In This Issue

How Much Protein Per Day?

How Many Calories Per Day?

Psychiatric Help

The Pill And Menopause

Creatine, Again

Increase Your Walking Intensity

Coffee And Its Health Effects

Questions And Answers

How much protein do we need? The answer to that question sort of depends on who is answering it. [In other words, there is no single answer to this question.] A standard answer has been that we need .8 grams of protein per kilogram of body weight. I recently saw a recommendation of .9 - 1.0 grams per kg of body weight. If you "Go Ask Alice" on the Internet, "she" will tell you .8 grams, or 1.2 - 1.6 grams per each kg of body weight for active weight lifters.

Then there is the other way of determining protein need - percent of total calories. This value can be from a low of 14-15% of total daily calories to as much as 30% - the remainder being carbohydrates and fat.

Howard Jardine of "Balance" has this to say about protein consumption for increasing muscle mass: protein has a primary task in the body, which is to repair, maintain, and provide growth for muscle tissue. Furthermore, he says that an excessive protein intake, one beyond meeting its basic tasks, results in 1) conversion to and storage as fat, 2) conversion to energy, and/or 3) elimination as a body waste.

For serious athletes/bodybuilders he recommends 60-70% of total calories be from carbohydrates, up to 20% from protein, and the rest from fat - about 10% for those who are trying to be quite lean.

That covers a range of .8 grams of protein per kilogram of body-weight for an average individual to 2 grams per kilogram for a bodybuilder. Some athletes consume 2.0 - 2.5 grams of protein per kg of body weight, but sports nutritionists commonly consider that amount excessive.

Jardine touches on the protein supplement question by relating that the average diet contains more than twice the .8 g/kg RDA, which means that a good diet can make a protein supplement superfluous. He considers protein supplements to be an expensive waste of time.

A question that some of you may ask yourselves is: "How many calories do I need each day?" And it just so happens that the March '99 issue of the UC Berkeley Wellness Letter tackles that very issue.

The numbers provided assume that you are not attempting to lose weight, only to maintain it.

In this two-step process, first do the following calculations to determine your resting calorie needs:

• Men 18-30: multiply your weight by 7 and add 679.
• Men 31-69: multiply your weight by 5.3 and add 879
• Men over 60: multiply your weight by 6.1 and add 487
• Women 18-30: multiply your weight by 6.7 and add 496
• Women 31 to 60: multiply your weight by 4 and add 829
• Women over 60: multiply your weight by 4.8 and add 596

Note that this "formula" is less accurate for obese individuals because energy is created mostly in muscles; the more fat you have the fewer calories you will burn. As you may know RMR, or resting metabolic rate, is determined by several factors, most of which we can't change - including age, sex, body surface area ; but one that we can change is lean body weight, mainly muscle. Regular exercise - just one more reason.

Psychiatric therapy - Can it help? Sure! Maybe. Here is an example:

My friend "John" was having some problems, so he finally went to see a psychiatrist.
"What happened John? What did he do? Have your problems been resolved?"
"Oh, you know psychiatrists," he said: "all they do is listen, and say yes, yes."
"Why do people bother going to them?"
"Who knows," said John. "I suppose the world's a bit short on people who will listen and say "yes, yes."

The "Pill" has some little-known benefits for those who find themselves encountering perimenopausal symptoms like hot flashes, night sweats, insomnia, and vaginal dryness. Besides its primary use as a contraceptive, it may also help with early symptoms of menopause, and may even help prevent the long-term conditions related to menopause.

Many women still believe that taking the Pill after about age 35 is fraught with health risks, but birth control pills aren't what they used to be. They used to have close to five times more estrogen, and 10 times more pregesterone than they do today. However, if you smoke, taking the pill may not be such a good idea. The combination increases risk of both stroke and heart attack. Today's low-dose pills come in a variety of preparations and regimens for their use. Chances are you can find a combination that you can tolerate and that is effective against both the minor(?) inconveniences of menopause and some of the more serious risks like ovarian or endometrial cancer, colorectal cancer, osteoporosis, benign ovarian cysts, and PID (or pelvic inflammatory disease).

It turns out that the longer one is on the pill, the greater the reduction of risks. For ovarian cancer, after at least 10 years of being on the pill, risk may be reduced by 60-80%. That risk reduction may last as long as 15 years after one stops taking the pill. Endometrial cancer is similar with as much as a 50% risk reduction for 15 years after stopping the pill.

In the case of benign ovarian cysts, it may be that taking the pill for only a few cycles will shrink them. Taking the pill may even decrease their development in the first place.

Risks of taking the pill - there are some, of course; although there are fewer now than ever before - very likely a result of lower potency of each dose. And it should be noted that the increased risks, where they exist, are minor.

• Risk of blood clots rises from 1 in 10,000 to 2 in 10,000
• Increased blood pressure - A study found that women on the pill for five years or less during their lifetimes had a slightly increased diastolic pressure.
• Stroke - minute increase

This information was extracted from the Mayo Clinic Health Oasis publication, the March 1, 1999 edition.

Information on creatine is ubiquitous these days - it seemingly can't be avoided. It's on TV, in newspapers and magazines, on email/websites, a hot topic in exercise facilities; and now the Georgia Tech Sports Medicine And Performance Newsletter. Here is a summary of their salient points:

• Creatine supplementation isn't effective for everyone - about 15-25% of users receive no benefits. Some athletes have naturally high levels in their muscles, and won't benefit from creatine supplements.
• When effective, creatine supplementation seems to prolong power production during short-duration, intense exercise; resulting in longer training sessions.
• Creatine supplementation for endurance events doesn't help, except maybe for finishing sprint sessions. On the other-hand, it seems to promote weight gain, which isn't necessarily desirable for an endurance athlete.
• There don't seem to be any negative side-effects, but, literally hundreds of anecdotal reports of cramps and dehydration have been made. [Results, I would guess, of the extended workout times possible.] Truly long-term effects are unknown, however (e.g., possible liver or kidney problems).
• Creatine studies to-date have used creatine monohydrate. Other forms (e.g., creatine phosphate, or creatine citrate) are not backed up by published research.

• Women don't seem to use it much (maybe because of weight-gain aversion), but it seems to have the same general effects as with men.
• Proper doses include the generally accepted "loading" dose of 20-25 grams per day for five to six days. The maintenance dose is more equivocal. Five grams a day is common, but Jeff Volek, M.S., R.D., a creatine researcher at Ball State University, claims that the dose should be determined by body size - 0.3 g per kg of body weight.
• If you miss a day, don't worry about making it up. In muscle tissue, creatine breaks down very slowly, so just start back up again using a normal dose.
• Volek supports use of creatine for adult athletes only. Ann Grandjean, Ed. D., Director of the International Center for Sport Nutrition in Omaha does not support its use, but doesn't prohibit its use by a serious, mature teenager or adult athlete. Gene Coleman, Ed. D. Strength and Conditioning coach for the Houston Astros, and chairman of the Department of Health and Human Performance at the University of Houston-Clear Lake, is opposed to its use. He supports the concept of athletes getting stronger through proper diet and exercise, as opposed to gimmicky supplements.

Fitness walkers sometimes start to feel as if their efforts are stagnating. They want to increase the intensity, but without significantly increasing the time spent. For those of you who feel like you need to rev up your engine a little, try some of the following ideas:

1. Get your arms moving - a-gainst resistance. Don't use wrist or hand weights; experts say you only use an extra 10-15% more calories, and about half of them are from your arm swing. And if you happen to get tired arms and want to lose the weights, there is nowhere to put them. A more viable alternative is a "Power-belt." This is a $50 gizmo - a wide belt with attached retractable resistance cords. To use it, grab onto the handles and start walking with a slightly exaggerated arm swing (as your arm moves forward, the cords are stretched forward). The resistance is light, but it can result in an additional 42% calories being burned
2. Just walk faster - increase your speed by one mile-an-hour and you'll burn roughly 25% more calories.
3. Walk up a moderate incline and calories burned may increase by as much as 450 per hour.
4. Stair climbing is good - charge right up, but descend slowly. Fast descents put extra stress on your joints and muscles.
5. Intervals are very effective for increasing the intensity of your workouts, as well as increasing your overall pace. They are appropriate for walkers, joggers, runners, even competitive runners or race walkers. Simply alternate slow with faster walking - maybe your fast interval will become a jog. In the beginning, the slower intervals will be longer, but work toward shortening the slow intervals while increasing the fast intervals.
6. Try walking with poles - old ski poles will work, although there are actually walking poles being produced. Use the poles to push-off with each stride. Using the poles gets your upper body involved, and can increase calories burned by 20-25%.

Coffee - we seem to go around and around on this issue, but what does it do to our health? Part of the problem is that there are a myriad of studies, but with few concrete answers as to its effects. For every study that shows an increased risk for coffee drinkers of one health problem or another, there seems to be another one that doesn't.

As you know, it is the stimulant caffeine that supplies most of coffee's punch - it can keep you awake, alert, and increases reaction time - okay, unless you're trying to go to sleep. It is also sometimes connected by some medical studies to some problems like cancer, cardiovascular disease (CVD), osteoporosis, and fibrocystic breast changes; but, are those claims legitimate? Seemingly not, if you are a moderate drinker. It is heavy drinkers (eight cups or more a day) who may need to worry a little. And since caffeine seems to be the culprit, moderate consumption or decaf should eliminate even the jitters, not to mention the serious stuff.

Some studies have linked coffee consumption to increased cholesterol, which is of course linked to an increased risk of coronary artery disease and heart attacks; but a 1996 study of 121,000 nurses, when adjusted for smokers, did not show an increased risk for heart attacks.

There have been studies that have suggested a link between coffee and some cancers. Some unknown ingredient(s) that may contribute to pancreatic or bladder cancer, but more recent studies have not shown such a link.

How about osteoporosis - caffeine increases the amount of calcium in urine, and at least one study has seemingly shown an increase in hip fractures resulting from caffeine intake, but it would seemingly take a very high daily amount.

Another charge has been that coffee intake can result in fibrocystic breast changes - painful but benign lumps in breast tissue. There is currently a reduced support for coffee as a cause, but caffeine may aggravate an existing condition.

It seems that there is little support for coffee as a cause of serious health problems, but it is certainly not completely benign - and remember that we are talking about caffeine. Depending on your own tolerance to caffeine, relatively small amounts can affect your:

• Nervous system - it can make you nervous, restless, anxious, irritable, exacerbate panic attacks, and cause sleeplessness.
• Digestive system - caffeine causes your diaphragm to relax, thus allowing stomach acids to back up into your esophagus (acid reflux) - commonly called heartburn. It can also irritate existing stomach ulcers, and can cause gastro-intestinal upset, diarrhea, and constipation.
• Bladder irritation is caused in some people by caffeine, which is also a mild diuretic - causing more frequent urination.

(Q) This isn't really a question. It is a comment about stupidity. I just read that 60% of children killed in car collisions are not buckled up, even though there are frequently child safety seats in the vehicles. That is disgusting!
A.W.R., Fremont, CA

(A) Thanks for the information, and it is disgusting. Let's hope the parents and friends (anyone who transports children) start doing a better job of protecting children by using seat belts, child safety seats, AND by stopping smoking around them as well - another disgusting and brainless habit, as we know secondhand smoke is particularly damaging to children.

(Q) A friend told me that aspartame (Nutrasweet and Equal) causes multiple sclerosis. Can that be true?
J.R., Berkeley, CA

(A) Your friend is mistaken, according to the FDA, AMA, and the World Health Organization. Aspertame has been studied more intensively than any other food additive, and has been found safe - with one known exception, people with the rare genetic condition, phenylketonuria, should not consume it.

(Q) I spend quite a bit of time hiking in forest areas inhabited by potential Lyme disease carrying ticks. Is there anything I can do to avoid the possibility of getting the disease?
R.L., Chico, CA

(A) Yes. One potential preventative comes in the form of a vaccine called LYMErix (It is given according to a 3-shot protocol.) was recently approved by the FDA. It is reportedly 68-92% effective at preventing the disease (only about 50% without the third shot). It's not cheap - $50-$100 for all three shots; but it seems to be a viable option if your chances of exposure are high.

(Q) I am a 23-year old female who would like to start running again (I did some non-competitive running during my college years.), but I am a bit scared from hearing that women have a higher rate of knee injuries (frequently ACL) than men because of anatomical differences (the hip thing, you know). Is there anything I can do to reduce my risk of injury?
C.P., San Jose, CA

(A) One thing that may help is to strengthen the hamstrings (back of the thighs) and quadriceps (front of thighs) muscle groups that help to stabilize the knee joints.

For hamstrings, do leg curls (move your heels toward your buttocks) using either a leg curl machine or ankle weights.

(Q) As I approach my 70's, are there any nutrition changes that I might benefit from?
O.G., Los Gatos, CA

(A) There are a few concerns that have prompted the Human Nutrition Research Center on Aging at Tufts University to develop a Food Guide Pyramid for the aging, to meet their special nutritional needs. Here is a summary of the basic recommendations:

• Drink eight or more servings of water (liquids) daily. This is basically the same recommendation as for everyone, but is especially applicable to the aging because the thirst mechanism declines with age.
• A minimum of 20g of fiber (20-35g is the normal recommendation for adults) should be consumed. It, along with water, helps avoid constipation, which can lead to diverticulitis - both conditions common among the elderly. It helps to eat whole grain breads, whole fruits, and a high fiber breakfast cereal. Eat beans instead of meat a couple of times a week - a half cup contains 5-10g of fiber.
• Emphasize deeply colored vegetables (no significant difference between fresh, frozen, or canned) for vitamin C, beta-carotene, and folate.
• Make a conscious effort to eat three calcium-rich foods, like milk, yogurt, cheese, or even calcium-fortified orange juice, daily.
• Eat lean meats, or fish - it is a good source of protein as well as omega-3 fatty acids, which may decrease one's risk of heart disease.
• Supplements may be in order - calcium, vitamin D, and vitamin B-12 are all good candidates. Add 400 IU of vitamin D if you don't drink milk (vit-D fortified). For B-12, absorption declines with age, but before taking calcium or B-12 supplements, it may be a good idea to consult a physician.

(Q) Someone at my gym recommended "Blue Ice" as a supplement that will build muscle, enhance sex, reduce stress, and induce sleep. Have you ever heard of it?
B.B.B., Sunnyvale, CA

(A) It is sold as a GBL supplement, but GBL is an FDA-unapproved drug, not a supplement. Some reported negative side-effects, include one death, in addition to 19 cases of becoming either unconscious or comatose - from 55 reported reactions. The "odds" do not seem very good, so I suggest you pass on this junk, and other products containing GDL, including Renutrient, Revivarant, GH Revitalizer, Remforce, or Gamma-G.

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