The Shocking 65 & Other "Sweet" Tales

Last week, while preparing for a presentation on wellness, I came along food labels for certain soft and energy drinks.

I must have read this type of information hundreds of times but it never stops shockingly amaze me to realize that they may contain up to 65 grams of sugar (or more) per 600 ml (20 oz)!

Now consider that the American Heart Association recommends no more than 25 grams of added sugar per day for women and no more than 37.5 gm of added sugars per day for men. So, if you just consumed 20 oz of a sugary beverage you’ve probably gulped in your added sugar allowance for an entire 2-day period!

And it is not just sugary beverages that contain a shocking amount of sugar, much more sugar that a health-conscious person could possibly afford. All of the so called “fast carbs” (high glycemic index carbohydrates) have lots of sugars that are quickly digested and absorbed from the stomach into the bloodstream. Fast carbs include not only sugary beverages, cookies, desserts, ice cream, baked goods and donuts but also added sugars found in low-fat yogurt and starches present in white bread, white pasta, white rice, white potatoes. If consumed daily or in large quantities, fast carbs are dangerous for our health because:

• They have a great taste and texture that we cannot resist

• Instead of keeping us full for several hours they promote hunger: the sugar-high leads to insulin-spike and then, 1.5-2 hours later, sugar-low, making us hungry and forcing us to eat again and again.

So, read the food labels and limit the amount of added sugar you have per day to no more than the equivalent of 6-9 teaspoons of table sugar. Avoid sugary beverages and be skeptical of “low-fat” yogurt. If you cannot entirely resist white bread, white pasta, white rice or white potatoes, consume them only in small amounts. If you are diabetic or obese, I highly recommend that you invest in a personal nutritionist. It will be one of the best investments you can make in your health journey!

To your health,

Dr. Anthony

Prediabetes in Depth

While not as serious as frank diabetes, prediabetes is, nevertheless, dangerous and common: 1 in 3 adults in the US has prediabetes and most of these people are not aware of it (unless their blood sugar or A1c has been checked by their doctor). They also have no symptoms. The risk for developing frank type 2 diabetes, heart disease, and stroke is significantly increased in people with prediabetes, so we need to take prediabetes very seriously. Go and get tested for prediabetes if you fall into any one of the following categories:

·     have belly fat

·     are over 45 years old

·     have a family history (parent or sibling) of type 2 diabetes

·     have high blood pressure (higher than 130/80 mm Hg)

·     are a woman with previously diagnosed gestational diabetes, polycystic ovaries or have given birth to a child weighing over 9 pounds

Make an appointment to see your primary care provider and make a point to exclusively focus on prevention of diabetes, heart disease, and stroke. Your provider may order blood tests beyond merely your blood sugar and A1c (cholesterol, LDL, HDL and triglycerides and your TSH to evaluate thyroid function).

Be a true partner to your provider: know your weight, waist circumference (ideally no more than 37 inches in men and 32 in women; for Asians the numbers are about 5 inches lower). Know your family history and what your average blood pressure (home measurements) is. Mention any prior history of heart or artery disease or procedures (stress tests, echos, ultrasounds of your carotid arteries, angiograms). If you have an old ECG, bring it to your appointment.

A blood pressure log with at least 10-15 measurements is especially helpful. You need to have a good blood pressure monitor and follow your provider’s instructions on how to accurately measure your blood pressure at home.  

If you smoke, you need to give up smoking. The combination of smoking and either diabetes or prediabetes is too dangerous for your arteries. It can lead to heart attacks and stroke even if your doctor prescribes adequate medications to control blood sugar, blood pressure, and cholesterol.

You have to increase the level of your physical activities, achieving at least 15,000 steps a day, grabbing any opportunity you have (at home, work or school) to move, lift light or medium weights on a daily or every other day basis and perform balance and stretching exercises like tai chi or yoga.

You also need to understand what a healthy diet is: what a portion of fruits and vegetables is and what are the healthful fats. You have to severely restrict added sugars (sugary beverages, cookies, desserts, candies, cakes, donuts), refined grains (white bread, white past, white rice, white potatoes) and fried foods. Depending on other factors, you may be more liberal with good sources of protein like fish, nuts, eggs, dairy (avoid full fat) and lean meat.

Investing in a personal trainer and/or a dietician/nutritionist is a great idea.

Getting your metabolism back on course requires motivation, willingness to invest about two hours of your personal time, and working closely with your primary care provider. Insulin resistance, prediabetes and type 2 diabetes are all serious conditions. Treat them as such.

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