Friday, December 14, 2012

Introducing Life On The Triad and Maximize Your Health

Today is a very exciting day for me.  I’m officially launching 2 new books!  I thought I’d use this post to tell you a little about them.

Life On The Triad
I published my first book, The Weight Loss Triad, almost 4 years ago. This book presented a comprehensive weight loss program divided into 3 key areas: Diet, Cardiovascular Exercise, and Resistance Training.  It has done far better than I ever would have imagined. 

Life On The Triad is a meal plan and recipe companion to The Weight Loss Triad.  It includes 28 days of breakfasts, lunches, and dinners that comply 100% with The Triad principles.  For this project, I teamed up with my sister, Diana Halton, who is a graduate of New York City’s prestigious Institute of Culinary Education.  She is an absolutely awesome chef.  With her help, we created 28 recipes ranging from quick and easy to gourmet.  Again, all of these recipes comply 100% with the principles of The Weight Loss Triad to keep you moving steadily toward your weight loss goals.

Life On The Triad also includes chapters on eating out, traveling, sugar free living, and a shopper’s guide.  For those who have not read my first book, I’ve also included a brief summary of The Weight Loss Triad program.

To learn more about Life On The Triad or to pick up a copy, please click here.

Maximize Your Health
Maximize Your Health is a simple, yet powerful top 10 list of the most important things that you can do to reduce your risk of chronic diseases like heart disease, stroke, diabetes, and cancer.

We are bombarded with health advice on a daily basis from newspapers, TV, our government, medical societies, doctors, and of course books on diet and fitness.  Much of this advice is conflicting.  It has become very difficult for people to separate the good information from the bad. The key to making the right decisions for your health is to separate sound research hypothesis from personal opinion.

There is a huge and remarkable body of research literature that has been published in the past 30 years that shows just how the right combination of diet, exercise, and lifestyle habits can promote robust health and dramatically reduce risk of chronic disease.  Sadly, most Americans don’t even know that this research exists or how to separate the good studies from the bad.

I have yet to see a simple, easy to read summary of this research. 

That is why I wrote Maximize Your Health.  The book lists out the 10 most important and modifiable lifestyle factors to improve your health and reduce your risk of chronic disease.  All of the claims are backed by the latest research.  The book also includes detailed action steps to help you improve your adherence to these health promoting strategies.

To learn more about Maximize Your Health or to pick up a copy, click here.

Wednesday, November 14, 2012

Research Update: Macronutrient Composition And Weight Maintenance

Effects of dietary composition on energy expenditure during weight loss. 
Journal of the American Medical Association 2012; 307(24):2627-34.
After weight loss, the human body fights hard to regain weight. One of the ways it does this is to decrease the amount of calories it burns on a day to day basis. This is known as a decrease in resting energy expenditure. The objective of this study was to examine the effects of 3 different diets varying in macronutrient content and glycemic load on resting energy expenditure following weight loss.
21 overweight young men and women completed a 12 week weight loss program that resulted in an average weight loss of 13.6% of body weight. Once the weight was lost, they each went on one of 3 diets for a period of 4 weeks. Each of these diets contained the same exact number of calories.
Diet #1: Low Fat: 60% carbohydrate, 20% protein, 20% fat
Diet #2: Low Glycemic Index: 40% carbohydrate, 20% protein, 40% fat
Diet #3: Low Carbohydrate: 10% carbohydrate, 30% protein, 60% fat
After each 4 week diet intervention, a variety of measures were taken, including resting energy expenditure, hormone levels, and components of the metabolic syndrome.
The decrease in resting energy expenditure was greatest with the low fat diet (-205 calories per day). Next was the low glycemic index diet (-166 calories per day). The least was the low carbohydrate diet (-138 calories per day).
This is a ground breaking study that challenges the assertion that a calorie is a calorie. The 3 diets that were tested were isocaloric, in other words they had the same amount of calories. The fact that each had a different impact on resting energy expenditure means that something is going on hormonally that will impact your body’s reaction to weight loss. It would be easy to look at the results of this study and say that the low carb diet is the way to go.
Not so fast! The researchers measured a bunch of other things besides resting energy expenditure. During the low carb phase, subjects had a significantly higher cortisol level. This is a hormonal measure of stress and has been associated with a variety of negative health outcomes, such as insulin resistance and cardiovascular disease. Subjects in the low carb phase also had a higher level of C-reactive protein.  This is a measure of body wide inflammation and has also been associated with a variety of chronic diseases.
The low fat diet showed the greatest decrease in resting energy expenditure and also showed some negative metabolic effects, including an increase in insulin resistance, a decrease in HDL cholesterol, and an increase in triglycerides.
The low glycemic index diet seemed to be the best of both worlds. You get a reduced decrease in resting energy expenditure without the metabolic changes that increase risk of chronic disease.
Take Home Message
The study provides more evidence that a low fat diet is not the way to go if you want to lose weight and keep it off. While the low carb diet had the most favorable impact on resting energy expenditure, it also resulted in some very unfavorable metabolic changes. The low glycemic approach seems to offer the best combination of blunting the reduction in resting energy expenditure that comes with weight loss while protecting you from chronic disease.

Monday, October 15, 2012

Brown Rice And Arsenic: What Is Going On?

Chances are, you have recently read in the papers the disturbing report of high levels of arsenic in rice products. Many of my clients have been asking me if they should alter their consumption of brown rice, which is a staple for many looking to include a lower glycemic, whole grain in their diet.

figured I’d do a little research on the matter and update everyone with a Blog post on the subject, so here goes!

Where Did This Report Come From
The media attention on rice and arsenic stemmed from a Consumer Reports article that came out just a few weeks ago.

You can read the report here:

Scientists tested over 200 samples of rice products for levels of arsenic.  Products tested included white rice, brown rice, hot and cold rice cereals, rice crackers, and rice pasta.  Many of the products tested positive for what Consumer Reports call “worrisome” levels of arsenic.

What is Arsenic And Why Is It Bad For You?
Arsenic is an element that can be found naturally in rocks and soil, water, and even the air we breathe.  It has also been introduced into the environment from agricultural and industrial sources.  Many years ago, arsenic was used as a pesticide in areas that grew cotton.  While it is no longer used in this way, much of the arsenic used for this purpose can still be found in the soil.

Arsenic comes in two forms.  Inorganic and organic.  Organic Arsenic is thought to be much less toxic to humans.  Inorganic arsenic is the form used in industry and has been linked to cancer in humans.

Both the National Toxicology Program and the Environmental Protection Agency classify inorganic arsenic as a “known human carcinogen”.  Studies have shown that high levels of arsenic exposure are associated with an increased risk of bladder, lung, and skin cancer.  It may cause other types of cancer as well. 

It is clear that high levels of arsenic are not good for us.  The question is how high is too high?

My Take On The Consumer Report Findings
Should we be concerned about the report of arsenic in our rice? Yes.  Should we freak out about it?  Absolutely not.  Here is why:

1) The EPA has known about the presence of arsenic in our foods for years and is not overly concerned with negative health outcomes at current levels of exposure. They do not recommend changing consumption patterns of brown rice, but suggest including a variety of other whole grains as part of a balanced diet.  They are currently investigating the matter in more detail.

2) According to the EPA, rice is actually the 3rd biggest source of arsenic in our foods, accounting for 17% of dietary exposure.  The biggest source is vegetables at 24% and the second biggest is fruit at 18%.

3) The levels reported were not earth shattering.  For example, many of the brown rice samples tested reported an arsenic exposure of 6-7 micrograms of inorganic arsenic per serving.  The federal government standard for safe drinking water is 10 micrograms per liter.  In other words, if the same amount of arsenic found in a serving of brown rice was found in a liter of drinking water, it would be deemed safe for consumption.  Keep in mind you would be drinking several liters of this safe water per day.

4) The reality of our world is that most of our food is contaminated with something.  The question becomes is it contaminated enough to make us sick?  You need to consider the pros and cons of consuming the food.  For example, our fish supply contains small amounts of mercury.  However, the benefits of eating fish outweigh the increased risk of the mercury so that people who eat fish are actually healthier than people who do not.  The same goes for fruits and vegetables.  Most contain a small pesticide residue, but the benefits of eating fruits and vegetables far outweigh the risk so that people who eat a lot of fruits and vegetables are healthier than those who don’t.  This is actually explained very nicely in an article in U.S. News And World Report by Dr. David Katz, a respected nutrition researcher from Yale. You can find this article here.

What Do I Recommend?
If you are eating 5 servings of brown rice per day, you may want to cut back a bit.  If you are having it a few times per week, there is no reason to change this behavior.  Brown rice is a very good source of whole grain that has a research proven beneficial impact on our health.  

I would be cautious about eating a lot of rice products if you are pregnant and I wouldn’t feed a lot of it to young children.  This is because even smaller levels of arsenic appear to be more harmful to fetuses and young children.

Rice grown in the southern U.S. is higher in arsenic that that grown in California (cotton was grown in the South and not in California).  If you can find a brown rice that is grown in California, go with that one.

Another recommendation would be to change the way you cook your brown rice.  According to Consumer Reports, if you use 6 cups of water for each cup of brown rice, and drain off the excess water after the rice is cooked, you can reduce arsenic levels up to 30%.  It is a good idea to start doing this.

Friday, September 14, 2012

Questions And Answers: The Right Beverages If You Are Trying To Lose Weight

I’m always fielding questions from my clients on what they are allowed to drink given their goal of losing weight.  This is actually a very important topic, so I figured I’d use this blog post to answer some of these questions.  I’ll answer each question from both a weight loss and a general health perspective.

Can I Drink Coffee?
Yes!  In the literature, coffee has been shown to have a positive impact on risk of heart disease and stroke.  I’m not too crazy about caffeine, so I have my clients limit their consumption of regular coffee to 1 or 2 cups per day.  Decaf can be consumed in unlimited quantities.  One asterisk here, it is not good to load up on cream, sugar, or nonnutritive sweeteners.  I have my clients use a little milk or light cream and no sugar or nonnutritive sweeteners.   Sugar will spike your blood glucose while the nonnutritive sweeteners will increase cravings for refined carbs.

Can I Drink Orange Juice Or Other Juices
I have my clients eliminate all juices.  When you juice a fruit, you are separating the sugar from the fiber and the glycemic load starts to really increase.  This spikes blood sugar and insulin levels which will negatively impact both your weight and your overall health.  Fruits are unbelievably healthy when eaten in their whole form.  Eat your fruit the way nature intended.

Can I Ever Drink Regular Soda?
Absolutely not.  The large amount of sugar causes blood glucose and insulin to skyrocket. 

What About Diet Soda?
There are several problems with diet soda.  The non-nutritive sweeteners used in these products are well tested and generally safe when consumed in moderate amounts.  However, there are 2 major issues with diet soda:  1) When you strictly limit refined carbohydrate foods like sugar, white bread, and pasta, your craving for them virtually disappears.  Diet soda perpetuates your cravings for sugar and refined carbs so you’ll always be hungry.  2) Humans have the cephalic response.  If you were to put your favorite food on your kitchen table; your eyes see it, your nose smells it, and you release digestive enzymes before you put a bite into you mouth.  There is some evidence that this also happens with diet soda.  Your body senses the sweet taste and releases insulin anyway.  This is exactly what you are trying to limit.  Treat yourself to 1 or 2 diet sodas a week, but not more than that.

Can I Drink Alcohol?
When consumed in moderate amounts, alcohol has been associated with improved health.  The research literature shows that consuming about 1 drink per day reduces risk of heart disease, stroke, and diabetes.  Keep in mind that this amount may also slightly increase risk of breast cancer in women.  I have my weight loss clients limit alcohol consumption to a total of 4 drinks per week.  More than that has the potential to impact their weight.

Well, Than What Can I Drink?
Feel free to drink:
1) Water: filtered tap or bottled.
2) Decaf coffee or tea, either hot or iced.
3) Naturally flavored club soda such as Polar or Poland Spring.  These come in a number of great flavors and have no sugar or non-nutritive sweeteners. 

I know that this isn’t the sexiest of lists, but these choices will keep you hydrated and moving toward the more fit, thin, and awesome version of yourself.


Tuesday, August 14, 2012

Book Review: Wheat Belly

Wheat Belly is next up for review.  The author, Dr. William Davis, is a medical doctor and preventive cardiologist in Wisconsin.

The basic premise of Wheat Belly is that the elimination of wheat products is the key to weight loss and improved health.  The book is broken down into 3 sections.  The first is a detailed history of the evolution of wheat and how it has changed genetically over the years.  The second part explains all of the negative health effects of eating wheat.  The third part of the book deals with tips on eliminating wheat from your diet, including a 7 day meal plan and recipes.  Overall, the book is well researched and very well written.  I enjoyed reading it.

Five Things I Really Liked About Wheat Belly
1) The Concept Of Blood Sugar Stability.  A major concept in this book is that swings in blood sugar have a negative impact on weight control and health in general.  I couldn’t agree more.  Blood sugar control is at the very foundation of my nutritional recommendations.

2) Explanation Of How Wheat Has Changed Over The Years.  I found this part of the book absolutely fascinating.  Agricultural scientists have changed wheat dramatically over the past 50 years.  It has been altered genetically to make it resistant to environmental conditions and to increase yield.  Wheat used to grow 4 feet tall.  The new genetic, “dwarf” version grows only 1 foot tall, so it will yield quicker, requiring less fertilizer.  The author found a woman who grows the old fashion wheat and bought some flour from her.  After eating 2 slices of bread made with this flour, his blood sugar rose to 110.  He repeated the test with modern flour.  His blood sugar after eating 2 pieces of bread made with modern wheat rose to 167!  It is quite plausible that wheat used to be a healthy, lower glycemic grain years ago, but is now high glycemic due to genetic manipulation.

3) Great explanation of LDL particle size.  The size of your LDL is just as important as your number.  Large, buoyant LDL’s are far less atherogenic than small dense LDL’s.  He explains this nicely.

4) Good Recipes.  The wheat free recipes are very nicely put together.

5) Comprehensive List Of Wheat Containing Products And Ingredients.  The author puts together an interesting list of places where you’ll find wheat unexpectedly.  You’ll find wheat in hydrolyzed vegetable protein, modified food starch, textured vegetable protein, flavored coffees, beer, flavored teas, vodkas, blue cheese, and my 2 favorites; envelope glue and lipstick.  Wheat really is everywhere!

Five Things I Didn’t Agree With In Wheat Belly
1) Promises Unrealistic Weight Loss.  The author says you will lose 10 lbs in the first 14 days, or even a pound a day.  When expectations are this high, it is easy to get frustrated with more realistic weight loss, such as a pound a week.  Having realistic expectations for weight loss is vital to long term adherence. 

2) Very Little On Exercise.  If you want to lose weight and keep it off, exercise is a huge part of the equation.  Both experience and the research literature have taught me this. Wheat Belly doesn’t focus on it very much.

3) Restricts Several Foods That Are Healthy.  The following foods are strictly limited on the Wheat Belly plan: oatmeal, quinoa, brown rice, sweet potatoes, legumes, fruits, and polyunsaturated oils.  These have been shown in the literature to be health promoting, and I’m not quite sure why you wouldn’t want people to eat them.

4) Allows Several Foods That Are Not So Healthy.  The following foods are encouraged on the Wheat Belly plan and in the recipes: steak, pork, full fat cheeses, coconut oil, small amounts of fruit juice, daily use of non-nutritive sweeteners, dried fruit, full fat sour cream.  These are foods I have my clients limit due to their negative impact on health.

5) Fat, Protein, Carb Ratio.  This plan allows for unlimited protein intake, which typically amounts to no higher than 20-25% of calories, unlimited fat and 50-100 grams of carbohydrate per day.  On a 2000 calorie diet, this equates to 25% protein, 20% carbohydrate and 55% fat.  I think this is a bit too low on the carb and a bit too high on the fat.  I have my clients shoot for more like 20% protein, 35% fat and 45% carb.

Is Wheat Belly Worth Reading?
Absolutely.  Wheat Belly gets a lot right.  You’ll learn in great detail how the wrong types of carbohydrate can make you unhealthy and overweight.  For years, I have been recommending a lot of what is in this book to my clients.  There are just a few foods I would limit on this plan and a few foods I’d add in.  Oh yeah, one other thing I’d add in is a whole lot more exercise!

Sunday, July 29, 2012

Research Update: Metabolic Hormones Changes After Weight Loss

Long Term Persistence of Hormonal Adaptations to Weight Loss
New England Journal of Medicine 2011: 365:1597-604.

Objective:  To examine the changes in metabolic hormones for up to a year after weight loss.  We need to learn more about why so many people who lose weight gain it right back.

Methods: 50 overweight subjects were enrolled in a 10 week weight loss program which included a very low calorie diet.  At baseline, after the 10 week weight loss intervention, and 62 weeks, the researchers measured leptin, ghrelin, peptide YY, gastric inhibitory peptide, glucagon-like peptide Y, amylin, pancreatic polypeptide, cholecystokinin, insulin, and subjective ratings of hunger.  Each of these hormones has been shown to have an impact on metabolism and/or energy intake.

Results: After the 10 week low calorie diet, subjects lost an average of 29.7 lbs.  Immediately after weight loss, levels of leptin, peptide YY, cholecystokinin, insulin, and amylin were significantly lower and levels of ghrelin, gastric inhibitory polypeptide, and pancreatic polypeptide were significantly higher.  There was also a significant increase in subjective measures of appetite.

One year after the weight loss, there were still significant differences from baseline in levels of leptin, peptide YY, cholecystokinin, insulin, ghrelin, gastric inhibitory polypeptide, pancreatic polypeptide, as well as hunger.

Discussion: It is not surprising that following weight loss, hormones were changed in a way that promoted weight regain.  We’ve known this for some time.  What is surprising is that they remained that way for a full year after the weight loss!

It is evident that our bodies have amazing defense mechanisms to weight loss.  We evolved in times of drought, famine, and food scarcity.  Those who survived to pass on their genes gained weight quickly, and lost it slowly.  This was most helpful during our early period, but this mechanism has really hurt us in the era of unlimited food availability.

It is becoming clear that the reason so many people regain lost weight is not because they become weak and unfocused with their diet and exercise, but because their body very strongly wants them to put the weight back on.  Weight relapse clearly has a physiological basis.

Take Home Message: After you lose weight, you need to realize that your body starts an all out war to put it back on.  Keep your foot on the gas with your diet, cardio, and resistance training programs.  Your weight loss plan is in no way a temporary thing.  In reality, you need to work just as hard to keep it off as you did to lose it.

Saturday, July 14, 2012

Product Review: Bodylastics Resistance Bands

Getting to the gym can be a real challenge given our busy lives of work and family responsibilities.  When I was in college and even grad school, there seemed to be plenty of time to get to the gym and enjoy a leisurely workout.  Now that I’m a bit older, time is definitely more limited.  I’ve noticed the same thing with my clients over the years.  Once they hit a certain age, it becomes very hard for them to get to the gym on a consistent basis.   Therefore, as I’ve mentioned before, I’m a big advocate of working out at home. 

Most parts of the body are very easily exercised with a flat bench and some dumbbells.  However, the back can be a bit more challenging to workout at home.  There are several dumbbell exercises that focus on the back, but to really get the variety you want, you’ll need to bring in some other equipment.  I figured I’d use this post to introduce one such piece of equipment: Bodylastics Resistance Bands.  

Bodylastics Resistance Bands are a stackable and adjustable resistance system.  The kit I purchased has up to 96 pounds of resistance, but they also sell kits with more or less resistance.  The system comes with 4 different colored bands of varying thickness that you can combine to produce the exact resistance you need for any exercise.

In addition to the stackable resistance bands, the system comes with handles for both your hands and ankles as well as a door anchor.  The door anchor is the absolute key.  It allows you to attach the system to any door that closes in your home.  If you put it up high, you can simulate high pulley exercises like lat pulldowns.  If you keep the anchor a bit lower, you can simulate low pulley exercises like seated rows.  This adds a completely new element to how you can work your back at home.  Let’s take a quick look at the pros and cons of the Bodylastics system.

1) Extremely Well Made And Durable:  These will last you a lifetime.  I’ve had mine for 2 years and they are showing no signs of wear and tear.

2) Serious Resistance: I’ve historically been a bit down on resistance bands in general.  I never felt like I was getting the type of resistance that I needed.  Not so with the Bodylastics system.  These feel a lot tighter than other bands I’ve used.  I get a great workout with these.

3) Comes With A Door Anchor:  Great for working the back with simulated high and low pulley exercises.

4) Very Portable:  The system comes with a carrying case that can easily fit in your luggage for when you need to bring your workout on the road.

5) Very Secure Door Anchor: Door anchors tend to make me nervous.  Not this one.  It is solid and it’s going no where, so feel free to workout with confidence.

1) The only con that I can come up with is the price.  They are a bit more expensive than other resistance bands.  They retail for $54.95, but as of this writing, has them on sale for $35.95.

Do I Recommend Bodylastics Resistance Bands?
Absolutely.  These are a great addition to any home gym and will allow you to be much more creative with your workouts.  While they cost a bit more than other bands on the market, the quality of the product easily makes it worth the extra investment.  To learn more about these bands or to pick them up, check out their amazon page (here).

Thursday, June 28, 2012

The Top Non-Dairy Sources Of Calcium

Calcium is a very important nutrient.  We all know that it is pivotal to the maintenance of our bones.  Calcium also serves several other important functions, including the regulation of the hearts rhythm, the transmission of nerve impulses, and even plays a role in blood clotting.   The best sources of calcium are dairy products.  However, many people are lactose intolerant or have other, less dramatic sensitivities to dairy.  For many of these people, daily consumption of dairy products is not an option. 

I figured I’d use this post to list out some of the healthiest non-dairy sources of calcium.
This information was found in Appendix B of the Dietary Guidelines For Americans (Reference 1)

 1) Calcium Fortified Almond Milk: 1 cup has 457 mg of calcium.

 2) Calcium Fortified Soy Milk: 1 cup has 368 mg of calcium.

 3) Sardines, in oil:  3 oz has 325 mg of calcium.

 4) Pink Salmon, canned, with bone:  3 oz has 181 mg of calcium.
 5) Collard Greens: ½ cup has 178 mg of calcium.

 6) Spinach: ½ cup has 146 mg of calcium.

 7) Soybeans, green: ½ cup has 130 mg of calcium.

 8) Turnip Greens: ½ cup has 124 mg of calcium.

 9) Ocean Perch, Atlantic: 3 oz has 116 mg of calcium.

 10) White Beans: ½ cup has 96 mg of calcium.

 11) Kale: ½ cup has 90 mg of calcium.

 12) Okra: ½ cup has 88 mg of calcium.

 13) Blue Crab: 3 oz has 86 mg of calcium.

 14) Clams: 3 oz has 78 mg of calcium.


Thursday, June 14, 2012

Research Update: New Research On Beverages And Health

Coffee consumption and risk of chronic disease in the European Prospective Investigation into Cancer and Nutrition (EPIC)- Germany study.  American Journal of Clinical Nutrition 2012; 95:901-908.

This study of 42,659 men and women from the European Prospective Investigation into Cancer and Nutrition cohort examined the association between coffee consumption and risk of chronic disease, including stroke, cancer, myocardial infarction, and type 2 diabetes.  After approximately 9 years of follow up, subjects consuming 4 or more cups of coffee per day had no increased risk of any disease when compared to those consuming less than 1 cup a day.  In fact, they had a 23% reduced risk of type 2 diabetes.

Take Home Message: Coffee drinking has long been vilified as an unhealthy vice.  However, the research is beginning to mount that at the very least it is not harmful and may even be beneficial to our health.  So if you like a cup of coffee or two in the morning, there is no reason to stop. 

Soda consumption and the risk of stroke in men and women.  American Journal of Clinical Nutrition 2012; 95:1190-1199.

This study takes a look at the association between soda consumption and risk of stroke in a very large group of subjects.  Two cohorts were included in this study: the Nurses’ Health Study (n=84,085) and the Health Professional Follow-up Study (n=43,371).  The women were followed for 28 years and the men were followed for 22 years.  Consuming one of more sodas per day was associated with a 16% higher risk of stroke compared to those who did not drink soda.

Take Home Message: Add stroke to the long list of chronic diseases that are associated with sugar sweetened beverage consumption.  We’ve also seen increases in risk of obesity, type 2 diabetes, hypertension, high cholesterol, and heart disease in heavy soda drinkers.  This is not an ideal beverage choice, to say the least.

Tuesday, May 29, 2012

Question And Answer: Gazelle Edge

If you’ve read my book or work with my privately, you already know that I’m a huge fan of the Gazelle Edge Elliptical Trainer.  This machine is perfect for home use.  It is inexpensive at just over $100, it folds up for storage when not in use, and is extremely low impact.  The majority of my clients pick up one of these machines and use it as their primary source of cardio.  I have one myself and use it every day.  I figured I’d use this question and answer post to help owners of the Gazelle Edge get the most out of their machine.  For a complete review of the Gazelle, including where to get it, check out this earlier post (click here).
One note before we begin: whenever starting an exercise program, it is imperative that you contact your doctor and get medical clearance.  I will not even think about recommending exercise to a new client until I conduct a medical history and contact their doctor for clearance.  Safety first!  On to the questions:

Should I Use The Arms?
No. In fact, I recommend unscrewing and removing the arms altogether.  I say this for 2 reasons:  1) I want you to emphasize the large muscles of the lower body during your cardio, not the arms.  2) Having the arms off the machine will free up your hands to hold a phone, the remote control, your Ipad, book, or newspaper.

How Can I Prevent The Gazelle From Sliding Around?
If you place the Gazelle on a hardwood floor, you’ll notice that it moves around a bit during your workout.  To prevent this, use the Gazelle on a carpet if at all possible.  If this isn’t possible, a thin yoga mat underneath it will help a lot.  I actually use a yoga mat on top of the carpet to keep the Gazelle from leaving indentations on the carpet.  This combination reduces movement completely.

Initially, I Feel Like I’m Not Working Out Hard Enough, Am I Doing Something Wrong?
When you first start using the machine, you are not entirely comfortable and balanced.  This will slow down your pace.  During this early phase, many feel that they are not working hard enough.  You’ll find that if you keep at it, your balance will improve and you’ll be able to work harder.  Take long, fluid strides; kind of like you are cross-country skiing on one of those Nordic Track’s from years ago.  Also swing your arms as if you were running quickly.  Before you know it, you’ll be sweating and your heart rate will be up.

Can I Do Anything Else To Pick Up The Intensity?
For most people, just following the above recommendations will get their intensity to the proper level to improve fitness and lose weight.  However, if I have a client that is a bit younger and healthy, I’ll recommend interval training to ramp up the intensity.  I’ll have them start out their cardio at the normal intensity for 4½ minutes, and then sprint for 30 seconds.  I’ll have them repeat this 4 or 5 times during their workout.  This is a great way to increase intensity and calories burned.  The sprint does not have to be a maximal effort; simply increase your pace for 30 seconds.  If a client is very overweight or has risk factors for heart disease (high blood pressure, high cholesterol, etc), I don’t recommend intervals, as the increased intensity can spike heart rate and blood pressure.

My Gazelle Is Starting To Squeak, How Can I Fix This?
You may notice after some time that your Gazelle squeaks a bit. I normally have headphones on when I use it, so I don’t even really notice, but some of my clients have found this annoying.  Here’s how to fix this straight from the user manual:

If squeaks or other noises develop over time, we recommend lubricating all
moving parts as follows:
             a) Apply clear household grease (i.e. petroleum jelly) to axle tube.
             b) Spray cable holders (top & bottom) with WD40 or equivalent.”

Monday, May 14, 2012

Feature Article: Healthy Weight

When I meet a new weight loss client, one of the first questions I ask is, “How much weight would you ideally like to lose?”  Usually they turn around and ask me, “Well, how much do I need to lose?”   I figured that I’d create a post to help my readers answer this common question.

There are several guidelines to help you figure out your ideal weight.  As a Licensed Nutritionist and an Exercise Physiologist, my goal is to get my client down to a point where their weight will no longer increase their risk of chronic disease.  If they want to go a bit lower for cosmetic reasons, that is fine and I’m happy to help them do so.  However, when their weight is no longer going to negatively impact their health, I truly feel like I’ve done my job.  So how do you set your weight loss goals to minimize your risk of chronic disease?  There are actually 3 important measures.

Body Mass Index
Body mass index is a great place to start.  Your body mass index is your weight in kilograms divided by your height in meters squared.   If your body mass index is 25 or lower, your weight is considered normal.  If it falls between 25.1 and 29.9, you are considered overweight.  If it is 30 or more you are considered obese.

Risk of chronic disease begins to increase with BMI’s over 25 and rises sharply with BMI’s over 30.  I always have my clients shoot for a BMI under 25.  While the BMI measure isn’t perfect, there is a lot of solid research behind the numbers, so I always have my clients start there.  The Center for Disease Control has a free BMI calculator (click here).  You can use this calculator to figure out your BMI today and also what weight you need to reach to get it under 25.

Waist Circumference
The next area you want to focus on is your waist circumference.  Abdominal fat is particularly harmful to our health.  It has been associated with insulin resistance and inflammation, which can lead to increases in risk of heart disease, diabetes and even some cancers. 

Measure your waist with a tape measure right at your navel.  Men want to be below 40 inches and women want to be below 35 inches.  Your waist measure is important even if you are at a healthy weight.  Studies have shown that if your BMI is below 25 but your waist circumference is too high, your will have a significantly higher risk of death.

Body Fat
One other useful measure is your percent body fat.  The best way to measure this is with a DEXA scan.  This machine is often used to measure bone density.  Many don’t have access to one of these, so your next best bet is a bioelectrical impedance analyzer.

These machines work by shooting an imperceptible electric pulse up your body.  Since muscle and fat conduct electricity differently, your body fat can be measured.  If you are interested in picking up an analyzer, I recommend the brand Tanita.  Tanita sells a line of very accurate scales that come with a bioelectrical impedance analyzer.  They generally run around $100.  I’ve seen validation studies on these scales and when used correctly, they correlate highly with DEXA scans, which are the gold standard for body composition assessment.  Since bioelectrical impedance relies on proper levels of hydration, for 3 hours before the test you don’t want to eat, sleep, or exercise.

I’ve had a Tanita Ironman for years and love it.  To learn more about these analyzers or to pick one up, check out their website at

So what body fat should you shoot for?  A fit level of body fat is generally considered 14-17% for men and 21-24% for women.  That is a great goal to shoot for.

Saturday, April 28, 2012

Research Update: Beverages And Weight Loss

Replacing caloric beverages with water or diet beverages for weight loss in adults: Main results of the Choose Healthy Options Consciously Everyday randomized clinical trial.  American Journal of Clinical Nutrition 2012: 95:555-63.

Objective:  The objective of this study was to examine the effects of replacing caloric beverages with water or diet beverages as a method of weight loss over a 6 month study period.

Methods: 318 overweight and obese men and women who consumed at least 280 daily calories in beverage form were recruited for this study.  Subjects were placed into one of three groups:

Group 1 replaced 2 servings of soda per day with water.
Group 2 replaced 2 servings of soda per day with diet soda.
Group 3 was a control group that received general weight loss advice but no specific instructions on beverages.

The intervention lasted for 6 months and then weight was measured.  Replacement beverages were provided to all study participants in replacement groups.

Results: At the end of the 6 months, all three groups had lost weight.  However, participants assigned to beverage replacement were two times as likely to have achieved a 5% weight loss when compared to the control group.

Discussion: It appears that our body is not very good at registering calories in liquid form.  Studies show that when we snack on solid food, most people will generally compensate by eating fewer calories the rest of the day.  This does not seem to happen with liquid calories.  When the same people received snacks in liquid form, they did not eat any less throughout the rest of the day.  This study provides further evidence that liquid calories are usually just added to what we would normally eat in a day. 

Take Home Message: If you are trying to lose weight, dump the liquid calories.  Stick with water, decaf coffee/tea or naturally flavored sparkling water.  Don’t go too crazy with the diet sodas-- they have some issues of their own.  (To learn more about non-nutritive sweeteners, check out this post)

Saturday, March 31, 2012

Book Review: The Fertility Diet

The Fertility Diet is next up for review.  Many of my clients and blog readers are at the age where they are thinking of starting a family.  Problems with conception are common and can be very difficult to deal with.  It turns out that the lifestyle habits of the mother and father have much more to do with the ability to conceive than previously thought. The book is co-authored by Dr. Walter Willett and Dr Jorge Chavarro.  Dr Willett is the Department Chair at the Harvard School of Public Health Department of Nutrition.   Dr. Chavarro is a research fellow there as well.  Full disclosure:  I know both of the authors: Dr Willett was my Department Chair while at Harvard and Jorge and I were both getting our doctorate at the same time.  Trust me when I say that my familiarity with these two amazing researchers will not bias this review.  My high opinion of this book is based solely on the fact that the book is truly well done.

The Nurses’ Health Study has produced an impressive array of research on the subject of diet and fertility.  The Fertility Diet presents this research in an easy to understand format.  The basic premise of the book is that there are 10 diet and lifestyle strategies that will improve a couple’s chances of conception.  In the first chapter, all 10 strategies are briefly presented.  The remaining chapters of the book each cover one of these strategies in depth, and the supporting research to back up the claim is presented and analyzed.  The last part of the book features a 7 day meal plan that includes several recipes.  The book is extremely well written and converts a lot of complicated research into simple lay terms that are easy to understand to those unfamiliar with scientific research design.

5 Things I Liked About The Fertility Diet
1) It Is Research Based: Far too many nutrition books present opinion and not research based hypothesis, adding to the generalized confusion on how nutrition impacts health.  The Fertility Diet basis all recommendations on current, well designed research.  If the research isn’t definitive on a topic, the authors have the courage to say “we don’t know about this yet”.

2) It Is Comprehensive: The Fertility Diet is not just about nutrition, it covers all aspects of lifestyle that may impact the ability to conceive, including: weight, exercise, and stress.

3) Glycemic Index And Glycemic Load Are Very Well Explained:  There is a comprehensive discussion of glycemic index and glycemic load that is one of the best I have ever seen.

4) Interesting Section On Dairy:  The chapter on dairy is fascinating.  You’ll learn a lot about the difference between low fat and high fat dairy products and how they may impact the ability to conceive.  You’ll definitely be surprised by some of the research in this area.

5) Review Of Popular Diets:  In the chapter on maintaining a healthy weight, the authors present a really well done, research based review of popular weight loss diets.

Do I Recommend Reading The Fertility Diet?
Absolutely and strongly!  This book is great.  Research is becoming clear that the lifestyle habits of mother and father can not only influence the ability to conceive, but the long term health of the child.  I also think there is tremendous value in reading this book if you’re not trying to conceive.  Most of the recommendations that promote conception also promote general health as well.  In fact, the book spends a lot of time explaining how each strategy impacts health and risk of disease before getting into the impact on conception.  At times, the book had the feeling of being an updated version of Dr. Willett’s Eat Drink And Be Healthy, which, in my opinion, is one of the best nutrition books ever written.

Wednesday, March 14, 2012

Product Review: Fitbit Ultra

If you are interested in losing weight or improving your health, cardiovascular exercise is extremely important.  Most people are really busy, and I’ve found over the years that an inadequate level of cardio is one of the biggest obstacles to weight loss success.  Any tool that can help in this area is worth its weight in gold.  The Fitbit Ultra is one such tool.
The Fitbit is like a pedometer on steroids.  It’s a tiny gadget that you can put in your pocket or clip on your waist.  It contains a 3D motion sensor that allows you to record every aspect of your daily physical activity, including:

1) Step taken
2) Miles walked
3) Stairs climbed
4) Hours slept

You can cycle through all of these measurements on the Fitbit itself.  It also wirelessly loads them onto your computer, so you can graph and keep track of all of your activities. 

The Fitbit is a great tool to keep you aware of your physical activity and has a lot of great features. I picked one of these up a few months ago and have used it a ton. 

Fitbit Pro’s
1) Small and easy to wear, you don’t even notice it’s on you.

2) Great features: including measurement of steps, miles, stairs climbed, and sleep.

3) Free access to the Fitbit website where you can keep track of your activity, set up goals, and much more.  Many other lifestyle monitors charge you a monthly fee for access to such a site.

4) Helps you accurately gauge your level of physical activity.  I was amazed at how much my level of activity varied from day to day, depending on my schedule.

5) Provides accountability.

6) Motivates you to become more active.

1) The only con I can come up with is that compared to other pedometers it is a bit pricey at $99.  However, this is a one time outlay with no other fees to use the website.  You also get a bunch more features than you do with everyday pedometers.

Would I recommend the Fitbit Ultra?
Absolutely.  The Fitbit Ultra is a great tool to help you assess your activity levels.  You’ll actually become competitive with yourself.  If you set a goal of 10,000 steps and your looking short one day, you may find yourself looking for excuses to walk a bit more.  It is also great for when you travel and are not sure of your physical activity levels.

Monitoring your diet and exercise is a huge part of making lifestyle changes stick.  Fitbit allows you keep track of your physical activity in a simple and highly motivating way.  

The Fitbit retails for $99 and is shipped for free.  For more information or to pick one up, check out their website at