Tuesday, January 13, 2015

Questions And Answers: Should I Join A Gym?

Whenever I meet a new client, they often wonder if it is necessary to join a gym in order to attain their weight loss and fitness goals.   

The answer is no, there really is no good reason to join a gym. For the vast majority of my clients, working out at home makes a lot more sense. Here are some of the biggest reasons why:

1) Working out at home saves you time. Driving to the gym, parking your car, changing your clothes in the locker room and then doing the reverse after your workout can take up a lot of time. I, personally, can get half of my workout done by the time it would take me to get on the gym floor. When you are really busy, that extra 20 minutes can be the difference between getting your workout in and having to skip it.

2) Working out at home saves you money. Gyms are not cheap, especially the nice ones. You can take one year’s worth of gym fees and set yourself up with equipment that will last you a decade or longer.

3) Working out at home will make you more consistent. It is virtually impossible to get to the gym every day. Having equipment at home will allow you to work out more regularly, or at least get half a workout in when time is tight. In 15 years as a trainer, I have had exactly one client who was able to get all of her cardio done at a gym with consistency. I can’t even count the number who hit their cardio goals while exercising at home.

4) Working out at home will make you more efficient. Combining your cardio with something you already do is a great idea. Watching the news or other taped shows, returning phone calls, and checking your email are all things you can do while working out. It is not easy to multitask at a gym.

So what will you need? Not much, really. A set of dumbbells, an exercise mat, and a piece of cardio equipment will do the job amazingly well. I am a big fan of elliptical trainers for cardio, they are efficient calorie burners and create minimal joint stress. If you want to go the more thrifty route, a Gazelle Edge ($113 on Amazon.com) is all you’ll need. If you want to spend a bit more money on the bells and whistles, a Life Fitness elliptical is a great choice.


Mediterranean Diet And Telomere Length

The Study
A telomere is a DNA structure on a cell that shortens each time the cell divides. Telomere length is considered a biomarker for aging, because shorter telomeres have been associated with a decreased life expectancy and an increased risk of major chronic disease. In this investigation of 4,676 women from the Nurses’ Health Study, the impact of a Mediterranean diet on telomere length was examined. 

A score was created for each participant that gauged adherence to a Mediterranean diet. The score had 9 components: vegetables, fruits, nuts, whole grains, legumes, fish, monounsaturated fat:saturated fat ratio, red and processed meat, and alcohol. Women with higher scores had significantly longer telomeres after adjusting for confounders. These results provide further evidence that adherence to a Mediterranean diet promotes greater health and longevity. British Medical Journal 2014:349:g6674.

Take Home Message
In the last decade, there has been a tremendous amount of research showing a real benefit to the Mediterranean style of eating. This study is unique because it uses a biomarker for aging, which has been associated with longevity and chronic disease incidence in the research literature. 

The results of this study were pretty impressive. The difference in telomere length for each 1 point change in the Mediterranean diet score corresponded to 1.5 years of aging. A three point change in score was equivalent to 4.5 years of aging, which is comparable to the difference between smokers and non-smokers. This study provides further evidence that a Mediterranean diet is the way to go if you are looking to reduce your risk of chronic disease and increase longevity. For those of you that work with me or have read my book, congratulations, you are already consuming a Mediterranean diet!


Soda Consumption And Rheumatoid Arthritis

The Study
79,570 women from The Nurses’ Health Study and 107,330 women from the Nurses’ Health Study II cohort were divided into groups according to their consumption of soda and followed for over 20 years. The number of new diagnoses of rheumatoid arthritis (RA) in each group was compared at the end of follow-up. Women who consumed 1 or more sodas per day had a 63% increased risk of developing seropositive RA (the most common form) when compared to those consuming less than 1 serving of soda per month. Diet soda was not associated with risk of RA. The American Journal of Clinical Nutrition 2014; 100:959-67.

Take Home Message
This study provides further evidence that sugar sweetened beverages, like soda, can have a powerful impact on our health. Soda may increase inflammation and reduce insulin sensitivity, which the authors believe explains the increase in RA among the soda drinkers. Strictly limit consumption of sugar sweetened beverages, and all added sugars for that matter.

Monday, January 12, 2015

Book Review: The Forks Over Knives Plan

Next up for review is The Forks Over Knives Plan. The authors, Dr. Alona Pulde and Dr. Matthew Lederman, are both medical doctors specializing in nutrition and lifestyle medicine.

Forks Over Knives essentially has one central theme; the path to optimal health and longevity is to eat a plant based diet with absolutely no animal products. The book is broken down into 3 sections: 1) The science part: this section covers the scientific rationale behind the recommendations.  2) The lifestyle part: this section covers the 4 week transition to going vegan.  3) The recipe section.  The book is 285 pages long and is well written. I truly enjoyed reading it.

5 Things I Really Liked About The Forks Over Knives Plan
1) The foundation of this diet is fruits, vegetables, whole grains, and legumes. In my opinion, this should be a primary recommendation for every healthy diet.

2) This style of eating strictly limits red meat, processed meats, and saturated fat.  I’m in full agreement here.

3) I am really in sync with their “food dictates health” philosophy.  As a nation, we all need to understand how our diet and exercise habits can impact our health. We need to stop relying on medicine to fix us after years of abusing our bodies.

4) The section on meal planning, meal prepping, and grocery shopping is really well done and provides great tips on how to incorporate these changes into your life. 

5) The recipe section is great.  The authors include over 100 recipes that range from quick and easy to gourmet.

5 Things I Didn’t Agree With In The Forks Over Knives Plan
1) This program is heavy on the carbs at 80% of calories and includes a lot of very rapidly absorbed carbohydrates.  The glycemic index/glycemic load of this style of eating is really high and in my opinion, not a good idea if you are trying to lose weight or reduce your risk of chronic disease.  I was also a bit surprised at how much sugar was in the recipes, some of which called for ¾ cup of maple syrup!

2) This program is quite low in protein, with 10% of calories as the goal.  Recent research suggests that a bit more protein is necessary to reduce the loss of muscle that naturally occurs with aging.  The recommendations are now closer to .5 grams of protein per pound of body weight, which is about 20% of calories for most people.

3) The author’s choice of research to back up the recommendations was a bit curious.  They cited a lot of less methodologically sound research, like ecological studies, cross sectional studies, and correlational studies to prove their points, while ignoring more carefully designed randomized trials and prospective cohort studies that showed the opposite of what they recommend.  Whole areas of research were completely ignored, such as glycemic load and health, the benefits of mono and polyunsaturated fats, the benefits of consuming fish, et al.

4) The authors are very deliberate in recommending a B-12 supplement when going vegan.  B-12 is only found in animal products and B12 deficiency is no joke.  It can cause the following symptoms: numbness in hands, legs, or feet, difficulty walking, balance problems, anemia, swollen tongue, jaundice, difficulty thinking or reasoning, memory loss, paranoia or hallucinations, depression and weakness.  Many of these symptoms are irreversible if the deficiency goes on for too long. In my opinion, any diet that can make you this sick without taking a supplement pill is not a natural way of eating for humans.  

5) There were some statements made by the authors that were real head scratchers.  These statements are not in any way supported by the current nutrition research literature.  Here is a small sample:

Oil based salad dressings are unhealthy (Page 77).
Dairy can promote premature aging (Page 88).

Salmon contains harmful levels of fat (Page 103).

Fish contains heart unhealthy cholesterol and leads to bone loss (Page 103).

All vegetable oils promote heart disease (Page 107).

Vegetable oils have a negative effect on lung function (Page 107).

There is nothing health promoting about alcohol (Page 126).

And, as a glycemic load researcher, my absolute favorite: “We prefer not to talk about the glycemic index because it is a measure of something that has nothing to do with good health” (Page 123).

Is The Forks Over Knives Plan Worth Reading?
Absolutely! I enjoyed this book. You’ll learn a lot about the benefits of fruits, vegetables, whole grains and legumes.  These foods form the foundation of any healthy diet.  You will also get some great tips on meal planning, meal prep and grocery shopping. However, the very low levels of protein and healthy vegetable fats are recommendations that simply are not consistent with the current nutrition research literature.