Tuesday, May 31, 2016

“How do I get Summer Sleek, Stat?”

I take care of patients with a wide variety of lifestyles, backgrounds, ages, challenges and careers. One of my rather humorous patients, who also happens to be a physician, asked me “How do I get summer sleek, stat?”  Pretty funny, and here in New England we want to make the most of every summer minute, whether we want to hike the White Mountains, kayak the cool lakes, swim in the brisk ocean, our just relax on the beach!  We want to be fit and “sleek”, and healthy at the same time.

The first step to get back on track quickly, if we’ve slipped off our healthy routine, is to preplan and SIMPLIFY our food and exercise as much as possible.  We need basic, smart strategies, based on research, which also fit into our lives in a realistic way.  I wrote about this last year: http://healthyweightcenter.blogspot.com/2015/08/lose-weight-fast-and-safely-strategy-to.html
The National Weight Control registry is a great resource which gives us insight into what works well for long term successful weight control:  http://healthyweightcenter.blogspot.com/2016/02/how-do-i-lose-weight-and-keep-it-off.html?q=national+weight+control+registry

Simplifying our decisions can help decrease our stress, give us time to breath and think, and relax a bit.  http://healthyweightcenter.blogspot.com/2014/10/decision-fatigue-make-choices-easier.html

The good news is that the season is here for Farmer’s Markets and CSA’S - so lots of local produce to freshen up our food routines:  http://seacoasteatlocal.org/find-local-food/csas/

But healthy produce alone is not enough to obtain sustainable weight loss.  We need protein and healthy fats along with our great fruits and vegetables and grains - and for long term health we also need healthy exercise (not too much, not too little.)  Finding the “sweet spot” can be a challenge - and we can help you set up a plan that fits your life and needs.  This takes some time and planning, and we help patients set up their plans every day, in person at our clinic, or on the phone or via virtual visits:  healthyweightcenter.com  

We want to not only get on track quickly, we also want to set ourselves up for long term success. http://link.springer.com/article/10.1007/s12529-010-9092-y “Fast weight losers obtained greater weight reduction and long-term maintenance, and were not more susceptible to weight regain than gradual weight losers."  

This can be done through regular grocery store or farmer's market foods, with careful planning to ensure the proper calories, protein, carbohydrates and fats, for your needs.       Studies have shown more rapid weight loss success with medical meal replacements. http://www.ncbi.nlm.nih.gov/pubmed/12704397

Our patients have really enjoyed getting on track quickly with the “Rapid Reboot Fast Track”. Research has shown that protein can help accelerate our weight loss, when eaten in the proper amounts, at proper times, as part of a complete healthy food plan.  We help people set up easier healthy lifestyles at the office, or you can start at home on your own:  http://seacoastnutrition.com/phase-one-2-week-quot-fast-trackquot-pla2.html

Is weight loss sustainable when we lose weight relatively quickly?  It depends on HOW you do it, and how quickly. http://healthyweightcenter.blogspot.com/2015/08/lose-weight-fast-and-safely-strategy-to.html Some people were worried recently when they heard that people on the Biggest Loser television show regained much of the weight they lost, and had slower metabolic rates. Experts explain that extreme, unsustainable lifestyles, and imbalanced diets could lead to problems - whlle properly planned approaches can lead to success. Some responses by experts:

Dr. Yoni Freedhoff: "The term I coined to describe it is "best weight," where your best weight is whatever weight you reach when you're living the healthiest life that you actually enjoy...If you want to succeed with long-term weight loss, it's crucial that you embrace both reality and imperfection." http://www.vox.com/2016/5/10/11649210/biggest-loser-weight-loss"

Another interesting article from a "colorful" author (great research links, but occasional colorful language - caution for the sensitive!) http://ca.askmen.com/sports/bodybuilding/how-weight-loss-affects-metabolism-2.html

The balance of protein, fats, and carbohydrate we eat may be as important as the calories we eat: http://jama.jamanetwork.com/article.aspx?articleid=1199154

When paired with exercise which meets your fitness and health needs, plus lifestyle strategies, healthy sleep, stress management, and something called “CBT”  (cognitive behavioral therapy) techniques, you really can become “summer sleek stat” - and stay sleek year round!  

Read more about our program:  Healthyweightcenter.com

Call anytime!  (603) 379-6500

Thursday, May 26, 2016

“The Perfect Storm: Nature Plus Nurture, Genes, Addictive Foods and our Obesogenic World”

“Doctor, why do so many people struggle with excess weight these days?”  I hear this question frequently, and people are often looking for a single, simple answer.  Wouldn't it be nice if things were so simple? No surprise, reality is a bit more complicated.  In fact, it is quite complex!  But to simplify as much as possible, I tell people that weight is the result of our genes, plus our environment.  “Nature plus Nurture.”  Our biology, and the world in which we live. And research now highlights that we are living in “the perfect storm” for weight gain - exposed constantly to tempting calorie-dense foods,  high-stress lives, sleep deprivation, often sedentary lifestyles, and more.  Our current world sets us up for trouble.  Experts often say “genes load the gun, and the environment pulls the trigger.”

Many people feel guilty and ashamed  if they have trouble controlling their intake of high-calorie, fatty, carby/starchy/sweet foods.  These addictive, super-tasty foods are called  “hyperpalatable foods” in research - and for good reason!  Some of us are neurologically “wired” so that our brains “go crazy” when exposed to these foods.  This can create a feedback loop which makes us feel out of control. https://www.researchgate.net/publication/51722471_The_Addiction_Potential_of_Hyperpalatable_Foods  

If you are “wired” to feel a strong desire to eat when faced with tempting, tasty food, you face a real challenge in our modern world, where we are bombarded with “addictive foods” everywhere - on tv, at gas stations, shopping centers,  at work, sometimes at school - and sometimes even in our own homes!  Research has shown that certain foods can create an “addictive response” in the brain chemistry - and this response can happen by simply SEEING the foods, or thinking about them - even if we dont’ eat them!  Our modern world is the “perfect storm” to lead to excess weight gain and poor health.  Researchers call the modern environment “obesogenic” -  it leads to excess eating of foods high in fat, carbs, and dense in calories, that can create inflammation throughout our bodies, and our appetite centers in our brains (causing them to malfunction, and not register “fullness” appropriately.)  Inflammation is tied to metabolic syndrome, belly fat gain, prediabetes, diabetes, cancer risk, and more health risk.  

Some of us have inherited genes (and have had these genes activated, sometimes even before we are born)  which create an extremely strong neurologic reaction - a powerful biological urge - to eat these hyperpalatable foods, while other people simply do not have the same brain response.  Those who aren’t wired this way do not have the same cravings, or the same “drive” to eat fatty/carby/starchy/sweet foods. Neurologically they have it easy -   they  don’t experience the same “urge” to eat  in excess. They can walk right past a box of donuts and not really care whether they pick one up or not.   And if they do decide to pick on up, they can easily “stop at one bite”, almost effortlessly.  And here is the frustrating thing - trying to explain what cravings feel like, to those who don’t have them, is like trying to explain “color” to someone who is colorblind!  They just don’t “get” it.  I suppose we can’t really blame them, though, can we?   It is hard for anyone to understand what someone else is experiencing (empathy is tough!)  It’s not their fault - or their willpower - that allows them to easily control their eating.  It’s just neurobiology (and a new field of science called “epigenetics”.)  But here is the thing - we don’t have to blame them, but we do have to “protect ourselves” from well-intentioned - but misguided and uneducated - comments and actions that can sabotage our efforts to eat and live healthfully.   When they are critical and offer “helpful advice”, they generally “don’t know what they don’t know.”  When they say silly things like “you should be able to keep ice cream  in the house, but just don’t eat it”, or “you can eat a piece of coffee cake, just stop at one small piece”, you need to recognize that they don’t understand the biology, the neurochemistry - or the psychology behind what they are saying.  Never feel guilty for being wired to love food.  It is what it is, as they say, and the good news is that we can control our cravings and food drive by setting up our lives so they are not constantly seeing/smelling/thinking about hyperpalatable food.  And more good news - even if we can’t completely create a healthy environment, can’t remove all addictive food triggers, there are still things we can do to make our world a “safer, easier place” to be healthy!  And sometimes we can even educate those around us, so they can help, rather than harm, our efforts to be healthy.

It is absolutely CRITICAL for success, to clear out the “junk” triggers from your environment as much as possible - get the fatty, carby, starchy, sweet stuff OUT of the house, OUT of the work environment, etc, as much as possible.  And if the “trigger” addictive foods cannot be removed completely, at the very least “hide” them away, out of sight, out of reach.  If the junk isn’t there - you can’t eat it!  If the junk is hard to reach, you’ll be less likely to fall victim to it.  And if you can’t see it, it won’t trigger brain chemical surges and cravings (research shows that simply THINKING about junk food can cause your neurochemicals to spike out of control.)

Family, friends, co-workers and others can inadvertently sabotage your success by bringing trigger foods into your environment.  If they don’t have the “wiring” to eat addictive foods in excess, they often don’t understand how much they are contributing to the problem. They don’t understand the biology, the neurochemistry, and since they don’t feel the addictive response/cravings themselves, they can have a hard time understanding what it feels like in others.   Even parents can accidently set their children up to “fail”, when they do not understand that they have to remove “addictive food” from the home.  Parents (and others) can help contribute to success by removing triggers, and replacing them with healthy, tasty, simple options.  Human nature is such that we will naturally “go to” what is easiest, tastiest, and most fun.  Rather than fight human nature, we have to honor and accept it - and set our lives (and homes) up for success.  We need to make the HEALTHY options the EASY options, in order to succeed!  We need to make the UNHEALTHY options less available  - out of sight, out of mouth, as they say.

They same goes for healthy activity.  If you have to spend an hour getting ready for and driving to a gym, you are less likely to do it.  You are more likely to do an activity when it is simple to get to, simple to do, kind of fun, and not stressful!  

The bottom line is that it is important to know yourself - your own past experiences with eating and exercise - and use these NOT to feel guilty, but instead to SUCCEED.  Make it HARD to get to unhealthy food, and make it EASY to get to the “good stuff”!  Surround yourself- at eye level - with healthy choices, and get unheatlhy options out of the house (or at least out of sight.)  If you watch cooking shows, make sure it is only those featuring HEALTHY recipes.  Ask your friends/family/coworkers to help your efforts by offering ONLY healthy options to you - and if you must, tell them that offering you “treats” is like offering alcohol to an alcoholic.  It’s not “nice” to do that, it is really mean.  Tell them if they want to be nice, and “treat you”, they can help you make healthy snacks and meals.  They can go to the farmer’s market with you.  They can offer to go with a walk with you on a local trail or beach, or bike, or do something else active and fun!  Ask them to offer positive options, and if they wouldn’t mind, keep the critical comments to themselves, since research shows that criticism leads to MORE weight gain!  Smile and say, “It’s all about the science  - and thanks, I appreciate your help!”  

If you would like help setting up your own personal environment so it is "safe for healthy living" - give us a call any time! Our goals are to help people establish simple, realistic, healthful lifestyles which make it easier to make healthy choices every day. Read more about our program: healthyweightcenter.com Call any time: (603) 379-6500.


https://www.researchgate.net/publication/51722471_The_Addiction_Potential_of_Hyperpalatable_Foods The Addiction Potential of Hyperpalatable Foods,  by Gearhardt, Davis, Kuschner, Brownell
Yale University, New Haven, Connecticut 06511, USA.
Current Drug Abuse Reviews 09/2011; 4(3):140-5. DOI: 10.2174/1874473711104030140
Source: PubMed

"A little acceptance is good for your health: Interpersonal messages and weight change over time"  http://onlinelibrary.wiley.com/doi/10.1111/pere.12050/abstract


Tuesday, May 3, 2016

Research: Exercise "Bursts" During the Day Improve ADHD, Asthma, Health, Fitness - a Little Exercise Gives You A Lot

New Research on Exercise:  A Little Can Give You a Lot

Can short "bursts" of activity during the school day really make a difference in children's health?  Once again research shows the answer is YES.  When it comes to adults, the answer is yes as well.  Thanks to Dr. David Katz once again for sharing great research!  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901580/

The research points out that sadly, childhood fitness has been declining, despite the previously documented, wide-ranging benefits of healthy exercise for children.  There have been calls for school exercise programs extending back many decades -  I recently came across a speech given by JFK in 1960 promoting the necessity of childhood fitness as a national security concern:


Prophetic words from 1960:
"For physical fitness is not only one of the most important keys to a healthy body; it is the basis of dynamic and creative intellectual activity. The relationship between the soundness of the body and the activities of the mind is subtle and complex. Much is not yet understood. But we do know what the Greeks knew: that intelligence and skill can only function at the peak of their capacity when the
body is healthy and strong; that hardy spirits and tough minds usually inhabit sound bodies.
In this sense, physical fitness is the basis of all the activities of our society. And if our bodies grow soft and inactive, if we fail to encourage physical development and prowess, we will undermine our capacity for thought, for work and for the use of those skills vital to an expanding and complex America."

The new research tested a program called ABC (Activity Bursts in the Classroom) for Fitness, a strategy which uses short, structured activity breaks throughout the school day, led by classroom teachers.  The results are impressive:  fitness improved in children's strength (upper body and core abdominal strength in particular.)  Even more impressive - asthma and ADHD improved so much that medication use declined!

So what exactly were they doing?  From the article:  "ABC for Fitness aims to provide fun and creative activities that are noncompetitive, age-appropriate, and gender-neutral to promote an interest in physical activity among children and increase their behavioral capacity.... The program was flexible; activity intensity could be raised or lowered according to the athletic abilities and attention spans of the students. The program was intended as a supplement to physical education programs. Ideally, the activity bursts added at least 30 minutes of daily physical activity."

The sessions had three parts:  1) warmup with light aerobic activity such as walking, arm circles, stretching; 2) strength-building activities such as squats, lunges, dancing; 3) cool-down similar to the warmup, with lower intensity activity and stretches.
The number of sessions per day, length of sessions, and types of activities varied based on the teachers' and students' needs and choices.  Teachers also had options to incorporate the activities to promote learning in other topics, such as science, math, health, social studies, music, and language arts.   Families and parents were also included in the program, helping families to be more active together.   You can access the teaching materials here:  http://www.davidkatzmd.com/abcforfitness.aspx
Can short bursts of activity help adults as well?  The answer is also yes!  
"43 percent of people who participated in bouts of 10 minutes or less of physical activity multiple times during the day — the so-called "active lifestyle" approach — met federal guidelines for being active... also they fared as well as people who exercised for longer stretches in key measures of health, such as C-reactive protein, blood pressure, HDL cholesterol, waist circumference and metabolic syndrome." Link to the reserch article:  http://ajhpcontents.org/doi/abs/10.4278/ajhp.110916-QUAN-348  "THE SCIENCE OF LIFESTYLE CHANGE: Association Between Biologic Outcomes and Objectively Measured Physical Activity Accumulated in ≥10-Minute Bouts and <10-Minute Bouts".
Of course exercise is just one component of health, and healthy weight control.  You can read my prior blog on the 6 M's of Exercise:  http://healthyweightcenter.blogspot.com/2015/02/the-6-ms-of-exercise-health-and-weight.html  Healthy nutrition, and healthy lifestyle including quality sleep, stress management, and life planning and organizing (and SIMPLIFYING), are key components of a healthy, happy life.  If you would like some help setting up a great routine - and some support and accountability to stay on track - call us any time:  (603) 379-6500.  Read more about our program at healthyweightcenter.com