REALLY true?" If so, post a comment here, and I'll do some digging. I'll then write a blog post covering what I found out about the topics you suggested.

Tuesday Twosome

2008-09-23T20:21:00Z

Got a couple topics to talk about today.....

Cancer Crapola

In a past blog, I told you about bogus medical devices that were supposed to cure cancer.

Cancer-curing medical devices aren't the only things that are bogus. You'll often find supplements that are supposed to "cure" cancer as well. In fact, 5 supplement companies are facing lawsuits from the Federal Trade Commission (FTC) for marketing cancer cures. Six others settled out of court.

Cancer is such a difficult disease. People who suffer from it are often willing to try anything to help themselves get better. I hate it when I see companies try to take advantage of people's desperation in such difficult times.

Treadmill Typing

In a past blog, I talked about "walk and work" desks...workstations that were combined with a treadmill.

The New York Times recently had an article about this. More and more people have been purchasing the commercial version of these Walkstations, or setting up their own. And it doesn't stop there. There's now a growing number of walk-and-work blogs, as well as a growing social network of office-walkers. The Mutual of Omaha has put 4 walkstations on their call floor as part of a small study to see if these stations could help improve employee health.

And these walkstations are working. One man lost 16 pounds in two months, walking 2 hours per day at work.

Nothing can improve your daily energy expenditure like walking. When you walk at only 1 mile per hour, you double your energy expenditure over sitting. In fact, if you used one of these walkstations for half of your work day, you would expend an extra 500 calories per day! That's as much as you would get in a workout in the gym. An extra 500 calories per day would be 52 pounds of weight loss per year, assuming everything else is equal.

So, nothing beats getting more walking into your day. And if you can't have one of these walkstations at your desk, get a pedometer and make an effort to get as many steps in per day as possible.

Metabolism Fiction

2008-09-16T17:27:00Z

I came across the following article on MSN Health today:

Metabolism Fact and Fiction

The article is supposed to tell you what is fact and what is fiction in regards to metabolism and weight loss. However, some of what they claim to be fact is more along the lines of fiction.

On the very first page, it says, "different studies have suggested that 5 or 6 ice cold glasses of water could help you burn about 10 extra calories a day, equaling about 1 pound of nearly effortless weight loss each year."

I hate statements that say, "Studies suggest" without any references to the studies. I've seen such "studies suggest" statements before, when in fact there are no such studies.

But, let's say there's a study or two that shows 5-6 glasses of water will help you expend an extra 10 calories per day.

Big deal.

On paper, everything else being equal, yeah, you might lose an extra pound per year. But in reality, it doesn't work this way. You can't micromanage your body like this. First, the calories you eat each day can vary dramatically from one day to the next, even if you're perfect at meal tracking. This is because you can't measure precisely what's goes in your body. That 100 calorie yogurt you eat, for example, may have 80 calories or 120 calories (there's a margin of error on food labels).

Also, our bodies are pretty good at making adjustments to small changes in energy balance, so that our weight stays pretty stable when it comes to small changes. I wrote about this in another blog. You need much larger changes in energy balance to "jolt" your body into losing weight.

On the second page, the article mentions research from Utah that indicates drinking water may boost metabolism. However, this research, to my knowledge, was never published in a scientific journal (I did a PubMed search for one of the study's authors, E. Wayne Askew, and nothing turned up). This strongly suggests that the methodology of this study wasn't strong enough for publication, and its results may have been questionable.

On the third page, the article says that your metabolism drops as you lose weight, which makes it harder to keep off. While it's true that your metabolic rate decreases with weight loss, this has nothing to do with why you regain weight. In fact, one study clearly showed that resting metabolic rate was not related to 4-year weight gain in women who had lost weight.

The decrease in metabolic rate is perfectly proportional to your weight loss (there's a direct relationship between body weight and metabolic rate), so you can't stop the decrease in metabolic rate no matter how hard you try.

On the seventh page, the article says you will boost your metabolism by 100 calories if you add 3 pounds of muscle. This is false; 3 pounds of muscle will only boost your metabolism by 18 calories.

The rest of the articles were accurate for the most part.

Articles like this make me think that we really need a factcheck.org of the nutrition world.

Banning fast food restaurants?

2008-09-09T00:06:00Z

Some of you may already know that California was the first state to ban trans fats in restaurants.

Apparently they're taking it one step further. Los Angeles has put a moratorium on fast food restaurants in low-income and minority neighborhoods.

I don't really see how a moratorium like this would do much good. First, there's already tons of fast-food restaurants in these areas. People are still going to eat there. Banning the opening of new ones isn't going to help anything.

Second, it doesn't address the primary reason why low-income people eat fast food in the first place...it's cheap and easy. If you ban a fast food restaurant, people will just go look elsewhere for one. Or, they'll go to a convience store and find food that is just as bad.

L.A. councilwoman Jan Perry said the law is intended to attract healthy alternatives and grocery stores, which are few and far between in poor neighborhoods.

I still don't see how that will help. Places that sell healthy alternatives, and grocery stores, aren't attracted to these areas, probably due to the higher crime rates. Also, some places that sell healthy food simply are out of the income range of some of the people in these areas. I doubt Whole Paycheck, err, I mean Whole Foods would have much success setting up in an area like this.

I think Los Angeles should find other ways to help encourage healthy eating in the lower-income neighborhoods. For example, maybe they could give tax breaks to fast-food businesses that offer healthy alternatives that cost the same as less healthy ones.

I'd like to hear your opinions. How should Los Angeles tackle the problem of poor eating habits in lower income neighborhoods? Is it even something that is possible to do something about?

Friday Fusion

2008-09-05T18:13:00Z

A lot of different little blurbs to talk about today, a "fusion" of topics if you will.....

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Most Important Meal of the Day Part Deaux

In a past blog I talked about the importance of breakfast. Let's add another study to the growing body of evidence supporting eating breakfast in weight control.

A study published in Diabetes Care found an inverse relationship between breakfast eating and BMI. Fewer breakfast meals per week were associated with a higher BMI.

There's just something about breakfast that "sets" your appetite and blood sugar regulation for the rest of the day. So don't miss it!

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More Meals = Less Metabolic Syndrome

As a 20/20 client, you already know the importance of multiple meals per day, so I'm preaching to the choir here, but it never hurts to mention studies that support what you're doing.

In the journal Obesity, researchers found that eating meals regularly was inversely associated with risk for metabolic syndrome. People who ate on a regular basis on were 73% less likely to have metabolic syndrome.

So chalk up another point for multiple small meals per day when it comes to your health.

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Morning Protein Power

I can't seem to get away from this breakfast theme. Dr. Wayne Campbell (who I met last year at the Protein Summit in Charleston) of Purdue University published a study showing how people had better satiety when they ate more protein at breakfast versus lunch or dinner.

This was a pretty cool study. First, the subjects in the study were all overweight. He then put them on two diets. On the first diet, their protein intake was normal. On the second diet, they ate additional protein. This additional protein was either added at breakfast, lunch, or dinner, or was divided evenly throughout the day.

The people who ate a lot of protein at breakfast had the greatest feelings of fullness throughout the day.

It makes you think how American has got it all wrong when it comes to breakfast. For breakfast, we often eat cereal, or pancakes, or oatmeal, or some other high carbohydrate food. But this is backwards...we should be loading up on the protein in the morning instead.

So get your protein for breakfast, whether that's some whey protein mixed in with your oatmeal, or cottage cheese, or a protein shake, or eggs and ham, or something along those lines.

Moderation Monday

2008-08-25T21:30:00Z

Apparently some people in the supplement industry are up in arms about a B-vitamin study showing that supplemental B vitamins did not reduce risk of cardiovascular events or death.

Of course, this response isn't surprising coming from industry, but some of their criticisms are amusing. Dr. Daniel Fabricant criticized the study's exclusion criteria, saying that many of the study's subjects were taking beta blockers (drugs that help control blood pressure) or statins (drugs that help control cholesterol) at the same time.

Dr. Fabricant, this shouldn't matter. This is what randomization is all about. If you randomly assign your subjects to the treatment or placebo (which was done in this study), the two groups will balance themselves out. In fact, in a summary report of the study here, it states, "the groups did not differ significantly regarding age, gender, clinical, laboratory or angiographic findings, cardiovascular risk factors or concomitant medication".

Supplemental B-vitamins have been pushed in the past because they are known to lower homocysteine. Homocysteine is a protein in the blood that has been found to be correlated with heart disease; the higher your homocysteine level, the higher your risk of disease. However, this doesn't necessarily mean that homocysteine causes heart disease. In fact, this study, along with many others, have failed to show any benefit from lowering homocysteine levels with B vitamin supplementation.

As I mentioned in another blog, we tend to get a little bit crazy in our society when it comes to vitamin/mineral supplementation. We automatically think more is better (although more could actually be worse). We expect that taking a multivitamin/mineral is going to stop us from getting cancer or heart disease or some other terrible condition. But that's not the purpose of a multivitamin/mineral. Really, the reason to take a multivitamin/mineral is more as a safeguard against potential deficiencies. This means the doses don't need to be very high. Doses near the RDA should be more than adequate in a multivitamin (with some exceptions, like vitamin D).

Remember, everything in moderation....

Hungry Decisions

2008-08-21T16:44:00Z

There's a good article over on FoodNavigator on how hunger causes us to make bad decisions in regards to eating. You can read the article here.

Here's a good excerpt:

“When individuals extend the interval between meals or consume more of their food away from home, they are significantly more likely to consume more calories and more calories from solid fats, alcohol, and added sugars (discretionary calories) at each eating occasion.

“For example, going five hours between meals instead of four adds about 52 calories for someone on a diet of 2,000 calories per day; extending that interval from four to six hours would add about 91 calories to the meal. Going longer stretches between meals is also estimated to lower diet quality at each meal.”

This adds to the body of evidence that frequent, small meals (5-6 per day) is important in hunger control and weight management. The longer you go without eating, the more calories you'll end up eating at a meal, and the less likely you'll make good choices at that meal. I know, for myself, if I go to the grocery store hungry, I'm much more likely to buy foods that I normally would never buy. Or, if I go too long without eating, I'll make less healthy choices at my subsequent meal. You can reach this "I'm so hungry I don't care what I eat" state.

Anyone want to share their experiences related to this subject? What are your strategies for avoiding this? With our busy lifestyles, it can be easy to fall into these traps.

Insurance...for treatment or prevention?

2008-08-18T22:50:00Z

Back in 1999, I had a brief 3-month stint in cardiac rehab, working a lot with coronary artery bypass graft (CABG) patients.

We had a Phase II and Phase III to our treatment. Phase II was for clients soon after their discharge from the hospital, and typically lasted for 12 weeks. It involved closely monitored aerobic exercise, along with some weight training and flexibility training.

Phase III was a maintenance program for patients that had graduated from Phase II, and again involved closely monitored exercise, although at a lower frequency.

Phase II was often covered by insurance, but Phase III wasn't. I remember discussing with my colleagues about this how the insurance companies would save themselves money in the long run if they covered Phase III. The importance of exercise in the prevention of future cardiovascular events (like heart attacks) is well documented in scientific studies. But the insurance companies would only pay for the post-surgery rehab, which only gets patients "back on their feet" so to speak. Often, the patients who did not continue to exercise after Phase II ended back up in the hospital at some point down the road, which obviously cost the insurance companies more money...probably more than they would've payed for an on-going prevention program.

The reason I bring this up is because a colleague recently emailed me an article in the New York Times about weight loss camps for kids, and how they usually weren't covered by insurance. Unfortunately, when they weren't covered by insurance, the families couldn't afford the programs.

It's been well-established that childhood obesity leads to a host of health problems, and that more and more children are experiencing type 2 diabetes, a disease that only middle-to-older aged adults used to get. The burden that these problems will place on our health-care system and on employers is tremendous. For example, it's been estimated that a type 2 adult diabetic's health-care costs are 2.3 times greater than a person without diabetes. In the long-run, insurance companies probably would save more money by paying for preventive programs rather than paying for the problems after they've already occurred.

I'm interested in hearing your thoughts. What do you think? Do you think insurance companies should cover preventive programs? If not, why not? If so, what types of coverage would be fair?

Artificial/Natural Wars Episode III: Return of the Sweeteners

2008-08-15T19:00:00Z

A long time ago, in some blogs far, far away, I talked about how the line between artificial and natural is more like a fog rather than a line.

I also talked about how natural ingredients aren't inherently any safer or better for us than artificial ingredients.

I also mentioned how natural ingredients can be used to disguise what's really in a product.

A recent experience I had shows this perfectly. I had a meeting with the CEO of a beverage company planning to come out with a new drink. The drink was sweetened with agave syrup, a sweetener that comes from the agave plant.

He made a big deal out of this, because agave syrup is a natural sweetener. This drink was going to be marketed towards health & fitness-conscious people as a post-workout recovery drink.

Agave syrup is big as a sweetener in health foods because of its "natural" label. Health-conscious people like this as an alternative to sweeteners such as high-fructose corn syrup, which they don't consider natural. Also, agave syrup is extremely sweet, much moreso than normal table sugar, meaning you don't need as much to get the same sweetness.

However, what makes agave syrup so sweet is exactly what makes it unhealthy for you, despite its "natural" label.

Agave syrup is almost 90% fructose. Sweetening something with agavey syrup is like using pure crystalline fructose as a sweetener. Fructose is almost 200% more sweet than regular table sugar. It's the fructose content of agave syrup that makes it so sweet.

But it's this high fructose content that makes agave syrup unhealthy. Too much fructose in the diet is associated with a lot of health problems, including insulin resistance, metabolic syndrome, disruption of appetite regulation, fat formation in the liver, and high blood cholesterol and triglycerides. It's estimated that the American diet is much, much too high in fructose.

By comparison, high fructose corn syrup is only 55% fructose, and isn't much different from normal table sugar. Thus, high fructose corn syrup is actually a healthier choice of sweetener than agave syrup, despite the fact that agave syrup is "natural".

So, don't be fooled by "natural" labels. Agave syrup is probably one of the worst sweeteners out there, even though it's "natural."

Monday Mix

2008-08-12T00:02:00Z

MORE D, LESS DEATH

If you aren't already sick of me talking about vitamin D, well, I'm going to talk about it again.

In a study in the Archives of Internal Medicine, researchers found that people who had the lowest blood levels of vitamin D had a 26% greater risk of death from any cause as compared to people with the highest levels. This was a well-designed epidemiological study of over 13,000 people.

The evidence is becoming overwhelming how important vitamin D is to your health. Thus, it's extremely important that you consider getting your vitamin D levels tested by your doctor. If your levels are low, then adequate sun exposure and vitamin D supplementation will probably be necessary. Even if your levels are fine, getting some sun exposure and supplemental vitamin D is a good preventative measure. Consider supplementing with a minimum of 1000 IU, and try to get 15-20 minutes of sun exposure to your hands, arms, and face about three times per week.

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RUN LONG, LIVE LONG

Vitamin D isn't the only thing that may help you live longer. Another study in the Archives of Internal Medicine found that people who ran regularly had a 39% decreased risk of dying during old age than people who did not run. The researchers looked at runners who ran about 4 hours per week in their 50's, and continued to run about 76-80 minutes per week into their 70's and 80's. They compared the runners to controls who did not run.

Another interesting aspect of this study was that the researchers found that the runners had less disability with old age. Many people associate running with an increased risk of joint problems with age, but the researchers did not find this. In fact, running delayed the onset of disability by about 16 years.

The bottom line is that exercise truly is a miracle drug. Nothing works better for slowing the effects of aging than exercise.

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SALT SENSITIVE?

I used to be of the opinion that high salt intakes only increased blood pressure in people who were "salt sensitive." However, a recent study indicates that I may have been wrong.

In a study published in the American Journal of Clinical Nutrition, researchers looked at salt intake and people's genes. The researchers looked at a special gene for angioitensinogen, a chemical in your body that is related to blood pressure control. In this study of over 11,000 people, the researchers found that the effects of salt on blood pressure were not affected by a person's genotype. People that had higher salt intakes and higher salt excretion in their urine had higher blood pressures, regardless of their genetics.

While not salting your food can help reduce your salt intake, the best way is to simply avoid processed foods. In fact, only 10% of your daily salt intake comes from salting your food. Processed foods, like canned goods, soups, frozen meals, and deli meats are the real culprits. These foods often have high sodium contents because of the flavor and because of the increase in shelf life. Check the sodium content of the food labels, and talk to your dietitian if you have concerns that your sodium intake may be too high.

Out-D-oor Exercise

2008-08-11T23:57:00Z

Summer months bring the sun. Well, usually. Yeah, we got off to a bad start to our summer here in the Northwest, but things have improved.

Of course, even if we had a completely lame summer, summer months bring something else....travel. Road trips and vacations are popular summer activities. So you're bound to get some sun somewhere.

In a past blog, I talked about vitamin D, and how sunlight is your most important source. So whether you're on vacation or sticking around here in the summer, if you just get 15 minutes of sun exposure (without sunscreen) 2-3 times per week, you're getting a nice dose of D.

This is particularly important if you're overweight, as people who are overweight are more deficient in vitamin D than people of normal weight.

Since exercise is an important component of any weight loss program, you might want to consider doing your exercise outside during the summer months. A recent study showed that overweight people who exercised outside were 47% less likely to be vitamin D deficient than people who didn't exercise outside.

So, take advantage of your vacation or any sunny days you may get, and get some outdoor exercise in, especially if you're overweight.

A good way to see if you're getting enough vitamin D is to have your doctor test you for your blood levels. If your levels are deficient, you know you need to get more sun or may need to supplement.

Those are my thoughts for this first week in August. Forecast looks good, so I think I'm going to go grab myself some vitamin D :)

Monday Hodge-Podge

2008-07-28T23:06:00Z

Good afternoon, everyone! Here's a bunch of interesting stuff I've been reading about lately....

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INTERVAL TRAINING FOR METABOLIC SYNDROME

A study was recently published in the journal Circulation indicating that interval training may work better than steady cardio for improving metabolic syndrome. In this study, two groups exercised 3 days per week. One group did steady aerobic exercise for 47 minutes at 70% of maximum heart rate. The other group did a 10 minute warmup at 70% maximum heart rate, and followed that with four 4-minute intervals at 90% maximum heart rate, with a 3-minute recovery between each interval at 70% maximum heart rate. They then did a 5 minute cooldown.

The researchers found that interval training resulted in superior improvements in metabolic syndrome risk factors, fitness, insulin signaling (the ability of insulin to tell cells to take sugar out of the blood), blood sugar reduction, and endothelial cell function (the function of the cells that line your blood vessels). The interval training also reduced the body's ability to form fat more than the steady cardio did.

So, if you've got no conditions that might stop you from throwing in some intense interval training into your workout regimen, then give interval training a shot. It will make your workout more interesting, and you'll get better results.

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DON'T MONKEY AROUND WITH TRANS-FATS

I'm sure you know that trans-fats aren't good for you. They increase your risk of heart disease and diabetes. Well, it looks like they can also make you fat. In a study on monkeys, researchers found that trans fats increased body weight without an increase in calories. This means that trans fats are stored much more efficiently in your body as fat than normal fats are. Also, the researchers found that trans fats increase abdominal obesity and insulin resistance.

So, if you didn't have enough reasons to avoid trans fats in your diet, now you have another one.

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EASY ON THE SELENIUM

I mentioned in a past blog how we're a bit too antioxidant-crazy in our society. Antioxidants in moderation are good for us, but too much can be harmful.

Selenium is a mineral that our bodies need in low amounts. It is used to make important antioxidants called selenoproteins. However, be careful of getting too much. One study found that people who got 200 micrograms of selenium each day had a 55% greater risk of developing diabetes over the next 7-8 years. These were people who weren't getting much selenium in their diet, either.

The RDA for selenium is 55 micrograms. If you stick with doses of 55 - 70 micrograms that are found in most multivitamins, you'll be getting plenty of selenium. I'd stay away from antioxidant supplements that contain doses higher than 100 micrograms.

Another fish oil plug

2008-07-21T22:52:00Z

I hope everyone had a great weekend!

In some past blogs, I mentioned how fish oil is good for your brain and also that it may help with weight loss.

Well, let's add appetite control to that list.

In a study out of Spain, researchers reported fish oil to decrease appetite.

They assigned overweight subjects to one of 4 diets:

No seafood + 6 placebo capsules
150 grams of lean fish, 3 days per week (provided less than 260 milligrams of omega-3 fatty acids)
150 grams of salmon, 3 days per week (provided more than 1.3 grams of omega-3 fatty acids)
6 fish oil capsules per day (provided more than 1.3 grams of omega-3 fatty acids)

They then had the subjects rate their satiety after a test meal. The subjects receiving either the salmon or the fish oil reported being more full and less hungry than the subjects on the other diets.

Scientists aren't quite sure how the omega-3 fats help to control appetite. It may have something to do with the fact they are involved in the transport of appetite-regulating chemicals in the brain.

I've said it before and I'll say it again. There are three supplements that I think everyone should take....a basic multivitamin, extra vitamin D, and fish oil. The benefits of fish oil are just too overwhelming to not take it.

Probiotic Passion

2008-07-15T18:48:00Z

Happy mid-July, everyone! Finally summer seems to have arrived in the Northwest (knock on wood).

If being overly-crazy about antioxidants wasn't enough, it seems this year the rage is with probiotics.

Probiotics are basically live bacteria that are supposed to give you health benefits. That's right, people, you're eating live bacteria. No, E. Coli is not a menu item on the drive-thru at Jack in the Box (although it used to be.)

Not to say that you don't eat bacteria everyday...there's always bacteria on many of the foods we eat, but they never make it alive through the nasty acidic environment of your digestive system. There is some bad bacteria that can make it through your digestive system and make you sick (salmonella, anyone?), but proper cooking and food storage/handling usually gets rid of most of those.

In fact, there are live bacteria sitting in your large intestine right now, eating away at any undigested food that makes it down there. You might be freaked out to know that you have E. Coli sitting in your intestine right now. Don't worry...most forms of E. Coli are harmless...it's not the strain you might find in undercooked meat. The E. Coli you have in your intestine is helpful to you...it helps form vitamin K, and also prevents bad bacteria from taking over.

But let's get back to probiotics. The idea is, by eating these bacteria, you will get all sorts of benefits from a healthier immune system to less allergies to cheaper gas prices.

OK, I'm being facetious, but you get my point. Food manufacturers are taking advantage of the hype by adding probiotics to all sorts of foods. You can even get probiotics as a pill-type supplement.

Is there any substance behind this hype?

Yes and no.

First, you need to realize that not all probiotics are created equal. You can have bacteria strains that have the same Latin name but have different effects. For example, there are beneficial strains of Lactobacillus acidophilus, and then there are strains that just make yogurt. So, just because you're eating yogurt that has "live active cultures" doesn't mean the bacteria is going to give you any benefit. In fact, some bacterial strains don't even make it through your stomach intact!

Some food manufacturers don't even list the exact strain on the ingredient label. The label may say Lactobacillus acidophilus, but there are thousands of strains of this bacteria. If the label doesn't tell you the exact strain, you have no idea if what you're getting will benefit you.

The amount of bacteria is also something you need to look at. You usually need millions or billions of colony-forming units (CFU's). If the amount of bacteria isn't listed on the label, then avoid the product. Also, vague statements like "proprietary formula" are a red flag.

You also need to consider why you're taking the probiotic. In fact, probiotics have no benefit to already healthy people. There's not a shred of good scientific evidence that taking a probiotic will help you if you already have a healthy digestive tract.

Probiotics can help people with certain conditions, however:

Bifidobacterium infantis 35624, found in the OTC product Align, is the only probiotic that's been found in good studies to help with Irritable Bowel Syndrome (IBS).
Lactobacillus Rhamnosus GG (LGG), found in Culterelle and Dannon's Danimals Drinkable Yogurt, has been found to decrease the risk of antibiotic-associated diarrhea. It also may decrease the risk of traveler's diarrhea and acute viral (not bacterial) infectious diarrhea.
Lactobacillus casei immunitas, found in DanActive, has been found to reduce the risk of antibiotic-associated diarrhea.
Bifidiobacterium animalis lactis (Bifidus regularis), found in Activia, may help with irregularity
Saccharomyces boulardii, found in Florastor powder, can decrease the risk of antibiotic-associated diarrhea and traveler's diarrhea.

The bottom line is, if you're on antibiotics, if you're traveling, if you're irregular, or if you have IBS, probiotics may benefit you, as long as you stick with the particular strain that's been shown to help with your condition. But if you're already healthy, eating probiotics will only eat into your wallet.

Measure your burn

2008-07-07T18:31:00Z

Hi, everyone! I hope everyone enjoyed their holiday.

A long time ago, in a blog far, far away, I mentioned the importance of total daily energy expenditure to your success in losing weight and keeping it off. I also mentioned a device called the Sensewear Armband, which estimates the amount calories you expend each day.

Well, we're now offering this as a service to you, our current 20/20 clients and 20/20 alumni.

It's a pretty nifty device. It only measures about 2 inches by 2 inches, and you wear it on the back of your left arm. It measures skin temperature, galvanic skin response (electrical resistance of the skin), heat flux, and motion via a 3-axis accelerometer (side-to-side, up-and-down, and forward/backward). It then takes this data, and combines it with information about you (like your age and weight), and gets an estimate of your energy expenditure.

The most accurate method to measure your energy expenditure is through a technique called doubly labeled water. However, this fancy-schmancy technique is only available to scientists and is insanely expensive (over $1000 per person!). Research shows that the armband does pretty good when compared to doubly labeled water. In fact, in most people, the armband will be accurate to within +/-300 calories. That's pretty good for such a small device.

I know from personal experience that the device works pretty well. The armband measured my energy expenditure at around 3,300 calories per day. Given the error rate in the armband, that means my true energy expenditure is between 3,000 and 3,600 calories per day. I know, from meal-tracking, that I need to eat around 3,000 to maintain my body weight. So, at least for me, the device is nearly right on.

If you've hit a plateau in your weight loss, and you can't seem to figure out why, this can help you narrow down the causes of why you're not improving. For example, maybe your physical activity levels are too low. Or, maybe you're off on your meal-tracking and you're eating more than you think you are. Regardless of the reasons, this is a very handy tool. It can also be fun for those of you who are simply curious what your daily energy expenditure is.

If you're interested in finding out how many calories you burn, then you can sign up for a "Measure Your Burn Profile" for $60. With this package, you get to wear the armband for 3 full days, and you get an analysis of your results.

If you're a 20/20 alumni and you would like to discuss the results with a dietitian, then there is an alumni package that includes the 3-day rental, analysis of your results, and a 30-minute dietitian appointment.

If you want more information, you can call 425-869-4764.

GET OUT FOR SOME ADVENTURE!

2008-07-01T00:05:00Z

With summer finally being here in the Northwest, I say it's time that you get out of your gym routine and get outside.

Now, when I say get outside, I don't mean just go out for a jog or something.

I mean get out and do something new or unusual. I'm talking trying an activity you haven't done before.

For example, my passion is kiteboarding. If you don't know what that is, imagine riding a wakeboard, but instead of being pulled by a boat, you have a giant kite pulling you.

Yes, that's me, kiteboarding at Jetty Island in Everett. Imagine being able to catch 20-30 feet of air when you jump, but then land softly in the water. Yes, you can do that with kiteboarding. And let me tell you, you'll never get a better ab workout than this sport.

The cool thing about this sport is you can take your gear anywhere in the world with you. For example, I took my gear to Maui and went kiting there. You can't do that with most other sports!!!! Not only that, but you can also do it on the snow with a snowboard (called snowkiting), or on the land with a landboard.

That pic is not me (I have yet to snowkite), but you get the idea. There are plenty of places you can learn kiteboarding right here in the Seattle area.

Of course, I'm being biased here, as there's many other things you can do. For example, one of my fellow coworkers and friends here, Dave Joyce, is into adventure racing. Think of a triathlon, but instead of running, biking, and swimming, you are mountain biking, trail running, kayaking, or whatever else is called for on the race. Often, you can compete as a team. In fact, I know Dave has gotten some of his clients to participate in adventure racing with him as a team.

Speaking of adventure racing, there are plenty of trails around here where you can go mountain biking. Or, if you prefer the road, the east-side is loaded with bike lanes.

Now, if you're not the adrenaline/extreme sports type, there are plenty of places around here where you can go on a hike. From Snow Lake near Snoqualmie Pass (which I've hiked before)....

...to Tiger Mountain just north of the Issaquah Highlands...

...to Mount Si near North Bend. For Mount Si, you can either hike Little Si (which is a shorter hike, but still good exercise) or Big Si (steep and long hike if you're looking for a big challenge).

This is just a fraction of the adventures you can have around here in the summer, and these are just off the top of my head as I write this. So, take advantage of this beautiful weather we've had. You'll have plenty of time to hit the gym in the winter.