Gretchen Reynolds is the Phys Ed blogger at the New York Times. She posted a five-minute demonstration of high intensity interval training on a stationary bicycle. It’s narrated by Martin Gibala of McMaster University.
No mention of Tabata.
-Steve
Gretchen Reynolds is the Phys Ed blogger at the New York Times. She posted a five-minute demonstration of high intensity interval training on a stationary bicycle. It’s narrated by Martin Gibala of McMaster University.
No mention of Tabata.
-Steve
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Posted in Exercise
Tagged bicycle, Gibala, Gretchen Reynolds, HIIT
The Mediterranean diet is associated with a 33% reduction in stomach cancer, according to a study published in the American Journal of Clinical Nutrition.
Stomach cancer (aka gastric cancer) is uncommon in the U.S. Most cases are advanced and incurable at the time of diagnosis. So prevention is ideal.
European investigators studied 485,000 people over the course of nine years, during which 449 cases of stomach cancer were found. Surveys determined how closely the food consumption of study participants tracked nine key components of the Mediterranean diet. Compared with people who had low adherence to the Mediterranean diet, those with high adherence had 33% less risk of developing stomach cancer.
The Mediterranean diet has long been associated with a lower risk of cancer: specifically, cancers of the breast, colon, prostate, and uterus. We can add stomach cancer to the list now.
Reference: Buckland, Genevieve, et al. Adherence to a Mediterranean diet and risk of gastric adenocarcinoma within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study. American Journal of Clinical Nutrition, December 9, 2009, epub ahead of print. doi: 10.3945/ajcn.2009.28209
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Posted in Cancer
Here’s my review of The Blue Zones: Lessons for Living Longer From the People Who’ve Lived the Longest, a 2008 book by Dan Buettner. I give the book four stars on Amazon.com’s five-star system (“I like it”).
The publisher donated three copies of The Blue Zones as give-aways, which I gave away to my blog readers.
♦ ♦ ♦
The lifestyle principles advocated in The Blue Zones would indeed help the average person in the developed world live a longer and healthier life. The book is a much-needed antidote to rampant longevity quackery. Dan Buettner’s idea behind the book was “discovering the world’s best practices in health and longevity and putting them to work in our lives.” He succeeds.
Mr. Buettner assembled a multidisciplinary team of advisors and researchers to help him with a very difficult subject. Do people living to 100, scattered over several continents, share any characteristics? Do those commonalities lead to health and longevity?
They studied four longevity hot spots (Blue Zones):
Research focused on people who lived to be 100.
Until recently, two of the Blue Zones—the Nicoyan Peninsula and Sardinia—were quite isolated, with relatively little influence from the outside world.
Mr. Buettner et al identify nine key traits that are associated with longevity and health in these cultures. Of course, association is not causation, which Mr. Buettner readily admits. He draws more conclusions from the data than would many (most?) longevity scientists. Scientists can wait for more data, but the rest of us have to decide and act based on what we know today. Here are the “Power Nine”:
Of these, I would say the available research best supports numbers 1, 4, 7, 8, and the social support system.
I doubt that hari hachi bu (eat until you’re only 80% full) will work for us in the U.S. It’s never been tested rigorously. The idea is to avoid obesity.
The author believes that average lifespan could be increased by a decade via compliance with the Power Nine. And these would be good, relatively healthy years. Not an extra 10 years living in a nursing home.
Appropriately and early on, Mr. Buettner addresses the issue of genetics by mentioning a single study of Danish twins that convinces him longevity is only 25% deterimined by genetic heritage. Environment and lifestyle choices determine the other 75%. I believe he underestimates the effect of genetics.
Over half the population of the Nicoya Peninsula Blue Zone are of Chorotega Indian descent, not from Spanish Conquistadores. Would a Danish twin study have much to say about Chorotega Indians’ longevity? We don’t know, but I’m skeptical. Also, the Sardinians and Okinawans would seem to have centuries of a degree of inbreeding, too, according to Buettner’s own documentation.
Do the Adventists tend to marry and breed with each other (like Mormons), thereby concentrating longevity genes? You won’t find the question addressed in the book.
Because I think genetics plays a larger role in longevity than 25%, I’d estimate that the healthy lifestyle choices in this book might prolong life by six or seven years instead of 10. But I’m splitting hairs. I don’t have any better evidence than Mr. Buettner, just a hunch plus years of experience treating diseased and dying patients.
These four Blue Zones do share a mostly plant-based diet of natural foods with minimal processing. Two of the populations—the Okinawans and Costa Ricans—didn’t seem to have any choice. Heavy meat consumption just wasn’t an option available to them. Rather than promoting a low-meat plant-based diet, it might be more accurate to conclude that “you don’t have to eat a lot of meat, chicken, or fish to live a long healthy life.”
In other words, it may not matter how much meat you eat as long as you eat the healthy optimal level of fruits, vegetables, and whole grains. It’s a critical difference not addressed in this book except among the Adventists.
Even if you could live an extra two years as a vegan, I’m sure many people would choose to eat meat anyway. By the way, this book conflates vegan, lacto-vegetarian, lacto-ovo vegetarian, near-vegetarian, and vegetarian into one: vegetarian. They are not necessarily the same. It’s a common problem when considering the health aspects of vegetarianism.
By the same token, plenty of my patients have told me they don’t like any kind of exercise and they won’t do it, even if it would give them an extra two years of life. What many don’t realize is that from a functional standpoint, regular exercise makes their bodies perform as if they were ten years younger. There’s a huge difference between the ages of 80 and 70 in terms of functional abilities.
Why read the book now that you have the Power Nine? To convince you to change your unhealthy ways, and indispensible instruction on how to do so.
Disclosure: The publisher’s representative did not pay me for this review, nor ask for a favorable review. They offered me a review copy and three give-aways, and I accepted. I figure the cost of the books to the publisher was $16 USD total.
Age-related macular degeneration is the leading cause of blindness in Americans over 65. Impaired vision precedes blindness. A recent study linked consumption of omega-3 fatty acids with 30% lower risk of developing macular degeneration. Believe me, it’s a lot better to prevent it than try to treat it once present.
(I have a couple older relatives with macular degeneration, so I pay close attention to the scientific literature.)
What’s the best source of omega-3 fatty acids? Our friend, the fish. Especially cold-water fatty fish such as tuna, trout, sardines, herring, mackerel, halibut, and sea bass. A few plants are also decent sources, but our bodies don’t utilize those omega-3 fatty acids as well as they do from fish.
Note that both the Advanced Mediterranean Diet and Ketogenic Mediterranean Diet feature fish.
Reference: SanGiovanni, J.P., et al. Long-chain polyunsaturated fatty acid intake and 12-y incidence of neovascular age-related macular degeneration and central geographic atrophy: AREDS report 30, a prospective cohort study from the Age-Related Eye Disease Study. American Journal of Clinical Nutrition, 90 (2009): 1,601-1,607. First published October 7, 2009. doi:10.3945/ajcn.2009.27594
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Posted in Uncategorized
Tagged blindness, cold-water fatty fish, fish, macular degeneration, omega-3 fatty acids
The direct yearly medical cost of being obese in the U.S. is $1,723 per obese person, according to a 2009 report in Obesity Reviews. Being overweight is a relative bargain at $266.
These numbers translate into $114 billion yearly, or five to 10 percent of total healthcare spending.
Not included in the numbers are costs such as lost productivity due to obesity-related illness and replacement or repair of items that wear out or break due to excessive amounts of physical stress. Not to mention pain and suffering.
Are you overweight or obese? Find out with an online body mass index calculator.
Want to do anything about it? See my “Prepare for Weight Loss” series.
Reference: Tsai, A.G., et al. Direct Medical Cost of Obesity in the U.S.A. Obesity Reviews, online January 6, 2009. doi: 10.1111/j.1467-789x.2009.00708.x
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Posted in Overweight & Obesity
Tagged cost of obesity
I loved the sound of this phrase – hari hachi bu – even before I knew what it meant.
“Hari hachi bu” comes from the Japanese islands of Okinawa. It refers to eating a meal until you’re only 80% full, then stop eating. It’s a method to control weight.
Okinawa, remember, is one of the longevity hot spots in Dan Buettner’s Blue Zones.
But would it really work for many in Western culture? Probably not. We don’t have the discipline to stick with it long-term. Maybe for a day.
One of the currently popular dieting gimmicks is to eat every 3-4 hours while awake. The rationale is, “you need the energy.” If you eat 5-6 meals a day, you’re not cutting back on total calories even if you eat only until 80% full.
As long as you’re eating a fair amount of carbohydrates, you can store plenty of energy as glucose in glycogen – in your liver and muscles – to easily live without eating for at least 8-12 hours. So, there’s no “need” to eat every 3-4 hours. If there were, we would have gone extinct years ago. At rest, you’re getting about 60% of your energy supplied by metabolism of fats, not carbohydrates. Most people can live without all food, but not water, for about two months.
Plenty of people have said, “I’m going to lose weight by cutting back on food intake.” I don’t have scientific data to back it up, but I’d bet that a food diary works better.
A simple weight-loss or management plan that would work better for Western world inhabitants would be:
Don’t eat anything man-made.
So off limits are bread, rolls, soft drinks, table sugar, high fructose corn syrup, pancakes, pizza, potato chips, Pringles, pies, cookies, cake, casseroles, cannolis, Doritos, Ding-Dongs, Snickers, etc. I’d complicate it just a bit by also avoiding naturally starchy foods like potatoes and corn.
For those who don’t like the negativity of “don’t eat that,” here’s the positive spin:
Eat only natural, minimally processed food.
In other words, eat fresh fruit, fresh vegetables, eggs, meat, chicken, fish, olive oil, nuts, etc. These are God-made foods, not man-made.
The Healthy Librarian at the Happy Healthy Long Life blog wrote about a small scientific study documenting an incredibly easy way to increase blood levels of vitamin D in people taking supplemental vitamin D:
Take the supplement with the largest meal of the day
Subjects of this research were taking vitamin D supplements—often a very high dose—for medical reasons, yet blood levels remained unacceptably low. Blood levels of vitamin D (25-hydroxyvitamin D) rose by 50% simply by taking the same dose with the largest daily meal.
Other people, including young healthy adults, may or may not respond the same way. Do you know?
As for me, I’ll be sure to take my vitamin D supplement with my largest meal.
Disclaimer: All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status. Always consult your personal physician before making any dietary, nutritional supplement, or exercise changes.
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Tagged blood level, Happy Healthy Long Live, vitamin D
Dieters with particular genetic make-up respond better or worse to specific types of weight-loss diets, suggest researchers who presented data at the 2010 Cardiovascular Disease Epidemiology and Prevention /Nutrition, Physical Activity, and Metabolism conference. Findings are preliminary, but may explain the common phenomenon of two people going on the same diet, but only one achieving good results.
I’ll bet you can imagine several other explanations.
Several years ago, the “A to Z” study compared the weight loss of 311 overweight women on one of four diets: Atkins (low-carb), Ornish (very low fat, vegetarian), Learn (low-fat), and Zone (moderate carb restriction, high protein, moderate fat). Atkins was a bit better than the other diets, in terms of long-term (one year) weight loss. But within each diet group, some women lost 40–50 pounds (18–23 kg), whereas others gained over 10 pounds (4.5 kg).
Stanford University researchers obtained DNA from 138 of the 311 women and noted the occurence of three genes—ABP2, ADRB2, and PPAR-gamma—that had previously been shown to predict weight loss via diet-gene interactions. For example, a particular mix of these genes predict better weight loss with a low-fat diet; a different mix predicts more loss with a low-carb diet.
Women who had been randomly assigned to one of the A to Z diets tended to lose much more weight if they happened to have the gene mix appropriate for that diet (compared to those on the same diet with the wrong gene mix). The difference, for example, might be loss of 12 pounds versus two pounds.
The lead researcher, Dr. Mindy P. Nelson, told TheHeart.Org that the proportion in the general population genetically predisposed to the low-fat versus low-carb approach is about 50:50.
Take-Home Points
These results, again, are preliminary; additional testing is necessary for confirmation. If they had been able to test the DNA of the other 178 women in the A to Z study, the results could have been either stronger or shown no diet-gene interaction. The study hasn’t even been published in a peer-reviewed journal yet.
Men may or may not be subject to similar diet-gene interaction.
With a little effort, you’ll be able to find the aforementioned genetic test available via the Internet. It’s under $100 (U.S.). The company sends you a kit to swab the inside of your cheek, then you mail your DNA to them.
Other peope just try a particular diet first and see if it works over 4–6 weeks. Successful long-term weight loss is like smoking cessation—most smokers try 5–7 different times or methods before hitting on one that works for them.
Regular readers here know that I advocate, for weight loss, both a reduced-calorie, balanced Mediterranean diet (Advanced Mediterranean Diet) and a very low-carb diet (Ketogenic Mediterranean Diet). Regardless of genetics, experience has taught me that there’s no single weight-loss program that works for everyone across-the-board.
This potential diet-gene interaction could be a major finding that will stop the arguing about which is the single best way to lose excess fat. Many paths may lead to the mountaintop.
Reference: O’Riordan, Michael. Dieting by DNA? Popular diets work best by genotype, reseach shows. HeartWire by TheHeart.Org, March 8, 2010.
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Posted in Weight Loss
Tagged genes, weight loss
The Mediterranean diet preserves heart muscle performance and reduces future heart disease events, according to Greek researchers reporting in the American Journal of Clinical Nutrition, May 19, 2010.
Reuters and other news services have covered the story.
The Mediterranean diet is well-established as an eating pattern that reduces the risk of death or illness related to cardiovascular disease—mostly heart attacks and strokes. Most of the studies in support of the heart-healthy diet looked at development of disease in general populations. The study at hand examined whether the diet had any effect on patients with known heart disease, which has not been studied much.
The study population was 1,000 consecutive patients admitted with heart disease to a Greek hospital between 2006 and 2009. In this context, heart disease refers to a first or recurrent heart attack (70-80% of participants) or unstable angina pectoris. Acute heart attacks and unstable angina are “acute coronary syndromes.” Average age was 64. Sixty percent had a prior diagnosis of cardiovascular disease (coronary heart disease or stroke). Thirty percent had diabetes. At the time of hospitalization, half had diminished function of the main heart pumping chamber (the left ventricle), half had normal pump function. Men totalled 788; women 212.
On the third hospital day, participants were given a 75-item food frequency questionnaire asking about consumption over the prior year. If a potential enrollee died in the first two hospital days, he was not included in the study. A Mediterranean diet score was calculated to determine adherence to the Mediterranean diet. Mediterranean diet items were nonrefined cereals and products, fruits, nuts, vegetables, potatoes, dairy products, fish and seafood, poultry, red meats and meat products, olive oil, and alcohol.
Left ventricle function was determined by echocardiogram (ultrasound) at the time of study entry, at the time of hospital discharge, and three months after discharge. Systolic dysfunction was defined as an ejection fraction of under 40%. [Normal is 65%: when the left ventricle is full of blood, and then squeezes on that blood to pump it into the aorta, 65% of the blood squirts out.]
Participants were then divided into two groups: preserved (normal) systolic left ventricular function, or diminished left ventricular function.
They were followed over the next two years, with attention to cardiovascular disease events (not clearly defined in the article, but I assume including heart attacks, strokes, unstable angina, coronary revascularization, heart failure, arrhythmia, and death from heart disease or stroke.
Results
The Authors’ Conclusion
Greater adherence to the Mediterranean diet seems to preserve left ventricular systolic function and is associated with better long-term prognosis of patients who have had an acute coronary syndrome.
My Comments
I agree with the authors’ conclusion.
We’re assuming these patients didn’t change their way of eating after the initial hospitalization. We don’t know that. No information is given regarding dietary instruction of these patients while they were hospitalized. In the U.S., such instruction is usually given, and it varies quite a bit.
In this study, lower risk of cardiovascular death was linked to the Mediterranean diet only during the initial hospital stay. Most experts on the Mediterranean diet would have predicted lower cardiovascular death rates over the subsequent two years. Mysteriously, the authors don’t bother to discuss this finding.
For those who don’t enjoy red wine or other alcoholic beverages, this study suggests that the Mediterranean diet may be just as heart-healthy without alcohol. A 2009 study by Trichopoulou et al suggests otherwise.
Reference:
Chrysohoou, C., Panagiotakos, D., Aggelopoulos, P., Kastorini, C., Kehagia, I., Pitsavos, C., & Stefanadis, C. (2010). The Mediterranean diet contributes to the preservation of left ventricular systolic function and to the long-term favorable prognosis of patients who have had an acute coronary event American Journal of Clinical Nutrition DOI: 10.3945/ajcn.2009.28982
Posted in Coronary Heart Disease, Heart Failure, Longevity
Tagged death prevention, heart failure, longevity, Mediterranean diet
Losing excess weight is easier than keeping it off.
Neither is exactly a walk in the park.
Prevention of weight regain is the most problematic area in the field of weight management. You may have heard that “diets don’t work,” but they do. Many different weight loss programs work short-term, if “work” is defined as loss of five, 10, or more pounds while you adhere to the program for several weeks or months. The problem is that the lost pounds usually return.
Why? You get bored with the diet, or your willpower flags, or the diet simply stops working, or the transition from weight loss to maintenance is unclear, or you just feel too bad to go on, or you lose your commitment, or you take a job as a taste tester for Baskin-Robbins Ice Cream, or whatever.
Most diets ultimately fail in the long run because people go back to their old habits.
Read on for the secret to prevention of weight regain. They apply to a majority of weight-loss methods, although many programs ignore this problem because the cure is a hard pill to swallow.
Moving Ahead
For purposes of further discussion, I will assume that you have already lost excess weight down to your goal and now we must focus on staying thereabouts from here on out. Finally down to your goal! A grand accomplishment! You’ve got a new wardrobe, or the old clothes fit again. You have more energy and feel younger. Maybe you cured or improved some health problems. Perhaps you’re getting more attention from the opposite sex.
Our species’ scientific name is Homo sapiens. It is from the Latin sapere, which means “to be wise.” Wisdom is the ability to make correct judgments and decisions. Undoubtedly, your success at weight loss required correct judgments and decisions. You are not done yet. You will need sustained wisdom to avoid weight regain.
Be wise about this especially: you can never again eat all you want, whenever you want, over sustained periods of time.
Now that you have reached your goal weight, you must restrain yourself on a daily basis. Think about it. You became overweight because you didn’t watch what you ate and didn’t exercise enough. You can’t go back to your old ways. Reject this advice, and you have a 100 percent chance of regaining your lost weight.
Have you heard of the Energy Balance Equation?
Calorie Intake minus Calories Burned
= Change in Body Fat
You have been able to lose fat weight because you ate less energy (calories) than your body required for metabolism and physical activity. Your body remedied the energy deficit by converting fat into energy. A pound of fat contains 3,500 calories of energy. If you lost a pound per week, your body on average converted 500 calories of fat daily into energy (7 days x 500 calories = 3,500 calories = 1 pound of fat).
Now that you are at your goal weight and want to stay there, you need to add 500 calories per day back into the equation. Add the calories by eating more food, exercising less, or a combination of the two. But if you add back more than 500, you will regain weight.
The true measure of a successful weight management program is not simply how much weight is lost, but whether the lost weight stays lost over the long run. What distinguishes weight losers who keep the weight off from those who gain it back? Two factors, mostly:
1. Restrained eating
2. Regular physical activity.
“Successful losers” apply self-restraint on an almost daily basis, avoiding food that they know will lead to weight regain. They limit how much they eat. They consciously choose not to return to their old eating habits, despite urges to the contrary. The other glaring difference is that, compared to regainers, the successful losers remain physically active. They exercised while losing weight, and continue to exercise in the maintenance phase of their program. This is true in at least eight out of 10 cases. It’s clear that regular exercise is not always needed, but it dramatically increases your chances of long-term success.
In a nutshell, my maintenance phase prescription for you is: Keep exercising, and eat a little more. Keep exercising, and eat a little more.
Go out of your way to be physically active for 30 to 45 minutes on at least four days per week, if not all days. Walking is fine. The more you exercise, the more you can eat without getting fat again.
At the end of your weight-loss phase and the beginning of the maintenance phase, it is surprisingly easy to start overeating. Forewarned is forearmed. Avoid this landmine any way you can. It helps to continue monitoring food consumption and exercise on your food diary while eating an additional 200–500 calories per day. Continue weighing daily. Keep exercising. After a month or two of this regimen, you’ll have an intuitive sense of what and how much you should be eating without regaining weight. Then stop the daily log routine.
Another option for transition to the maintenance phase: if you have been exercising regularly but loathe it, you could stop exercising and stay on your current calorie level diet. In other words, don’t start eating more. See what happens with your weight. Perhaps you could later eat an extra 100 to 200 daily calories without gaining weight. Continue recording your daily intake and weight for a couple months.
Weigh yourself daily during the first two months of your maintenance-of-weight-loss phase. After that, weigh weekly. Daily weights will remind you how hard you worked to achieve your goal. When you look now at a brownie, candy bar, or piece of pie, you ask yourself, “Do I really want to walk an extra hour or jog an extra three miles today to burn off those calories?” If so, enjoy. Otherwise, forego the unneeded calories.
Be aware that you might regain five or 10 pounds of fat now and then. You probably will. It’s not the end of the world. It’s human nature. You’re not a failure; you’re human.
But draw the line and get back on your old weight-loss program for one or two months. Analyze and learn from the episode. Why did it happen? Slipping back into your old ways? Slacking off on exercise? Too many special occasion feasts? Allowing junk food back into the house? Learn which food item is your nemesis—the food that consistently torpedoes your resolve to eat right. For example, I have two—candy, and sweet baked goods such as cookies and muffins. If I just look at them I add a pound. Remember an old ad campaign for a potato chip: “Betcha can’t eat just one!”? Well, I can’t eat just one cookie. So I don’t get started. I might eat one if it’s the last one available. Or I satisfy my sweet craving with fresh fruit or a diet soda. Just as a recovering alcoholic can’t drink any alcohol, perhaps you should totally abstain from…? You know your own personal gastronomic Achilles heel. Or heels. Experiment with various strategies for vanquishing your nemesis.
It’s OK to overindulge in food infrequently (10–12 times per year), on special occasions such as birthdays, wedding anniversaries, holidays. But you must counteract the extra calories by cutting down intake or by exercising more, either before or after the feast. No big deal.
Click to read additional ideas on prevention of weight regain.