Wednesday, April 21, 2010

8 Surprising Foods That Lower Cholesterol

Certain foods have been shown to decrease heart disease risk by lowering LDL (“bad”) cholesterol levels and raising HDL (“good”) cholesterol. And while you probably know about the cholesterol-busting powers of oatmeal, beans, and olive oil, you may be surprised to discover that some of your favorite foods can also make an improvement in your cholesterol profile. Here, the authors of The New American Diet lay out the science behind some surprising foods that can help protect your heart.
The antioxidants in pasta help control inflammation and insulin, which in turn helps reduce levels of harmful LDL cholesterol and triglycerides. When Harvard University researchers analyzed the diets of more than 27,000 people over 8 years, they discovered that those who ate whole grains daily weighed 2.5 pounds less than those who ate refined grains. Barilla, a major manufacturer of pasta products, recently released a line of whole-grain pastas that are almost identical to the average supermarket brand, and you can buy them in bulk at discount stores!

Scrambled Eggs
A study in the Journal of Nutrition found that eating eggs increases good (HDL) cholesterol but not bad (LDL) cholesterol. So eggs actually help your arteries stay clear! In another study, overweight participants ate a 340-calorie breakfast of either two eggs or a single bagel 5 days a week for 8 weeks. Those who ate eggs (including the yolk) reported higher energy levels and lost 65 percent more weight—with no effect on their total cholesterol levels.

Hamburger (from Grass-Fed Beef)
The perfect heart-healthy diet is balanced in its ratio of omega-3 to omega-6 fatty acids. While conventionally farmed beef is about 1:20 in its ratio of omega-3 to omega-6, grass-fed beef is more like 1:3—close to the ratio found in most fish. And grass-fed beef has twice the vitamin E and only about 15 percent as much fat as conventionally raised beef. Grass-fed beef is available through a variety of Internet sources or at most farmers’ markets.
And if you must grab a burger on the go, be sure you don't pick up any of the 15 worst burgers in America.

Egg McMuffins
It might not be perfect, but a fast-food breakfast is better than none, and the Egg McMuffin’s nice balance of protein, carbs, and fats with just 450 calories make it one of the best go-to options in fast-food land. The National Health and Nutrition Examination Survey II revealed that serum cholesterol levels are highest among those who skip breakfast. According to Harvard researchers, eating breakfast makes for smaller rises in blood sugar levels throughout the day. And regulating blood sugar helps reduce levels of harmful LDL cholesterol and triglycerides.

When researchers at Purdue University had people eat 2 ounces of almonds a day for 23 weeks, they found that not only did they not gain any weight, but they decreased their caloric intake from other unhealthy food sources while improving cardiovascular risk factors like lipid metabolism and cholesterol levels.
Almonds are also great muscle-builders, which in turn revs up your metabolism. Check out this list for more foods that pack on lean muscle.

Chipotle Grill’s Carnitas Bowl
A fast-food pork dish can improve your cholesterol profile? Yes. Chipotle Grill uses naturally farmed pork that’s high in stearic acid—the same kind of heart-healthy fat found in olive oil. By skipping the carbohydrate-laden wrap and adding black beans, you’ll get a healthy dose of protein and fiber as well.
If Chipotle isn't your choice for eating out, try one of these other surprisingly healthy restaurant foods.

Dark Chocolate
Research shows that dark chocolate can improve heart health, lower blood pressure, reduce LDL (bad) cholesterol, decrease the risk of blood clots, and increase blood flow to the brain.
Choose the best dark chocolate and other packaged foods with the Men's Health list of the 125 best foods in your supermarket.

Anchovy Pizza
The magic of the anchovy pizza comes from its combination of fish and garlic. Fish is loaded with minerals such as zinc, copper, iron, iodine, and selenium that work as cofactors to improve the effectiveness of cholesterol-lowering fish oils. Adding garlic to the mix lowers total cholesterol better than eating those fillets or cloves alone. Any fish/garlic combination will work, but few others will show up at your door in 30 minutes or less. Just be sure you don't order any of the worst pizzas in America.
Here are three 'healthy' foods that won't help:
You might think ordering the fish is always the best idea, but a 2008 report from the Journal of the American Dietetic Association stated that eating farmed fish such as tilapia may actually do harm to people suffering from heart disease. The reason: Tilapia is naturally low in omega-3s and high in omega-6s, and often served breaded and fried, making it no better or possibly even worse for your heart than fried chicken.
What you think is good for you sometimes isn't.
An apple a day might keep the doctor away, but when you strip away the apple’s fiber-dense skin and add sweetners, as most applesauce makers do, you create a processed food that’s high in sugar and low in fiber—a perfect recipe for blood-sugar swings that raise cholesterol levels. Conventionally grown apples also tend to be high in pesticides, which have been linked to obesity and metabolic syndrome.
Isn’t soy supposed to lower cholesterol? A study in the journal Circulation found that you’d need to eat 2 pounds of tofu every single day to lower your LDL cholesterol by a measly 3 percent. As a result, the American Heart Association no longer recommends soy as a heart-healthy food. Still, Americans eat enormous amounts of soy already, and recent studies show that soy makes it harder to retain muscle and easier to store fat.

Tuesday, April 20, 2010

5 Ways to Be Happier and Less Stressed

Try these simple tweaks to boost your mood.

Experts attribute about 50 percent of a person’s happiness to genes and another 10 percent to circumstances—where we live, how much money we make, how healthy we are. That leaves 40 percent of our happiness in our control. Fortunately, science has much to say about how we can make the most of that 40 percent. Even small improvements in mood can have cascading effects. The trick is to pay attention to what strategies work best for you. Try these for starters.

Savor mystery

In a culture obsessed with the power of information, the fact that most of us are a little unnerved by uncertainty is hardly surprising. Yet research suggests that a dash of mystery can make positive experiences last longer. In one study, University of Virginia psychologist Timothy Wilson, Ph.D., and colleagues found that students who were given a $1 coin with little explanation reported feeling happier a few minutes later than those who were given either the same amount of money for a clear reason or no money at all. Next time you're nearing the end of an engrossing book, save the final pages for a few days later. Or shop from catalogs so you won't know exactly when your purchases will arrive—if you're lucky, when they do you may have forgotten what you've ordered.

10 secrets of happy people

Diversify your good deeds

Being kind and helpful makes most everyone feel good. But just as the novelty of a new car or electronic gadget inevitably wears off, so does the warm glow that comes from doing the same good deed over and over. People who performed various small acts of kindness every week for 10 weeks—shoveling a friend’s sidewalk, giving pets a special treat, sending a birthday card—grew happier with each passing week, and the benefit lasted for at least another month, found a study by University of California, Riverside psychologist Sonja Lyubomirsky, Ph.D., and colleagues.

Hope for small changes, not big ones

Research shows that even major life events, such as winning the lottery, hardly nudge people’s overall sense of satisfaction. But that doesn’t mean you shouldn’t try to improve your well-being. Recent research finds that the little things we do regularly, like exercising or attending religious services, can have a major impact on our happiness. In one study, Yale University psychologist Daniel Mochon, Ph.D., and colleagues at Harvard and Duke universities discovered that people leaving religious services felt slightly happier than those going in—and the more regularly people attended religious services, the happier they felt overall.

Small changes for major health benefits

Invest in experiences, not stuff

Doing things, not buying things, gives you the most bang for your buck. Why? For one thing, says University of Colorado at Boulder social psychologist Leaf Van Boven, Ph.D., it’s easier to reinterpret experiences than to retool material purchases. If your new smart phone disappoints, you have to either shell out for a better one or lower your expectations. But if it rains on a hiking trip, you can recast the drenching experience in your memory as a character-building challenge.

Why a to-do list keeps you healthy

Shift your focus

From work to relationships to health, we have choices about where to concentrate our attention. When a snowstorm keeps you from getting to the office, do you choose to focus on how behind you’ll be by tomorrow or on the eight-hour gift of time you’ve just been given? The answer to such questions has a big influence on your well-being, writes Winifred Gallagher, author of Rapt: Attention and the Focused Life. Studies show that focusing on positive emotions—curiosity instead of fear, compassion instead of anger—leads to broader, more flexible thinking, more playfulness and exploration, and richer social connections.

Monday, April 19, 2010

7 Reasons You're Still Hungry

Do you sometimes feel ravenous, even though you just polished off a tasty lunch, a full dinner, or a midnight snack? Some food ingredients can trick our bodies into not recognizing when we’re full, causing “rebound hunger” that can add inches to our waistlines. But these simple tweaks from the authors of The New American Diet can help quiet your cravings.

Craving culprit: You’re bored
Researchers at Flinders University in Australia found that visual distractions can help curb cravings. To test yourself, envision a huge, sizzling steak. If you’re truly hungry, the steak will seem appealing. But if that doesn’t seem tempting, chances are you’re in need of a distraction, not another meal.

Craving culprit: You’re not staying fluid
Dehydration often mimics the feeling of hunger. If you’ve just eaten and still feel hungry, drink a glass of water before eating more, and see if your desires don’t diminish.
If you're sick of H2O, but need to replenish fluids, reach for one of these 10 surprising water alternatives.

Craving culprit: You don’t stop for tea time
According to a study in the Journal of the American College of Nutrition, people who drank one cup of black tea after eating high-carb foods decreased their blood-sugar levels by 10 percent for 2.5 hours after the meal, which means they stayed full longer and had fewer food cravings. Researchers credit the polyphenolic compounds in black tea for suppressing rebound hunger.

Craving culprit: You skipped the salad
Most Americans don’t eat enough leafy greens, which are rich in the essential B-vitamin folate and help protect against depression, fatigue, and weight gain. In one study, dieters with the highest levels of folate in their bodies lost 8.5 times as much weight as those with the lowest levels. Leafy greens are also high in vitamin K, another insulin-regulating nutrient that helps quash cravings. Best sources: Romaine lettuce, spinach, collard greens, radicchio.
Also include these 15 new superfoods in your meals for delicious ways to flatten your belly.

Craving culprit: Your breakfast wasn’t big enough
After following 6,764 healthy people for almost four years, researchers found that those who ate just 300 calories for breakfast gained almost twice as much weight as those who ate 500 calories or more for breakfast. The reason: Eating a big breakfast makes for smaller rises in blood sugar and insulin throughout the day, meaning fewer sudden food cravings.

Craving culprit: Your dinner came out of a can
Many canned foods are high in the chemical bisphenol-A, or BPA, which the Food and Drug Administration recently stated was a chemical “of some concern.” Exposure to BPA can cause abnormal surges in leptin that, according to Harvard University researchers, leads to food cravings and obesity.

Craving culprit: You drink too much soda.
Sodas, iced teas, and other sweetened beverages are our biggest source of high-fructose corn syrup—accounting for about two-thirds of our annual intake. New research from the University of California at San Francisco indicates that fructose can trick our brains into craving more food, even when we’re full. It works by impeding the body’s ability to use leptin, the “satiation hormone” that tells us when we’ve had enough to eat.
To prevent your waistline from expanding when you sip, avoid the 20 worst drinks in America.
Order your copy of The New American Diet and lose up to 15 pounds in 6 weeks!

Sunday, April 18, 2010

Thin on the Outside, Obese on the Inside

fitting into size 2 ins't all it's cracked up to be if you're really fat inside.
By Martica Heaner, Ph.D.

To the world, they’re picture-perfect: enviably thin and free of the health problems associated with being overweight, and they can fit into the skinniest of jeans. But to researchers like Jimmy Bell, Ph.D., a professor of molecular imaging at the Imperial College at the University of London, skinny people—even supermodel types—can be superfat: “Everyone expects an overweight person to have lots of fat, but it can be a shock when a thin person has as much internal body fat as an obese, or even morbidly obese person.”

Normal-weight obesity is a term used for thin people who are really fat because, despite weighing light on a scale or having a “normal” body mass index of 24.9 or below, they have high levels of body fat.

Researchers have long used the BMI, derived from height and weight, as a surrogate measure of fat and the health risks associated with it, although BMI does not actually measure body fat. A BMI of 25 or above is classified as overweight, since this is the point where health risks start to rise. A BMI of 30 or above is considered obese, because risk factors increase exponentially at that point.

While classifying people by BMI is convenient, the measure is not without limitations. BMI can convey a false sense of risk to people who are heavier but fit—either because they are cardiovascularly trained from regular exercise, or because they have more muscle and less fat.

But as it turns out, presumably healthy BMIs can be misleading, too. People with a normal BMI may have a high level of risk if they have a high level of body fat. And as many as 30 million Americans may fall into this normal-weight but obese category, according to a 2009 study in the European Heart Journal.

Researchers looked at the BMI and body fat of more than 6,000 U.S. adults. When BMIs were compared with body fat percentages, a surprising number of people who were normal-weight according to BMI were actually obese judging by body fat levels. Worse, this study found that many of these thin-but-fat people had cardiovascular disease (heart attacks or strokes) and/or signs of metabolic syndrome such as abnormal cholesterol levels and high blood pressure. The skinny-but-fat had four times the prevalence of metabolic syndrome as those with less body fat, and normal-weight women with a high level of body fat had more than twice the risk of death from cardiovascular disease compared with those with a low level of body fat.

“People get so obsessed with how much they weigh and what they look like, and they think that if they are thin, then they are healthy,” Bell said. “But you can’t judge by how you look, because you can’t tell what’s on the inside by looking on the outside.”

And where your fat is turns out to be as important as—or more important than—how much of it you have. Today’s high-tech lab equipment is allowing glimpses of body fat like never before. Bell has centered much of his research on quantifying the amounts and locations of fat within the body using magnetic resonance imaging machines. This, and similar technology, has revealed that not only do people of all shapes and sizes have the pinchable or jiggly fat known as subcutaneous fat, or fat that is just under the skin, but that fat is also stored internally throughout the body.

Internal fat can be in the intra-abdominal area, from the top of your hips to the top of your liver. Within this area is a depot of visceral fat, deep within the belly. Fat can be ectopic—hidden in and around organs such as the liver and pancreas. It can also be stored in and around muscles. “The more internal body fat a person has, the more they are setting themselves up for health problems later, because internal fat is correlated with more health risks than external fat. A thin but overfat person without health problems may eventually reach a tipping point where suddenly they develop high blood pressure or Type 2 diabetes,” Bell says.

So how can you gauge whether you are too fat?

“Pinching an inch or more at the waist is a wonderful wake-up call that you may have too much fat,” says Len Kravitz, Ph.D., a professor of exercise physiology at the University of New Mexico.

Measuring waist circumference can be an indicator of the amount of fat in the torso. (Higher health risks have been shown in women with waists that are 35 inches or more and in men with waists at or larger than 40 inches.)

But a little bit of flab around the middle won’t tell your overall body fat percentage or how much internal fat you may have. “Getting measured with skin fold calipers from a trained professional in a health club, university or clinical setting is the easiest way to get an estimate of total body fat and lean mass,” Kravitz says. More precise body-composition measures include the Bod Pod, an underwater-weighing scale, or the DEXA (or DXA) scan, but they are hard to find and expensive.

The only way to get an idea of your fat distribution, or how much internal fat you have and where it is deposited, is to get an MRI, CT or DXA scan. These expensive machines aren’t usually available for those who are simply curious about their body fat. But check your local university or research hospital; you may be able to enroll in a study and get a scan performed as part of your participation.

How can you lose the internal fat?

You don’t really need to know how much internal body fat you have to reduce it. To lose it, you just need to start exercising, if you’re not already. Bell conducted a study in the journal Lipids on 17 normal-weight women, having them perform aerobic exercise three days a week for at least 30 minutes. The women did not diet. After six months, MRIs showed significant fat losses—an average 17 percent reduction in the internal fat and a 25 percent decrease in visceral fat. “Some women lost up to 60 percent of their internal fat, showing a great improvement in metabolic health,” Bell says, “yet they were all disappointed because they did not lose weight on the scale.” Bell and colleagues also measured fat in slim men who were fit and in men who were slim, but unfit and inactive. Their 2009 study, published in the International Journal of Obesity, showed that the fit men had lower levels of visceral and liver fat than the unfit men.

“Your main exercise thrust should be to do a combination of cardio exercise on most days of the week with resistance exercise on two to three days a week,” Kravitz says. And don’t get too obsessed with how much you weigh, since the scale can’t reveal the true picture of what shape your body is in.

Saturday, April 17, 2010

To Stretch or Not to Stretch Before Working Out?

it is safe to skip flexibility moves before running or taking a fitness class?
by Martica Heaner Ph.D., M.A., M.Ed.

Q. I got to serveral exercise classes where we dont't before going into the workout. Should I be concerned?

A. As long as you are warming up before you start doing vigorous or intense physical activity—and that includes strength training as well as cardio—you can safely skip a pre-workout stretch. In fact, some research suggests that you may perform better if you don’t stretch before intense or dynamic exercise. Most people tend to respond better to flexibility exercises when muscles are thoroughly warmed up anyway, so to increase flexibility, stretching at the end of a workout makes the most sense.

If skipping your pre-exercise stretches seems like surprising advise , it's because stretching before exercising is almost a ritual in some fitness disciplines. Dancers typically start off by doing “isolations” (exercises that move a joint through its normal range of motion) and long-held, deep, static stretches. Many martial arts include deep stretches before dynamic high kicks and jumps. And starting in the ’80s, the typical aerobics class format began with a few minutes of easy movements followed by deep stretches of all the major muscles. Many people believe that they will suffer injuries if they don’t stretch first. So it’s not uncommon to see people in the gym stretch before they run on the treadmill or launch into a heavy-duty workout.

But just because this approach is status quo doesn't mean it's the best way to start off a workout. In fact, research has shown that stretching, especially slow, deep, still (or static) stretches can create a pre-workout relaxation state in muscle fibers that actually inhibits their ability to contract powerfully. And if you are moving quickly (running, jumping) or powerfully (climbing, sprinting or lifting heavy weights), the last thing you need is muscle fibers that are slow to contract.

In 2007, the journal Sports Medicine published academic reviews looking at the effects of stretching on strength performance and at the research on the role of warming up and/or stretching in the prevention of injuries to muscles. Both reviews concluded that warming up was essential.

Warming up involves easy movements that take joints through their natural range of motion. So walking for five or 10 minutes is a warm-up for running. Marching in place and moving the arms and/or legs gently in different directions (doing arm raises, knee lifts, etc.) can warm up the body to do most any kind of exercise. The point of a warm-up is to increase body temperature, increase the lubrication of the joints, increase the blood flow to muscles and prime the nerves to transmit signals to muscles. A warm-up literally prepares the body to work efficiently once the intensity starts to increase: Muscles contract more easily, joints bend more smoothly, and so on.

Stretching, on the other hand, is not universally recommended. The research on whether it helps or hinders a workout—or leads to injury or prevents it—is contradictory. This is partly because of different research designs that have used a wide variety of stretches (from slow and deep to fast, dynamic stretches to contract-relax muscle maneuvers) and protocols (stretching for 10 seconds versus 90 seconds, for example).

The review on stretching before lifting weights found that strength performance could be hampered by stretching first. Other research has found that it’s better not to relax muscles with long, deep stretches just before asking them to contract with great force or intensity.

On the other hand, the review on how stretching and warming up affects injuries concluded with a recommendation that a warm-up with stretching should be performed up to 15 minutes before exercise. The authors point out that muscles work effectively when they can easily move through a joint’s normal range of motion, and that poor flexibility has been associated with higher injury risks. It’s unclear whether people who are very flexible—such as those who dance or do yoga—should emphasize maintaining a high level of flexibility or try to become even more flexible.

More research on what kinds of stretching are beneficial, how much and on which bodies needs to be conducted.

Find all articles by Martica.

Do you have a fitness or weight-loss question for Martica? Send e-mail to Please include Ask Martica in the subject line. Each of our experts responds to one question each week and the responses are posted on Mondays on MSN Health. We regret that we cannot provide a personalized response to every submission.

Martica Heaner, Ph.D., M.A., M.Ed., is a Manhattan-based exercise physiologist and nutritionist, and an award-winning fitness instructor and health writer. She has a Ph.D. in behavioral nutrition and physical activity from Columbia University, and is also a NASM-certified personal trainer. She has written hundreds of articles for publications such as Self , Health , Prevention , The New York Times and others. Martica is the author of eight books, including her latest, Cross-Training for Dummies. (Read her full bio.)

Friday, April 16, 2010

Fast-Food Dieting: Can You? Should You?

what you should know about lower-calorie menu items at fast-food restaurants.
by Martica Heaner, Ph.D., M.A., M.Ed.

Is it OK to diet by eating smarter fast-food choices?

A. As Jared of Subway-dieting fame proved, you can lose weight eating fast food. But, as Morgan Spurlock, the star and director of the 2004 documentary Super Size Me, showed, your food choices at fast-food restaurants matter. Spurlock ate nothing but fast food from McDonald’s for every meal for one month. Not only did he gain weight and grow a substantially larger belly, many indicators of his health plummeted—including a worsening of his liver function—likely due to increased fat stored in the liver from the super-high-fat diet.

Of course, that was then and this is now. Most fast-food restaurants took notice of this award-winning exposé and have started offering some low-calorie, low-fat, non-trans-fat or otherwise healthier versions of their foods.

With a little research, you can figure out which foods have fewer calories and less fat. Most every major fast-food chain now provides extensive nutritional information on their Web sites. And in some states and cities, the calorie content of products is listed on the menu boards.

Posted calorie counts can be eye-opening. For example, not many people realize that the average cookie or slice of cake at Starbucks ranges from 300 to 500 calories. Who would have thought that meeting a friend for a midday coffee drink at Starbucks and nibbling on a piece of cake can pack an extra 800 to 1,000 calories into your day? (That’s as much as a Big Mac and fries and can add up to nearly 50 percent of your calorie quota for an entire day!)

When you’re on the road and making a spontaneous food stop, Web site information won’t help, and you may not be in a city that offers detailed nutritional info. So, a helpful resource to carry with you is the book Eat This, Not That, written by the editor of Men’s Health magazine, David Zinczenko. The book contrasts the nutritional and calorie content of a variety of foods at the different major fast-food outlets and guides you to the better option.

Some chains, such as Taco Bell, are making concerted efforts to offer healthier choices, specifically items from its “Fresco” line, including a crunchy taco that contains around 92 calories, and a bean burrito that has only 213. It’s important to keep in mind, however, that these figures may not be reliable. A 2010 study in the Journal of the American Dietetic Association analyzed 39 lower-calorie fast-food items and frozen meals from supermarkets. On average, the fast-food items contained 18 percent more calories than stated on their menus (the frozen meals contained an average of 8 percent more calories). Some of the items came with free side dishes that may not have been included in the published calorie estimate, or portion sizes varied, which accounted for the caloric differences. These discrepancies were mostly within the ranges of deviation allowed by the Food and Drug Administration in packaged foods. But three of the 39 items actually had double the amount of calories stated. While the differences in calories were not found to be statistically significant, if you are closely monitoring calories and get just 50 to 100 more than you calculated, theoretically that could add up to an extra five to 10 pounds gained (or not lost) per year.

Should you diet with fast food?

There are some advantages to dieting with fast food. Mainly, it’s cheap and your portion sizes are determined for you. So it’s easier to control what and how much you eat—as long as you stick to the predetermined healthiest fast-food items.

Of course, it’s important to keep in mind that fast food is processed food. Even lower-calorie items may not have as much fiber or other nutrients as you may need. And you may also be getting a dose of preservatives, extra sodium or other undesirable ingredients with your lower-calorie choice. For example, you might miss out on many important nutrients from fruits and vegetables if you eat mostly fast-food fare. The typical vegetable offerings center on lettuce and tomato. If you’re going Mexican, you might stumble across some beans, avocado or peppers (all very nutritious). But for the most part, you are not going to be able to obtain a green, organic, high-fiber diet with these meals.

To ensure that your focus is not only on calories at the expense of nutrition, make sure that you are eating plenty of fresh fruit in addition to your fast food, always order menu items that contain beans if they are offered (high in fiber and plenty of nutrients) and ask for extra vegetables, such as tomatoes, on whatever you order. Try to supplement by eating extra veggies during your other meals.

How to diet eating fast food

You should approach a fast-food diet like any other: Aim to eat fewer calories per day than normal. General recommendations are to reduce the amount of calories that you normally eat by around 250 to 500 calories per day. Of course, this implies that you already know how many calories you take in, on average. If you don’t, read my article here to figure it out. Then take the total you normally eat, subtract 250 to 500, and use the resulting number as your calorie-intake goal while you are dieting. Choose menu items and other foods in your day that total up to this number. Remember to supplement with extra fruits and vegetables, and order beans when you can.

Also, don’t forget to exercise. It is nearly impossible to lose weight in a healthy way if you are not exercising while you do it. Regular cardio activities, such as walking or cycling, and weight lifting can help prevent you from losing muscle mass and can help you lose deep belly fat as you lose weight.

Find all articles by Martica.

Do you have a fitness or weight-loss question for Martica? Send e-mail to Please include Ask Martica in the subject line. Each of our experts responds to one question each week and the responses are posted on Mondays on MSN Health. We regret that we cannot provide a personalized response to every submission.

Martica Heaner, Ph.D., M.A., M.Ed., is a Manhattan-based exercise physiologist and nutritionist, and an award-winning fitness instructor and health writer. She has a Ph.D. in behavioral nutrition and physical activity from Columbia University, and is also a NASM-certified personal trainer. She has written hundreds of articles for publications such as Self , Health , Prevention , The New York Times and others. Martica is the author of eight books, including her latest, Cross-Training for Dummies. (Read her full bio.)

Thursday, April 15, 2010

How Bad Are Your Health Vices?

Can you ever reverse the damage of a past smoking habit or the savage tans you sported into your 30s? Here, what's forgivable, what's regrettable, and how to get healthier.

OTC Diet Pills: Forgivable
The FDA continues to recall various OTC diet pills because of health and safety concerns.
Most recently, it pulled the plug on Hydroxycut because of liver injuries (complaints ranged from jaundice and elevated liver enzymes, an indicator of potential liver injury, to liver damage requiring liver transplant). Others may contain untested active pharmaceutical ingredients, including antiseizure meds and diuretics. Yet another substance found in some products (sibutramine) can cause high blood pressure, seizures, tachycardia (rapid heartbeat), palpitations, heart attack, or stroke, or interact with other medications that patients may be taking. A few years ago, the FDA banned ephedra after 16,000 reports of adverse events revealed two deaths, four heart attacks, nine strokes, and one seizure.
If you're concerned about whether you will experience longer-lasting effects from these drugs, ask your doctor. In many cases, the chemicals leave your system quickly so there's less of a long-term damage risk. For example: "Ephedra, like most stimulants, is out of your system after 12 hours," says Shari Midoneck, MD, an internist at Weill Medical College of Cornell University.

Fasting: Forgettable
If you've ever been suckered into a weekend detox fast at one of those high-priced spas where supermodels go to slim down for Fashion Week, relax.
The effects of fasting once or twice a year won't make you ill—and you won't lose bone mass the way you might with yo-yo dieting. On the downside, despite the claims, doctors say that fasting won't rid your body of toxins or result in lasting weight loss.

Yo-Yo Dieting: Forgivable
This is generally defined as gaining and losing 10 pounds at least five times in your life.
Though there's no definite evidence that this is harmful, "some studies have suggested it may be," says Sharonne Hayes, MD, director of the Women's Heart Clinic at the Mayo Clinic. One University of Michigan study found that people with a history of yo-yo dieting had reduced blood flow to the heart; another study suggested it may also lead to decreased bone mass. The potential upshot: heart and bone problems after menopause.
However, experts aren't sure whether the yo-yoing itself is the culprit or whether extreme diets lead to nutritional deficiencies that can affect long-term health. To break the cycle, set your sights on a realistic goal and try to maintain that weight. If you must diet, "aim to lose only a pound or two a month and try not to gain 10 pounds over the winter," says Hayes. Get yearly cholesterol and blood pressure checks to detect early signs of heart disease.

Alcohol: Forgivable
First, be honest about your drinking days: Did you occasionally overdo it on weekends? Or were you a problem drinker who downed up to four drinks a night, several times a week, for an extended period?
The former is repairable, says Robert M. Swift, MD, a professor of psychiatry and human behavior at Brown University, because the major organs affected by alcohol—the brain, liver, and pancreas—are fairly resilient. Moderate amounts, about one drink a day for women, may even prevent heart disease and certain cancers and could make you live longer. However, if you put yourself in the latter category, ask your primary care doctor for an ALT (alanine transaminase/aminotransferase) test, which detects liver damage. And make sure you watch your waistline. Scientific research has found that more than four drinks a day predisposes you to belly fat, which can increase your risk of heart disease; the same amount of alcohol can put you at risk of stroke.
Also, be sure to get an annual mammogram. In a study by researchers at the Fred Hutchinson Cancer Research Center in Seattle, older women who had consumed two or more drinks a day for 20 years—and were still drinking—had 3 times the risk of getting hormonally sensitive breast cancer than did abstainers. Finally, drinkers should know that one study found that just two drinks a week can raise the risk of certain types of cataracts by 13%, so visit an ophthalmologist every year.

Fast Food: Forgivable
Studies show that just hours after you've eaten a typical fast-food lunch, fat globules start to obstruct your blood vessels. Continued consumption of these unhealthy meals can trigger heart problems, obesity, and diabetes.
That's not to say that if you enjoyed regular drive-thru meals when your kids were young, you should check in to the hospital now. Much of the damage from a poor diet can be undone. "A general rule: As long as it took for you to get to an unhealthy state, that's about how long it takes to become disease free," says Merz. Research suggests that taking 1,200 IU of vitamin E and 500 mg of vitamin C before an unhealthy meal can help your heart by alleviating fat-induced inflammation. Over the long run, following either a low-fat vegetarian regimen or a Mediterranean diet that's rich in healthy fats, whole grains, and vegetables has been shown to reverse heart disease risk. Getting 30 minutes of aerobic exercise at least three times a week works, too.
"Women who eat a fast-food diet tend to miss out on calcium, which helps build healthy bones, because they don't drink milk," says Judith S. Stern, ScD, RD, a professor of nutrition and internal medicine at the University of California, Davis. Premenopausal women should be vigilant about getting 1,000 mg of calcium per day; older women need 1,200 mg. Weight-bearing exercise, such as walking, hiking, or lifting weights, also boosts bone density, and is a must for former junk-food junkies.

Loud Concerts: Regrettable
If you spent college weekends swaying to live Grateful Dead jams, don't blame your ringing ears and hearing loss on age.
One-third of the 28 million Americans with hearing loss can attribute the problem to noise exposure, according to the National Institute on Deafness and Other Communication Disorders. Loud sounds destroy the ear's sensory nerve cells, sometimes so gradually that you don't even notice it. Although you can't repair this damage, you can preserve what you have left. The golden rule: "If you're in a noisy room where you have to raise your voice to be heard by someone 3 feet away, then it's too loud," says Greg Flamme, PhD, an assistant professor in the department of speech pathology and audiology at Western Michigan University. Also, play your iPod on the lowest volume that's audible to protect against further damage. And if you return to the concert arena or climb onto the back of a roaring motorcycle, please do so sporting protective earmuffs or musicians' earplugs.

Sunburns: Regrettable
Although dermatologists know that ultraviolet (UV) radiation alters DNA, which can eventually cause cancer, they don't know how much UV exposure it takes to cause DNA damage.
They also can't say for sure who will get cancer, or how soon after a blistering burn cancer could develop. All the more reason for former sun worshippers to follow this four-point plan: 1) See a dermatologist every year for a skin cancer screening. 2) Wear SPF 15 sunscreen every day; use 30-plus when spending time outside. 3) Avoid being outdoors between 10 AM and 4 PM. 4) Try to cover yourself with a long-sleeved shirt, pants, and a broad-rimmed hat if you must be in the sun.

Too Much Coffee: Forgettable
Don't worry too much if you can't stop jonesing for java.
"There's no proven link between caffeine and heart disease or cancer as long as you stay under six cups of coffee per day," says C. Noel Bairey Merz, MD, director of the preventive and rehabilitative cardiac center at Cedars-Sinai Medical Center in Los Angeles. Even better, long-term coffee consumption may reduce your risk of type 2 diabetes. And an alkaloid in coffee may prevent cavities. However, more than 300 mg of caffeine a day combined with insufficient calcium could contribute to bone loss, so coffee, tea, and cola drinkers should compensate with a calcium supplement. The final word on caffeine from one bone-health and nutrition expert: "Stick to two cups a day, and add milk for the calcium," advises Jasminka Ilich-Ernst, PhD, an associate professor of nutrition at Florida State University.

Pot: Regrettable
Sorry, Cheech, but scientists have determined that this habit is as unwholesome as tobacco.
"We used to think that marijuana was safe, but it contains many of the same cancer-producing chemicals as cigarette smoke and has the same health-harming effects," says Diane Stover, MD, chief of pulmonary service at Memorial Sloan-Kettering Cancer Center in New York City. Ex-tokers would be wise to follow the same advice given above for ex-smokers.

Cigarettes: Regrettable
By Daryl Chen, Prevention
Lung cancer is the leading cause of cancer death in women. It turns out that the 4,000 chemicals in tobacco appear to be even more lethal when ingested by women than by men.

Lung damage from emphysema or bronchitis can't be reversed, but your cardiovascular system can bounce back. "Within 24 hours of stopping smoking, there is improvement in the function of the blood vessels. After 1 year, there's a 50% reduction in the risk of having a heart attack," says Sharonne Hayes, MD, director of the Women's Heart Clinic at the Mayo Clinic in Rochester, MN. Thirty minutes of exercise a day will speed the return to normal heart function.

Although everyone should eat at least 5 to 7 servings of fruits and vegetables a day, ex-smokers should consider making one or two of those servings strawberries or black or red raspberries, which may prevent the onset of esophageal cancer, according to research at Ohio State University. Getting one to two times the daily value of folate (found in whole grains and greens) and B12 (in meat and dairy products) can reduce cell damage that may lead to cancer.

Wednesday, April 14, 2010

How Nutritionists Eat Fast Food

Find out what dietitians and other food experts eat when they're on the go.

Cold Stone Creamery: Sinless Cake Batter with Fudge
“Cold Stone Creamery is famous for its Cake Batter ice cream flavor because it’s just like licking batter from the bowl,” says Krieg, who oversees new flavor development for the ice cream chain. But the “Sinless” option saves you about half the calories and 95% less fat per serving. “In terms of dessert, I always feel less guilty about treating myself to ice cream compared to other sweets because I know it also provides an extra serving of calcium,” Krieg says.
Nutrition info: 230 cal, 8 g pro, 52 g carbs, 0 g fiber, 2 g fat, 1 g sat fat, 0 mg chol, 230 mg sodium

Subway: Roasted Chicken Sandwich
Subway’s dietitian Lanette Kovachi, R.D., has advised the company on nutrition info for the last 8 years—so we were very curious for her take on how to build a healthy, tasty sammie. Her secret: Mound it with all the fresh veggies—doing so provides 2 full servings. Kovachi orders the 6-inch oven-roasted chicken on 9-grain bread (one of the more fiber-filled options) with water and baked potato chips. “I love the way this tastes, plus it fills me up,” she says.
Nutrition info (for sandwich and chips): 382 cal, 25 g protein, 79 g carbs, 8 g fiber, 7 g fat, 1 g sat fat, 25 mg chol, 1,180 mg sodium.

Samurai Sam’s: Teriyaki Chicken Bowl
“There are so many healthy options at Samurai Sam’s to choose from,” says Krieg. “My favorite is the regular Teriyaki Bowl with white meat chicken. The grilled chicken provides an excellent source of protein, while the brown rice has more fiber than white rice and the fresh steamed vegetables round out the meal."
Nutrition info: 470 cal, 36 g protein, 68 g carbs, 5 g fiber, 5 g fat, 1.5 g sat fat, 80 mg chol, 520 mg sodium

Great Steak: Chicken Philly Slider
“These new little Philly Sliders are perfect for people looking to save calories and dollars,” says Krieg, who helps plan the menu of the Great Steak chain. “I like to share them with a friend over lunch along with a salad.” The mini offerings provide healthier, realistic portion sizes. “I’m always on the lookout for ‘little’ serving sizes when I’m eating out,” she says.
Nutrition info (for 1/2 slider and 1/2 salad with ranch dressing): 415 cal, 21 g pro, 31 g carbs, 4.5 g fiber, 22.5 g fat, 7 g sat fat, 53 mg chol, 980 mg sodium

TacoTime: Soft Chicken Taco
“So often when people think of Mexican food, they don’t think healthy,” says Krieg, TacoTime’s nutrition expert. “But here we focus on fresh, quality ingredients, so there are several options for anyone looking for lighter menu items. My favorite is the Soft Chicken Taco.” Swapping the typical fried taco shell for the soft cuts calories and fat, “but it’s still filled with seasoned chicken, lettuce, salsa fresca, and cheddar cheese, so you get all the flavor of a classic taco along with some lean protein, vegetables, and fiber."
Nutrition info: 360 cal, 28 g pro, 40 g carbs, 7 g fiber, 9 g fat, 4.5 g sat fat, 50 mg chol, 860 mg sodium

McDonald’s: Premium Southwest Salad with Grilled Chicken
“Each of our salads provides about 3 cups of greens, so I’m getting a great veggie serving,” says Cindy Goody, Ph.D., R.D., director of nutrition for McDonald’s USA. “I like that it gives me protein from the grilled chicken and beans, plus a variety of vegetables like corn, tomatoes, and chiles.”She uses half of the Southwest dressing packet, which shaves 50 calories off her meal, and her beverage of choice is a small Diet Coke.

Nutrition info (for salad, full dressing packet, and soda): 420 cal, 31 g protein, 41 g carbs, 6 g fiber, 15 g fat, 4 g sat fat, 90 mg chol, 1,320 mg sodium

See 25 mouthwatering salads you can make at home.

Ranch 1: Teriyaki Grilled Chicken Sandwich
“This new sandwich is one of the lower-calorie options on the Ranch 1 menu,” says Krieg, who also oversees the nutrition and menu for this chicken-focused chain. “But just because it’s low-cal does not mean it’s low in taste—I love how the teriyaki sauce and grilled pineapple complement each other. Plus the grilled chicken breast provides a good source of lean protein.”
Nutrition info: 400 cal, 30 g pro, 56 g carbs, 2 g fiber, 7 g fat, 1.5 g sat fat, 70 mg chol, 980 mg sodium

Panera Bread: Black Bean Soup & Mediterranean Veggie Sandwich
“I always do a ‘You Pick Two,’ which is any two of the following: a half sandwich, a half salad, or a soup,” says Scott Davis, chief concept officer and senior vice president at Panera Bread, who lost 60 pounds last year “pretty much by eating Panera.”
He likes to get the Low-Fat Vegetarian Black Bean soup (a spicy vegetarian broth with onion, red bell pepper, cilantro, garlic, and cumin) with the Mediterranean Veggie Sandwich on tomato basil bread (sweet piquante peppers, feta cheese, cucumbers, lettuce, tomatoes, red onions, and cilantro jalapeño hummus).
“It’s the right combination of carbs, protein, and fiber to keep me going all day,” says Davis, who washes down his meal with an unsweetened iced tea.

Blimpie: Turkey and Provolone Sandwich
"This sandwich on wheat bread is a great lower-calorie lunch option any day of the week,” says Nola Krieg, research and development chef for Kahala Corp., which runs Blimpie and other national chains (more on those later). “The turkey meat is sliced in front of you so you know it’s quality, fresh meat—a good source of protein. The sandwich also comes with lettuce, tomatoes, and onions, and I always think it’s a good idea to pile your favorite veggies on any sandwich.”
Her favorite trick for kicking up flavor: Extra pickles, which add taste without a bunch of fat or calories.
Nutrition info: 380 cal, 27 g pro, 45 g carbs, 6 g fiber, 10 g fat, 4.5 g sat fat, 45 mg chol, 1,950 mg sodium

Burger King: BK Veggie Burger
"I typically order the BK Veggie Burger, but I hold the mayo,” says Stephanie Quirantes, R.D., the nutrition and health manager for Burger King Corp., North America. For a side and beverage, she has the Fresh Apple Fries and either fat-free milk or water. “This gives me four of the main food groups—grains, protein, fruit, and dairy.”
Nutrition info (for burger, apple fries, and milk): 465 cal, 32 g pro, 66 g carbs, 8 g fiber, 8 g fat, 1 g sat fat, 5 mg chol, 1,180 mg sodium

By Lauren Gelman, Prevention
We all know it’s healthier to skip the drive-thru, but everyone eventually finds themselves at a roadside rest stop or caves into a late-night french-fry craving. The trick is making the best meal choice you can.
So we turned to the nutrition experts who created the menus for our favorite fast food joints to find out what healthy meals they order when they eat on the job.
Note: Most of the foods that follow are pretty good in terms of calories and fat, but they’re still loaded with sodium. Most adults should have less than 2,300 mg daily, and many of these meals provide half that amount or more!

Tuesday, April 13, 2010

Remedies for Incontinence

Substitute Cranberry Juice
Cranberry juice is key to bladder health because its acidity helps prevent urinary tract infections, a common problem to people who live with many forms of incontinence. Cranberry juice also helps deodorize the urinary tract, making accidents a little less noticeable.
It's a good idea to empty your bladder on a regular basis, Dr. Jeter says. For example, don't sit at the dinner table and hold it until dinner's over. Holding too long may lead to bladder infection and an overstretched bladder. Also, if you have a too-full bladder and a weak sphincter muscle, she says, you're likely to leak when you cough, sneeze, or laugh. Your best bet is to empty your bladder before and after meals, and at bedtime.
Slide show content includes excerpts from The Doctors Book of Home Remedies (Rodale, 2003).
Panel of Advisors
Cheryle Gartley is the founder and president of the Simon Foundation for Continence in Wilmette, Illinois.
Katherine Jeter, Ed.D., is founder of the National Association for Continence in Spartanburg, South Carolina.
Joseph Montella, M.D., is director of urogynecology and an associate professor of obstetrics and gynecology at Jefferson Medical College of Thomas Jefferson University in Philadelphia.
Abraham N. Morse, M.D., is an assistant professor of urogynecology at the University of Massachusetts Medical School in Worcester.
Neil Resnick, M.D., is a professor of medicine and chief of the division of geriatric medicine at the University of Pittsburgh Medical Center.
Robert Schlesinger, M.D., was formerly a urologist at Faulkner Hospital in Jamaica Plain, Massachusetts.

Stay Loose
Constipation can contribute to incontinence. So eat a high-fiber diet, and be sure to drink adequate amounts of fluid. One incontinence clinic's prescription is daily helpings of popcorn!

Buy Special Supplies
There are several brands of absorbent underpants, pads, and shields. The products absorb 50 to 500 times their weight in water, neutralize odor, and conceal fluid to prevent leakage. The kind you need depends on your individual anatomy and the kind and degree of incontinence you have. It's understandable if you're embarrassed to buy them. Find an understanding pharmacist and ask to have your purchase waiting for you when you arrive, or purchase them online and have them delivered to your door.

Don't Smoke
Nicotine and other chemicals in tobacco smoke can irritate the bladder, says Dr. Montella. "People who smoke may have chronic irritation that can lead to an overactive bladder," he explains.
Also, if you have stress incontinence, coughing can trigger leaking.

Go Easy on Fluids
Your bladder diary may reveal that you've been downing gallons of water a day, Dr. Jeter says. "Usually, it's because a person is on a diet that requires forcing liquids. If you drink a little less, your incontinence problem should ease up."
Take note of the timing, too. It's better to sip water throughout the day rather than pouring it down all at once. And it's especially important to stop drinking water within 3 to 4 hours of going to bed, especially if you get up several times during the night to go to the bathroom, adds Joseph Montella, M.D.
But Not Too Easy
Cutting your fluid intake to below-normal levels without your doctor's approval can lead to dehydration, worsening urinary problems and possibly causing serious illness. Doctors usually advise people to drink eight glasses of water daily to prevent dehydration.

Reduce the Tension in Your Life
"Whenever you're anxious or depressed, your body sensations are magnified in a negative way," says Dr. Morse. "If you're anxious to begin with, feeling as though you have to rush to the bathroom is one more thing that can put you over the edge."
Take a hint from your bladder and unwind. Give yourself an hour each day to do something that's just for you, like taking a long walk, watching some television, or going to a movie or museum.
Another strategy for sudden urges is to "breathe deeply, calm yourself down, and have confidence that you're not going to make a mess," says Dr. Morse. If you can calm yourself for 30 to 60 seconds, there's a good chance the urge will go away, he explains.
"The idea is to get control over your bladder, rather than having a panic situation," adds Dr. Montella. "Wait until you're calm, then go to the bathroom."

Lose Excess Weight
Foundation president Cheryle Gartley says that letters from patients seen at the Simon Foundation for Continence in Wilmette, Illinois, show people who lose even a few pounds can reduce incidents of incontinence.

Do Special Exercises
Kegel exercises were developed in the late 1940s by Arnold Kegel, M.D., to help women with stress incontinence during and after pregnancy. The experts say that these exercises reduce and may even prevent some forms of incontinence in both sexes and at all ages. Here are the guidelines from the National Association for Continence.
  1. Without tensing the muscles of your legs, buttocks, or abdomen, imagine that you're trying to hold back a bowel movement by tightening the ring of muscles (the sphincter) around the anus. This exercise identifies the back part of the pelvic muscles.
  2. When you're urinating, try to stop the flow, and then restart it. This identifies the front part of the pelvic muscles. (For women: Imagine you're trying to grip a slipping tampon.)
  3. You're now ready for the complete exercise. Working from back to front, tighten the muscles while counting to four slowly, then release. Do this for 2 minutes, at least three times a day—that's at least 100 repetitions.

Avoid Caffeine
Caffeine is another well-known diuretic. Caffeine also irritates the bladder and stimulates muscle contractions, which can aggravate the symptoms of urge incontinence, explains Abraham N. Morse, M.D.
Caffeine is found in beverages, but also in foods such as chocolate and in medications such as Excedrin. Doctors advise limiting caffeine intake to no more than 200 milligrams daily, about the amount in 12 ounces of coffee. Your diary will help you notice whether you're getting too much.
Switching to decaffeinated coffee or to tea will help, but it may not eliminate the problem, Dr. Morse adds. Other substances in coffee and tea also act as bladder irritants.

Urinary incontinence is a symptom, not a disease.
"The vast majority of people with mild to moderate symptoms do not have to rush off to see a doctor. Give yourself 3 months to see if lifestyle measures work," says Abraham N. Morse, M.D.
Other symptoms—painful urination, for example, incontinence that accompanies painful intercourse, or urine that's cloudy or tinged with blood—are signs that it's time to call a doctor right away. Urinary tract infections or even tumors can cause the bladder to go into overdrive.
You should also call a doctor if you're having large "accidents" rather than small leaks. Or if accidents are accompanied by numbness or weakness in your arms or legs, vision changes, or a change in bowel habits. These symptoms may be a sign of nerve damage or other neurological problems, such as Parkinson's disease.

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