Healthy Hands

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 Here is the latest Get Fit email from Dr. Jacobs.


Tips for pain-free hands
Unnoticed and unsung, healthy hands perform countless small tasks, from pouring your morning coffee to brushing your teeth at night. But aching hands transform even a simple task into a painful ordeal. Beneath the skin, your hands are an intricate architecture of tendons, joints, ligaments, nerves, and bones. Each of these structures is vulnerable to damage from illness or injury.

Your hands may hurt for a variety of reasons, from the mechanical to the neurological. Arthritis — which affects one in five American adults — and other persistent joint problems are by far the most common cause of hand pain and disability. Another common cause of hand pain, carpal tunnel syndrome, affects an estimated 2% to 3% of Americans. Contrary to conventional wisdom, this nerve disorder rarely results from repetitive work-related tasks, as a growing body of research reveals. True work-related musculoskeletal disorders are known as repetitive stress injuries and can be quite debilitating. But there are steps you can take to prevent them.  

Help for office workers’ hands
If you work in an office, it’s a good idea to have an ergonomic evaluation of your workspace to avoid habits that may put you at risk for repetitive strain injuries. If that’s not possible, the following tips may help:
• Keep your wrists in a neutral position, not flexed downward or extended upward, when using your computer. To check, place your wrist, palm facing down, on a flat, hard surface. Put a Band-Aid lengthwise over the top of your wrist, and then move to your keyboard and type. If the Band-Aid stretches or goes slack, your wrists aren’t in a neutral position.
• Get up from your desk and stretch at least once every hour. In between, take shorter breaks to rest your hands, palms up, on your lap or on a wrist rest. You can install software on your computer that reminds you to take micro-pauses or rest breaks and restricts your daily time on the computer.
• Be skeptical about new keyboard configurations (such as split keyboards) or mouse designs claiming to be ergonomic. It will take many years of study to learn whether such changes translate into fewer work-related upper-extremity musculoskeletal disorders.

Customizing your workstation
Ergonomics specialists who design strategies to improve the fit between workers and their jobs suggest the following arrangement for computer workstations: • Keep documents, telephone, keyboard, mouse, and supplies within easy horizontal reach — not more than 16 to 18 inches away.
• Place the computer monitor directly in front of you, at arm’s length, with the top line of the screen at or slightly below eye level (possibly lower for someone with bifocals or trifocals).
• Set your keyboard on an adjustable tray so that your forearms are parallel to the floor, wrists are straight and in line with your forearms, and elbows are relaxed and bent at a 90-degree angle at your waist.
• Keep your mouse close to the keyboard and at the same height, possibly with a padded wrist rest.
• Use an adjustable chair, with a rounded front edge and good lower- and upper-back support, positioned so that the knees are slightly lower than the hips and the feet rest firmly on the floor (or on a footrest).

Lingering Benefits of Exercise

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Here is the latest Get Fit email from Dr. Jacobs.

We all know that doing exercise is good for you.

Now it turns out that our bodies continue to work out long after we have stopped exercising.

Anyone undertaking a vigorous fitness session continues to burn calories for hours after they finish, research shows.

Men who exercised on a stationary bike for around 45 minutes burned an additional 190 calories over the 14 hours afterwards, the study found.

The same theory should apply to any intense activity, be it football, swimming or running, researchers say – and for the fairer sex.
However, to get the extra calorie-burning benefits, the workout needs to be enough that ‘you’re sweating, your body temperature is up and your heart beats fast’.
Ten volunteers, aged 22 to 33, each burned an average of 519 calories during their biking tests.

Afterwards, however, they burned another 190 calories – meaning their bodies carried on working when physical activity ceased.

Researcher David Nieman, of Appalachian State University in Kannapolis, North Carolina, U.S. said: ‘That means a person would lose one pound after five intense exercise bouts if they resisted the temptation to eat more.

‘This shows that intense exercise can have a meaningful impact on your body fat stores if you don’t counter it with an extra piece of cake. I hope this will motivate people to get out there to do sweat-producing activities. You get so much bang for your buck.’

Mr. Nieman added that although only men were used as test subjects, there is ‘every reason to believe that the findings apply to women, too’.

The researchers used a metabolic chamber for the study, which is a silicone-sealed room with a bed, sofa and sink. Food was sent in through an air-locked entrance.

This allowed scientists to measure how much oxygen a volunteer consumed and how much carbon dioxide was produced, before calculating the number of calories burned.

Each of the men was given a rest day in the chamber and did little physical activity for 24 hours, bar stretching every two hours for two minutes.

They then spent a second day in the room doing exactly the same despite cycling vigorously for 45 minutes at 11am.

Measurements were taken immediately afterwards and again at 1am the following morning.

Other research has looked at the number of calories burned during exercise, but this is the first study to identify that it happens afterwards as well.

Taking Fitness on the Road

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Here is the latest Get Fit email from Dr. Jacobs.

Taking Fitness on the Road
By: April Swales, Cooper Fitness Center professional fitness trainer

Do you sometimes feel like you live in a hotel room? Just because we leave town doesn't mean we have to leave behind our fitness routine. Learn more about simple yet effective ways to stay in sharp while on the road.

It happens on every vacation. We’re getting ready for a trip and as we load our suitcase, we decide that we mustn’t forget our workout clothes. Of course we’re going to get up early each morning, of course we’re going to use the hotel workout facility and of course we’re going to practice good judgment at each meal. Our intentions are genuine, but reality is a bit more tarnished. Why is it so hard to stay on the healthy track when we travel? Maybe we’re tired. Maybe we don’t feel comfortable working out in a strange place. Or maybe we don’t want to wait in line for limited equipment. Sound familiar?

First and foremost, our expectations need to be realistic. If your travels are taking you away on business and meetings will consume much of your energy, you’re more likely to skip those “good intentions,” i.e. workouts. Dining over business can also be difficult, especially when the meal includes cocktails and/or dessert. This usually leads to guilt, which can be frustrating and counterproductive. Falling off the wagon is not the real problem—the real issue is how long it takes for us to get back on. Allowing ourselves a small break from routine is OK, but we need to be cautious about how long that break is. If you plan to be gone more than a few days, then it’s best to try and get some sort of exercise while you’re away. Your travel exercise mantra should be, “Something is always better than nothing.” The good news is that you’ll only need a few simple tools to stay on task.

One of the easiest exercise travel tools you can own is the basic workout band with handles. They’re inexpensive (around $20 each), easy to find and they travel light. They come in many different resistance levels and often come packaged with a soft nylon door anchor already attached. All you need to add is a door that will shut completely when the anchor is in place. Nearly any exercise performed on a cable in the weight room can also be done with an exercise band and the proper amount of space. The door anchor makes it easy to place and you may secure the band at any level. Since you’ll be correcting your own posture as you exercise (vs. leaning back against the chair on a machine), you’ll be recruiting more muscles and strengthening your trunk. And don’t forget your own body weight plus gravity! Basic movements such as sit ups, push-ups, jumping jacks and squats are a great way to break a sweat and require no equipment at all. Visit the Cooper Aerobics blog for examples of exercise band movements.

Anyone who uses applications on their smart phone understands how helpful they can be. There are so many exciting fitness applications out there, many of them free. You can download exercise demonstration photos, nutritional info and eating logs—you can even get an application that can track your movement via GPS and map out a walking or jogging route for you. Record keeping is an excellent way to motivate yourself, even when you’re not on the road.

Many hotels include fitness options for guests. There are also options at certain hotels to have basic equipment in your room, free of charge. Marriott International Inc. and Hilton Hotels Corp. offer in-room fitness options for business travelers. Both chains provide low-tech workout equipment such as mats, free weights and exercise bands.

If you're interested in fitness options at your hotel, ask the hotel concierge. If you’re fortunate enough to be traveling for fun, try and mix some healthy activities into your itinerary. Wear comfortable shoes and walk whenever possible, try dancing with dinner or maybe hike and enjoy the scenery. The change in your routine will also help you recover from your normal workouts without being sedentary. Your body enjoys change just like your mind, even if what you’re doing is less strenuous than what you’re used to.

Inevitably, we will hit bumps on the road to health and wellness. But traveling should never be a roadblock. Being consistent, although challenging, is not impossible. Even with the best intentions, there will be times when we simply have to take a break. Budgeting that time off wisely with our diet will help. Remember that this lifestyle is a long term commitment and there will be peaks and valleys. Stay positive, stay focused and have fun!

Getting Ready for Labor Day

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It has been a crazy day!

Here is the latest Get Fit email from Dr. Jacobs.

For most people, Labor Day signals the ending of the summer season. This includes the grill or the barbecue pit. Traditional barbecue and picnic foods are a labor of love and many find the selections delicious. In many cases, the foods most associated with summer eating range is caloric value, and even though a grilled chicken and corn on the cob may be on the menu, so are many high fat, high sugar selections. Many people are surprised to find out basic picnic food can present a large number of hidden calories. A single portion of macaroni salad may have up to 50 g of fat and a single serving of barbecued ribs (2 ribs) equals 320 calories, 16 g sugar and 20 g of fat. The addition of other foods to round out an ideal barbecue will contribute to a high calorie event.

Food Item| Single serving reference values

Hamburger| 10 g fat, 254 calories, 378 mg sodium

Cheeseburger w/condiments| 26 g fat, 482 calories, 640 mg

Hot dogs| 16 g fat, 180 calories, 620 mg sodium

Ribs| 21 g fat, 320 calories, 790 mg sodium

Coleslaw| 16 g fat, 206 calories

Potato salad| 21 g fat, 1323 mg sodium

Macaroni salad| 26g fat, 760 g sodium, 349 calories

Barbecue sauce| 10 g sugar, 50 calories, 330 mg sodium

Baked beans| 19 g sugar, 570 g sodium, 190 calories

Apple pie| 20 g fat, 33 g sugar, 390 calories

Pecan pie| 22 g fat, 30 g sugar 541 calories

Corn bread| 6 g, 13 g, 200 calories

Soda| 30-40 g sugar, 12 calories per ounce

Domestic Beer| 200 calories each

Consider a basic meal of a cheeseburger, side of potato salad and baked beans and a slice of apple pie and a conservative net would equal 1,312 calories, over 3000 mg of salt and 67 g of fat. If you side with two hot dogs (who eats one?), a side of macaroni salad, some chips and slice of pecan pie you’ve reached 1,450 calories and 2,650 mg of sodium. Consider these numbers as conservative; most people each multiple servings and also consume additional calories from sodas, alcohols and other side dishes.

It is not surprising to see a single picnic meal reach over two thousand calories. So what is a person to do – skip barbecues? Rather than go extreme, make a couple of conservative changes and the day and waist line can be saved. For instance, using Fat-free hot dogs at 50 calories, 0 g fat, 490 mg sodium cuts the calories to a third and reduces the sodium. Swapping out hamburgers for chicken, soy burgers or buying extra lean meats will save calories and reduce saturated fat. Using a spice mixture like “Suddenly Pasta” and some olive oil cuts the fat and calories in half on the pasta salad. Condiments hide a lot of calories, fat and sugar. Use reduced calorie mayonnaise and low sugar barbecue sauce instead. Slice avocado for hamburgers or grill onions as healthier toppings. For beverages, brew up unsweetened ice tea and offer calorie free options like Crystal Light. Rather than serving calorie-rich desserts serve fruits like watermelon and cut strawberries; even topping it with lite Cool Whip only adds 25 calories.

In addition to making some smart food choices, be sure to center your Labor Day and other picnics around activities. Touch football, playing catch or horse shoes or Bacchi all expend calories and remove people from the temptation of boredom and proximity eating. Lastly, do not forget about sunscreen. Be sure the SPF is adequate for the environment; even though many people have been cooped up for months and the temptation for a quick tan beckons, excess sun exposure raises risks for skin cancer.

Healthy Eating Without the Hassle

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Here is the latest Get Fit email from Dr. Jacobs.

The latest nutritional science points toward a diet rich in fruits, vegetables, and whole grains, paired with healthy sources of protein and fats. A largely plant-based diet with protein from fish, skinless poultry, nuts, legumes, and small amounts of lean meats opens the door to good health.

Equally important is to choose foods in forms that are as close as possible to the way they came from nature. A cherry, for example, is a better choice than a cherry fruit bar. Whole-grain bread trumps white bread.

While it may seem like a lot of extra effort to eat more healthfully, it doesn’t have to be. You only need to keep in mind three simple steps: eat more plant-based foods, fewer animal-based foods, and only as much food as your body needs. Here are some ways to do this:

Focus on unprocessed or minimally processed foods.
By doing so, you’ll naturally consume foods that have the amounts and combinations of fiber and nutrients that nature intended. Many factory-made foods, in contrast, are stripped of natural fiber and nutrients and filled with ingredients made to stimulate appetite and keep you eating more. Processed meats, in particular, are linked with heart disease and cancer. Unprocessed foods have no added sugar, fat, or salt. Most also have more fiber.

Be adventurous.
To get a broader range of disease-fighting nutrients, think beyond whole-grain pasta and broccoli. Try new grains, vegetables, and fruits. Bulgur and quinoa are good grain alternatives. Novel kinds of beans, fruits, and vegetables abound. You can experiment with new recipes that rely less on meat and make use of different ingredients and herbs and spices for flavor sources.

Mix it up.
A good rule of thumb for each day is to try to get three servings of fruit, three to four servings of vegetables, some lean protein, some whole grains, healthy oils, some nonfat or low-fat dairy, and a serving of nuts or legumes. At each meal, look at your plate: about one-half should be fruits and vegetables, one-quarter lean proteins (fish, poultry, beans, or tofu), and one-quarter whole grains.

Drink enough liquids.
Because many foods contain water, most people get sufficient liquid each day without making a special effort. But it can be helpful throughout the day to drink water or another no-calorie liquid as an alternative to snacking or to wash down meals. Plus, as you increase your fiber content with whole-grain foods, water helps ferry it smoothly through your digestive tract and protects you from constipation. Drinking 4 to 6 cups of water a day is a reasonable and healthful goal.

Keep protein portions small.
For proteins like meat and chicken, 3 ounces for lunch and slightly more for dinner is a good goal. Keep in mind that 4 ounces of meat is the size of a deck of cards.

Aim for at least two servings of fish each week.
However, avoid large, predatory deep ocean fish (such as swordfish, shark, king mackerel, and blue fin tuna) because of their higher mercury content.

Plan ahead.
If you snack, plan ahead for healthy snacks to minimize the risk of impulsively eating unhealthy foods. Stay away from sugary drinks and their empty calories.

Should You Wear "Toning Shoes"?

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Here is the latest Get Fit email from Dr. Jacobs.

Should you buy Skechers Shape-Ups or Reebok EasyTone or other “fitness shoes”?

According to the research – no:

The Results
Across the board, none of the toning shoes showed statistically significant increases in either exercise response or muscle activation during any of the treadmill trials. There is simply no evidence to support the claims that these shoes will help wearers exercise more intensely, burn more calories or improve muscle strength and tone.

However,

“These shoes may be encouraging a fair number of people who probably wouldn’t put on a normal pair of walking shoes and go out and walk, to do so because they think they’re getting some super toning effect,” says Bryant. “So if you want to look at a positive, it’s probably serving as a bit of a motivator to get a group of inactive individuals to
at least get up and get moving.”

If you want to read the whole report, click here. Please don’t let the research stop you from exercising. If you have some of these shoes, keep using them if they are helping you to get fit. More importantly, keep walking/jogging/exercising!

Fitness Mistakes

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Here is the latest Get Fit email from Dr. Jacobs.

Ten Common Fitness Mistakes
If you are experiencing pain while working out, not seeing the results you want or becoming bored, you may be making common exercise mistakes.

Many people don’t realize there is a right and wrong way to workout. Cooper Fitness Center Professional Fitness Trainer Loren Maine gives us ten common mistakes you might be committing during your exercise routine.

1. Exercise frequency - Too little exercise can lead many health problems. However, too much exercise can cause aches and pains, fatigue, weakened immune system, decrease in performance and more. Aim for four to five days of physical activity each week for around 30 minutes each day.

2. Keeping the same routine - Your body will stay at the same level of fitness if exercises aren’t new or challenging. At this point, your body is said to be on a plateau. Change is good!

3. Only practicing cardio - Your exercise program needs balance. A successful training regime should address both cardiovascular training and resistance training.

4. Keeping the same volume - When the body gets used to an amount of weight, fitness improvements are limited. Change the number of sets, repetitions and weight being lifting to avoid reaching a standstill.

5. Eating too little – You might not think that your diet affects your work out. If you aren't eating enough, your body goes into "protection mode" and actually stores fat to survive. Also, exercise performance will be hindered if the body is not properly nourished.

6. Skipping the warm up - Properly warming up reduces the risk of injury. At the beginning of the exercise routine, dedicate approximately ten minutes to prepare the targeted muscle group.

7. Lifting too much weight - Lifting weight that is too heavy alters proper posture. This can lead to muscle and joint compensations that increase risk of injury. Lift a weight that is challenging enough that the muscle fatigues by the last few repetitions.

8. Not drinking enough water - Drink plenty of water before, during and after exercise. Dehydration alters exercise performance and may cause dizziness, cramps, lethargy and more.

9. Working through an injury - Acute pain could turn into chronic pain if not properly addressed. If you have an injury, consult an expert and/or remember the acronym RICE: rest, ice, compression and elevation.

10. Forgoing a professional fitness trainer –Utilizing a professional trainer keeps you on task, challenges your body and provides expert assistance. As a motivation factor, it’s easier to go to the gym when you know you have an “appointment.

Core Strength for Summer

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Here is the latest Get Fit email from Dr. Jacobs.

The Facts about Core Strength
By: Cooper Fitness Center

Now that summer is here, it’s time to get that midsection in shape. But how do you know you are practicing the right exercises and targeting the correct muscles? Learn more from a Cooper Fitness Center expert about the anatomy and exercises for your core.

Just about every health professional has fielded this question at some point, “What can I do to get rid of the fat around my stomach?” Cooper Fitness Center Senior Professional Fitness Trainer April Swales, says the answer is as frustrating to give as it is to receive.

There is no way to strategically “spot reduce.” But you can greatly improve your chances of overall inch loss by implementing a few simple changes in your exercise programs. Most people are familiar with the term “core muscles” and we know they’re important. Do you know why they’re important, and do you know how to train them? To understand how to effectively work the core, you must first know how it’s built and what it does. April gives us the run-down of our “core” needs.

First, it’s important to realize that “core” and “abs” are not one in the same. The abdominal wall—and its many parts—is only one piece of the core puzzle. Simply put, the core is made up of what we call the inner unit—our deep skeletal muscles that generally work involuntarily in a stabilizing role (for example, internal obliques, transversus abdominus and quadratus lumborum)—and the external spinal flexors (that is rectus abdominus, also known as the “six-pack” muscles and external obliques). Each muscle has a specific job, but they all perform synergistically to achieve the same goal: efficient stabilization of the spine as we move without pain.

All movement originates from the center and radiates out to our extremities. Since we live in a three-dimensional world, our bodies find ways to compensate for our lack of core strength usually by overusing other parts of our bodies such as the shoulders, low back and knees. This hasn’t gotten us very far. In fact, most of us are closer to injury and farther away from our health and fitness goals.

Often we make the mistake of not building the proper foundation. We place aesthetics over function when considering our goals. Having a chiseled stomach where tone is visible is more about having low body fat than it is about being strong. While there is certainly no shame in working towards reducing lower body fat, we need to remember that our system is only as strong as its weakest link. We need to stop thinking of the body as separate parts and begin working it as a whole. Before performing an exercise, imagine how it relates to how you move in real life. If the exercise doesn’t integrate the core with the movement of your limbs, it can’t be considered functional.

Fortunately, it’s very easy to incorporate core work into your existing exercise program. It requires no special skills and no special equipment. Here are some tips for getting the most out of your core workout.

1. Stand up. You want to make sure you are doing the majority, if not all, of your exercises standing up. The less you have to help you stabilize, the harder your abs and back have to work by themselves.

2. Stand tall. Always think about staying long in the spine and maintaining your natural “S” curve.

3. Try a balance challenge. If you choose to sit for a particular movement, try using a stability ball versus a chair or bench. You’ll reinforce the natural opposite shoulder/opposite hip relationship that keeps us balanced as well as force the weaker side to do its job.

4. Work it into your routine. Brace the lower abdomen while sitting in traffic or stand on one leg while washing dishes (be sure and do it on both sides!).

5. Close your eyes. Even closing your eyes when performing a movement makes it more challenging. The idea is to create instability in a controlled manner in order to force your trunk to be more reactive and aware. This leads to better balance, better posture and better strength.

References:
1. Pattern Overload Part 1 & Part 2 by Paul Chek. Personal Training on the Net. Online. September 2000.
2. Training the Abdominals by Lou Barrie. Personal Training on the Net. Online. March 2001.
3. The Inner Unit by Paul Chek. Personal Training on the Net. Online. March 2006.

De-stress Your Life

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Here is the latest Get Fit email from Dr. Jacobs.

10 simple steps to help de-stress
There is no shortage of angst-inducing news these days: natural disasters, economic woes, political unrest. Add to this backdrop stresses in our personal lives, layoffs, illness, money woes, temper tantrums, and traffic jams, and it is clear that stressful situations are constant and inevitable.

Just as serious as the stressors themselves are the adverse effects stress can have on your emotional and physical health. Many well-respected studies link stress to heart disease and stroke — the No. 1 and No. 3 causes of death, respectively, in the United States. Stress is also implicated in a host of other ailments such as depression and anxiety, chronic lower respiratory diseases, asthma flare-ups, rheumatoid arthritis, and gastrointestinal problems.

Stress is not all bad. Your perception of a real or imagined threat can spark the stress response, which prepares the body to fight or flee. That swift reflex was encoded in you for survival. Thanks to the stress response, you might suddenly jump out of the path of a speeding car or flee from a burning house. But when your stress response is evoked repeatedly, your body experiences unnecessary wear and tear — such as high blood pressure — that can lead to poor health.

Even if you only have a few minutes to spare, the stress-busting suggestions described below can make your days calmer, if not easier.

Take the sting out of 10 common stressors
Sometimes just thinking about embarking on a program of stress control can be stressful. Rather than freeze in your tracks, start small and bask in the glow of your successes. Give yourself a week to focus on practical solutions that could help you cope with just one stumbling block or source of stress in your life. Pick a problem, and see if these suggestions work for you.

1. Frequently late? Apply time management principles. Consider your priorities (be sure to include time for yourself) and delegate or discard unnecessary tasks. Map out your day, segment by segment, setting aside time for different tasks, such as writing or phone calls. If you are overly optimistic about travel time, consistently give yourself an extra 15 minutes or more to get to your destinations. If lateness stems from dragging your heels, consider the underlying issue. Are you anxious about what will happen after you get to work or to a social event, for example? Or maybe you’re trying to jam too many tasks into too little time.

2. Often angry or irritated? Consider the weight of cognitive distortions. Are you magnifying a problem, leaping to conclusions, or applying emotional reasoning? Take the time to stop, breathe, reflect, and choose.

3. Unsure of your ability to do something? Don’t try to go it alone. If the problem is work, talk to a co-worker or supportive boss. Ask a knowledgeable friend or call the local library or an organization that can supply the information you need. Write down other ways that you might get the answers or skills you need. Turn to CDs, books, or classes, for example, if you need a little tutoring. This works equally well when you’re learning relaxation response techniques, too.

4. Overextended? Clear the deck of at least one time-consuming household task by hiring help. If you can, hire a housecleaning service, shop for groceries through the Internet, convene a family meeting to consider who can take on certain jobs, or barter with or pay teens for work around the house and yard. Consider what is truly essential and important to you and what might take a backseat right now.

5. Not enough time for stress relief? Try mini-relaxations. Or make a commitment to yourself to pare down your schedule for just one week so you can practice evoking the relaxation response every day. Slowing down to pay attention to just one task or pleasure at hand is an excellent method of stress relief.

6. Feeling unbearably tense? Try massage, a hot bath, mini-relaxations, a body scan, or a mindful walk. Practically any exercise — a brisk walk, a quick run, a sprint up and down the stairs — will help, too. Done regularly, exercise wards off tension, as do relaxation response techniques.

7. Frequently feel pessimistic? Remind yourself of the value of learned optimism: a more joyful life and, quite possibly, better health. Practice deflating cognitive distortions. Rent funny movies and read amusing books. Create a mental list of reasons you have to feel grateful. If the list seems too short, consider beefing up your social network and adding creative, productive, and leisure pursuits to your life.

8. Upset by conflicts with others? State your needs or distress directly, avoiding “you always” or “you never” zingers. Say, “I feel _____ when you _____.” “I would really appreciate it if you could _____.” “I need some help setting priorities. What needs to be done first and what should I tackle later?” If conflicts are a significant source of distress for you, consider taking a class on assertiveness training.

9. Worn out or burned out? Focus on self-nurturing. Carve out time to practice relaxation response techniques or at least indulge in mini-relaxations. Care for your body by eating good, healthy food and for your heart by seeking out others. Give thought to creative, productive, and leisure activities. Consider your priorities in life: is it worth feeling this way, or is another path open to you? If you want help, consider what kind would be best. Do you want a particular task at work to be taken off your hands? Do you want to do it at a later date? Do you need someone with particular expertise to assist you?

10. Feeling lonely? Connect with others. Even little connections — a brief conversation in line at the grocery store, an exchange about local goings-on with a neighbor, a question for a colleague — can help melt the ice within you. It may embolden you, too, to seek more opportunities to connect. Be a volunteer. Attend religious or community functions. Suggest coffee with an acquaintance. Call a friend or relative you miss. Take an interesting class. If a social phobia, low self-esteem, or depression is dampening your desire to reach out, seek help. The world is a kinder, more wondrous place when you share its pleasures and burdens.

Are You Nuts?

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Here is the latest Get Fit email from Dr. Jacobs.

Nuts — A healthy treat

Could nuts be one of the secret ingredients to weight loss? A couple of studies have found a correlation between relatively high nut consumption (two or more servings a week) and avoidance of weight gain and obesity. Researchers at Harvard-affiliated Beth Israel Deaconess Medical Center reported results in 2010 from a small (20 volunteers) study that showed walnuts at breakfast gave people a pre-lunch feeling of fullness that might make it easier to eat less. Ultimately, weight loss is about reining in calorie consumption (and increasing physical activity). But if nuts make people feel full, perhaps they can help lower calorie counts over all, even as they add to those totals.

Nuts are dense little packages of fat and protein, with most of the fat being the healthful, unsaturated kind. They don’t contribute much in the way of vitamins but make up for it by supplying respectable amounts of potassium, magnesium, and several other required minerals.

Dieters have tended to stay away from nuts because the fat content makes them a high-calorie food. It doesn’t help that we tend to shovel them in as snacks, not as part of meals. But nuts contain very little carbohydrate, so they’re showing up in low-carb diets these days, particularly the ones that emphasize plant-based foods.

Nutrients in nuts per 1.5 ounces (43 grams)

Calories/Fat (grams)/Protein (grams)

Almonds 254/22.5/9.4

Brazil nuts 279/28.2/6.1

Cashews 244/19.7/6.5

Hazelnuts 275/26.5/6.4

Macadamias 305/32.4/3.3

Peanuts 249/21.1/10.1

Pecans 302/31.6/ 4.0

Pistachios 243/19.6/ 9.1

Walnuts 278/27.7/6.5

Source: Report of the Dietary Guidelines Advisory Committee, 2010.

Nuts and your heart
Apart from weight issues, nuts seem to have some protective effects against heart disease. Numerous studies have shown that if you put people on nut-filled diets, favorable effects on cholesterol levels, blood pressure readings, and inflammatory factors follow. And in large epidemiologic studies, high nut consumption has been associated with lower rates of heart disease. An analysis of data from the Harvard-based Nurses’ Health Study showed that having one serving of nuts a day is associated with a 30% lower risk of heart disease compared with having one serving of red meat a day.

A plate full of walnuts for dinner tonight?

Nuts as a meal may not sound very appealing. But cookbooks are full of recipes that incorporate nuts into pasta dishes and the like. And it would be easy for most of us to add almonds or walnuts to a bowl of cereal or low-fat yogurt at breakfast and occasionally eat a meatless lunch or dinner.

Nuts may help with diabetes, too. The lack of carbohydrate content means nuts don’t add appreciably to the surges in blood sugar we experience after many meals. In fact, they can blunt the effects of carbohydrates on blood sugar levels. Those “postprandial” spikes in blood sugar contribute to the development of diabetes in people vulnerable to getting the disease and must be controlled in those who have already have it. Yet the evidence for nut consumption reducing the risk for developing diabetes is mixed, as are results of studies of the effect it has on blood sugar levels.

What to Eat

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Here is the latest Get Fit email from Dr. Jacobs.

New Dietary Guidelines — 8 foods to eat more of, 7 to cut back on
The latest nutrition guidelines from the U.S. Department of Agriculture and the Department of Human Services have a new emphasis: weight control. In previous years, the guidelines focused on nutrients: What proportion of fats, proteins, and carbohydrates is optimal for health? Or, what amounts of different vitamins and minerals do you need to protect yourself from diseases?

The slogan for the new guidelines is: “Calories in, calories out.” Put another way: Americans should strive to maintain a calorie balance, eating no more calories than they burn each day. If you are overweight, the goal is to eat fewer calories than you burn each day to reach a healthy weight. Calorie control and daily physical activity are the cornerstones of the new guidelines.

Why the emphasis on weight control? The Dietary Guidelines report explains it this way: “Poor diet and physical inactivity are the most important factors contributing to an epidemic of overweight and obesity affecting men, women, and children in all segments of our society. Even in the absence of overweight, poor diet and physical inactivity are associated with major causes of morbidity and mortality in the United States.” With this in mind, the Dietary Guidelines include these recommendations for foods to cut back on and foods to increase:

7 foods to reduce
1. Reduce daily sodium intake to less than 2,300 milligrams (mg) and further reduce intake to 1,500 mg among persons who are 51 and older and those of any age who are African American or have hypertension, diabetes, or chronic kidney disease.
2. Consume less than 10% of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids.
3. Consume less than 300 mg per day of dietary cholesterol.
4. Keep trans fatty acid consumption as low as possible.
5. Reduce the intake of calories from solid fats and added sugars.
6. Limit the consumption of foods that contain refined grains, especially those with solid fats, added sugars, and sodium.
7. If alcohol is consumed, it should be consumed in moderation — up to one drink per day for women and two drinks per day for men — and only by adults of legal drinking age.

8 foods and nutrients to increase
Eat more of these foods while staying within your calorie goals.

1. Eat a variety of fruits and vegetables, especially dark green, red, and orange vegetables, fruits, and beans and peas.
2. Consume at least half of all grains as whole grains. Increase whole-grain intake by replacing refined grains with whole grains.
3. Increase intake of fat-free or low-fat milk and milk products, such as milk, yogurt, cheese, or fortified soy beverages.
4. Choose a variety of protein foods, which include seafood, lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds.
5. Choose seafood in place of some meat and poultry.
6. Replace protein foods that are high in solid fats with proteins that are low in solid fats and calories.
7. Use healthy vegetable oils to replace solid fats where possible.
8. Choose foods that provide more potassium, dietary fiber, calcium, and vitamin D, which are nutrients of concern in American diets. These foods include vegetables, fruits, whole grains, and milk and milk products.

Save Your Heart

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Here is the latest Get Fit email from Dr. Jacobs.

These five habits can save your heart — here’s how
According to hard data, five harmful habits herald the coming of heart disease. These five are smoking, being inactive, carrying too many pounds, eating poorly, and drinking too much alcohol.

Alone and together, they set the stage for artery-damaging atherosclerosis and spur it onward. They do this by deranging metabolism and changing how cells and tissues work. They also disturb the markers of health we worry about so much: blood pressure, cholesterol, and blood sugar. All too often, the end result of these five habits is a heart attack, stroke, peripheral artery disease, valve problem, aortic aneurysm, or heart failure. And the damage they cause isn’t limited to the cardiovascular system, but extends to the kidneys, bones, and brain.

What can making better choices do for health and longevity? Consider this provocative finding from the Nurses’ Health Study. Nonsmoking women with a healthy weight who exercised regularly, consumed a healthy diet, and had an alcoholic drink every other day were 83% less likely to have had a heart attack or to have died of heart disease over a 14-year period, compared with all the other women in the study. The results were almost identical in a similar study in men. In these two studies, more than two-thirds of all cardiovascular events could be chalked up to smoking, excess weight, poor diet, and drinking too much.

Five strategies for change
Count on these five white knights to protect your heart, your arteries, and the rest of you. They will make you look better and feel better. And it’s never too late to start.

1. Avoid tobacco. Smoke from cigarettes, cigars, and pipes is as bad for the heart and arteries as it is for the lungs. If you smoke, quitting is the biggest gift of health you can give yourself. Secondhand smoke is also toxic, so avoid it whenever possible.
2. Be active. Exercise and physical activity are about the closest things you have to magic bullets against heart disease and other chronic conditions. Any amount of activity is better than none; at least 30 minutes a day is best.
3. Aim for a healthy weight. Carrying extra pounds, especially around the belly, strains the heart and tips you toward diabetes. If you are overweight, losing just 5% to 10% of your starting weight can make a big difference in your blood pressure and blood sugar.
4. Enliven your diet. Add fruits and vegetables, whole grains, unsaturated fat, good protein (from beans, nuts, fish, and poultry), and herbs and spices. Subtract processed foods, salt, rapidly digested carbohydrates (from white bread, white rice, potatoes, and the like), red meat, and soda or other sugar-sweetened beverages.
5. Drink alcohol in moderation (if at all). If you drink alcohol, limit your intake — one to two drinks a day for men, no more than one a day for women.

Making change
If you have one or more habits that are working against you, now is as good a time as any to set a course for better health. How? The American Heart Association recommends “cognitive behavioral strategies for promoting behavior change.” They aim to help you think more positively about yourself as you make healthy changes. Here are some of those strategies:

Set goals. Having specific, achievable goals is a key strategy for successful change. Goals that involve behaviors (“I will eat three servings of whole grains a day”) tend to work better than physiological goals (“I will lower my cholesterol”).

Track your progress. With all the things you have to remember each day, it’s hard to know whether you are meeting your daily goals. Data from dozens of studies show that self-monitoring is an important attribute of successful changers. You can track your exercise or pounds lost with a notebook, a computer, a smart phone, or an invention of your own.

Motivation. Changing a habit or behavior is easier if you have a good reason for doing it. Motivation can be something big, like getting in shape for a walking trip with a grandchild, or small, like fitting into a slimmer suit for a wedding. The more personal the motivator, the better.

Get support. Starting a change isn’t nearly as challenging as sticking with it. Support from family, friends, a doctor, or someone else — even from an online community — can provide feedback and encouragement, especially when you are feeling low.

You don’t need to aim for a complete transformation all at once. Small changes in diet, exercise, or weight can make a big difference in your health. Setting goals you can realistically achieve, and then meeting them, can snowball into even bigger improvements.

No Excuses

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So you're one of the millions whose New Year's resolution was to "get in shape." You begin with nothing but the best of intentions. You vow to go to the gym everyday and sweat off all the holiday cookies, turkey, and multiple glasses of eggnog. Visions of yourself pounding it out on the treadmill and weight lifting like a pro dance through your head.

And then it happens: reality kicks in. So what do you do?

Physical activity is often one of the first things to go when schedules get busy. However, staying active is an integral part of leading a healthy lifestyle. According to the Center for Disease Control, regular physical activity can help "control your weight, reduce your risk of cardiovascular disease, type 2 diabetes, metabolic syndrome, strengthen your bones and muscles, improve your mental health and mood and increase your chances of living longer." As you can see the CDC doesn't mention anything about fitting into your skinny jeans. Leading an active lifestyle shouldn't be about getting a six-pack fast or losing 20 pounds in 20 days. It should be about creating a strong and healthy self.

So, how much physical activity is the "right" amount? The CDC recommends that adults get "two hours and 30 minutes of moderate-intensity aerobic activity every week and muscle-strengthening activities on two or more days a week." However, finding the time can be hard. Despite the best intentions, promises we make to ourselves often get lost somewhere between the bio notes and empty Dominoes boxes.

The focus should be on finding activities you love and will be able to do for a lifetime.

It can be hard to get in the habit of regular exercise, but it must be made into a priority. Make a habit of going to the gym after certain classes and stick to it, workout with a buddy and keep each other accountable or sign up for a class. At the end of the day, it is up to us as individuals to take the resources offered and put them to good use.

Taking Care of Your Sight

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Here is the latest Get Fit email from Dr. Jacobs.

Safeguarding your sight

Although aging puts people at greater risk for serious eye disease and other eye problems, loss of sight need not go hand in hand with growing older. Practical, preventive measures can help protect against devastating impairment. An estimated 40% to 50% of all blindness can be avoided or treated, mainly through regular visits to a vision specialist.

Regular eye exams are the cornerstone of visual health as people age. Individuals who have a family history of eye disease or other risk factors should have more frequent exams. Don’t wait until your vision deteriorates to have an eye exam. One eye can often compensate for the other while an eye condition progresses. Frequently, only an exam can detect eye disease in its earliest stages.

You can take other steps on your own. First, if you smoke, stop. Smoking increases the risk of several eye disorders, including age-related macular degeneration. Next, take a look at your diet. Maintaining a nutritious diet, with lots of fruits and vegetables and minimal saturated fats and hydrogenated oils, promotes sound health and may boost your resistance to eye disease. Wearing sunglasses and hats is important for people of any age. Taking the time to learn about the aging eye and recognizing risks and symptoms can alert you to the warning signs of vision problems.

Although eyestrain, spending many hours in front of a television or computer screen, or working in poor light does not cause harmful medical conditions, it can tire the eyes and, ultimately, their owner. The eyes are priceless and deserve to be treated with care and respect — and that is as true for the adult of 80 as it is for the teenager of 18.

Five common eye myths dispelled
Myth: Doing eye exercises will delay the need for glasses.
Fact: Eye exercises will not improve or preserve vision or reduce the need for glasses. Your vision depends on many factors, including the shape of your eye and the health of the eye tissues, none of which can be significantly altered with eye exercises.

Myth: Reading in dim light will worsen your vision.
Fact: Although dim lighting will not adversely affect your eyesight, it will tire your eyes out more quickly. The best way to position a reading light is to have it shine directly onto the page, not over your shoulder. A desk lamp with an opaque shade pointing directly at the reading material is the best possible arrangement. A light that shines over your shoulder will cause a glare, making it more difficult to see the reading material.

Myth: Eating carrots is good for the eyes.
Fact: There is some truth in this one. Carrots, which contain vitamin A, are one of several vegetables that are good for the eyes. But fresh fruits and dark green leafy vegetables, which contain more antioxidant vitamins such as C and E, are even better. Antioxidant vitamins may help protect the eyes against cataract and age-related macular degeneration. But eating any vegetables or supplements containing these vitamins or substances will not prevent or correct basic vision problems such as nearsightedness or farsightedness.

Myth: It’s best not to wear glasses all the time. Taking a break from glasses or contact lenses allows your eyes to rest.
Fact: If you need glasses for distance or reading, use them. Attempting to read without reading glasses will simply strain your eyes and tire them out. Using your glasses won’t worsen your vision or lead to any eye disease.

Myth: Staring at a computer screen all day is bad for the eyes.
Fact: Although using a computer will not harm your eyes, staring at a computer screen all day will contribute to eyestrain or tired eyes. Adjust lighting so that it does not create a glare or harsh reflection on the screen. Also, when you’re working on a computer or doing other close work such as reading or sewing, it’s a good idea to rest your eyes briefly every hour or so to lessen eye fatigue. Finally, people who stare at a computer screen for long periods tend not to blink as often as usual, which can cause the eyes to feel dry and uncomfortable. Make a conscious effort to blink regularly so that the eyes stay well lubricated and do not dry out.

Getting Ready for Summer

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Here is the latest Get Fit email from Dr. Jacobs.

No, it’s not too early to be thinking about it! As the weather warms and we come out of hibernation (and get ready for warm vacations), there are should be no excuses for getting out and getting moving. Here are five tips to get your fitness schedule up and running.

1. Change up your routine. If you can run through your routine without breaking a bead of sweat on your brow, or if the movement patterns seem to move automatically with little effort, it is definitely time to update your plan of action. You need a routine well balanced in both cardio-based exercises (running, swimming, elliptical, etc.) and resistance training exercises.

2. Go for full body. Large, full-body movements elicit a strong metabolic boost during and after the workout. Research has shown that the after burn effect of resistance exercises utilizing more of the body has a greater effect on the metabolism through the day than just doing cardio exercises on their own.

3. Switch to less-stable movements. Always begin with as much assistance as needed to maintain proper form. Once form is perfected, move to less stable patterns of movement. This is a great way to utilize a stability ball or BOSU ball. This will increase the number of muscle motor units used, which in turn will increase calorie depletion.

4. Increase intensity. This is one of the easiest things to change, but the most challenging to implement. Many people work below their potential. Start increasing one workout a week above comfort zone and move to more frequency in intensity.

5. Discipline, Determination, Dedication. With these three words in mind, you are sure to reach your fitness goals.

Women and Heart Disease

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Women, work, stress, and heart disease: 5 ways to protect yourself

Harvard researchers have uncovered strong links between women’s job stress and cardiovascular disease. Findings from the Women’s Health Study (WHS) — a landmark inquiry into disease prevention involving more than 17,000 female health professionals — show that women whose work is highly stressful have a 40% increased risk of heart disease (including heart attacks and the need for coronary artery surgery) compared with their less-stressed colleagues. The results, which were presented at an American Heart Association meeting in 2010, also showed that women who worry about losing their jobs are more likely to have high blood pressure and unhealthy cholesterol levels and to be obese. These findings are especially distressing in the current economic climate.

The researchers used a definition of “job strain” that combines psychological demand and degree of control. Demand refers to the amount, pace, and difficulty of the work. Control means the ability to make work-related decisions or be creative at work.

More evidence
The WHS wasn’t the only source of bad news about work stress and heart problems in women. A large 15-year study of nurses in Denmark concluded that the greater the work pressure, the higher the risk for heart disease among women ages 51 and under. And in a study of white-collar workers in Beijing, job strain was associated in women (but not in men) with increased thickness of the carotid artery wall, an early sign of cardiovascular disease.

Possible mechanisms
The body is programmed to react to life-threatening stress (“The house is on fire!”) with a “fight-or-flight” response, in which the brain triggers a cascade of chemicals and hormones that speed the heart rate, quicken breathing, increase blood pressure, and boost the amount of energy (sugar) supplied to muscles. Unfortunately, the body does a poor job of discriminating between grave, imminent dangers and less momentous ongoing sources of stress, such as financial difficulties, job strain, and even worries about potential problems that haven’t yet arisen. When the fight-or-flight response is chronically in the “on” position, the body suffers.

It’s unclear how job strain causes cardiac problems. The stress may aggravate inflammation in coronary arteries, leading to blood clots that can trigger a heart attack. Stress also makes it harder to practice heart-healthy habits, such as exercise, a good diet, not smoking, and adequate sleep. It’s hard to tell what proportion of heart attack risk is due to psychological stress as opposed to, say, smoking or lack of exercise. And some women may be predisposed (genetically or from early life experience) to react less effectively than others to stressors. We’ll learn more about these matters as research into women’s unique risks for heart disease continues.

What can you do?
The stress induced by excessive demands and too little control is not unique to the workplace. Many women have multiple concurrent jobs — for example, caring for children, aging parents, or other relatives while running a household and working outside the home — often without the resources to manage them all. Situations like this may be unavoidable, and in a tight job market, you may feel there’s little you can do to make your work life less stressful. Nevertheless, there are steps you can take, including these:
1. Foster mutually supportive relationships with friends, family, and co-workers.
2. Get regular exercise. It’s good for the heart, reduces anxiety and depression, and improves sleep.
3. Limit intrusions (such as work-related e-mails) on your life outside of work.
4. Practice relaxation techniques, such as meditation, deep breathing, progressive relaxation, or visualization.
5. If you’re feeling overwhelmed, seek help from a mental health professional.

Carbohydrates

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Here is the latest Get Fit email from Dr. Jacobs.

Foods that Fuel
By: Cooper Clinic Nutrition

While carbohydrates sometimes get a bad rep, they are a great source of fuel food. Carbs are imperative for muscle, brain, and nervous system function. Read more about picking the right carbohydrates and how they can fuel our system to a top performance.
As a dietitian, I know that power comes from more than just good genetics; it comes from food fuel, commonly known as carbohydrates.

Carbs have unfairly been given a bad reputation. Some people believe carbohydrates are the culprit for weight gain. More often, weight gain is the result of too many calories total and too little exercise. An adequate intake of carbohydrates are necessary for muscle, brain, and nervous system function.

After you realize that carbs do have health benefits, you need to understand which carbs are the best options.

Picking the Right Carbs
We can and should discriminate when making food choices in the carb category. Choose complex, whole grain carbohydrates whenever possible. This includes foods such as whole-grain spaghetti, potatoes, corn, cereals, and other whole grain products. It is recommended that we get in three servings of whole grains a day, and unfortunately only one in nine Americans is currently meeting that recommendation.

So now you are ready to move forward with adequate carbohydrates on your plate. You might get a measuring cup and see what ½ cup or 1 cup looks like on your plates at home to help with portion accountability. You can take that carbohydrate “mental snapshot” out to the restaurants with you as well and be better able to stay on track with your health and wellness goals.

The following are some favorite complex carbohydrate choices – try some!
1. Quinoa is now readily available in many supermarkets and is one of the best whole grains you can eat. It is high in protein (8 grams in 1 cup cooked), fiber (5 grams per cup) and a naturally good source of iron. Quinoa is as easy to prepare as rice and can be eaten alone or mixed with vegetables or lean protein.

2. Beans really are good for the heart! They are loaded with fiber and are a good, low-fat source of carbohydrates, protein and potassium.

3. Sweet potatoes are a delicious member of the starchy vegetable family and are high in vitamin A.

Moderation is Key
The other kind of carbohydrate to consume (in moderation) is simple carbohydrates. These are found in sweets like honey and sugar. These foods lead to a rapid rise in blood sugar, followed by a decline in blood sugar and subsequently, less energy.

In addition, high doses of concentrated sweets can draw fluid into the gastrointestinal tract and contribute to dehydration, cramping, nausea and diarrhea. Fruits are considered simple carbohydrates, however, they are rich in fiber and nutrients and low in calories. We do not put them in the same category at the other simple carbohydrates.

Energized
If you want to improve your energy level, consider small amounts of carbohydrates throughout the day balanced with lean protein and some healthy fat. We can improve our focus and lower our level of distraction by keeping blood sugar levels consistent that way.

And don't forget that portion size matters, even when it comes to healthy foods. You can take more liberties when eating simply prepared vegetables, but you should be aware of the volume of other foods and strive for sensible portion.

Exercise for Your Health

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The secret to better health — exercise
Whether you’re 9 or 90, abundant evidence shows exercise can enhance your health and well-being. But for many people, sedentary pastimes, such as watching TV, surfing the Internet, or playing computer and video games, have replaced more active pursuits.

What exercise can do for you
Millions of Americans simply aren’t moving enough to meet the minimum threshold for good health — that is, burning at least 700 to 1,000 calories a week through physical pursuits. The benefits of exercise may sound too good to be true, but decades of solid science confirm that exercise improves health and can extend your life. Adding as little as half an hour of moderately intense physical activity to your day can help you avoid a host of serious ailments, including heart disease, diabetes, depression, and several types of cancer, particularly breast and colon cancers. Regular exercise can also help you sleep better, reduce stress, control your weight, brighten your mood, sharpen your mental functioning, and improve your sex life.

A well-rounded exercise program has four components: aerobic activity, strength training, flexibility training, and balance exercises. Each benefits your body in a different way.

Fighting disease with aerobic activity
Aerobic exercise is the centerpiece of any fitness program. Nearly all of the research regarding the disease-fighting benefits of exercise revolves around cardiovascular activity, which includes walking, jogging, swimming, and cycling. Experts recommend working out at moderate intensity when you perform aerobic exercise — brisk walking that quickens your breathing is one example. This level of activity is safe for almost everyone and provides the desired health benefits. Additional health benefits may flow from increased intensity.

Protecting bone with strength training
Strength or resistance training, such as elastic-band workouts and the use of weight machines or free weights, is important for building muscle and protecting bone.

Bones lose calcium and weaken with age, but strength training can help slow or sometimes even reverse this trend. Not only can strength training make you look and feel better, but it can also result in better performance of everyday activities, such as climbing stairs and carrying bundles. Stronger muscles also mean better mobility and balance, and thus a lower risk of falling and injuring yourself. In addition, more lean body mass aids in weight control because each pound of muscle burns more calories than its equivalent in fat.

Ease back pain with flexibility exercises
Stretching or flexibility training is the third prong of a balanced exercise program.

Muscles tend to shorten and weaken with age. Shorter, stiffer muscle fibers make you vulnerable to injuries, back pain, and stress. But regularly performing exercises that isolate and stretch the elastic fibers surrounding your muscles and tendons can counteract this process. And stretching improves your posture and balance.

Preventing falls with balance exercises
Balance tends to erode over time, and regularly performing balance exercises is one of the best ways to protect against falls that lead to temporary or permanent disability. Balance exercises take only a few minutes and often fit easily into the warm-up portion of a workout. Many strength-training exercises also serve as balance exercises. Or balance-enhancing movements may simply be woven into other forms of exercise, such as tai chi, yoga, and Pilates.

Exercise at a glance
In a nutshell, exercise can:

• reduce your chances of getting heart disease. For those who already have heart disease, exercise reduces the chances of dying from it.
• lower your risk of developing hypertension and diabetes.
• reduce your risk for colon cancer and some other forms of cancer.
• improve your mood and mental functioning.
• keep your bones strong and joints healthy.
• help you maintain a healthy weight.
• help you maintain your independence well into your later years.

Headaches

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Here is the latest Get Fit email from Dr. Jacobs.

What type of headache do you have?

Headaches are familiar to nearly everyone: in any given year, almost 90% of men and 95% of women have at least one. In the vast majority of cases, however, the pain isn’t an omen of some terrible disease.

About 95% of headaches are caused by such common conditions as stress, fatigue, lack of sleep, hunger, changes in estrogen level, weather changes, or caffeine withdrawal. The three most common types of headache are tension, sinus, and migraine (see table below).

Mixed headaches
As understanding of the different types of headaches has evolved, researchers have altered some of their beliefs about tension and migraine headaches and the relationship between the two. This is largely because of the realization that some headaches don’t neatly fit either category. “Mixed” headaches have characteristics of both types, and because they’re hard to classify, treatment can be challenging.

For instance, the more intense a tension headache gets, the more it resembles the sharp, throbbing pain of a migraine headache. Likewise, when a migraine headache becomes more frequent, its pain begins to feel like that of a tension headache. Thus, experts now believe that headaches fall along a continuum ordered by their characteristics: the occasional tension headache is at one end and the migraine headache is at the other. In between are chronic tension headache and chronic migraine, which are often lumped together as chronic daily headache.

This doesn’t mean that all headaches share the same mechanisms. Experts still generally believe that tension headaches are stimulated by muscle tightness, while migraine headaches are caused by the dilation and inflammation of blood vessels. However, if you have migraine headaches frequently, you may develop muscle tightness, which can trigger more headaches, creating a vicious cycle.

Headache caused by a medication or illness
Some headaches are actually symptoms of another health problem. Many non-life-threatening medical conditions, such as a head cold, the flu, or a sinus infection, can cause headache. Some less common but serious causes include bleeding, infection, or a tumor. A headache can also be the only warning signal of high blood pressure (hypertension). In addition, certain medications — such as nitroglycerin, prescribed for a heart condition, and estrogen, prescribed for menopausal symptoms — are notorious causes of headache.

Because the following symptoms could indicate a significant medical problem, seek medical care promptly if you experience:
• a sudden headache that feels like a blow to the head (with or without a stiff neck)
• headache with fever
• convulsions
• persistent headache following a blow to the head
• confusion or loss of consciousness
• headache along with pain in the eye or ear
• relentless headache when you were previously headache-free
• headache that interferes with routine activities.

Always take children who have recurring headaches to the doctor, especially when the pain occurs at night or is present when the child wakes in the morning.

Caffeine and Young People

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Caffeine Consumption Among Children and Adolescents (National Council on Strength and Fitness, January 2011)

Caffeine is the most widely utilized psychoactive substance among people of all age groups and cultural backgrounds. This is most likely due to the fact it is legal, easy to obtain, and socially acceptable to consume. It is classified as a stimulant drug, and is typically used to arouse the central nervous system for cognitive or physical endeavors. It is generally recognized as safe by the Food and Drug Administration (FDA), but when taken in excess can result in serious side effects, health hazards, or even in rare cases, death. Caffeine is produced by a variety of beans, leaves, and fruits; but is most commonly consumed in the forms of coffee (70%), soda (16%), and tea (12%). Approximately 9 out of 10 adults report regular use of caffeine, with an average daily intake of around 230mg.

Caffeine exerts perceived positive effects when taken in moderate dosages (200mg-300mg) through a few different mechanisms of action. First off, it activates adenosine receptors to promote stimulation of the sympathetic nervous system (SNS). Since the SNS initiates what is referred to as the “fight or flight response” caffeine causes an adrenaline-like energy response. This mechanism of SNS provocation has been shown to improve concentration, memory retention, auditory vigilance, and reaction time. Secondly, caffeine is known to directly enhance dopamine neurotransmission, which provides for an endorphin-like pleasure response and resistance to pain. This mechanism of action is believed to be the reason that caffeine use in research has resulted in greater exercise workloads until fatigue – particularly workloads that are associated with a greater level of discomfort such as interval sprints or high-intensity hypertrophy training. Conversely, high dosages (>400mg) have been shown to produce negative effects such as anxiety, nausea, jitteriness, and nervousness.

In recent times, it appears that caffeine-containing beverages have become increasingly accepted within the diets of children. Current research attempts to decipher if this could be a major health concern for children as they age. Statistics demonstrate that caffeine intake among children and adolescents have increased by 70% in the last 30 years. In the Eighties, the average intake among children between the ages of 5 and 18 was reported to be 38mg per day (the equivalent of one soda). A study in 2005 showed increasing consumption within the age range of 12-17 to an average of 69.5mg per day. In updated figures, published in the December 2010 issue of the Journal of Pediatrics reveals children ages 8-12 consuming an average of 109mg per day. This trend may be reason for concern due to the following:

1. The overall physiological and psychological implications of caffeine use among children have not been adequately investigated and are poorly understood. No safe ‘minimal’ limit has been set for the population. In a few studies, positive subjective effects such as enhanced feelings of well-being, confidence, and sociability seen among adults who use caffeine are not replicated in children. It appears that caffeine does not act upon children or adolescents in the same manner as adults.

2. Caffeine has been shown to have a negative impact on sleeping patterns. Adequate sleep allows for proper growth and brain development. In a study published in 2007, 90% of middle and high school students sampled reported getting less than 8 hours of sleep on average each night; with a primary contributing factor to the lack of sleep being caffeine consumption.

3. Caffeine is thought to have the potential to cause long-lasting effects on brain function when utilized during the formative years (period when neural control center function is developed and refined). Specifically, areas such as the orbitofrontal cortex and temporal lobe, which appear to develop beyond the teenage years, have the potential to be modified by caffeine due to their intrinsic adenosine receptors.

4. Childhood and adolescence are considered critical periods for establishing eating patterns and taste preferences. Consuming common caffeinated beverages such as sodas may enhance the preference for sweet foods throughout the lifespan when taken regularly during childhood. This can contribute to excess caloric intake and have a negative impact on proper nutrition. Specifically, caffeine in the form of sugar-sweetened carbonated beverages has been shown in research to be strongly associated with a greater incidence of obesity or being overweight in children. One particular study reported that for each additional serving of a soda-like beverage consumed daily during childhood, there is a 60% increase in the odds of becoming obese. Furthermore, studies have shown that children who consume more sodas each week will generally consume fewer servings of milk, fruits, and vegetables.

5. Studies have shown that caffeine use increases the response to any subsequent drug exposure, and children seem to have an additional vulnerability to this effect. This can potentially turn a ‘child’s dosage’ of a given medication into a dangerous or toxic dosage.

6. Research suggests that caffeine consumption during adolescence (approximately 220mg per day) is associated with increased impulsivity, sensation seeking, and risk-taking behaviors – such as is seen with illicit drug and tobacco use. One particular study revealed that consuming four or more caffeinated beverages a day during adolescence was associated with daily cigarette use, aggressive behavior, and attention and conduct problems.

Common Caffeinated Beverages

A novel issue related to this seen among children is the consumption of energy drinks. These beverages, such as Red Bull™ or Rockstar™, represent the fastest growing component of the beverage industry. In many cases, they have significant quantities of caffeine (up to 500% of the content seen in soft drinks) as well as high levels of sugar, herbal stimulants, and other energy metabolites. These drinks can place children at high risk for caffeine intoxication. Alarmingly, many energy drink marketing campaigns explicitly target youth with advertisements featuring extreme sports, cartoon characters, and catchy sayings such as “Red Bull gives you wings.” In fact, some energy drinks such as Spark™ are recommended by the company for use in children four years and older; while others such as XS™ go to the extent of making sure the can is sized (8.4oz) so that it is comfortable for children to hold, and claims that it is recommended by health professionals as a nutritionally superior ‘treat’ when compared to soda or juice. Unfortunately, excessive consumption of energy drinks has been associated with high risk behaviors such as smoking, drinking, illicit drug use, risky sexual behavior, and fighting. Relatively small quantities may be needed to be considered ‘excessive’ in children due to low body weight and tolerance levels.

There is no question that caffeine use is on the rise among children and adolescents. This may be a reason for concern as little empirical data exists on the physiological, psychological or behavioral effects of habitual caffeine use within the population. It appears that there are many potentially negative effects of high usage during youth, and some of them may have lasting repercussions. Consuming caffeinated beverages can have an effect on optimal sleep, overall growth and development, healthy nutritional habits, and the risk for engaging in risky behaviors.