How do you adjust your exercises as you get older?

Let’s face it, as we get older things get harder to do.  Running a mile may feel like 6 miles, an hour long workout leaves you breathless and even pushing the lawn mower is harder to do than it was years ago. But just because we are getting older, doesn’t mean we should stop exercising. As a matter of fact, the opposite is true.  It is important to keeping moving as we get older! 

We envy the youthful, but age is mind over matter. Of course, it is true that we lose muscle and bone and that our heart becomes stiffer (causing shortness of breath when physically active).  But  even though physically we can’t lift as much weight as we used to or dance the night away like we did in our 20s, there are certainly activities to keep you feeling and looking good.

Physical activity becomes increasingly important as we age. As we lose muscle over time, our metabolism slows down when we get older, so burning off calories becomes more of a challenge.  Plus with age we discover our years of bad habits have caught up with us….too much salt, sugary drinks, smoking, etc all now take a toll on the “adult” us.  We can’t get in a time machine but we can try to make good on our future. Withering leg muscles (due to combined effect of muscle loss with aging and physical inactivity) means inability to walk and loss of independence.

Many organizations have activities for seniors: churches, YMCA, and other groups encourage older adults to keep moving and in a fun way. Zumba Gold is specifically designed for older adults.  Even senior living centers have exercises for the elderly, sometime just Wii (video game) bowling  offers a way to move about and keep the blood flowing.

The American Diabetes Association says aging is the most universal contributor to the  onset of disease such as diabetes, cardiovascular disease and stroke. Insulin resistance is a major component of metabolic syndrome and is commonly seen in older adults.

Bone density begins to diminish as early as age 30-40 and loss of bone density means your bones are more fragile and likely to break.  Your blood vessels and arteries also become stiffer making your heart work harder to pump blood through them. High blood pressure is a result of this.  As we age muscles lose strength and flexibility .

So this all sounds like terrible news, right? Wrong. Although aging is a fact of life, you can still enjoy your senior years. Your diet is important in maintaining a healthy lifestyle: increase your calcium, vitamin D and eat a healthy diet.  Getting enough sleep and managing stress will also help. And move! Yes, physical activity is important.  You may not be able to run a marathon anymore, but taking walks certainly will help. Swimming is a fantastic exercise that is easy on joints.  Yoga and Pilates are also easy on joints and non-cardio types of exercise.  They may help with balance and flexibility as well, preventing the risk of a fall.  Take a dance will burn calories, get the heart pumping and probably have fun while doing it!  If you can’t find a class, just stretch at home, or find a video to help you get started.  A walking club in the neighborhood could also be a fun social activity and a healthy endeavor.

It doesn’t have to be fancy or cost a lot of money, but the key is to keep moving! Once you slow down, it is harder to get back on track.  Talk to your physician for more ideas, he or she will be happy to hear you are not going to let age keep you down!  Jack LaLane was 96 when he died and his family says he had been performing his daily workout routine the day before his death.  We all have to pass from this life at some point, but going through life happy and HEALTHY is a much better way to live.


To your health!


Dr. Anthony

Fitness Trackers … Are they worth it?

The newest rage in fitness is the fitness tracker. They range in price from  around $30.00 to several hundred dollars. Do they work? Are they worth the money? And what exactly are they “tracking”?

The fitness tracker is a wearable device that will track everything from your steps, your sleep, your heart rate, blood pressure or oxygen level and even your sweat.  It may reveal that you need to “step it up” (pun intended) or that you are on track to your fitness goals.  It is available in app form as well and/or will work in conjunction with an app or your smart device. For most people, it is a reminder that you need to do more, and to some a surprise, that they have not been doing enough!

The fitness trackers are usually in the form of a band (usually worn on your wrist, ankle or neck) and they track your progress. One brand will light up to show your progress, another will display a red move bar after one hour of inactivity acting like a personal coach.  A sweat tracking wearable is attached to the skin of your leg.

Shape magazine reported a recent survey by the NPD Group showed 58 percent of women who were asked intend to buy one of these devices. The most sought after features: counting calories and tracking the number of steps taken in a day.

I believe that the most important benefit of a fitness tracker is that it signals your determination to be directly involved in your own health and to start monitoring it. This is a much bigger step than most people would think. A great example is the number of steps you take in a day; taking at least 10,00 steps a day means that you meet or exceed the minimum exercise requirements of 150 minutes per week, an important milestone in healthy living.  The 10,000 steps a day is also part of the “Step Diet”, a relatively straightford combination of physical activity and diet to help you lose weight. Exercise can also help you reduce your  blood pressure (which can also be monitored by some wearables) and, thus, reduce the chances of heart attack, stroke and kidney disease.

Tracking your fitness is valuable; it can bring you back to reality. Maybe walking down the hall for that cup of coffee at work is not walking enough even though you pat yourself on the back for getting up and moving. Fitness trackers or apps can be the extra kick in the pants to help get you on the right path, but only YOU can make the changes you need.

There are a few issues that come along with the benefits of the fitness trackers. One is that they are not always very accurate. They can miss the number of steps you took and can tell you that you did not get enough sleep even if you did. Their data may also be too much to handle and can cause some confusion. There are technical improvements on the way that can improve the accuracy of these devices.  And you don’t have to get caught up in the entire amount of information the tracker is telling you. You body, body weight and waist circumference, are good indicators of your health report card and complements the information from your wearable.

In Abdobesity, I write that “diagnosis is extremely important in medical care because it reveals the seriousness of the illness and suggests those treatments that are most likely to help the sick person.” While a tracker or app or device cannot diagnose a problem, they may be able to indicate if there is an issue with something such as blood pressure, blood oxygen levels, etc. If this is the case, discuss it with your physician.  Your doctor can delve deeper to uncover what the issue is and what can be done to help with the problem at hand.

As always, be your own health advocate. Choose wisely. A fitness tracker is definitely an important step forward, but you may not need to pay too much for all the bells and whistles. Use your wearable to keep you in check, get moving or “coach” you to a healthy lifestyle. Just don’t rely on it as the end-all-be-all to good health.

To your health!

Dr. Anthony


You read labels that say “HFCS”, or High Fructose Corn Syrup, or corn syrup….but what does that mean? If corn is in HFCS...well, corn is a vegetable so it must be healthy, right? Well, don’t be fooled. HFCS is a form of sugar and like all simple sugars, gives our body empty calories that turn into fat without providing any fiber, vitamins or antioxidants.

HFCS, like ALL simple sugars, is quickly absorbed into the bloodstream and forces insulin to spike, leading to a mild hypoglycemia and then two hours later it makes us hungry and forces us to eat again...

This creates a Vicious Cycle of Hunger -

Hunger = Sugar Eating = Insulin Spikes = Hypoglycemia = More Eating

with the cycle repeating again and again, several times a day!

The result is all too well known: obesity, leading over time to type 2 diabetes and high blood pressure, with the final result being heart disease and stroke. In this respect, HFCS is as dangerous and as unhealthy as cane sugar or any other calorie-containing artificial sweetener. But is it more dangerous than cane sugar?

Since the 1970’s, the use of HFCS as sweetener in sodas, baked goods and packaged products has increased dramatically in the US, as it cheaper and easier to use and more tasty. As the use of HFS has coincided with the dramatic increase in obesity, scientists and consumers alike legitimately questioned whether HFCS was behind the obesity epidemic.  Well, after decades of serious scientific work, all the evidence points to HFCS being as bad but no worse than cane sugar in contributing to obesity. Too much added sugar of any kind contributes an excess of empty calories that lead to weight gain, type 2 diabetes, heart disease, metabolic syndrome and liver disease, several forms of cancer, and tooth decay. While HFCS is part of the cause of high levels of obesity and diabetes in our country, it is not the only villain; consider that from 1970 to 2000 the average person in the US has increased its consumption of fat by almost 50%, compared to sugars increased by about 25%.

The American Heart Association recommends most women get at most 100 calories a day of added sugar from any source, and men get no more than 150.  That equates to about 6 teaspoons of added sugar for women and 9 for men.  Additionally, HFCS is not the only sweetener that contains fructose. Honey is approximately 50% fructose and 50% glucose and fruit and nectar-based sweeteners may have more fructose than glucose.

The corn industry will try to fool you to think corn syrup is ok. Please don’t fall for it. They have even gone so far as calling it naturally occurring corn sugar.

So what can YOU do to cut out HFCS and other fattening and dangerous sugars?

  • Read labels

    • Check to see what is in the food you are eating

  • Eat organic

    • This will eliminate the chance you are eating genetically modified foods.

  • Eat whole foods

    • This means real food not pre-packaged food

  • CUT out sugary drinks

  • Think before you eat

    • You would be surprised to find out how many foods have corn syrup as one of their ingredients.


Be smart, be healthy!

To your health!

Dr. Anthony

OBESITY 1988-2014: There is good news and bad news…well, sort of good news.

The good news is according to the findings of the Journal of the American Heart Association, obese adults (those age 20 and over, with BMI above 30) are now at lower risk for developing heart disease, compared to 30 years ago. However, with the good comes the bad - and the bad news is obese individuals are MORE at risk of developing Type 2 Diabetes.  

So what does all this mean? Well, first we need to understand diabetes … According to the American Diabetes Association, in diabetes there is a problem with the body’s metabolism that causes sugar (glucose) to rise in the bloodstream whereas the cells, that need glucose as their energy source, are starving. How does this happen?

  1. The main source of glucose is the carbs we eat; these carbs are digested and absorbed through the stomach and then enter into the bloodstream primarily as glucose (sugar).

  2. Once glucose is in the bloodstream, it can reach all the cells in your body. Once these sugar molecules arrive at their destination, imagine them knocking on the cell’s door, the body orders the pancreas to produce insulin, the “key” that opens the cell’s door and lets the sugar in.

  3. Either the pancreas cannot produce enough insulin (type 1 and late type 2 diabetes) or the normal amounts of insulin fail to work properly (“insulin resistance”/obesity and early type 2 diabetes).  Over time both these abnormalities take place and result in excess sugar in the bloodstream (with toxic effects for the cells) and, at the same time, severe shortage of sugar inside the cells.

  4. The cells are then forced to turn into fat, instead of sugar, for their energy needs. This diabetic state is very damaging to the body - both through the toxic effects of high blood sugar levels which can cause blindness, kidney failure and nerve damage to widespread damage of our arteries, leading to heart attacks, stroke and leg amputations.

The Center for disease control states 29 million people in the United states have diabetes which is three million more than just six years ago.  Worldwide more than 380 million people suffer from diabetes.  More than one in three adults in the US have pre-diabetes which us 86 million people. A healthy lifestyle, including almost daily exercise and healthy diet, both reduces the chances of becoming diabetic in the first place and improves the outcome in those already suffering from diabetes.

Now is the time to take on the challenge of obesity and diabetes. Not only do we need to personally practice prevention, but we also need to convey the message of wellness, through our personal examples, skills and knowledge, to our loved ones, our colleagues and the society at large. There is no reason why we cannot succeed in the fight against obesity and diabetes, should we show the necessary resolve and determination, and be given the time required to re-engineer our daily lives, both in the workplace and at home. Spread the good news and work for what remains to be done. Take care of yourself and your loved ones and help prove wrong the pessimistic statistics on the future of obesity and diabetes.

To your health!  

Dr. Anthony

Not All Fat is Created Equal...

Your health is, in many ways, determined by the size of your GUT.  

While fat around the hips (“pear” body shape) is metabolically innocent, but the fat inside the belly (“apple” body type) can be truly dangerous and, potentially, life-threatening. Abdominal obesity or Abdobesity is defined in men as a waist circumference of 40 inches or more and, in women, 35 inches or more and is linked to type 2 diabetes and heart disease.

While a Body Mass Index (BMI) above 30kg/m2 defines obesity, the two conditions (abdobesity and obesity) do not always coexist, as is the case of a “pear” type person or a muscular person that weighs a lot but the above-average weight consists mainly of lean protein (muscle).

The fat confined in our belly is dangerous, in part because it is directly connected to our liver, the main factory of our metabolism. A “highway” called portal vein, allows for constant traffic of belly fat to the liver, turning the liver into a factory of “fat bullets” that bombard our arteries, giving rise to cholesterol plaques. Those plaques mature over the years and became inflamed and unstable, resulting in heart attacks, strokes or even sudden death. As the belly fat affects our entire metabolism, it contributes to diabetes, a serious disease with multiple complications of its own, including heart attacks, strokes, blindness, and kidney failure. Overeating and under exercising can lead to a flabby gut (abdobesity). That spare tire may be more than too much chocolate - it is the prelude of a series of potentially deadly medical conditions.

Sometimes you hear people refer to their “core”.  Your core is more than just your stomach. The core is a complex series of muscle that are essential for core stability and spine protection. It’s important to achieve core stability to protect the spine and surrounding musculature from injury.  The skin fat that surrounds the muscles and the stomach is not medically dangerous, but the deep belly fat, the one inside your belly muscles can cause health trouble. This deep belly fat, beyond contributing to diabetes and heart disease, it also makes it hard to strengthen the core and can lead to chronic low-back pain.

Most individuals with abdobesity were probably much thinner as young children. Some started putting on weight as kids, others as adolescents, and many as adults. Although every person’s metabolism is different (in part due to different rates of food absorption by the gut), healthy people will not become obese without taking in more calories than they burn.

So what can you do to lose that spare tire? There are a few things to kick start the process. Of course a healthy lifestyle (eating healthy and exercise) are the key.

Five ways to help reduce that gut are:

  • Don't Eat Sugar and Avoid Sugar-Sweetened Beverages
  • Eat the right amount of Lean Protein
  • Cut the Bad Carbs From Your Diet
  • Eat Foods Rich in Fiber
  • Eat Good Fats
  • Exercise almost Daily

It is important to add some specifics about the stomach; It produces hydrochloric acid that serves as a first line of defense for the immune system by killing off bacteria and viruses that may enter with the food you eat. Stress can upset your stomach, and not just discomfort. As the central nervous system, through its “subsidiaries”, controls the function of your stomach, stress can often upset these organs, contributing to discomfort, acid reflux, gas, bloating or diarrhea.

So keeping your tummy healthy is important to your overall health. It would be wonderful to have “6 pack abs”, but the health beyond it is important. If your belly is hanging over your belt, take it seriously, as this may be the only obvious sign that other medical problems may be going on in your body. A big belly can be “hiding” prediabetes or diabetes, high cholesterol or high blood pressure, conditions that predispose to serious complications, like heart attacks, stroke and kidney failure. Adopt a healthy lifestyle and ask your doctor about what should be done to help you lose that weight and, even more importantly, to protect your arteries, your liver and your life.


To your health!

Dr. Anthony