How important it is to be mindful about what and how you eat during meals

What we eat defines (in a large part) our lifestyle and determines our health.

The older we are, the more belly fat we have and the more health issues we have (high blood pressure, prediabetes, diabetes, abnormal cholesterol), the more careful we have to be with our diet. For example, a 25-year-old athlete with almost zero belly fat and blood pressure of 110/75 can be much more liberal with his/her diet (may consume many more carbs and more salt) than a 35-year old who is overweight and has high blood pressure or a 45-year old with prediabetes.

While we need to get nourishment (protein, fiber, vitamins, and healthful fats) and pleasure out of our meals, we must watch our carbs, total calories, and salt. For food that comes in a package, we need to look at the food label and make sure that we can afford the calories and that salt is less than 400 mg per package and added sugars less than 10 grams. 

High sugar or refined grains (white bread, white pasta, white rice) will make us hungry every two hours (due to insulin spikes and mild hypoglycemia two hours after the meal) and thus is much more “costly” in calories than the initial calorie count might make us think.

Fast foods like hamburgers and pizza are very calorie dense and have too many unhealthy fats and should be eaten in very small amounts and no more than once or twice a week (unless you are a youngster or an athlete). 

For most of us, sugary beverages, cookies, desserts and ice cream should be left out of our regular meals and eaten very rarely. 

Fresh vegetables should make up the largest part of our meal. So get your fiber, protein, and vitamins but be stingy with your sugars, salt, and bad fats.

To your health
Dr. Anthony

Healthy Habits to Implement in 2019

- Aim at no more than 20 grams of added sugars per day. Allow up to 100 grams of natural sugars (natural sugars are present in dairy, vegetables, and fruits) a day.
Reduce refined grains: no more than 2 slices of white bread or 2-3 ounces of cooked white pasta, white rice, or a medium-size potato a day.

- Aim at no more than 6 hours of sitting a day (including sitting during commuting, during meals, at work, and at home). Use standing desks to alternate between sitting and standing at work or at home. As standing still for longer than 4 hours a day is bad for our backs and our leg veins, be creative and move side-to-side or any other way that does not interfere with your productivity.

- Aim at 15,000 steps a day. Strengthening exercises are essential; cardio- or aerobic exercise alone is not enough, as we lose muscle after age 30 and our metabolism slows down as a result.

- Reclaim muscle by lifting light or medium-size weights for 5-10 minutes a day or 10-15 minutes every other day. Avoid heavy weights that make you hold your breath
and strain.

- Get 7-9 hours of sleep per night. Working at night and sleeping during the day is not optimal and comes at a dear price for your health. 

- Zero cigarettes, no hookah, no vape, and no marijuana.

- Have up to 1 glass of wine (or one beer) per 24 hours for women of any age or men 65 years of age or older; up to two drinks of alcohol per 24 hours for men younger than 65. These limits apply even if you drink alcohol only once or twice a week. While these moderate amounts of alcohol listed above are good for our health, alcohol abuse is a terrible disease that kills 3 million people a year worldwide.

What is the Healthy Habit that you want to implement today in your life?

To your health!
Dr. Anthony

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 class...you 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

Go to the Health Club OR Exercise at Home?

Physical activity, along with healthy diet are the pillars of healthy lifestyle. So, you have made the decision to get in shape. Wonderful! Your next move is to either go to a  gym / health club or start exercising on your own. You may think buying exercise equipment could be too expensive, but think again. There are so many option out there today and the same goes for joining a gym or fitness center. What is important is to be physically active for a few hours a day, at work, at home, at the gym, anywhere.

Many gyms now accept health insurance. There are so many men and women who pay into their health insurance and have no idea they could be working out for free or near free.  Many large companies have learned that keeping employees healthy actually keeps their health costs down in the long term.  And gyms seem to always run deals or specials. Sometime you can ask for a discount: student, senior citizen, etc.  And if a medical issue arises or pregnancy or you lose your job - most gyms will place a hold on your membership.

The cost of equipment can also be reasonable. Remember: you get what you pay for when buying equipment brand new. Do a little bit of research if you are going to invest in a large expensive piece of exercise equipment.  Don’t forget other outlets. Many people buy items or gear and after a while, it is collecting dust or sitting in a closet. Their loss can be your gain.  Treadmills, weight sets and other items can be found on craigslist, eBay, or local virtual garage sales, or the old fashioned garage sale or classified ads.  If you are just starting your foray into working out- you may want to buy pre-owned items to save some money.

If your company has a gym in it, make use of it! Head into work early, or stay late to get that workout in.  Or you may be  able to use part of your lunch hour to eat at your desk and use that extra hour to get in a workout. Walking with other employees can be fun and fruitful.

Employers are starting to add fitness to the workday in many new ways.  Physical activity at the workplace is becoming the way of the future.  Standing desks, walking mats, and exercise balls in place of chairs are all ways companies are promoting health.  Elliptical work desks and ab-focused workout chairs are available and furniture for your home like a curvy pilates lounger, and other furniture that is disguised as just furniture, but turns into exercise equipment is available for online purchase. A stool that  looks like a stool, can work your core, since it is not flat on the ground, and can turn into a workout mat.  If you are short on room, closet gyms can work for you. You can fit the treadmill, bands, and dumbbells into what looks like a closet.

Fitness trackers and wearable devices are making accountability easier and are a great way to show that you care about and monitor your health. It is not uncommon to see men & women wearing fitness trackers on their wrist as part of their everyday outfit.  These trackers can report several pieces of information to you, including how many steps you have taken in a day (like a pedometer).  

There are so many options whether you shop online or in a brick and mortar store. Or - just use what is at your disposal: take a walk, buy or rent or check out YouTube for exercise videos, or get creative at home (marching in place, sit ups, jumping jacks, planks will not cost you a thing)! So get moving; you have no excuse!!!

To your health!

Dr. Anthony

Start Your New Year's Resolution Now!

Do you remember January 1st, 2016….seems like a distant memory now. Remember the New Year’s resolutions you made? Have you kept them? Most people would say - no, I gave up on it about March (maybe May if you were “good”)!  Well, it is never too late to start again!

The struggle to lose weight, quit smoking, eat healthy and exercise is a lifelong one. It is not hundred meters dash; it’s a marathon. So, setbacks are to be expected and need to be dealt with in a pragmatic way, without overreacting or completely abandoning your efforts to become a healthier person.

Don’t let the calendar dictate your promises or your failures. As your health and personal well-being should be at the top of your list of most important things in your life, you need to be determined to stand up after every fall and never accept defeat.  Sometimes, all you need is that little push to get you going again. If, for example, you used to eat unhealthy every day of the week, aim at a healthy Tuesday; that’s a real progress. Once you conquer this first step you can add another day, allowing yourself your old-style unhealthy binge on the rest of the week. Capitalizing on your positive psychology of eating healthy on certain days, it is very likely that, over time, you will be able to eat healthy most days of the week. One healthy day is better than none! There is a quarter of the year left, enough time to prove you can really improve to yourself and achieve your initial goal.

Let’s talk about diet: if you can only eat five or more portions of fruits and vegetables a day and cut out sugar (especially sugary soda), even if you also eat some junk food, you have made a big step forward. Then, try to eat lean meat and the good fats (olive oil, fish, nuts), and prefer fresh non-GMO foods over processed food. Control your calorie intake, as too many of the bad carbs or even the good fats, can lead to belly fat or abdobesity.  This can lead to a whole host of problems down the road (diabetes, heart attacks, stroke, to mention but a few).

Also, take advantage of your “wellness” visits to your primary care doctor. Most plans require no copay for these visits. If you have not made that doctor’s appointment that you meant to do- do it now! Many insurance companies have a flex fund or HSA account where money is put aside, and if you don't use it, often you lose it. So put that money to use and make your health a priority. A wellness visit can unmask a high blood pressure or cholesterol, prediabetes or diabetes and start you on the right path towards health.

Exercise usually ranks high on New Year’s resolutions. With summer, and vacation and work and kids and,and, and….well you see where this is going.  It is easy to fall off the workout wagon. But climb back on.  Pretend the calendar says 1/1 again!  Get to the gym, grab a friend or your spouse and start a walking routine (and light weight training every other day-muscles improve your metabolism), check around to find home exercise equipment that someone ELSE is now selling after buying it last Christmas! Make their loss your gain.  Consider buying a standing or a treadmill desk and use it at work. It is a waste of precious time and opportunity if we spend all our working hours sitting; we get the “sitting disease’, as many scientists now call it-contributing to obesity, muscle wasting, diabetes, high blood pressure and more.

If your resolution was to stop smoking and you haven’t ... please consider stopping now. There are several smoking cessation tools, including groups and/or medication to help. Ask your doctor to help you quitting. Be aware, though, that if you are not really determined to quit, no nicotine patches or gums, no Wellbutrin and no Chantix will get the job done.

Make today your “new year” day and get in gear! If you do this, by December 31st, you will not need to make as many resolutions.  

To your health!

Dr. Anthony

Top Must Have Ideas to Exercise at Work!

Just because you have to sit at a desk all day long at work, it doesn’t mean you can’t sneak in some exercise. Many employers have long been encouraging their staff to stay healthy. And some new office furniture may look like it is from the future - but this future, be sure, is coming very soon! Not only is it useful to get some exercise during your workday, it is a MUST! It is actually a surprise that for so long we have been wasting the longest part of our wakefulness (while working) sitting and expecting that when we return home after an exhaustive day of work and faced with home chores we will be spending an hour on treadmill! The “sitting disease” is bound to suffer a serious blow at the workplace.

So, now the entire world needs to respond aggressively and effectively to the obesity-diabetes epidemic. Creating opportunities for physical activity during our working daily schedule is one of the most untapped opportunities for increasing our daily physical activity. Replacing sitting at the workplace is becoming probably the most significant development in our fight against the health challenges of our time. We can no longer sit for 8 – 10 hours a day!

Let’s start with the easiest and most traditional way to get in some exercise at work...use your lunch break to get moving. Form a group of workers who want to walk during their lunch hour. Maybe you take 30 minutes to eat and the other 30 is spent walking outside. Not only will the fresh air and movement do you good, but it is a chance to catch up with friends. Furthermore, some offices offer gyms in their building which is a perk but only if you take advantage of it. Yet another idea is to take a 3 minute “exercise break” a few times during the day. If you have an area you can go to, take 3 minutes to get in jumping jacks, squats and jogging in place. What about, wall squats or calf raises while waiting at the copy machine, dips using your desk, leg lifts and even squeezing and tightening your buttocks while you sit. And if you have the choice of the elevator or stairs, take the stairs.

And then there is the “new kid in town” - Pieces of office furniture that allow you to work out while you are doing your job! Here are just a few examples:

• A treadmill desk; it can briefly challenge your balance but have no worries; once you get used to it will run smooth and will not disrupt at all your job; you will be able to remain focus on the project and hand while shedding lots of calories

• Standing desks, walking mats, and exercise balls in place of chairs are all new and available ways to use at work, a win-win situation for your employer who wants to promote the health of his employees and yourself who are desperately looking for those 40 minutes of exercise a day your doctor has been advising you for so long.

• A bike desk is a unique way to work also. It looks like a stationary bike, with a desk attached. Elliptical work desks and ab-focused workout chairs are good choices too for sneaking in exercise at work.

As all this is new and there is, of course, resistance to change, it is possible that your employer has not incorporated any type of exercise equipment or furniture. Once they get over the unconventional, but great new workplace environment, they are likely to embrace it, some sooner than others. Rest assure, this new look and functionality in the workplace will soon become standard practice. After all, your employer knows all too well that a healthy employee is a happy and more productive employee!

To your health!

Dr. Anthony

Please HELP! What do I do about my Belly Fat?

Excessive belly fat (a waistline over 40 inches in men or over 35 inches in women) can destroy your metabolism and damage your arteries. It is also an early sign that you may be on your way to becoming diabetic, developing high blood pressure and, later, heart attacks or stroke. It also increases your chances of colon and breast cancer and Alzheimer’s disease. So what do you do?

Given the importance of belly fat, it is natural for people to try to get more information by googling it. If you google “belly fat” you may be directed to websites with advertisement for pills, supplements, shakes and drinks that “guarantee” you will lose belly fat. Should you believe them? Like most health-related issues, there are no easy fixes for abdobesity (excess belly fat); if they existed there would have not been as many people with a big belly walking around. But, in order to be fair about the web, one can find credible sites from reputable hospitals like Cleveland and Mayo Clinic, professional medical organizations like the American Diabetes Association and the American Heart Association or recommendations from professionals like physicians, registered nurses, registered dieticians or exercise physiologists. None of these credible websites will ever claim that you can lose your excess belly fat in a few weeks and keep it off for the rest of your life with a minimum effort.

In my book Abdobesity, I explain the seriousness of the belly fat and show how it is damaging our body’s metabolism and arteries’ health. As opposed to fat under the skin or around our hips (which is metabolically innocent), belly fat is directly wired to the liver, our chief metabolic factory. Under the constant negative influence of the belly fat, our liver is turned into a production line of chemical poisons that induce inflammation all over our body and promote cholesterol plaque development in our arteries; along with the other risk factors (smoking, high blood pressure, high LDL, diabetes, aging and family history) these cholesterol artery plaques mature overtime and they may become unstable as unpredictably as an earthquake. If this happens a heart attack, a stroke or sudden death follow with little or no warning. This is why a healthy lifestyle and early and aggressive treatment (with medications, if necessary) of high blood pressure, high LDL cholesterol or diabetes are so important; to effectively protect our artery health, however, they must be implemented as early in life as possible.

Don’t let abdobesity (excess belly fat) and the catastrophes that may follow it irreversibly damage your health and ruin your life. Espouse the elements of a healthy lifestyle; monitor your blood pressure, blood sugar and cholesterol; and nurture a close relationship with your primary care physician. Start by measuring your waist; if your numbers are in the red, don’t wait; take action. And, if you ever find your daily battle against abdobesity difficult or impossible, think of those who need you and believe in you: how will they be affected if your health takes a turn for the worse?

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

Can your Mental Health affect your Physical Health?

The World Health Organization (WHO) defines health as “ a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. So, does the way you feel emotionally have an affect on your physical health? It certainly does!

When you feel good about yourself, you are more likely to take good care of your physical self, but you are not happy with your physical being, possibly due to excessive stress, anxiety or depression (feeling blue mentally), not only does your body machinery malfunction but also your behavior changes for the worse.

The mind/body connection is strong and if one is out of balance it adversely affects the other. Stress, anxiety and anger can all lead to physical ailments. The reverse is also true: physical problems such as heart disease, diabetes and chronic pain can make you depressed. There are many stresses in life - the death of a loved one, divorce, loss of a job or moving to a new place, can all take a toll on our physical health. It is important to try to keep things in check or ask for help, so that the initial stressful condition doesn’t escalate into a serious physical illness.

The effects of mental illness on physical health can be serious. The journal of World Psychiatry reported in its February 2011 issue that the lifespan of people with severe mental illness is shorter by 13-30 years, compared to the general population. This excess mortality is mainly due to physical illness. Mental health illness can lead to substance abuse, risky sexual behavior and neglect of your essential body needs, eventually hurting you physically as well as mentally.

On the brighter side, a positive perception of our physical health positively can be a mood booster. When we are happy with life it is easier to hit the gym, make good choices about our health and stay “the course”.  FamilyDoctor.org reports  “…people who have good emotional health are aware of their thoughts, feelings, and behaviors. They have learned healthy ways to cope with the stress and problems that are a normal part of life. They feel good about themselves.” Also, increased levels of physical activity are positively associated with general well being, lower levels of anxiety and depression, and a positive mood.

Looking good and feeling well go hand in hand. With all life’s stressors we need to work on a daily basis to keep ourselves both mentally/emotionally sane and physically healthy. And while we all have bad days and may get down in the dumps from time to time, we need to be reminded that, poor mental health can lead to a serious physical condition. In case we feel down for longer than a few weeks, it may be worth talking to your health care provider.

So as the song says “don’t worry, be happy”-well, as much as you possibly can!   If not, ask for help.  

To your health!

Dr. Anthony

THE VICIOUS CYCLE OF HUNGER!

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