Timi Gustafson, R.D.

Helping people to live healthy and fulfilling lives.

How Can Education Make You Live Longer? It’s Complicated

April 4th, 2012 at 4:39 pm by timigustafson
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The average life expectancy of all Americans has continuously increased over the past few generations for a number of reasons, including advances in nutrition, hygiene and medical care. But there are significant disparities within the population, which seem to be linked to social, economic and – as it turns out – educational differences.

According to a new study by the University of Wisconsin Population Health Institute, sponsored by the Robert Wood Johnson Foundation, there could be a direct correlation between a person’s education and the number of years he or she can hope to live.

For this study, researchers analyzed over 3,000 counties nationwide and ranked them within their respective states by a number of diverse measures, including access to quality healthcare, obesity rates, tobacco sales, unemployment, environmental pollution, crime rates, even the density of fast food outlets. The significance of education levels stood out.

“If you have a community with a high number of high school dropouts, with a high unemployment rate and with children living in poverty, you can absolutely predict that poor health outcomes will be coming down the road,” said Dr. Pat Remington, associate dean at the University of Wisconsin School of Medicine and Public Health and director of the study.

Unemployment and poverty do not only lead to deprivation of essential resources such as good nutrition and basic health care but often also to self-destructive behaviors like smoking and alcohol- and drug abuse. “All these things are part of a web of health,” Dr. Remington added.

The Wisconsin study is not the first that has found a link between education and longevity. A study from Harvard University, published in 2008, described “a stunning correlation between the longer lifespan of people with at least one year of college compared to people with a high school education or less,” according to Dr. David Cutler, dean of social sciences at Harvard. Better educated adults gained on average 1.5 years of life expectancy over 10 years and an additional 1.6 years over 20 years compared to those with a high school diploma or less.

Going to college by itself, of course, does not automatically make you live longer. But the study does suggest that better education often leads to better lifestyle choices. “It turns out that across the board, if you look at any health behavior, better educated people do better than less educated, said Dr. Cutler. “Anything from smoking, obesity, wearing seat belts, having a smoke detector in your house, not using illegal drugs, not drinking heavily, better educated people do better,” he said.

Conversely, the average life expectancy of obese people, smokers and those without access to preventive health care has begun to plateau. Due to growing childhood obesity, some experts predict that the lifespan of significant parts of the population will likely decline in the future.

Needless to say that none of these findings are clear-cut. There are plenty of folks with PhDs and beyond who are overweight and smoke and drink heavily. “Sometimes, even a good education can’t keep smart people from doing dumb things,” said Lee Dye, a science writer for the Los Angeles Times who reported on the Harvard study.

And even centenarians have bad habits. Researchers at the Albert Einstein College of Medicine found that the 100 plus crowd does generally not adhere to dramatically healthier lifestyle choices than the rest of us. There seems to be no particular formula that allows some people to live exceptionally long lives. Even genetic factors have turned out to be less important than some have suggested, as demonstrated in studies that followed identical twins who were separated at birth, lived under vastly different circumstances and died at different ages.

Besides reasonably healthy diet and lifestyle choices, one thing, however, seems to matter greatly. People who remain free of debilitating illnesses at old age, physically as well as mentally, are typically very active. They enjoy a vibrant social life, pursue multiple interests, maintain a positive attitude and know how to take care of their needs. They may be well educated, but not always in terms of formal education. An open mind and an insatiable curiosity may have gotten them just as far.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Weight Loss Surgery for Diabetes Patients – A Problematic Choice

April 1st, 2012 at 3:19 pm by timigustafson
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With obesity rates in the United States and around the world continuously rising, surgery for weight loss is becoming an ever more acceptable option. Now, two clinical studies suggest that diabetics can benefit from operations as well. Type 2 (or adult-onset) diabetes is mostly linked to weight problems and has reached similarly epidemic proportions. According to the Centers for Disease Control and Prevention, the number of diabetes cases has nearly tripled over the last three decades and affects today more than 20 million Americans.

Both study reports – one from Italy, the other from the United States – concluded that surgical procedures, a.k.a. bariatric surgery, by which the size of the stomach is considerably reduced, enabled patients not only to lose weight but also manage their blood sugar levels more effectively than traditional measures like dieting and medication. Bariatric Surgery Can Carry Great Risks, Including Malnutrition

The findings, which were published in the New England Journal of Medicine, may change how many diabetes cases will be treated in the future. Proponents of bariatric surgery say the studies confirmed that stomach size reduction should no longer be seen as a last resort but should be considered earlier in the treatment of obese patients with type 2 diabetes. Others warned that more studies are needed and that the risks in connection with the procedures available today remain high.

According to the American Society for Metabolic and Bariatric Surgery (ASMBS), about 200,000 surgical procedures for weight loss are performed annually in the U.S. The National Institute of Health (NIH) says that surgery should only be recommended for people with a body mass index (B.M.I.) of over 40, or over 35 for those with diabetes and other serious illnesses related to weight problems.

For the studies, the researchers limited themselves to three types of weight loss surgery: Roux-en-Y, biliopancreatic diversion and sleeve gastrectomy. Roux-en-Y is the most commonly applied method of gastric bypass surgery, by which a small part of the stomach is sealed off and then directly connected to the small intestine. Biliopancreatic diversion removes large parts of the stomach and bypasses the majority of the small intestine as well, which limits both food intake and absorption of nutrients. Sleeve gastrectomy reshapes the stomach into a smaller tube but does not alter the way food enters or leaves it.

Needless to say, these are all very drastic steps to prevent weight gain and a host of diseases that often go with it, including diabetes, heart disease, hypertension, high cholesterol and so forth.

As a dietitian, my greatest concern is how the anatomical changes affect the metabolism of patients. Because bariatric surgery limits food intake so dramatically and also diminishes the absorption of nutrients, there is a great risk of malnutrition. Especially a sufficient supply of protein, which is extremely important during rapid weight loss for overall health and to allow for proper healing from the surgery, can become hard to obtain. Part of the reason for this is that the initial digestion of proteins takes place in the stomach, which after surgery is not only reduced in size but also in capacity. Even more problematic is the hindered absorption of essential nutrients in the small intestine because some or much of it is bypassed. This affects the absorption of carbohydrates, proteins and fats but also vitamins and minerals. Potential complications, not only from the surgical procedure itself but also from the nutritional deficiencies, are multiple.

Bariatric surgery should never be considered as a quick fix, on par with cosmetic surgery. It is a profound alteration of the digestive system that is risky and requires permanent changes in diet and lifestyle choices. Intensive post-operational counseling and strict observation of nutritional guidelines are an absolute must.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Widespread Chronic Sleep Deprivation Seen as a Cause for Concern

March 28th, 2012 at 7:23 am by timigustafson
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There are multiple causes for the so-called lifestyle-related diseases that plague us today. Obesity, diabetes, heart disease and hypertension can mostly be blamed on poor nutrition, lack of exercise, stress and, as scientists increasingly find out, sleep deprivation.

Over the last few decades, Americans have kept cutting back on their sleep as their lives have become busier. Long hours spent on work, commutes, kids’ activities and household chores leave less and less time for rest. While a few generations ago people slept for eight hours or more, most Americans have to get by on six hours or less today.

And it’s not only the difference in the amount of time but also the quality of the rest we get that has turned us into a nation of chronically sleep-deprived zombies.

“Sleep deprivation is reaching epidemic proportions and may soon be our nation’s number one health problem,” says Cindy Heroux, a Registered Dietitian and author of “The Manual That Should Have Come With Your Body.”

“When you don’t get enough sleep, you are more likely to suffer from certain chronic illnesses, including diabetes and heart disease. You are also more likely to gain weight or become obese,” she says.

What is the connection? Sleep deprivation can lead to disruption of your metabolism, which in turn can make the cells in your body more insulin resistant. Insulin resistance causes the cells to think they are being starved and, as a result, urgent hunger signals are dispatched to the brain, making you want to eat. That is one of the reasons why people reach for food when they are overtired or stressed out.

A recent study published in the “Journal of Clinical Endocrinology and Metabolism” concluded that even short-term sleep deprivation can activate the appetite-controlling part of the brain, increasing hunger levels. Researchers have calculated that for each hour a person cuts back on sleep, he or she consumes an average of 360 additional calories. If extra calories are not burned off, they are stored as fat and insulin resistance increases even further. It’s a vicious cycle and the negative health effects can be multiple.

Some experts say that it’s not just the perpetual lack of sleep that makes Americans sick but also the ways we are trying to cope with being chronically sleep deprived. Too many people just muddle through their tiredness, says Dr. Matthew Edlund, author of “The Power of Rest.” He believes that the widespread reliance on energy drinks like “Red Bull,” “Monster” and “5-Hour Energy” does potentially more harm than users realize.

“We don’t use our bodies the way they’re built to be used,” he says. “We guzzle energy drinks and then can’t sleep at night. We sit all day and then read e-mails at 3 a.m. It’s no wonder we walk around like zombies and treat these drinks like liquid life support. It’s a good time to question these trends and find healthier ways to power up.”

Instead of using energy boosters that work short-term but eventually only add to the exhaustion resulting from sleep deprivation, nutrition experts recommend protein-rich snacks like low-fat yogurt or cheese or peanut butter. In the end, however, there is only one solution and that is getting regularly a good night’s sleep.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Following a Heart-Healthy Lifestyle Can Add Years to Your Life

March 25th, 2012 at 3:48 pm by timigustafson
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Do you observe a healthy diet, abstain from smoking, watch your cholesterol, blood pressure, blood glucose levels and do you exercise at least for 30 minutes three times a week? If so, your chances of dying from a heart attack are much lower than those of your contemporaries with less health-promoting lifestyles.

Researchers found that taking a few simple, commonsense steps to protect your heart can reduce the risk of cardiovascular disease more substantially than previously thought.

For a recently completed study that followed almost 45,000 adult Americans, scientists looked into data collected by the U.S. National Health and Nutrition Examination Survey and linked them with a database of deaths over three time periods, starting in 1988 and ending in 2010. After almost 15 years of follow-up, the survey showed that participants who adhered most closely to the diet and lifestyle recommendations of the American Heart Health Association (AHA) had a 76 percent lower risk of dying from heart disease and a 51 percent lower risk of all-cause deaths than those who complied less. The details of the study were published in the Journal of the American Medical Association (JAMA – 3/23/2012).

Unfortunately, the researchers also found that only a small minority of Americans follows all or most of the AHA guidelines for heart health.

“Everyone knows that the heart health of Americans is dismal. Yet, despite of trying hard (really hard), I fail more than 90 percent of the time to get patients to change their heart-healthy behaviors,” laments Dr. John Mandrola, a cardiologist. “Nine in ten patients return just as fat and sedentary as they were at the time of my previous lecture on heart health.”

The problem is not that Americans lack access to information that prevents them from taking better care of their heart health. “Getting people to know [the facts] is not the issue, rather the issue is the implementation of the plan, says Dr. Mandrola.

Heart disease is the most common cause of deaths in the U.S. today, ahead of cancer and stroke. One and a half million Americans die every year from the disease or complications connected to it. While it is true that heart disease can be caused by inherent risk factors such as family history or simply by aging, poor lifestyle choices are to be blamed in most cases. Excess weight, diabetes, high cholesterol levels, high blood pressure, smoking, alcohol abuse and insufficient physical activity are all commonly known culprits. Most heart patients have several of these risk factors to deal with – and they tend to “gang up” and aggravate each other’s effects.

Heart disease usually shows no specific warning signs. You have to look at the numbers to find out about your heart’s health condition. “You can and should make a difference in your heart health by understanding and addressing your personal risks,” says Dr. Susan B. Shurin, director at the National Heart, Lung and Blood Institute of the National Institute of Health (NIH). For any successful treatment of heart disease as well as for prevention it is crucial to regularly monitor cholesterol levels – LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides –blood pressure and, of course, body weight.

Americans tend to rely too quickly on medications when they encounter heart health problems. In many cases that may be a necessary first step, but the goal should always be to achieve risk reduction by better diet and lifestyle choices. “Good Nutrition and lifestyle are the cornerstones of health,” says Dr. Leslie Cho, director of the Women’s Cardiovascular Center at the Cleveland Clinic. “Pills are supplements. They’re not a substitute for a healthy lifestyle.”

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Nutrition Can Greatly Impact Your Child’s Learning Ability

March 21st, 2012 at 12:08 pm by timigustafson
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The nutritional quality of our diet affects our wellbeing throughout our lives, but it has an even greater impact on children whose bodies and minds are still growing. Nutritional deficiencies can seriously damage a child’s neural development, possibly leading to lower IQ and learning disabilities.

Studies by neuroscientists have found that low-quality nutrition during childhood can be detrimental to the development of cognitive capabilities, such as learning, problem solving and memorizing. Early malnourishment can lead to deficiencies in vision, fine motors skills, language and social skills as well as an array of chronic illnesses lasting well into adulthood.

Unfortunately, the crucial role nutrition plays for developmental, cognitive and behavioral outcomes in life’s early stages is often not well understood and appropriately acted upon by schools and parents.

Some scientists see a direct link between high saturated fat intake and mental performance. Tests have shown that many items popular in school cafeterias such as hamburgers, chicken nuggets, pizza and French fries actually lower students’ ability to stay awake and concentrate. A dramatic drop in energy due to digestion of heavy foods leaves kids feeling lethargic, irritable and unable to focus.

According to a study by the American School Health Association (ASHA), students who had consistently insufficient protein intake scored lower on achievement tests than their classmates who had adequate nutrition. Students with chronic iron deficiency were more likely to suffer from attention deficit hyperactivity disorder (ADHD). Under- or malnourished children were found more prone to infections and illnesses, causing them to miss school and fall behind in their education.

Pediatricians and pediatric dietitians have long emphasized that giving kids a healthy breakfast plays an especially important role for their nutritional wellbeing. Without a boost at the start of their day, young brains cannot function well. To do its work, the brain needs a sufficient supply of healthy fats, proteins, carbohydrates, vitamins, minerals and water. Sugary cereals or white-flour pancakes with syrup don’t offer many essential nutrients. Eggs (preferably egg whites only), whole grain breads, fruits and low-fat milk are better choices.

By lunchtime, most children’s bodies are depleted and in dire need of another energy provider. Highly caloric and fatty foods with little or no nutritional value only worsen the situation. Soups, salads, fruits, vegetables, lean protein sources and whole grains can do the job much better. If your child’s school cafeteria does not offer healthy lunch choices, prepare a box lunch for him or her to take along.

An afternoon snack before play or study time is recommended, but, again, sugary items like candy, pastries and sodas should be avoided. Instead, you can serve a fruit salad or a tray of raw veggies and yogurt dips.

Dinner should help your child to wind down and relax before bedtime. Fatty foods like pizza or cheeseburgers are not a good idea. Items that contain high amounts of sugar late in the day can lead to sleep disruptions. Age-appropriate portions of pasta topped with a hearty vegetable sauce (preferably made from scratch), fish, chicken and other lean meats combined with healthy side dishes complete your child’s nutritional needs for the day.

Eating habits develop early. Most children acquire them from their parents and older siblings. Kids don’t develop food preferences on their own, not even for candy. They learn what to like or dislike by observing others. What you as the parent buy and bring in the house is what they will have access to. How you treat your own body in terms of diet, exercise and lifestyle choices will influence their own behavior.

Considering the potentially grave consequences of malnutrition during childhood, parents have a great responsibility to invest in their offspring’s nutritional health. Unfortunately, budgetary limitations and lack of knowledge about basic dietary facts prevent many parents from making better choices. They should not be expected to do it all on their own. A concerted effort involving families, schools, government agencies and community services is necessary to improve the nutritional welfare of all members of society, and especially the young.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Childhood Obesity, a Disease with Devastating Effects on Multiple Levels

March 18th, 2012 at 8:19 am by timigustafson
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The physical health effects of childhood obesity are well researched and documented. They include type 2 diabetes, high cholesterol, high blood pressure, sleep apnea and certain forms of cancer. Less talked about are the psychological damages children and adolescents with weight problems often suffer. But the truth is that low self-esteem, discrimination and isolation in connection with obesity can be just as devastating as the physical aspects and can make matters even worse.

Too many overweight kids find themselves being teased and made fun of because of their physical appearance, according to psychologist Dr. Kelly Brownell, the director of the Rudd Center for Food Policy and Obesity at Yale University. Teasing, he says can come from classmates, teachers, even from family members. More so than adults, children tend to internalize criticism or scorn, which can make them feel inferior, unattractive or out of place. In response, many lose their aspirations and motivations to better themselves. They withdraw and become socially isolated. Some develop behavioral dysfunctions, depression or addictions.

The psychological consequences of weight problems at a young age are not easily outgrown. As adults, many continue to carry the scars from their earlier struggles. A study conducted by epidemiologists at the University of Michigan found that people who were overweight during their high school years were significantly less likely to pursue higher education or professional carriers and were more at risk of unemployment and dependency on welfare programs than their normal-weight peers.

One of the reasons why overweight kids are discriminated against may be the still widespread assumption that all weight problems are caused by lack of personal discipline and restraint. “People think that overweight adults have only themselves to blame. They should eat less and exercise more,” says Dr. Brownell. “But blame is simply unreasonable when it comes to children, especially in low-income neighborhoods where markets are often inadequate and places to exercise are nearly nonexistent. So, it’s unfair to put people in an environment where weight gain is a very strong possibility and then blame them for having problems.”

Another issue often mentioned in connection with childhood obesity is the powerful influence of food marketing. Children and adolescents are extremely impressionable and don’t know how to respond to the conflicting messages they are receiving from society, popular culture and the media. On the one hand, they are constantly challenged to comply with physical beauty ideals, which can put a lot of pressure on them to be thin, especially on girls, thereby increasing the risk of developing eating disorders. On the other hand, they are constantly exposed to food and soda ads on TV, encouraging them to consume more. A 2006 study by the Institute of Medicine (IOM) found compelling evidence that food advertisements had a direct impact on childhood obesity. On average, American children watch up to 10,000 food, soda and snack commercials every year, according to a survey by the American Academy of Pediatrics (AAP), titled “Children, Adolescents and Advertising.” For the food and beverage industry, this is a multi-billion dollars investment worthwhile making. Under these circumstances, the notion that it’s up to the kids themselves to exercise self-control is just laughable.

In an ideal world, parents would be best equipped to prevent childhood obesity from occurring in their families in the first place. But parents are often too busy to control their offspring’s eating habits or are having weight issues themselves. Statistics show that if one parent is overweight, the children have a 40 percent chance to follow in his or her footsteps. If both parents are struggling, the chances increase to 80 percent.

Healthy eating and lifestyle habits do not just appear out of nowhere. They must involve the entire family but also social surroundings like schools, work places and communities. Instead of further stigmatizing people of all ages because of their weight problems, we as a society must find ways to address the issues at hand constructively by creating an environment that is conducive to the health and wellbeing of all its members.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Lifelong Learning May Be the Best Defense Against Alzheimer’s Disease

March 11th, 2012 at 5:00 pm by timigustafson
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Exercising the brain as much as exercising the body to keep both fit and healthy has become the new mantra for the aging baby boomer generation. Scientists seem to agree. Studies show that people who were cognitively active throughout their lives are less likely to experience mental decline as they grow older.

Age-related dementia such as Alzheimer’s disease is the most feared health condition among older Americans today, second only to cancer. It is also one of the most significant health threats of the 21st century, according to a report by the Alzheimer’s Association and the Harvard School of Public Health that was first published at an international conference on the subject in Paris, France, last year.

The causes for Alzheimer’s are not yet fully understood and there are currently no effective treatments that can halt or reverse the progressively debilitating disease. Researchers have suggested that diet and exercise as well as mental stimulation may serve as preventive measures, but there is not enough scientific evidence that these have a significant impact.

There are a number of health conditions, however, believed to promote the development of dementia. One is inflammation of the brain caused by stress hormones such as cortisol, which is toxic to nerve cells in the brain and especially to those responsible for memory. Another contributing factor is cardiovascular disease because it can prevent the brain from receiving sufficient blood supply, thereby damaging it.

A more controversial suggestion is that education, or lack thereof, can make a difference in the likelihood of someone becoming demented later in life. Obviously, the notion that the well-educated have a better shot at staying mentally healthy while the unschooled run the risk of losing their minds is hard to accept because it sounds elitist and snobbish. That makes it difficult to raise the issue without provoking strong reactions. Still, we have to look at the evidence.

Neuroscientists say that the reason why education can help prevent or at least slow down an aging person’s cognitive decline is that during learning processes structural changes in the brain’s neural network take place as neurons connect with one another. This is only possible because the central nervous system is in constant dynamic flux, which enables it to respond and adapt to changing requirements.

The more learning experiences we undergo over the years, the more neural connections we develop in the brain. This does not only happen when we learn something brand new – like a foreign language or a computer program – but even when we do routine work or play our favorite games. The already established neural connections just multiply as we repeat similar mental processes. That is why most tasks become easier to master over time, which is what learning is. This process is called “neural redundancy,” meaning that many neural connections become redundant through repetition – but not obsolete because when some connections get damaged or degenerate, others take over and continue to function in their place. In other words, the more “redundant” connections we develop over a lifetime through constant learning, the less likely we will lose our skills and abilities as we age.

So the question arises whether we can avoid the decline of our mental capacities by, let’s say, learning Mandarin, reading philosophical books or mastering programming software? Not if you start late, scientists say. Being mentally active from early on and throughout life, not just when you reach old age, is what makes the difference, according to Dr. William Jagust, a professor of public health and neuroscience at the University of California at Berkeley. What you do at 40 or 50 is more important than what you take on at 75.

“Older people seem to have less efficient brains [than younger people] and have to work their brains harder,” said Dr. Jagust in an interview on the subject with the New York Times (3/8/2012). “People who stay cognitively active may be able to use their brains more efficiently,” he added.

Does it then still make sense to strive for mental fitness when you are already approaching retirement age or even later? Within limits, yes, Dr. Jagust agrees. Memory usually diminishes with age, even with people who do not have dementia, he said. It’s more about preserving the abilities you have than acquiring new ones, although both go hand in hand.

For those looking for learning opportunities in their later years, there is no shortage of programs offered by universities and colleges throughout the country. And these are not the only options. Educational travel programs are becoming extremely popular among retirees and the travel industry is more than happy to accommodate them.

They say, a good education is wasted on the young – well, it’s certainly not wasted on those who see lifelong learning as yet another fountain of youth. It may not be able to prevent mental decline in the end, but, in the meantime, it clearly does no harm.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Better Than Your Mother’s Workout DVD?

March 7th, 2012 at 12:34 pm by timigustafson
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The so-called “active video games” that run on Microsoft’s Xbox or Nintendo Wii were supposed to make a big difference in the way people, especially kids, exercise at home and, hopefully, lose weight and get back in shape. That hasn’t happened yet, at least not on a large scale, according to researchers who studied the impact of these relatively recent innovations on children’s health.

Active video games offer virtual tennis, track and field or dancing experiences, which are meant to encourage consumers to get off the couch and move their bodies. In areas where opportunities for outdoor activities are sorely missing, where going to the gym requires a long drive, or where schools don’t offer physical education (PE), health advocates had hoped for an alternative tool to fill the gap. That expectation has so far been frustrated.

For the study, a research team from Baylor College of Medicine in Houston, distributed free active as well as inactive video games among a group of 9 to 12 year olds who were all above average weight. As it turned out, the children who played the active games lost no more weight than those who stuck to the inactive versions, like sing-alongs.

“We expected that playing the [active] video games would in fact lead to a substantial increase in physical activity in the children,” said Dr. Tom Baranowski, one of the researchers at Baylor in an interview with Reuters Health. “Frankly, we were shocked by the complete lack of difference.”

Over a time period of roughly 3 months, the children were tracked and monitored for their physical activity levels through a motion-measuring device called an accelerometer. The results showed an average of 25 to 28 minutes of moderate to vigorous physical activity among the kids who played active videos and 26 to 29 minutes for those who only played inactive ones.

Active video games “might increase caloric expenditure a bit more than a traditional sedentary video game, and if you do that on a daily basis that could have a cumulative effect that might be beneficial,” said Dr. Jacob Barkley, an exercise scientist from Kent State University who was not involved in the study. [But it] isn’t going to increase physical activity a whole heck of a lot,” he added.

In the meantime, sales of traditional workout DVDs remain strong, and not just among the Jane Fonda fans from decades ago. According to Reuters, 18 to 34 year olds account for 35 percent of fitness DVD buyers, followed by 35 to 50 year olds at 33 percent and people 55 and older at 20 percent.

Only lately has the weight loss and fitness industry begun focusing on children due to the ever-growing childhood obesity rates in the U.S. and much of the world. Workout DVDs can be cheaply produced and are easy to use, which makes them a viable alternative to more sophisticated and more expensive formats.

Still, health experts warn that we should not expect too much from the low-impact exercises you can do in front of your TV screen. All this virtual jumping, throwing and dancing or even the pushups people do on the living room floor do not compare to the impact you get from running in the park, swimming laps in an Olympic-size pool or working out in a well-equipped gym. But, I agree, it’s better than nothing.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Why Is Gaining Weight So Much Easier Than Losing Weight?

March 4th, 2012 at 1:40 pm by timigustafson
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One of the hardest things about weight gain is that it can happen so easily. Losing weight, on the other hand, can be a never-ending struggle. Some people say they put on a pound or two merely by looking at food. But no matter how much they deprive themselves or how hard they exercise, the numbers on the scale only seem to go up.

This experience is as common as it is counterintuitive. If you eat more calories than your body burns off, you will gain weight. The same should be true the other way around. Use up more than your intake and you will lose weight.

One pound of body fat represents 3,500 calories. You can increase or reduce that amount – it would seem – by equal measures. But that is not necessarily so. A great number of additional factors must be taken into consideration to understand the difference between weight gain and weight loss.

For example, your actual weight determines how many calories you burn. The heavier you are, the more calories your body requires to function properly. If you are overweight or obese, you need more calories to maintain your weight and, paradoxically, you can also lose some faster than if you were normal-weight – but only to a certain extent.

Dr. David Ludwig, director of the “Optimal Weight for Life” program at Children’s Hospital Boston and co-author of a commentary on the subject of weight gain versus weight loss in the Journal of the American Medical Association (JAMA), explained the difference like this:

“Our bodies don’t gain or lose weight indefinitely. Eventually, a cascade of biological changes kicks in to help the body maintain a new weight. A person who eats an extra cookie a day will gain some weight, but over time, an increasing proportion of the cookie’s calories also goes to taking care of the extra body weight. Similar factors come into play when you skip the extra cookie. You may lose a little weight at first, but soon the body adjusts to the new weight and requires fewer calories. Regrettably, however, the body is more resistant to weight loss than weight gain. Hormones and brain chemicals that regulate your unconscious drive to eat and how your body responds to exercise can make it more difficult to lose weight. You may skip the cookie but unknowingly compensate by eating a bagel later on or an extra serving of pasta at dinner.”

Unconscious or “mindless” eating, as Dr. Brian Wansink called it in his landmark book, “Mindless Eating – Why We Eat More Than We Think,” can contribute substantially to unwanted weight gain or the inability to lose weight. Indulging in some tasty but less-than-healthy snacks or downing a few sodas or alcoholic beverages on the side can add on unaccounted calories real quick. But burning those off can take a lot longer and require serious efforts.

Another issue is whether your weight gain was rapid due to some exceptional occasion or event (e.g. a party or a vacation) or whether you put on more pounds over time. The former can usually be undone by returning to your healthier eating and lifestyle habits. The latter is a different story. In that case, some self-evaluation may in order. Did your eating pattern change for any particular reason such as stress at work, a move, financial issues or domestic problems? Did you stop exercising? Age may also be a factor. As you get older, your metabolism slows down and you require less food than you used to – but your habits have not kept up with your biological changes.

One of the greatest frustrations people with weight problems can go through is the so-called weight cycling or yo-yo dieting – losing weight successfully, only to gain it all back. Unfortunately, this phenomenon is quite common. Over 80 percent of dieters regain some or all of their former weight back within two years and two-thirds of once successful dieters end up heavier than they were before their initial weight loss, according to a study by the University of California at Los Angeles (UCLA).

Yo-Yo dieting is not only emotionally frustrating, it can also have serious consequences for a person’s physical well-being. “The more diets you’ve been on, the harder it becomes to lose weight,” said Dr. Kelly Brownwell, director of the Rudd Center for Food Policy and Obesity at Yale University.

Even on a sensible diet, your body is reluctant to let go of some of its mass. When you are dieting, it may perceive it as impending starvation and a threat to its survival. In cases of rapid weight loss (e.g. crash diets), a metabolic overcompensation can kick in, resulting in a slower metabolism and greater difficulty to lose additional weight.

Weight cycling can actually change your physiology, according to Dr. Brownwell. One of the reasons for this is that through dieting a hunger hormone called ghrelin increases, and a fullness hormone called leptin decreases, so you feel hungrier and less satiated every time around. Also, frequent yo-yo dieting lets you lose muscle mass and replaces it with fat as you regain weight. Because muscle burns many more calories than fat does, your metabolism slows down even further.

“Losing and regaining weight regularly takes a huge toll on your body,” said Dr. Keith Ayoob, professor at Einstein College of Medicine at Yeshiva University in New York, not just aesthetically by loss of skin elasticity but, more importantly, by the damage being done to the inner organs, the arteries and the skeletal system, and by a host of potentially life-threatening illnesses resulting from unhealthy weight gain like diabetes, heart disease, high blood pressure and cancer.

Of course, there are cases where the body is resistant to weight loss because of an underactive thyroid or other disorders. But those are relatively rare by comparison to diet- and lifestyle-induced weight fluctuations. In the absence of such medical conditions, the best way to prevent weight gain and promote weight loss (if necessary) is, as always, healthy eating, regular exercise, managing stress and getting enough sleep – in other words, opting for an all-around healthy lifestyle.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Obesity and Diabetes – The Plague of Our Time

February 28th, 2012 at 6:00 pm by timigustafson
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When Michelle Obama announced “Let’s Move,” her signature initiative to combat childhood obesity, she emphasized that major diet and lifestyle changes were not required in her view to turn this growing health crisis around. “Small changes add up,” she said. “We don’t need to totally evaporate our way of being as we know it today.” In other words, if we just cut a few calories here and there and exercise a bit more, things will be fine before long. A comforting thought.

But that may be wishful thinking, according to Mark Hyman, MD, chairman of the Institute for Functional Medicine and medical director of the UltraWellness Center in Lenox, Massachusetts, and author of several bestselling health books, including his latest, titled “The Blood Sugar Solution.” The way he sees it, we are in the middle of an explosive epidemic of obesity and type 2 diabetes that will touch almost everyone in one way or another. He does not hesitate to call it “the modern plague.”

Obesity, insulin resistance, metabolic syndrome, pre-diabetes, type 2 diabetes, heart disease, dementia and cancer are ultimately all rooted in one and the same problem: Our dismal diet- and lifestyle choices. Diagnosing and treating these diseases separately as if they were not interconnected misses the whole picture. Instead, Dr. Hyman proposes using a more comprehensive term to describe the continuum of which all these health problems are part of: “Diabesity.”

Diabesity can range from slight weight problems and mild insulin resistance to morbid obesity and severe diabetes. Because the disease is not well understood as a continuum, millions of those affected by it remain undiagnosed and untreated. As a consequence, more people all over the world die now from chronic illnesses than from infectious diseases. The real tragedy is that the causes are almost always environmental and lifestyle-related, which would make them perfectly preventable or curable through public education and enough political will to implement the necessary changes.

“This is a lifestyle and environmental disease and won’t be cured by medications,” Dr. Hyman writes. “Billions and billions have been wasted trying to find the ‘drug cure,’ while the solution lies right under our nose. Shouldn’t the main question we ask be why is this happening? Instead of what new drug can we find to treat it?

Since most of our modern-day ailments are primarily caused by poor diet choices, chronic stress and sedentary lifestyles, as well as toxins and allergens in the environment, we must address these problems from the ground up (literally). Instead of looking for quick fixes through medication and surgical procedures, we can make many important corrections by ourselves and without delay by using the right ingredients that make us healthy again, including whole, fresh food, vitamins and minerals, water, fresh air, exercise, stress reduction, etc. “When we take out the bad stuff and put in the good stuff, the body knows what to do and creates health and disease goes away,” writes Dr. Hyman. Care for the environment is part of that, too. Here, he strongly agrees with Sir Albert Howard, who is by many considered the founder of the organic agriculture movement, when he wrote in his landmark book, “The Soil and Health,” that we must “treat the whole problem of health in soil, plant, animal and man as one great subject.”

Finding our way back to wholesome nutrition is one of the greatest challenges we face today. “In America, we eat more than we ever have, yet we are nutritionally depleted,” writes Dr. Hyman. The epidemic of diabesity and other chronic illnesses is paralleled by an epidemic of nutritional deficiencies. Most of us don’t eat enough the kind of food that protects us from diseases and too much of the kind that makes us sick.

“Food literally speaks to our genes,” he writes in a chapter titled “Nutrigenomics.” “The information your body receives from the foods you eat turns your genes on and off.” Whole-foods and plant-based diets have been shown in clinical studies to be able to turn off cancer-causing genes or turn on cancer-protective genes. No medication can do this. “What you put on your fork is the most powerful medicine you can take to correct the root causes of chronic disease and diabesity,” he writes.

“The Blood Sugar Solution” is a highly informative but, thankfully, also a very accessible book for both professionals and the laypersons. Some readers may find Dr. Hyman’s positions to be somewhat radical, if not utopian, especially where he seeks to offer hands-on solutions. Admittedly, he writes with passion and a sense of urgency – and rightly so. The obesity crisis keeps growing unabatedly worldwide and the time for “small steps” may have passed. Something has to change on a fundamental level. Unfortunately, that makes it so much less likely that we will see significant successes in the near future, if ever.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

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About timigustafson

Timi Gustafson, RD, LDN, FAND is a registered dietitian, health counselor, book author, syndicated newspaper columnist and blogger. She lectures on nutrition and healthy living to audiences worldwide. She is the founder and president of Solstice Publications LLC, a publishing company specializing in health and lifestyle education. Timi completed her Clinical Dietetic Internship at the University of California Medical Center, San Francisco. She is a Fellow of the Academy of Nutrition and Dietetics, an active member of the Washington State Dietetic Association, a member of the Diabetes Care and Education, Healthy Aging, Vegetarian Nutrition and the Sports, Cardiovascular and Wellness Nutrition practice groups. For more information, please visit http://www.timigustafson.com

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