As we transition to the new millennium, I think back to my growing up years (the forties and fifties) when the year 2000 was unimaginable -- science fiction. And now it's here, along with a walk on the moon, and other former fantasies that are now realities. We are also in the midst of a dichotomy -- we in the United States are getting both fatter and fitter. How can that be? Unfortunately, while many have accepted the idea that we need to exercise more and eat right to improve health and fitness, there seems to be another group that is eating a poorer diet than ever and getting more-and-more sedentary. Every time I turn around, I am exposed to statistics that underline the fattening of America. The latest that I have seen report that over 50% of women and over 60% of men are obese or overweight. I'm not a misogynist, but I was kind of shocked to learn that men are getting fatter than women, considering their metabolic advantage based on greater size/muscle. Too many Double Whoppers and Biggie Fries, I guess. And not enough physical activity. It seems to be time to stop driving next door to visit the neighbors. That was okay when neighbors lived a few miles apart, but not now when neighbors are separated only by inches. It's kind of sad to think about people who get winded walking to their car, especially when it is parked in the garage.
As you might have guessed by now, this newsletter focuses on weight loss issues, although not exclusively.
What makes the fattening of America so pathetic is that we have known what to do about it for years -- exercise and eat right. Of course we do get conflicting information on just how to do those things. The following information will hopefully help you make good choices.
A word that we often hear thrown around, especially in discussions of weight loss is "metabolism." What is it, exactly? According to one of my dictionaries it is: The sum of the chemical changes occurring in tissue consisting of anabolism (those reactions that convert small molecules into large), and catabolism (those reactions that convert large molecules to small), including both endogenous large molecules as well as biodegradation of drugs and other xenobiotics.
Where:
OK, so store that away for when we actually talk about metabolism.
Running for weight loss is a subject that may be of interest to some of you. Running is a good aerobic exercise for weight loss, but I don't recommend it to everyone because of potential damage to knees, ankles, or feet -- overuse injuries, normally.
If you have run sometime previously during your life, the risks may be reduced, although not necessarily. People with biomechanical imperfections are at greatest risk -- things like leg length differences, high arches, or overpronation, to name a few. Gender may also be a factor, along with current fitness level, weight, training surface, and training speed (running motion is normally more efficient at higher speeds. Also, females have a higher incidence of knee injuries because of hypermobile joints and often wider hips (pelvic girdle, and/or femoral attachment to the pelvic girdle). A result is a greater inward angle of the femur bones to the knee joints, resulting in extra stress. But, many women are successful runners at all levels, so injury is not a foregone conclusion.
And don't get me wrong, I am not anti-running. I have run for years, although my technique could now be best described as walk-jog.
I recently read an article that suggested that anyone who runs more than 20 miles a week, or over five miles in one session is doomed to injury. An exaggeration, I think; but there is a grain of truth to this allegation. I don't think there is a formula that applies to everyone, but beginners can certainly benefit from low mileage, to start, and small increases in speed/distance.
Intervals are a good way to progress from walking to running (or from running slow to running faster) -- walk a little, run a little, and alternate between the two until you have covered your target time or distance.
It is a reasonable goal for beginning runners (women especially) to do some resistance exercises for the knee stabilizing muscles -- quadriceps and hamstrings. Particularly effective are hamstring curls, knee extensions, and squats and/or lunges.
I recently attended a Nutrition and Weight Management Seminar, some information from which you might find interesting, so here is a summary of what was presented.
According to Dorie Krepton M.S., an exercise nutrition specialist at California State University at Hayward, founder of the Health and Fitness Institute (active in certifications and fitness information seminars), and consultant for a variety of fitness programs; effective weight loss programs should have some common elements which include:
Your food diary should include every bite of food eaten, all fluids consumed, when and where you ate, how much, and your mood at the time. Write down this information for seven full days, and do it throughout the day -- don't save it up until the end of the day and try to remember what you ate. And if you find that you have chosen an atypical week, keep the diary for another week. You should keep a pad with you constantly, so you can record your diet information in real-time. Pay attention to serving sizes; and, above all, be honest about this task, it is worthless otherwise.
Some important considerations are to measure and record what you eat -- cups, teaspoons, tablespoons, slices, inches, ounces, whatever. Describe cooking methods for meat, poultry, or fish. List all ingredients (e.g., for a sandwich list mayo, lettuce, tomato, etc.)
Also be aware that there are resources available to you, like computer nutrition software, and a plethora of books on the subject of healthy eating.
Anyone who is serious about losing weight should strongly consider a food diary. It isn't convenient, but it works. It helps show you where to make changes.
More headache information has fallen into my hands, so here it is to add to your arsenal, or not. After encountering a possible connection between chronic headaches and prednisone treatments, and the name Dr. Martin Samuels at Harvard as a proponent of this treatment, I was able to contact him. He stated that he uses prednisone only to abort an occasional continuous headache (called "status migrainosus"), but not for chronic use. This would be much too toxic, he said. He also said that many headache experts use a short course of about three days of oral prednisone for this purpose.
A new feature beginning in this issue is The Exercise Corner, which will address one exercise -- how to do it, and the muscles used. In this issue -- plyometric push-ups.
Plyometric push-ups? Never heard of them, you say. They are nothing new; I did them when I was in high school back in the fifties, but now they have a new name, a couple of them, in fact. They are also called "power push-ups." They are intended to increase power and speed, and are done just like your everyday, standard push-up, except that the upward movement (elbow extension) is done very forcefully. The object being to create some space between the floor and your hands. Some of you may remember another slight variation that called for you to clap your hands between each repetition (i.e., start with elbows straight, lower your chest almost to the floor; then push up forcefully, and clap your hands before touching the floor again. These old-fashioned, but highly effective push-up variations, provide a way to add intensity in case you are up to 100+ repetitions, and are getting bored -- that is in addition to the plyometric effect, of course. Getting bored happens since as you become more proficient at doing them, only the last few require much effort.
Plyometric push-ups, as with all variations, require effort especially from the muscles of the chest (pectorals), shoulders (anterior deltoids), and elbow extensors (triceps brachii).
Metabolism is one of those never ending issues, and has been addressed before in an earlier Newsletter, but it won't hurt to reiterate, and even add a little.
You may remember that Basal (or Resting) Metabolic Rate (BMR/RMR) is determined by the body based on several factors; only one of which we can change -- lean body mass (muscles, bones, and organs), or more specifically, muscle mass. Other factors include age, gender, and body surface area -- factors that we ordinarily can't change.
BMR is the minimum level of metabolic activity needed to keep us alive at rest, it keeps the heart beating, the lungs functioning, etc. Activity beyond that level requires more calories to be burned -- an increase in metabolism. Calories are burned in mini-organs called mitochondria, which are located primarily in muscle tissue. You can think of mitochondria as the calorie burning engines of our bodies.
Diet/digestion and aerobic/anaerobic exercise all affect metabolism -- digestion accounts for 10-15% of energy expended per day via dietary-induced thermogen esis (see Note 1) (DIT). Actually thermogenesis, in general, accounts for roughly 60-70% of energy expended per day.
DIT is significantly raised by complex carbohydrates and protein, but fats have little effect. Your resting metabolic rate can be elevated for several hours as a result. Eat breakfast to jump start your metabolism, as previously mentioned. Adopt a "grazing" eating pattern to keep your metabolism running, and you should eat at least every four hours.
Exercise-induced thermogenesis through both aerobic and anaerobic modes make significant contributions to metabolism.
Aerobic exercise effects growth of fat storing and releasing enzymes in fat cells, elevates metabolism for hours after exercise, and improves the body's ability to use fat for fuel (For example, well-conditioned runners are able to burn fat at higher intensities than less well-trained individuals.). It is recommended that you do at least 30 minutes of aerobic exercise, three times a week.
A strength training program should be performed every 48 hours to promote muscle development (remember that as lean body mass increases, so does metabolism). Also, this every-other-day pattern keeps muscle metabolically active, and your heart will appreciate that -- it's a muscle too, of course. OK, enough on metabolism for today.
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note 1 - Thermogenesis is the physiological process of heat production in the body, and consists of four parts: 1) BMR, 2) exercise-induced thermogenesis, 3) diet-induced thermogenesis, and 4) adaptive thermogenesis, which is energy spent adapting to trauma, temperature changes, starvation, etc.
A new view of the brain -- how it functions -- has been emerging over the past few years. It was once thought (and not very long ago) that our discoveries about how the brain worked had gone about as far as possible; the subject was considered just too complex to unravel. But during the 1990s amazing new information has been discovered, and maybe more importantly, there is now great anticipation of achieving a much fuller understanding of the brain and how it functions. Much of what we knew about the brain up through the 1980s resulted from research done on monkeys, but now new techniques have opened the gates to the brain -- new computer technology like fMRI (functional magnetic resonance imaging) and Diffusion Tensor Weighted Imaging; and molecular biology break-throughs like gene splicing, and experimentation with neural stem cells.
Now there are real expectations of new treatments, or even cures, for brain/mind diseases like Altzheimer's, depression, Parkinson's, schizophrenia, and stroke. There are already new treatments for these and similar diseases, and with great expectations of newer and profoundly effective treatments.
According to David Amaral, research director of the MIND Institute and professor of psychiatry at the University of California at Davis, it is an astonishing revelation that new brain cells are generated. It has long been thought that a person had his/her full compliment of neurons (nerve cells) before birth, but just last month (Oct 1999) researchers at Princeton University were able to show that monkey brains continually generate new neurons which end up in the cerebral cortex (center of higher intellectual functions in the brain). Earlier studies have also demonstrated examples of neurogenesis (creation of new brain cells). Examples are brain growth in mice when put in a stimulating environment, and increased neurons in canaries when they learn new songs. The same process is said to occur in humans.
At the Salk Institute for Biological Studies in La Jolla, CA, researchers did autopsy studies of brains of terminal cancer patients who had voluntarily agreed to allow a chemical tracer to be introduced to actively dividing cells, and evidence was found indicating recent cell division in the hippocampus (see Note 2) in everyone studied.
It has also been learned that the brain is much more adaptable than previously thought. It constantly interacts with its environment and adapts accordingly. An example is how the brain of a blind or deaf person is able to maximize different senses to compensate for loss in another sensory system.
Computer technology has opened new windows to the brain; for example, fMRI can ferret-out changes in the amount of oxygen used by neurons and thereby generate high-resolution images of brain activity. The newest addition to the brain-discovery tools is "Diffusion Tensor Weighted Imaging," which can track neuronal connections to/from different parts of the brain.
Molecular biology advances, like gene-splicing, have opened up study of DNA that reveals the inner workings of single brain cells, which has revealed new information about the brain's anatomy, structures, and molecules.
These new tools have provided amazing insight into the highly complex brain. It is likely to still take a very long time to fully understand it, but new discoveries are expected to help with treatment of a variety of illnesses. Take the case of Alzheimer's disease, for example. Genes have been discovered that affect the disease (They show how it develops.), and already one drug (donepezil) has been developed to enhance nerve-cell communications to improve memory disturbances.
Another area of discovery is addiction -- apparently a brain disease, says Alan Leshner, director of the National Institute on Drug Abuse. All drugs (the alcohol to heroin kind) change the brain significantly. They have an effect on dopamine, a neurotransmitter involved with "pleasure." Addictive substances all modify dopamine in similar ways, according to Leshner. He claims that people initially take drugs because of what it does for their brains (pleasure). but eventually they take drugs because they must (withdrawal avoidance?). Leshner says that drug addiction is unlike other illnesses, which can often be cured by a pill. Drug addiction changes our brain cells in serious and long-lasting ways. Maybe our new technologies will present some new treatments, if not cures.
Similarly, those with schizophrenia may also benefit from new understanding of the brain. Schizophrenia is more common than you may think. Over two million Americans have it -- mostly young ones. Only one out of five recovers completely, and one of ten eventually commits suicide. New imaging technology, like magnetic resonance spectroscopic imaging (MRSI), has provided a means for identifying brain abnormalities in schizophrenics, particularly low levels of N-acetylaspertate in certain areas. Low levels don't cause schizophrenia, but do increase the risk of getting it.
During the 1990s, new drugs have been developed and introduced, which are safer and more effective than what was available before.
Another new technology is the use of immature stem cells -- already used to treat cancer patients. ["Immature" means that the cells haven't yet "specialized" into bone cells, or cells for any other specific functions.] The hope is that they can be channeled into becoming specific types of brain cells, like dopamine manufactured cells that are destroyed by Parkinson's disease. Stem cell therapy may be able to allow the brain to repair itself.
At Harvard Medical School, researchers have successfully implanted neural stem cells into the brains of mice that were bred with a muscular disease. The implanted cells proliferated through the brain, and eventually developed into functional neurons. Nearly 2/3 of the mice showed significant improvement.
Research with human stem cells has made use of cells collected from embryos, which has been quite controversial, to say the least. But, stem cells have now been recovered from adult brains, which provides hope that a patient's own stem cells can be used to regenerate specific neurons to repair injured or diseased brains.
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note 2 - The hippocampus is an area in the limbic system in the brain where major functions seem to be to remember new information and facts, and is located in the medial aspect of the temporal lobe. People with bilateral damage to this area can't incorporate new memories, although they do retain memories from before the injury.
(Q) Have you heard of quinoa burgers? I had one and it was actually pretty good.
C.M., San Jose, CA
(A) No, I haven't heard of them, but quinoa should be an excellent ingredient in veggie burgers. Quinoa is, as you may remember, called a "super grain" for its high protein content. And, of course, it isn't a grain at all, but has similar uses. Long ago it was a staple among the Aztecs, but when the Spaniards showed up they eliminated its use because it had some kind of religious significance. It has recently re-emerged as a viable vegetable protein source. It also contains iron, potassium, riboflavin, magnesium, zinc, manganese, and folacin.
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