Sunday, December 30, 2012

Deep Water Running

As any runner knows, being injured is extremely frustrating! If you are looking to keep your fitness up in a time of recovery, try deep water running (DWR). DWR can be used as a way to maintain your aerobic fitness or to supplement a regular training routine. Aerobic fitness can actually be maintained for about six weeks when DWR replaces outdoor or treadmill running. Here are some things you need to know to get started:

1. Obtain a flotation belt so that you are more buoyant. While you will work harder without the belt, you will not be mimicking a natural running style. By using a more natural running stride, you will be activating the muscle groups that are used in running; therefore, maintaining your ability to run at the same level at which you were previously. This is called the principal of specificity.

2. DWR should be done in water deep enough that your feet do not touch the ground during your exercise.

3. Lean slightly forward from the vertical position with your entire body, bring your knee up to about 75 degrees, and then extend your leg toward the bottom of the pool.

4. Maintain relaxed arms in the same position that you would have them during regular running.

The type of DWR described above is called "cross country" (CC), which most closely mimics a regular running stride by activating the muscles slightly more than when treadmill running. Another commonly used style of DWR is called "high knee" (HK). While HK-DWR will give you a nice workout, it will not activate the appropriate muscles for running at the same intensity as CC-DWR.

Killgore, G.L. Deep-water running: a practical review of literature with an emphasis on biomechanics. Phys. Sports Med. 2012; 40(1).

Killgore, G.L., Wilcox, A.R., Caster, B.L., Wood, T.M. Alower-extremities kinematic comparison of deep-water running styles and treadmill running. J Strength Cond Res. 2006 Nov; 20(4): 919-927.

Masumoto K, Applequist BC, Mercer JA. Muscle activity during different styles of deep water running and comparison to treadmill running at matched stride frequency. Gait posture. 2012.

Reilly T, Dowzer CN, Cable NT. The physiology of deep water running. J Sports Sci. 2003 Dec;21(12):959-72.

Thursday, December 13, 2012

Don't Forget To Give Back To Yourself

When you are thinking about which charity to donate your time to this holiday season, consider adding yourself to the list. I agree that giving your time to help others is noble and important, which is why you MUST take care of yourself. You've heard something like this before, but have you taken it seriously? If you don't take care of yourself, you will likely have much less time to give to others. Not only may your life be cut short, but as you get older and continue to eat more and move less, you'll have much less energy for the items that are currently at the top of your priority list. So what is at the top of your list? Do you volunteer at your church, work hard taking care of your children, love visiting your grandchildren, work endless hours taking care of patients in a healthcare facility, volunteer with your favorite charity, etc? If exercise and eating healthy isn't right up there with those items, then you may find yourself falling short on what is most important to you in the near future. So give back to yourself so you can give back to others. This holiday season add exercise to your daily schedule. Do not wait for New Years because New Year's resolutions rarely ever last. When you want to make a change, you just do it. Real change happens any time of the year! Make a commitment to be there for your children, grandchildren, spouse, friends, and anyone else who counts on you. Make that commitment by taking care of yourself!

Thursday, November 15, 2012

Slow and Steady

The horn blows and we all take off running! Everyone is pumped and adrenaline is flowing. Soon, many people will "hit the wall" and begin to slow down for the remainder of the marathon. How do we avoid this problem? There are many solutions, but this post will focus on pacing.

While training for my last marathon, I got a lot of great advice from a great friend and fellow runner. Some of the greatest advice she gave me was that it is essential to start your marathon slow and build up your speed over time. We call this "negative-splits". For example, if your first mile was at a 9 min/mile pace and your second mile was an 8:50 min/mile pace, your split would be -10 seconds.

Hopefully, with ample training, your body will become more efficient at burning fat for fuel as the marathon progresses. However, you will still need plenty of glycogen in order to avoid hitting the wall. Running at a faster pace causes your body to use a higher percentage of glycogen versus fat. Therefore, starting your marathon around 6% slower than your goal pace will help to conserve energy for the miles to come.

I used this strategy at my last marathon and it was very difficult. Although I finished the marathon slightly under the predicted time of my coral, people were passing me like crazy in the beginning. With all of the excitement and energy I had to use, I wanted to just take off. I had to keep reminding myself of the great advice in order to hold myself back. After a while, the crowd thinned out and not as many people were passing me. At the half-way point, I was able to pick up the pace a little. I kept picking the pace up more and more as the miles increased. By mile 20, I knew the advice was solid! Granted, I did a lot of things better in this marathon. I fueled better, replaced electrolytes more efficiently, and ran more during my training (thanks to some encouragement from my helpful husband!). However, it seems like pacing myself had a huge impact on my time. I crossed the finish line with a new personal record.

It is so hard to pace at the beginning of the marathon, but it really pays off. So the next time you're out for a long race, remember that slow and steady wins the race!

Wednesday, October 10, 2012

Empty Promises for Calorie Burn

After my run today, I was stretching near the group exercise room at my gym. I noticed a couple of signs advertising an aerobics class and a weight lifting class. On those signs were estimations of calories that can be burned in those classes. I know there is no way that I would burn the amount of calories listed and many other people wouldn't burn that many either. I also can't help but laugh when I hear instructors yell out that we just burned 1000 calories in a class that lasted 45 minutes.

As stated, those calorie counts are just an estimation, and most likely an estimation on the very high end. "Calories burned" are typically calculated based on an "average weight" woman or man who is working to the fullest capacity in a class. Sorry, no breaks or lower impact options! These numbers not only do not take your individual weight into account, but they also do not take your gender, lean mass versus fat mass, fitness level, and age into account.

Wearing a heart rate monitor that takes your age, gender, and weight into account would be the best way to estimate your calories burned in any given activity. Granted, it will not be perfect either, but it will be a lot more accurate than the numbers any machine or instructor gives you at the gym.

This is really an important thing to know because many people overestimate their activity without the help of inflated calorie burns. When you start hearing that you're burning massive amounts of calories (even if you aren't), it is human nature to start eating a little more than you need to.

Ultimately, the best thing you can do is to exercise, eat when you are hungry, and stop eating when you are satisfied. Try not to get tied up in numbers that are inaccurate and unhelpful.

Tuesday, October 9, 2012

Liebster Award

I want to thank Busy-Dad-E over at for honoring my blog with the Liebster Blog Award. Apparently this award is given to up and coming blogs with less than 200 followers. What a fun day for the woRD on fitness!

With this fun little award comes rules. Here they are:

1. Each person must post 11 things about themselves.
2. Answer the questions the awarder has given you, the awardee.
3. You, now the awarder, choose 11 questions for your nominees who are now the awardees.
4. Choose 11 awardees, link to their website, and notify them.
5. No award-backs.

11 things about me:

1. I am a mom of three fun and crazy kids.
2. I love to run and run some more.
3. I consider myself a foodie and love to cook/try new recipes.
4. For no reason at all, my study partner for our metabolism class and I memorized the chemical structure for cholesterol. I have never forgotten it.
5. A clean house has always been important to me. I have now forgotten what that is after having three kids!
6. You can usually find me wearing gym clothes at the grocery store, home, gym, library, museum, or playground. I rarely wear regular clothes these days except at work, church, and a night out on the town. Even at work I often change into gym clothes. Hey, I work in a wellness facility!
7. In college I realized that I would need to learn to like vegetables if I was going to be a dietitian. I slowly started introducing new vegetables to myself and found new ways to cook them. Many years later, I can honestly say that I love vegetables!
8. I always look forward to quality time with my husband and best friend.
9. Seventy degrees is my favorite outdoor temperature.
10. Until the kids go to bed, the only time I sit down is when I'm driving.
11. I love this crazy life with my wonderful family!

Answer the questions from the awarder:

1. Coke or Pepsi? Coke zero cherry.
2. Pepperoni or plain cheese? I'll go with pepperoni.
3. What are you most passionate about? Professionally: Helping my clients to live their lives to the fullest by staying healthy with good food and exercise. Personally: Raising a family that lives in a way that is pleasing to God.
4. Do you believe in absolute truth? Yes.
5. Where in the world would you most like to visit? Ireland.
6. Which of my posts are your favorite? Oh my gosh, Busy-Dad-E! That is a tough question! So many of your posts are hilarious and so many are sweet. I will go with one of your sports posts.
7. What is your favorite thing about being a parent? Again, hard to pick just one thing. I will go with two! I love the hugs and seeing them master a new skill or hit a new mile-stone. It is such a happy time!
8. Do you floss before or after brushing? After, of course!
9. What makes you truly happy? My family!
10. What is your favorite hobby? Running!
11. What one question would you like to ask me? Does life get harder or easier as your children get older?

My questions for the awardees:

1. What is your favorite Friday night activity these days?
2. Books on tape or music while driving?
3. Would you rather text people or call them?
4. We always say technology is awesome, but what is the biggest drawback to the phones,computers, tablets, etc?
5. What is your favorite hobby?
6. What is your favorite birthday dinner?
7. Coffee or tea?
8. Favorite singer from your childhood?
9. Will you vote in the upcoming election?
10. Summer or Winter?
11. Favorite thing to do on Halloween?


Thank you, Busy-Dad-E!

Saturday, September 22, 2012

Sugar, Fat, and Salt....addictive? How do we stop overeating?

I just finished reading David A. Kessler, MD's book The end of overeating. It was definitely an interesting read and I recommend it as some food for thought.

For about the first half of the book, Kessler talked a lot about the enticing nature of processed foods and restaurant meals due to their overuse of sugar, fat and salt. He discussed several research studies that really showed just how enticing those foods are. I want to be careful not to use the word "addictive" because there is quite a controversy on that topic. Many research studies conflict and I am not a believer that food is a addictive. I need to be convinced by a lot more research first! However, I do agree, and Kessler's presented research shows that there are certainly foods that are hard to stop eating.

I would like to take you back to Intuitive Eating for a minute. In that book, the authors discussed studies that showed a major decline in the satisfaction level of a food after eating only a small amount. Also, there was a lot writing in that book devoted to the message that making no food off limits results in less overeating. Perhaps the high sugar, fat, and salt foods do have a significant pull on one's tastebuds. Maybe if we do follow the advice in Intuitive Eating we might realize that the food really isn't as satisfying after the 10th or 15th bite.

Getting back to Kessler's book, the second half was mainly about overcoming the urge to overeat. The end result of Kessler's process was similar to the ideas of Intuitive Eating; however, the road to get there was quite different. Kessler stresses avoidance of all foods that might trigger you to overeat. My first thought was that deprivation leads to overeating. Kessler made a point to say that this is not "deprivation". Instead, it is just the conscious decision you make and say to yourself, "I just don't eat that food." I do believe there is more than one right way to do a lot of things, but in my experience, I don't see that working for many people. There will always be family events, holidays, birthdays, and other tempting occasions when everyone is eating something except for you. When you get to that occassion, will you be able to resist? What if you allowed yourself to have a small portion? Kessler believes that you will end up with another small portion, and another, and another, until you have had way too much. Yes, I agree with him if you are a person who is always depriving yourself. However, what if you have learned to eat intuitively and know that you can have chocolate chip cookies any time you want? When they show up at a family function, maybe just one would satisfy you. Learning to savor and really taste your food makes a big difference in how you eat as well. If you pop an entire cookie into your mouth while you're talking at the same time, how can you really taste and enjoy it?

Kessler also encourages the reader to avoid all situations that might derail you. In some cases, I completely agree. If you can't walk past a Starbucks every day without stopping in for a danish, then maybe you should find a different route. Those types of modifcations to your life seem reasonable. However, there will always be special events, dinners out with friends, etc that you shouldn't have to miss out on. Furthermore, you have to learn how to cope in these situations and still walk away feeling like you had a great time but didn't overindulge. You should not miss good times with friends and family because of food!

As I mentioned, the end result that Kessler is hoping to get you to is not making any foods off limits. He wants you to be able to eat mostly healthy foods, some "play foods" (term from Intuitive Eating), and just the right amount. In order to get to that point, he believes that you do have to go through this avoidance phase and "I don't eat that" phase in order to "detox" yourself, if you will.

The end of overeating. is certainly an interesting book with many great points; however, I would encourage you to try to become an intuitive eater. I would also love any feedback from people on what works for them; or from professionals who have tried either of these two techniques and what the long-term results are like. In my experience, eating intuitively is still the best way to go!

Sunday, September 9, 2012

Dietary Confusion

Meat will kill you, milk gives you cancer, all sugar is bad, bread is evil, fruit is nature's candy, carbohydrates make you obese, and any dietary fat will give you a heart attack. What do you get when you add all of these so-called truths together? You get a diet of exclusively non-starchy vegetables. I don't know about you, but that makes me feel hungry and frail just thinking about it.

Throughout my career I have encountered hundreds people who fully believe one of the dietary comments listed above. There are hundreds of books written by doctors (medical doctors and doctors of philosophy) who swear that you must cut one of these food categories out of your diet in order to save yourself from disease and obesity. Many times when I try to discuss one of these "dietary truths" with someone who is a firm believer in their respective "truth", I get the "You just don't know anything. ____ will kill you and you obviously just believe in all of that crazy stuff you learned in school" comment.

I find it humorous when I get a comment like that because they may be a person totally against all carbohydrates and they believe that eating plenty of meat will keep them healthy. Later in the day I might encounter someone else who is a firm believer in a fat-free diet and eats many fruits, vegetables, and whole grains; however, neglects heart-healthy fats in their diet. They may give me the same comment. So, you see, I am constantly encountering people who believe that my advise, which is based on scientific evidence, is wrong, yet everyone's "dietary truth" conflicts with each other.

All of that brings me back to the simple idea that I always try to convey to my patients and anyone who will listen. Eat a variety of fruits, vegetables, whole grains, and lean protein. Each food category offers its own unique set of health benefits. Eating too much of any one food category could cause its own unique problems and avoiding any particular food category could cause health problems. That advise, my friends, is rooted in decades of scientific evidence.

When you read or hear about the latest "sure thing" in nutrition, I beg you to remember these things:

1. Anyone can write an article or book. Check the credentials of the author. If the author has none, move on. Even if the article or book is written by a professional who is an expert on the subject matter, the unfortunate truth is that you still have to look at it with a critical eye. Books, magazines, newspapers, and web articles are not peer-reviewed like scientific journals. Therefore, you may be reading some ideas that really aren't proven facts; or the author may have manipulated research by only presenting the part of the story that supports their ideas.

2. Medical professionals who make nutrition recommendations under the USDA, American Heart Association, Academy of Nutrition and Dietetics, and other reputable organizations do so based on scientific evidence. I have noticed that there is a lack of trust in these organizations from a number of people. Please remember that the professionals who make up these organizations have studied this information for years. Not only can they look at research with a critical eye due to their background knowledge, but they are also better able to see the big picture of nutrition as it relates to health because they have been trained in this fashion.

3. Have you ever wondered why nutrition advise is constantly changing? Surprise! It really isn't changing very much at all! Fad diets change all the time. Writers who misrepresent facts give Americans the impression that recommendations are changing. If you look at recommendations that are released by reputable organizations, there is never much of any change going on. Sometimes the way the recommendations are reported to the public may change a little bit. Over time, research uncovers better ways to reach the public and so the way in which information is conveyed may change. Recommendations are also more specific than they used to be. This is partly because research has uncovered more details and party because we already knew it, but realized that we need to do a better job of teaching the public about nutritional details. For instance, it is very recent that public health officials started giving details about the need for eating different colored vegetables due to their variety of nutritional offerings.

3. Nothing is perfect about our food supply, but it is pretty darn good. Would it be best to eat all whole foods and nothing processed? Yes! However, keep things in perspective. Preservatives make our food supply safe and we are living longer lives due to technology that keeps harmful bacteria out of our food. I am not saying that you should live on a diet of Oreo cookies; however, I am saying that a bowl of Cheerios isn't going to hurt you.

Thanks for reading! Please post questions or comments if you have them!

Saturday, September 1, 2012

How to make "intuitive eating" work for your children

In my last post, I briefly discussed Intuitive Eating by Evelyn Tribole, M.S., R.D. and Elyse Resch, M.S., R.D., F.A.D.A, C.E.D.R.D. Many people may be wondering how that applies to children, especially as so many children battle obesity. Making the intuitive eating process work for children is covered in this well-written book; however, I also recommend Child of Mine: Feeding With Love and Good Sense by Ellyn Satter, MS, RD, CICSW, BCD. While there are many great guidelines in Intuitive Eating, Satter gives more specific information in her book on how to let children continue intuitive eating from birth or help them return to intuitive eating if they have strayed. Please see my previous post for more on Satter's book.

This topic of childhood nutrition is more important than ever as we continue to hear about the war on obesity. To incorporate intuitive eating, we as parents need to:

1. practice the division of responsibility as Satter discusses in her book.

2. stay neutral by not commenting on how much or little our children eat. Let your children trust their instincts. Also, avoid comments about calorie content and how healthy or unhealthy a food is.

3. set a healthy example. Try new foods, find plenty highly nutrient dense foods that you enjoy and eat them, and regularly be active with your children.

4. refrain from comments about a child's thinness or fatness. Focus on providing mainly foods that will help to nourish their bodies and allow some flexibility for "play foods". (The term "play food" is used in Intuitive Eating to describe what is often called "junk food".)

5. understand that children sometimes need to be exposed to foods up to 10-20 times before they will accept them. Provide the food and just relax. Children take the responsibility of exploring food and deciding when they are ready to try it. Don't give up on a particular food. Keep offering a variety of food and say nothing about it. Most likely, your child will eventually try it.

I want to leave you with one more suggestion. Refrain from telling your child that he/she must finish all of the ______ on his/her plate in order to get dessert. That well-known practice simply glorifies desserts by sending the message that it is a reward for eating that "yucky" dinner you served. I know that this is difficult for most parents as I struggled with it for a while also. It just seems so wrong to give a child ice cream when they only took one bite of their entree. Our parents told us we had to eat enough to get dessert and their parents told them the same thing. It is hard to break a habit that has been passed down over the generations. To avoid basing dessert on whether or not your child has eaten, you could choose a few days during the week when you will serve dessert. Serve dessert regardless of how your child ate. On the other days, your child will not receive dessert regardless of how he/she ate. I know this is a difficult change for parents to make, but it is a good one.

Sunday, August 26, 2012

Warning: Diets are Toxic to Your Health

You have probably heard the saying that "diets don't work". Well, it is true. Research shows that people who chronically diet tend to continue gaining weight over the years. Diets can, and often do, result in weight loss. However, the weight loss from these diets is typically short lived as they are too restrictive and cumbersome to stick with for any length of time.

Many of us in the nutrition and fitness industry throw around the term "lifestyle change" as a way to explain that the changes you make in your diet and activity level must "stick" in order to maintain weight loss. That recommendation to make a "lifestyle change" is then followed by rules like "no sugar", "no junk food", "cut back on carbs", "don't eat meat", "exercise daily", or "never eat fast food again". That puts us back at square one with the "diet mentality".

To truly make a "lifestyle change" we have to abandon the ideas of diets, restrictions, and quick-fixes. I strongly encourage you to read Intuitive Eating by Evelyn Tribole, M.S., R.D. and Elyse Resch, M.S., R.D., F.A.D.A., C.E.D.R.D. The authors of this book discuss how to eat intuitively by listening and trusting your own hunger and fullness signals. We were born with this ability; however, many of us have moved away from using this simple tool to regulate our food intake. There is also an emphasis on enjoying food and allowing yourself to make room in your life for foods that often seem forbidden on diets.

The principles of intuitive eating are as follows:

"1. Reject the diet mentality.
2. Honor your hunger.
3. Make peace with food.
4. Challenge the food police.
5. Feel your fullness.
6. Discover the satisfaction factor.
7. Cope with your emotions without using food.
8. Respect your body.
9. Exercise-feel the difference.
10. Honor your health with gentle nutrition."
Tribole, E., Resch, E. Intuitive Eating. NY: St. Martin's Griffin, 2012.

If you truly want to change your lifestyle, mend your relationship with food, and reach a healthy weight, Intuitive Eating is the book for you.

Wednesday, August 8, 2012

Exercise Makes You Happy!

Exercise is medicine. I believe that a large amount of disease (mental and physical) and other ailments would decrease in our country if more movement and less sitting were going on. The impact of exercise on depression has been examined by many researchers and results look pretty promising.

Exercise appears to improve depression more quickly than medication alone and decrease relapses. Some researchers even believe that medication can be decreased or discharged from some patients' medical plan. There is very strong evidence that exercise helps to reduce anxiety levels.

Aside from the reduction in depression and anxiety, exercise is known to evoke a positive mood and improve confidence and self-esteem.

Going out for a walk once a week will most likely not make a huge difference in the factors listed above. While some walking is better than nothing, best results occur when people exercise regularly (at least five times each week) and when they stick to their exercise regimen. Also, vigorous exercise proves to be more effective than moderate exercise.

Another interesting note is that people tend to benefit from group exercise. Not to say that exercising alone won't be beneficial. However, the comaraderie that occurs while breaking a sweat with other people in aerobics classes, cycling, or a group of runners may help to give your mood a little extra boost.

So for anyone battling the stresses of life, struggling to beat depression, fighting off anxiety, or just wanting to be a little happier, get out there and start breaking a sweat!

Sunday, July 29, 2012

A New Favorite Snack

I recently bought Chobani's Champion Greek Yogurt for kids in the "very berry" flavor. The yogurt came as a 4-pack, so I had one container for each of my children and an extra for me! I sliced fresh strawberries and mixed it in each container. What a delicious snack!

Each container had about 100 calories and was low in fat and sugar compared to many other yogurts. I would definitely recommend this as a great snack for children or adults.

Of course Chobani yogurt is expensive, but I bought it on sale with a dollar off coupon, so it was very affordable that way.

Happy snacking!

Sunday, July 15, 2012

The Latest On High Fructose Corn Syrup

I recently attended a webinar that examined high-fructose corn syrup (HFCS) and its impact on weight gain, high blood sugar, high blood lipid levels, high uric acid levels, and increased blood pressure. The conclusion from the three health professionals was that we ultimately cannot blame HFCS for the previously stated health issues.

While I was working on my degree in nutrition, I was taught that HFCS was a bad ingredient in foods and that it should be avoided. Naturally, that has been my thinking, so I was taken aback by the new information in the webinar.

The research reviewed in the webinar basically showed that whenever humans ingest a diet that is calorically appropriate, they suffered no ill effects from replacing some of their carbohydrate intake with HFCS. Whenever diets were higher in calories than needed by the body; and some carbohydrate was replaced by HFCS, ill effects were present. The conclusion was that HFCS are safe; however, just like any other added sugar, eating too much will cause weight gain.

Keep in mind that these studies share the limitation that it is difficult to keep subjects on a specific diet for a long period of time. That fact makes it difficult to truly know the long-term effect of any diet.

I went back and looked at several studies to form my own opinion, and I have to say that the professionals in the webinar were really on target. This was truly surprising to me. However, the sentiment does make a lot of sense. We spend so much time trying to place the obesity/chronic disease epidemic on a particular nutrient, food, fast food chain, advertisement, drink, etc that we forget that all of these things work together. A bowl of ice cream certainly won't make you obese; however, always grabbing the low nutrient/high calorie food WILL make you obese.

Remember that HFCS is only in processed foods because it is a man-made sugar that includes glucose and fructose. It is very similar to sucrose (table sugar), but it doesn't occur naturally. Therefore, if you're eating a lot of HFCS, you are also eating a lot of processed foods. It is well accepted that the more whole foods and less processed foods you eat, the better off you will be.

In conclusion, eat more fruits, vegetables, whole grains, and lean proteins. It is okay if you have a little bit of HFCS every now and then, just don't over-do it!

Wednesday, June 27, 2012

Caffeine and Athletic Performance

Scientists have been studying the effect of caffeine on athletic performance for quite some time. Based on the evidence that exists, the American College of Sports Medicine (ACSM) currently reports that 3 to 9 milligrams of caffeine per kilogram of body weight can improve endurance athletic performance (lasting up to 2 hours) and short-term, intense exercise (lasting about 5 minutes).


Body weight = 150 lbs

150 lbs / 2.2 = 68.2 kgs

68.2kgs X 3 mg caffeine = 204.6

68.2kgs X 9 mg caffeine = 613.8

So a person who weighs 150 pounds would need between 205 mg and 614 mg of caffeine. A cup of coffee has at least 100 mg of caffeine.

Studies have shown that caffeine can help to increase power output and speed. Unfortunately, studies cannot confirm that caffeine in the form of coffee will elicit the same results because caffeine was administered in pill form. Fortunately, caffeine does not cause dehydration as commonly thought.

Practical advice: If you are using gels or sports drinks with caffeine in them, know that they are safe and they may even improve your performance. Do not ever try something new on race day! Do not overdo the caffeine. By that, I mean that more is not always better. Be sensible, do not take so much caffeine that you are jittery, and don't expect this to help you win the race. Train, train, train!

Tuesday, June 19, 2012

A Hidden Danger For Runners...

You're outdoors on a nice day getting exercise. What could be bad about that? While you're doing your body "good" by running, you may be ruining the appearance of your skin and putting yourself in danger for skin cancer. Of course, anyone who participates in outdoor sports is at risk for this.

This summer, and ALWAYS, make a commitment to wear sunscreen when you run outdoors. Remember that ultraviolet rays are still busy damaging your skin even on cloudy days. In fact, I got the worst burn of my life on a very overcast day when I was a kid. I will never do that again! However, I know that I still make silly decisions. Last October I went out for a run and came back with a burn. Even if I hadn't gotten a burn, I know there still would have been damage to my skin after being outside in a tank top and shorts for an hour and a half. If you're having trouble making yourself take the time to apply sunscreen, ask yourself, "Do I really want to have ugly sun-damage spots on my skin and look ten years older than I really am?" Even if you escape skin cancer, the sun will likely derail your plans for graceful aging.

Choose a broad spectrum sunscreen and reapply every two hours, even if the sunscreen claims to be sweat resistant. Check out this article for information about new FDA guidelines for sunscreens. Be sure to use an ounce of sunscreen to achieve the full benefits of skin protection.

In addition to sunscreen, don't forget other protective measures. Invest in some running sunglasses, such as my favorite, Tifosi. A hat or visor are also really good ideas to keep the sun off of your face. Hats are best if you have any exposed scalp.

We are so fortunate that we live in a time when sunscreen is available. Let's take advantage of this great invention and protect our skin.

Sunday, June 10, 2012

Glutamine for Endurance Athletes

Glutamine is an amino acid that has gained popularity among endurance athletes as an important post-workout nutrient. (Amino acids are the building blocks of protein). Many athletes take supplements or consume sports drinks that contain glutamine in order to improve immune function.

Glutamine is an important fuel for immune cells and is typically decreased in the body after endurance exercise. Immune function is known to be lowered after endurance exercise as well, so the idea that supplementing with glutamine post-workout would improve immune function does make sense. However, evidence shows that even when glutamine supplementation is used, immune function still suffers after endurance exercise. In fact, studies have not been able prove that a low level of glutamine in the body causes a higher rate of infections. So, even though there is a reduction in glutamine, and it is used by immune cells for energy, it doesn't appear to be the magic bullet for avoiding infections in the over-trained athletes.

It is interesting to note that immune function does improve in moderately trained individuals, but suffers in sedentary people. Moderation wins again, my friends. (Regardless, I can't tear myself away from marathon training!) Another important point is that glutamine is a non-essential amino acid. That means that your body can manufacture the nutrient all by itself. However, you should definitely increase your calories after a long work-out and include protein. Glutamine is a highly abundant amino acid in many foods including red meat, fish, poultry, legumes, and vegetables. There is no need to buy an expensive supplement or drink that contains this amino acid because we have found that it doesn't show efficacy in improving immune function and you can get it from your regular diet.

Agostini, F. & Biolo, G. Effect of physical activity on glutamine metabolism. Curr Opin Clin Nutr Metab Care. 2010 Jan;13(1):58-64.

Calder PC, Yaqoob P. Glutamine and the immune system. Amino Acids. 1999;17(3):227-41.

Gleeson, M. Dosing and efficacy of glutamine supplementation in human exercise and sport training. J. Nutr. Oct 2008; 138(10):2045S-2049S.

Parry-Billings M, Budgett R, Koutedakis Y, Blomstrand E, Brooks S, Williams C, Calder PC, Pilling S, Baigrie R, Newsholme EA. Plasma amino acid concentrations in the overtraining syndrome: possible side effects on the immune system. Med Sci Sports Exerc. 1992 Dec;24(12):1353-8.

Walsh NP, Blannin AK, Robson PJ, & Gleeson M. Glutamine, exercise, and immune fuction. Links and possible mechanisms. Sports Med. 1998 Sep;26(3):177-91.

Tuesday, June 5, 2012

Fiber Update

Someone recently requested information on the importance of fiber. I did briefly address this in a previous blog; however, I'll do a little update on that today.

Currently, the recommendations are 38 grams of fiber for most adult males and 25 grams of fiber for most adult females. Check this out for a more detailed breakdown. I have found with clients, it is quite difficult for men to reach that lofty goal of 38 grams daily. I recommend that you just try, try, and try some more! Even if you don't reach 38 grams, you will most likely do much better than the average American.

Be sure to obtain most of your fiber from natural sources, such as whole grains, fruits, vegetables, legumes, nuts, and oats. Research has shown than many of the products on the market that contain man-made fibers do nothing but give people gas. Unfortunately it is difficult to be sure which foods contain natural fibers and which ones contain man-made fibers. That is why I encourage you to choose mostly unprocessed foods that are naturally high in fiber.

Here are benefits of a high fiber diet:

1. Possible decrease in colon cancer risk. There are mixed results in studies that examine this.
2. Better weight control or weight loss. Fiber increases the feeling of fullness possibly decreasing total caloric intake. Also, foods that are high in fiber, such as fruits and vegetables, have less calories and more "bulk".
3. Fiber reduces constipation.
4. Improves blood cholesterol levels.
5. Helps regulate blood sugar in diabetics.

Read this for more information!

Tuesday, May 29, 2012

Avoid the Fat Trap

A friend of mine asked me what I thought of an article by the Poliquin Editorial Staff. Anyone who knows me well knows that I don't usually give brief answers. :) I thought this article brought up some great talking points, so I am answering her in a blog post!

Great points:
* While exercise will still be beneficial in many ways, it is true that you can't negate a poor diet with exercise. If you eat more calories than you burn, you will gain weight.

* There is research that supports the idea that weight training helps with insulin sensitivity. This is a great point and helps to prevent/prolong the onset of diabetes while also helping diabetics to manage their blood sugar.

* I completely agree with not getting so caught up in the game of counting calories to lose weight. Intuitive eating (watch for a blog post on this in the future) produces a better outcome than the calorie game. We should focus more of our efforts on choosing nutrient dense foods that are high in fiber, low in saturated and trans fat, and low in sugar; and stopping eating when we are satisfied.

* All fats are not evil. Well said! Fats are important in our diet, but just like anything else, too much will kill you!

* I love the point about eliminating juice and soda! Soda is just a bunch of empty calories and juice isn't a whole lot better.

* I also love the point about avoiding all trans/partially hydrogenated oils. This is very difficult, but less is better than more when we're dealing with these fats.

* It is true that when your body is releasing a lot of insulin, it does increase the amount of fat that you store. That is an important thing to remember when you have an impaired insulin response. For normal, healthy people who have a good insulin response, your body should be able to deal with sugar pretty efficiently. For people who have an impaired insulin response, your body may need to release more and more insulin to deal with a glucose (sugar) load. This does not mean you need to cut out carbohydrates. It means that you need to eat a normal amount of carbohydrate at meals. I say this because people think that diabetics have to cut down on carbohydrates. They really just need to get back to eating a "normal" amount, which is how everyone should eat. A range, depending on your body size, activity, and sex, of about 45-60 grams per meal would be "normal". Also, choosing foods that are high in fiber and eating some fat and protein along with it helps your body to manage the glucose (sugar) load.

Points that are a little misguided:

* Americans are overweight because of the 2800 to 3000 calories eaten each day, not because they eat too many carbohydrates specifically. Everyone is always trying to blame obesity on a particular factor that they believe is evil. Although there are empty calories and calories that have a higher nutrition density, a calorie is a calorie. By this, I mean that if you eat too many calories, no matter where they come from, you will gain weight. If you eat fewer calories than you burn, you will lose weight.

* As the author said, aerobic exercise doesn't really build muscle. However, it is key to burning fat and it will create a greater calorie deficit than weight training. Weight training should be a part of an exercise regemin for numerous reasons; and it does build muscle. However, your greatest calorie burns will come from aerobic exercise.

* The author brought up the thermic effect of food, the amount of energy/calories that it takes your body to actually digest food. Just because it may take a few more calories to digest protein than carbohydrate doesn't mean it will make any significant difference. We are talking about just a few calories here. It takes 3500 calories to equal one pound of fat.

* The journal article that the author sited was used to support the point that a low-carb diet is best. What the author failed to mention was that a third diet was also used as a part of this study. The third diet was a mediterranean diet and it consisted of a healthy percentage of fat in the diet (35%). The article did not mention the percentages of protein and carbohydrate. However, considering that the diet was also high in fiber, I will assume that a fair amount of calories came from carbohydrates. All three groups lost weight, but the low-carb and mediterranean groups lost the most. All three groups had a significant decrease in waist circumference and blood pressure; however, there was no significant difference between the three groups. The low-carb group showed the highest level of ketones in the urine. From this bit of information, my thoughts are:

-Because the mediterranean group and low-carb group were similar in their weight-loss, it is difficult to conclude that reducing carbohydrates is better.
-Because the low-carb group had more ketones in the urine, I would venture to say that this diet is not the safest.
-This study only lasted two years, so remember that it does not give us any information on differences of chronic disease.
-Only 272 people completed this study.

* The author's suggestion to eliminate sugar is...well...silly. He encourages fruits and fruits have natural sugar. Anyone who says they have eliminated sugar or tells you to eliminate sugar is highly misguided. It is not unhealthy to have some natural sugar in your diet. It is also very contradictory to say that fruit is good but sugar is not. Just like anything else, too much sugar will kill you, but a little won't hurt you.

* Please do not eat 50% of your diet as fat. If you do that, likely 40% will be from protein, and only 10% from carbohydrate. How will you get all of your fiber? And this brings up a totally different set points that would make this blog post entirely too long.

Shai, I., Schwarzfuchs. D., et al. Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet. The New England Journal of Medicine. 2008. 359(3), 229-241.

Monday, May 21, 2012

The Little Things Count

Many times I hear people say they want to lose weight, get healthy, lower their cholesterol, and fit into their clothes. For some reason, it seems like people often forget that each and every decision they make about food and activity contributes to their success or failure. When we're baking in the kitchen, those licks of the spoon and cookie crumbs don't count. We keep making excuses instead of following through on that daily exercise. We focus on the prize, but fail to make the little decisions that will make the prize a reality.

Recently I was inspired by someone who really put it beautifully. He was so caught up in the end result he was looking for that he realized he wasn't focusing on how to get there. When faced with candy or fruit, he thought to himself about how it was his decision right then and there that helped him to get a little bit closer to his goal. He explained that he realized that each and every choice that he makes impacts his success.

I'm sure to many people think this seems like common sense, and it is! Even though it is common sense, many people continue to rationalize little decisions that pile up and make a huge impact on their success or failure. Consider stepping away from the lofty goal and taking a closer look at the present moment. What can you do now to start moving in the right direction. Think about how will you make good decisions tomorrow rather than how you will fit into your favorite pants next year.

Monday, May 14, 2012

Coconut Oil: Beneficial or Just a Fad?

And so it begins, another trendy weight loss tool, or is it?

Coconut oil has recently gained popularity as a tool to improve heart health, thyroid function, the rate of metabolism, and immune funtion. Just one teaspoon of this oil contains a whopping 12 grams of saturated fat, which is the type of fat that is known to be converted into cholesterol in the body. Just because of that one detail, I was immediately skeptical of this new fad.

After doing a little bit of research on this topic, it seems that the evidence is quite weak in supporting the claims listed above. Before we throw out the copious knowledge that we have gained over the years about the dangers of saturated fat, I think we will need a lot more convincing.

Keep in mind that the American Heart Association and the National Cholesterol Education Program still recommend limiting saturated fat to no more than 7%-10% of total calories. For instance, if you are consuming an 1800 calorie diet, that would limit you to 14-20 grams of saturated fat daily. Two teaspoons of coconut oil would exceed the limit for the entire day!

Another point to remember is that you will always win with a diet very high in fruits in vegetables. They contain an unmatchable variety of vitamins, minerals, and phytochemicals that are known to decrease the risk of heart disease and cancer. They also contain fiber which tends to help people control their body weight, stabalize blood sugar, and decrease cholesterol levels. If you're looking for something in your diet to really increase, start chomping down on all of your seasonal favorite fruits and vegetables!

Thursday, May 10, 2012

Summer Vegetable Salad

1 tomato
1 avocado
1 yellow pepper
1 green pepper
2 carrots
2 Tbsp olive oil
1 Tbsp balsamic vinegar
2 Tbsp chopped fresh basil

Chop first four vegetables and mix together. Add carrot shavings, olive oil, balsamic vinegar, and fresh basil. Stir and enjoy!

This recipe really is just a jumping off point. You could add any vegetables that you have sitting in your refrigerator or take away and vegetables that aren't your favorite. Also, you could experiment with different herbs. This is easy, delicious, beautiful, and a great way to use up left-over vegetables! Enjoy!

Monday, May 7, 2012

Strawberry Avocado Wraps

1 pound cooked chicken sliced in small strips
5 8" whole wheat tortillas
3 cups fresh strawberries hulled
2 tsp raspberry vinegar
2 tsp Splenda
2 Tbsp chopped fresh mint
1 avocado sliced in strips

Preheat oven to 400 degrees. Chop the strawberries. I used the Pampered Chef Food Chopper, but you could also just use a knife. The strawberries should be soupy but still somewhat chunky. Stir in raspberry vinegar, Splenda, and mint. In the center of each tortilla place about 3 ounces of chicken and top with slices of avocado and about 4 tablespoons of the strawberry mixture. Fold up the bottom of the tortilla and then the two sides. Place seam down on a baking sheet or secure with toothpicks. Bake for about 10 minutes or until heated through. Enjoy!

Serves 5

Tuesday, May 1, 2012

Easy Mango Salsa Over Salmon

1 Mango, chopped
1/2 Red onion, chopped
1 Tbsp minced fresh cilantro
1 Tbsp minced fresh mint
1 Tbsp lime juice
16oz Wild Salmon

Mix all ingredients. Grill, bake, or pan-fry salmon. Top with salsa.


Why wild salmon? It has a higher amount of omega-3 fatty acids than farm-raised salmon.

Think this recipe sounds expensive? Buy mango when it is on sale! Also, buy several pounds of wild salmon when it is on sale and freeze it. During the off season, you can find frozen wild salmon in many grocery stores.

Consider growing some of your favorite herbs. You just can't kill mint! I have a pot of mint that keeps coming back every year without having to do anything to it. Be sure to grow it in a pot because it will take over your yard or garden. Cilantro is also fairly easy to grow. This way you have herbs just waiting to be cut and cooked with. If you still don't feel like you are ready for this, buy the herbs and plan several recipes in the same week with those herbs. That way you'll be sure to get a lot of bang for your buck!

Looking for more gardening tips? Check out my very knowledgeable cousin's guest post!

Monday, April 23, 2012

The China Study Part V (and FINAL): Politics and Your Plate

Yes, this is the FINAL post about The China Study. I am mainly hitting on this section for good measure because I really don't have much to say about it. The last part of the book mainly focused on all of the organizations that make nutrition guidelines for us. Campbell picked apart the politics of these organizations and made his case that these organizations are really driven by money, not by giving recommendations that truly benefit us. To be honest, I am quite deficient in my knowledge of this area. He may certainly have some good points about the motivations that certain people have for recommending certain guidelines. Still, the recommendations are sound and not everyone involved in these organizations is driven by money. However, I do know that groups such as the American Heart Association, American Diabetes Association, and the Academy of Nutrition and Dietetics are led by professionals who study research and make guidelines/recommendations based on science. I know that Campbell believes that he is one of the very few people on this Earth who cares about people and their health, but he couldn't be more wrong.

While I don't know the ins and outs of all of the politics involved in all of the groups that release health information, I DO know that there are many health professionals dedicated to their patients. It would be unethical for doctors, dietitians, food scientists, and other scientists to make recommendations solely based on monetary benefit. I certainly don't do that and I know many more health professionals who are ethical than unethical. Campbell really started drumming up paranoia and distrust in his rant against government and health officials. Campbell is the one who should be investigated for misleading the public

Sunday, April 1, 2012

There's Spinach In My Pizza?

Sorry there haven't been too many posts lately! March has been a busy month and April looks like it will be the same. Hopefully I'll be able to post more in May. However, here is another tid-bit until then:

Last night we made home-made pizza, a favorite treat in our home. I pureed some spinach in our food processor and mixed it in with the tomato sauce. Everyone seemed to enjoy their pizza just the same, except for one of my boys who was a little under the weather. The pizza tasted just the same to me too. I still whole-heartedly believe in continuing to offer vegetables. However, it sure is nice to sneak some extra vegetables in while the kids are still learning to like their greens! Try this trick at your house and let me know if it works!

Thursday, March 29, 2012

Refreshing Smoothie Review

Head over to Busy-Dad-E's blog to see a review of the refreshing smoothie!

Thursday, March 22, 2012

Refreshing Smoothie

I have been hearing a lot about these green smoothies. I finally decided to give it a try because I know I can always use more vegetables in my diet. I wasn't too excited about it, but it wasn't terrible either. I used kale which just doesn't give a nice smooth texture. I tried something different today and it was delicious, but it turned out more like a purple color! Two out of three kids in my house loved it too! Here is my recipe:

1 cup of fresh or frozen blueberries
1 cup of fresh or frozen strawberries
1 banana
4 cups of fresh spinach
1 cup of water

Blend in a blender or food processor.
Serves 2

Monday, February 27, 2012

Finding Motivation to Exercise

Finding motivation to exercise is a struggle for many people. It can really be difficult to get an exercise routine started and it can be even more difficult to continue on a regular basis.

We all want to look good in our favorite pair of jeans and feel confident in our own skin, so that may be a motivating factor to start putting one foot in front of the other. However, people who stick with exercise usually find deeper motivating factors. Looking fit could just be a nice side effect!

Here are some ideas to consider when you are trying to find something to get you going:

1. The way you feel when you are done exercising. This may be a really handy idea to focus on especially when you're just getting started with a routine. You may not like exercising, but don't you always feel great when you're done? Exercise often leaves people feeling more energetic, more confident, happier, and more focused. People also feel accomplished and proud of their efforts. So, if you're really having a hard time lacing up your shoes. Try to focus on the rewards at the end of your workout.

2. Mood enhancing effects. Exercise can often be as effective as an anti-depressant drug. Well, we already knew that exercise is medicine! If you're feeling a little down, stressed, or overwhelmed try exercise. You may feel like you don't have time because you're overwhelmed; however, exercise can give you the energy, clarity, and health to help you deal with those everyday stressors.

3. Feeling strong and confident. As you progress, you will get more and more confident...and strong! Focusing on how great you feel while exercising can help you to keep coming back. Even if you haven't lost all of the inches you want to lose, exercise can still make you feel a little happier in your own skin.

4. Taking time to enjoy a hobby. Find exercise that you enjoy and want to keep coming back to. Focus on the pure enjoyment of that exercise. Maybe you love the wind in your face while you bike, the runners high, or the cool water around you while you swim.

5. A little "me" time. Exercise can be a great way to get away from the craziness of life and just focus on yourself for a little while. Take time to think, pray, zone out, listen to music, or enjoy some silent time.

Sunday, February 19, 2012

The China Study Part IV: A Sham

I have been putting this off partly because my entire family has been sick (no time to spare!) and partly because I think I am growing a little tired of this topic! Another reason I have been putting this post off is because I just really don't know where to start when trying to really review the "meat" of this book (no pun intended). There is so much to cover. The more I discover about the actual study done in China (3), the more I realize that the book, The China Study, is a total sham. Michael R. Eades, M.D. did a wonderful job of summing up The China Study in his blog. His blog really described my thoughts on the book. I am certainly not endorsing everything on his website, but I do agree with this particular post. Dr. Eades appropriately calls The China Study "a masterpiece of obfuscation". So I would definitely recommend taking a look at his blog for a really great overview of the actual research done in China and the book that Campbell wrote following his research.

So instead of trying to really dig in and cover everything, I will bring up several points that show discrepancies and had me questioning the validity of Campbell's conclusion that everyone should avoid all animal products.

1. Please review The China Study Part I: Is Drinking Milk Damaging Your Health?

2. On page 30 I was very disappointed to see that Campbell actually mentioned the "eight essential amino acids" when there are actually nine. What a little but important detail to get wrong!

3. On page 59, Campbell finally mentioned casein as the "culprit" for cancer. He had already been going on for 58 pages about how animal products are the death of us before he finally mentioned that casein is actually what showed some link to cancer. However, as mentioned in my first post, this is really bogus anyway.

4. In Appendix A, Campbell reported that when glucose and other starches were tested alone, they increased cancer foci. So I guess this was better tucked away in the Appendix where few people would look.

5. On page 74 there is a chart comparing the dietary intake of Americans compared to the Chinese. It shows that the Chinese have an animal protein intake that is 0.8% of their total calories and Americans have an intake that is 10-11% of their total calories. How interesting that if you check out Appendix B, there is a star next to the 0.8% in the Chinese column (there is not a star next to the "10-11%" in the American column). The star denotes that this number excludes protein from fish. So how can we possibly compare the American intake to the Chinese when the two percentages do not contain the same things? Furthermore, if Chinese actually do get some of their protein from animal sources and their chronic disease is so much lower than ours, why is that we should avoid all animal protein?

6. Many of the studies that he uses to support his idea that animal protein "causes" chronic diseases such as diabetes, breast cancer, and heart disease typically aren't testing animal protein at all. In fact they are testing a low-fat diet in most of the studies. As a result, they tended to include portions of meat that were closer to the serving size that is recommended. Again, Campbell was just trying to make results appear to support his claim.

7. In chapter 8, Campbell goes on and on about fiber protecting against colon cancer despite other researchers' skepticism. He points out some great data that supports his claim that fiber does, in fact, prevent colon cancer. However, don't forget to check out the back of the book (p 385 #69) where he notes that "most of these associations were not statistically significant". This type of deception happened A LOT in The China Study. You simply can't take his word for anything. You have to look at all of the notes and critically look at all of his claims. He quite often discussed data as if it were significant and accepted by the medical community even when it was often not even statistically significant.

8. On page 175, Campbell states, "It just goes to show that when individually-observed nutrient effects are combined, as in a dietary situation, the expected may become the unexpected." He was referring to combining a high-calcium diet with a high-wheat diet and its effects on bile acids. That really doesn't matter. The point is, he is demonstrating how complex the relationship is between diet and physiology. Yet, he is so bold to assume that his little study on casein, a nutrient in isolation, is a great break-through in science demonstrating that cow's milk causes cancer.

9. On page 314, Campbell states. "For others concerned about nutrition, every time they see a dietitian, every time they see their doctor, every time they see a nutritionist and every time they go to a community health center, they may be told that a diet high in fat, animal protein, meat and dairy is consistent with good health, and they needn't worry about eating too many sweets." I am deeply offended by his remarks. As a Registered Dietitian I would never give someone that type of advice and I highly doubt that many doctors would either. I can't speak for "nutritionists" because anyone can call themselves a "nutritionist" without any training. Campbell is, again, just trying to make a case that he is the highest authority in nutrition and that all other professionals are lacking in intelligence and ability to properly advise their patients. I encourage a diet that is rich in fruits, vegetables, and whole grains. I certainly believe that meat is healthy in small portions and that fat is an important part of everyone's diet. Carbohydrates should contribute 45-65% of the caloric intake, so they should be the most abundant macronutrient; however, fat and protein are important macronutrients as well. By no means would I ever tell someone that they shouldn't worry about eating too many sweets. Campbell is making a mockery of my profession and Medical Doctors.

There were MANY more discrepancies and areas where Campbell took a different slant on the research in order to help him support his claim. Again, please check out the blog mentioned above for a really great overview. To see all of the data, check this out.

Thursday, February 9, 2012

Running: A Social Sport

I'm not quite done with The China Study yet, but I thought we could all use a little break!

While I was out doing a long training run for the marathon I'm getting ready for, I thought about something someone said about running once. Someone told me that running really isn't a social sport, and that's probably why she never liked it. Running can definitely be a sport of solitude. It can be a time of reflection, prayer, stress relief, and thought. I have used running for these things many times. However, running is most certainly a social sport, if you want it to be. It is truly a sport of versatility.

A lot of times when I'm out running, I tend to see other runners over and over again. Even when I pass runners who I've never seen before, we always exchange a "hello", "good morning", "lookin' good", "you're almost to the top of the hill", or other tid bit of encouragement. When I go to the running store that I frequent, they often recognize me from my last visit and I often run into them (not literally) at local road races. It is always fun to see familiar faces.

You can also run with a friend or in a group. I have great memories of running with a friend of mine in college. I got to know her best during our conversations during early morning runs. My husband and I used to run together all of the time before we had kids, but now one of us has to watch the kids while the other one runs. Most cities have running clubs where people get together and hit the pavement. It is fun to enjoy something active with other people who live around you. The energy and passion for running is often contagious in these groups.

Lastly, running in road races is a great way to spend a Saturday morning. I love seeing the same runners over and over and enjoying the comradery. Everyone is sweating, working hard, testing their mental and physical strength, and celebrating at the finish line. I love the energy and excitement in races. Along the way, fellow runners cheer each other on and ofter encouragement when it is needed.

Running is truly an invigorating sport that offers versatility, stress relief, health benefits, comradery, achievement, and excitement. If you don't believe me, ask around to find a great 5K in your city. Try it and see what you think. You have nothing to lose but calories/inches from your waste!

Sunday, January 29, 2012

The China Study Part III: Animal Protein, Good or Bad?

Atkins, South Beach, Sugar Busters, and the list goes on. Fad diets will probably always surround us and continue to confuse the general public. Unfortunately, it seems that Campbell is planting the seed for another fad with The China Study (1). Don't get me wrong, as I said in the last post, Campbell is completely right that we need more fruits, vegetables, and whole grains in our diet. We also need less refined foods and meat. However, is there really truth to the claim that all animal protein is slowly killing Americans?

As I mentioned in Part I of this discussion of The China Study, Campbell bases the idea that animal protein is detrimental on a study that linked casein to cancer. On page 104, Campbell states, "casein, and very likely all animal proteins, may be the most relevant cancer-causing substance that we consume (1)." So, it is Campbell's opinion that all animal proteins cause cancer. There is no proof and in the peer-reviewed journal article, a claim about animal protein being a carcinogen is not made (2).

The second major study (3) that Campbell draws his conclusions from was an ecological study that he performed in China. In the study, nutritional intake was compared to cholesterol levels, body weight, and many other factors that may be predictive of chronic disease. The study was very interesting and gave some insight to the idea that a whole foods diet high in plants can lead to a life with less disease. Other than the fact that this type of study cannot prove cause-and-effect, it seemed that it was fairly well designed. Of course there were limitations to the study, but it still produced a lot of interesting information. The biggest concern I had with the design of the study was that blood samples were pooled by commune, age, and sex. Those pools of blood were then used to measure a number of biochemical markers. I asked several Medical Doctors and other people skilled in research about this technique. Not one person failed to raise an eyebrow at this. It seems like a lot of validity would have been lost in dumping everyone's blood sample together and just taking an average. The actual study that was published in the American Journal of Clinical Nutrition, stated that "any inferences concerning cause-and-effect relationships should be considered to be hypothetical only, with validation to be provided by intervention or prospective analytic studies on individuals." In the book that Campbell wrote, he does mention that the study cannot prove cause-and-effect. However, he goes on to basically talk about animal proteins causing disease as if they are hard and true facts. It is very important to remember that the study published in the American Journal of Clinical Nutrition is peer-reviewed; whereas the book that Campbell wrote about the study and other studies is not peer-reviewed. As far as I can remember, there is actually no mention in the actual study that it is best if humans cut out all animal products. Please correct me if I am wrong. In The China Study book, Campbell highly encourages readers to cut out all animal products.

So let's get back to my claim that Campbell's book is starting a fad diet. Why would I go that far? If you look at the data, it shows that the Chinese eat animal protein. They have not cut it out of their diets, they just eat less than Americans. I don't think it is any secret that Americans eat way too much meat and cheese. If most Americans reduced their portion sizes of meat, ate less cheese, and stuck to low fat dairy products, I imagine that there would be much less chronic disease in our country. Notice that I did not say "eliminate" these products from our diets. So if the Chinese haven't eliminated animal products from their diets and their chronic disease rates are so much lower, why must we eliminate animal products from our diet? A serving size of meat is three ounces. How many people eat more than this serving size? Probably most people do. So, maybe our chronic disease rates are so high because people are eating way more than the recommended serving size, not because they're eating any amount of animal products. I believe that any diet that promotes completely cutting out a food group belongs in the "fad diet" category. Animal products provide us with necessary nutrients and we can obtain those nutrients by eating small portions of those products.

One disclaimer I would like to add is cutting out animal products in the case of ethical concern. I support any person's ethical convictions and believe that you can live a healthy life without animal products, as long as you take a few necessary supplements.

3. Campbell, T.C. & Junshi, C. Diet and chronic degenerative diseases: perspectives from Chima. Am J Clin Nutr. 1994; 59 (suppl): 1153S-61S.

Monday, January 23, 2012

The China Study Part II: Where We Agree

Campbell seems to have a passion for disease prevention, public health, and eating well. I share these same passions and this is where we can certainly agree. This post will mostly be about where Campbell and I agree.

An undeniable truth that Campbell discusses in The China Study is the fact that diseases such as heart disease, cancer, and diabetes are too rampant and something needs to be done. Lifestyle is a huge factor that impacts disease risk. Unfortunately, many people and some health professionals would rather blame genetics and rely heavily on medication to lower risk. While genetics certainly play a role in disease risk, the impact of lifestyle is quite dramatic, yet often ignored. It is easy to become complacent and not equate the food on your plate to disease risk, but everything we eat day-in and day-out is setting us up for health or debilitating disease. Remember that not everyone dies suddenly. Often, people live for decades with body aches, angina (chest pain), loss of sight, loss of limbs, painful surgeries, and the list goes on and on. That is what poor nutrition and lack of exercise do to a person. So, its not all about genetics and its not all about life or death. Your quality of life is heavily determined by what does or does not enter your mouth and how much you move. Of course, some people will need medication no matter what they do and it is important to take medication as directed. However, lifestyle can impact the amount you are taking and how effective the medication is.

On page 233 of The China Study, Campbell makes this statement:

"Much of this focus on genes, however, misses a simple but crucial point: not all genes are fully expressed all the time. If they aren't activated or expressed, they remain biochemically dormant. Dormant genes do not have any effect on our health. This is obvious to most scientists, and many laypeople, but the significance of this idea is seldom understood. What happens to cause some genes to remain dormant, and others to express themselves? The answer: environment, especially diet."

I am very deficient when it comes to understanding genetics, but I thought this was a very great and interesting way of explaining why lifestyle is so crucial. If anyone has more knowledge about genetics and would like to comment on the excerpt, I would love to hear it!

Nutrition is a vital ingredient to a healthy life. Another point that Campbell spent a lot of time discussing was that people do not eat enough fruits, vegetables, and whole grains. Adults need a minimum of three to five vegetables daily and two to four fruits. I am guilty of not always meeting my vegetable needs and I actually felt inspired to take the personal challenge of increasing my vegetables after reading this book. Fruits and vegetables are loaded with antioxidants, fiber, phytonutrients, vitamins, and minerals. They are so powerful at helping to reduce disease risk and are not consumed enough in America. Whole grains are also under-consumed whereas refined carbohydrates are abundantly eaten. Refined carbohydrates are stripped of many important nutrients and also tend to raise blood sugar more quickly due to their lack of fiber.

With the exception of just a few nutrients, Campbell believes firmly that nutrients should come from whole foods and not a pill. (The nutrients that he claims we should get from a pill are available in animal products.) This is an important point. We cannot replicate the many phytonutrients found in foods and we have yet to even identify most of them. Getting your fruits and vegetables will never be as easy as popping a pill. Vitamin supplements will not replace disease-protection that fruits and vegetables provide. I do not agree that we should take pills to replace the vitamins that are lost by avoiding animal products. Instead, I believe we should get those from small servings of meat and dairy. While I do believe that much is lost by depending on supplements to get the nutrients found in fruits and vegetables, vitamin supplements are sometimes needed for "insurance". I believe that it is important to take prenatal vitamins, especially because folate is actually more bioavailable in the synthetic form. Also, children may benefit from a multi-vitamin if they do not eat a good variety of foods. This is not to say that these vitamins replace what we find in plants, but they are helpful to reinforce some very pertinent needs. There are also other disease states and conditions that require specific vitamin supplementation; however, those should be overseen by a Medical Doctor and Registered Dietitian.

Another major area where Campbell and I agree is that Americans are consuming way too much meat. I don't know who could really argue with this. A serving of meat is three ounces. Most restaurants serve steaks in portion sizes that are at least double the proper portion size. Plates should be mostly full of plant foods and have a small portion of meat. Instead, plates are full of meat with a sprig of green. The amount of meat being consumed in America is really hurting our health. The part where we disagree is that I believe meat has a place in a small part of the plate. Campbell believes that meat should be avoided completely.

In general, Campbell and I share the same sentiment that we all need to eat healthier.

Sunday, January 15, 2012

The China Study Part I: Is Drinking Milk Damaging Your Health?

After completing The China Study by T. Colin Campbell, PhD and Thomas M. Campbell II, MD, I decided to discuss it over a few posts (1). Honestly, I feel like I could write a book about this book, but I will try to just hit the major highlights. The first topic I would like to write about concerns the question, "Are milk and other dairy products harmful to your health?"

Campbell hits this topic hard and fast in The China Study as he explains that milk products cause cancer. Throughout the book he encourages his readers to cut out all milk products and all animal products, for that matter. By the end of the book, the general idea is that if you eat any animal products, you are setting yourself up for major health failure whether it be from diabetes, cancer, heart disease, auto-immune diseases, etc.

Campbell's idea that milk products are dangerous originated from a study that examined rats which were fed different amounts of casein (a milk protein) and observed markers of early preneoplastic liver lesions (PNL)(2). Preneoplastic basically means that there is a very good chance this will eventually form into cancer. In the study, it was found that a minimum of 6-8% dietary casein was needed for proper weight gain. When rats were fed a diet 10% or less casein, there were negligible PNL; however, a diet of 12% or more casein showed a significant increase in PNL.

So what does all of this mean?

1. First of all, if you consume an 1800 calorie diet, you would have to drink about 7 cups of milk daily (or dairy equivalent) in order to ingest more than the 12% casein maximum threshold. Granted, casein does exist in very small amounts in processed foods. Most people don't come any where near 7 cups of milk daily, so chances are, you still won't exceed the 12% casein threshold even if you have a little bit of yogurt and some casein in processed foods. Of course, you should always strive to eat more whole foods and less processed foods.

2. We can certainly learn a lot by studying rats; however, it is impossible to directly extrapolate these results to humans. It even says this in the discussion section of the study.

3. What does this mean for breast milk? We know from countless human studies that breastfeeding has numerous benefits for babies and mothers. Breast milk does have less casein than cow's milk, but it still has casein and babies drink it all day long! Campbell does express the importance of breastfeeding and cautions about stopping too early. So, why is the casein in breast milk okay for babies, but Campbell believes that the casein from cow's milk is harmful? He doesn't address this question in the book.

4. It must be said that casein was given to the rats in isolation as well. When we drink milk, it is within the milk among a complex series of nutrients. We know that combining certain nutrients with other nutrients changes the way we absorb them, use them in our bodies, etc. It is a little difficult to compare casein given in isolation to rats versus humans drinking a glass of milk.

5. I am certainly no expert on cancer; however, I do know that it is a complex disease affected by a multitude of factors. I find it difficult to believe that we can easily isolate one little nutrient that causes cancer. Campbell actually has a whole chapter on "reductionism", taking specific nutrients, studying them, and making health claims about them. He disagrees with this practice and explains the complexity of nutrition and health. So, why does he make an exception for casein?

6. Campbell believes that, because casein causes cancer in his opinion, all animal protein must do the same. This is a wild extrapolation.

In summary, the data from the study done on casein and PNL suggests that you don't need to empty all of your milk cartons. It seems that moderation wins again! Drinking 7 cups of milk is a lot of calories, so I wouldn't suggest doing that anyway. Drink milk in moderation!

1. Campbell, T.C. & Campbell, T.M. The China Study. BenBella Books, Dallas, TX, 2006.
2. Dunaif, G.E. & Campbell, T.C. Dietary Protein Level and Aflatoxin B1-Induced Preneoplastic Hepatic Lesions in the Rat1. J, Nutr. 117: 1298-1302, 1987.

Monday, January 2, 2012

Prevent and Reverse Heart Disease: My Thoughts and Opinions

I recently read Caldwell B. Esselstyn, Jr., M.D.'s book called Prevent and Reverse Heart Disease. The China Study by T. Colin Campbell with Thomas M. Campbell II is next on my reading list; however, in retrospect, I realize that I should have read it first. Esselstyn's book is primarily centered on his study, involving 24 subjects, and Campbell's epidemiological study in China. There are several points that I really can't begin to discuss until I read Campbell's book, but I'll do my best to review Esselstyn's book and then will fill in the gaps later.

I think we can all agree that Americans eat way too much fat, meat, and refined grains while not eating enough fruits, vegetables, and whole grains. Esselstyn really harps on this and I agree with him. If we all reduced our portions of meat, replaced our refined grains with whole grains, cut down on the desserts, and filled our plates with more fruits and vegetables, we would certainly be a lot healthier. I would also be willing to bet that chronic diseases would be diagnosed with much less frequency. I even agree that it wouldn't hurt to eat a vegetarian meal here and there. Meat does not need to be the center of every meal.

Despite the fact that Esselstyn and I agree on some points, I would not recommend this book for several reasons. First of all, Esselstyn bases most of his beliefs on his study, which contained only 24 subjects, and Campbell's China Study. Given the small sample size of his study it is hard to put much faith in the outcomes. My second major criticism of the book is that Esselstyn adamantly promotes a vegan diet. I have never been a supporter of a vegan diet unless a patient is following it due to religious or ethical reasons. Based on available science, I do not believe that there are any health reasons to follow such a strict diet. Because Vitamin B12 is only naturally found in animal products, you would need a supplement to insure you were getting adequate amounts of Vitamin B12. Any diet that is lacking in an essential nutrient makes me very leery.

Certainly, decreasing animal products in the diet would result in a decreased total blood cholesterol; however, do we really need to play the "how low can you go" game? Many things in life, including the human body, are about balance. Cholesterol is essential to the body, but too much can be a bad thing. Effort should be focused on maintaining a balance, not on racing to see who can achieve the lowest possible cholesterol level. That being said, I cannot agree that eliminating animal products is the answer. Animal products, including meat and dairy, provide us with a host of important nutrients that keep us healthy and thriving. Because this is a blog post and not a book, I won't go into all of the details.

Speaking of cholesterol levels, Esselstyn states that if you can achieve a total cholesterol of less than 150 mg/dL, you will not develop heart disease. He says that even if you smoke, are obese, have a family history of heart disease, or hypertension, you will still not develop heart disease. Any of you who have any experience with heart disease patients probably just experienced your jaw dropping. I have personally worked with numerous patients who had total cholesterol levels well below 150 mg/dL, yet they still had a heart attack. Not that this has been backed up by a study, but I would rather see a patient with a total cholesterol of 180 mg/dL and be a non-smoker than to have a total cholesterol of 130 mg/dL and light up 5 times each day.

Esselstyn also promotes a diet very low in dietary fat. Again, while I do agree that Americans eat too much fat, I don't agree that we should aim to ingest as little fat as humanly possible. Fat is necessary for absorption of fat soluble vitamins, satiety, synthesis and repair of vital cell parts, and other important functions. Research has also shown that omega-3 fatty acids decrease inflammation, which is a key factor in preventing heart disease. Research also supports that a diet rich in omega-3 fatty acids helps to decrease the risk of dementia and Alzheimer's disease. In fact, it can even help to delay the progression of dementia and Alzheimer's disease after the onset. Esselstyn actually states that his diet could possibly save a person from senile-impairment. I am not sure how he came to this conclusion as he sites no research. He even says that you should avoid avocados and nuts (although he does mention that you can have some nuts if you do not have heart disease). Although he pushes a plant-based diet, he denies the diet of some very nutrient-dense plant foods that other experts believe to be healthy. In fact, there is plenty of research showing the benefits of nuts, especially walnuts. Furthermore, the American Heart Association actually recommends two servings of fatty fish each week due to its disease protective benefits.

If you ever want to celebrate your birthday with a little cake, you won't be able to follow this diet completely. Esselstyn does not believe in moderation or the occasional treat. For this reason, I feel that his diet is totally unrealistic for the average person to follow, including myself! Although I know that ice cream isn't good for me, I don't see the harm in an occasional splurge. I believe in keeping treats to a minimum and watching the serving size. But, to think I could never make Christmas cookies with my kids or treat them to ice cream on a hot summer day makes me a little sad.

I have a list of notes that I took while reading this book and I have much more to say; however, I am trying not to turn this into a book! I leave you all with this: this book did not sway my stance on nutrition. A balanced diet that contains fruits, vegetables, whole grains, dairy, meat, fish, beans, and nuts is healthy as shown by science. I did not feel that this book produced any compelling evidence that proves otherwise. As I said, I will be reading
The China Study next and will look forward to reporting on the text.