A new study reports that Vitamin D effects certain genes which are involved in muscle and fat mass and function. This could mean there is an important yet simple solution to the natural decline of muscle as we age, which could have many benefits – decreasing disease, falls, broken bones, and subsequent hospital and nursing home stays.
As we age, muscle mass and strength decrease, to the point where our muscles actually become “marbled” with fat (think bacon!), reducing their ability to function and our ability to live independent lives, according to the National Institute on Aging. That’s because muscle mass is essential for movement, balance, and even immune function. So if we don’t strength train as older adults, we’re more likely to lose our independence and end up in nursing homes, creating a massive public health burden, according to the study published in the journal PLOS ONE, and partly funded by the National Institutes of Health.
That said, we’ve known for years, and I’ve written about, the importance of working out, eating the right amount of protein, carbohydrate and fat, eating an anti-inflammatory, anti-oxidative diet filled with plant nutrients like polyphenols, (found in tea, fruits & vegetables), and living a low stress life. But there are other factors which come into play that scientists are studying. One may be Vitamin D, the sunshine vitamin.
In the past several years, researchers are finding that Vitamin D may be instrumental in preventing diseases from colds, heart disease to cancer. Even multiple sclerosis, parkinson’s disease and insulin dependent diabetes. And now, Vitamin D seems to be correlated with an increase in muscle mass and a decrease in body fat. Yet the most needy population, the elderly, is usually deficient. That’s because Vitamin D is produced by being exposed to sunshine. Today, many of us don’t go outdoors and when we do we’re wearing sunscreen. That particularly pertains to the aging population, whose muscle mass can mean independence – or the loss of it.
How much Vitamin D does improving muscle mass require? That should be up to your doctor. But, the usual recommendation from Vitamin D scientists is 1,000 IU per day but up to 4,000 daily is safe (Vitamin D can be toxic at much higher levels)… Most of us will need to get Vitamin D from a supplement because it’s in very few foods (egg yolks, salmon) and most of us don’t get enough sunlight. This level is much higher than authorities at the National Academy of Sciences’ Food and Nutrition Board have been recommending for decades. That’s because they determine how much Vitamin D is needed to prevent rickets (a Vitamin D deficiency disease which softens the bones), as opposed to how much is good for your overall health. The NAS believe that more definitive research needs to be done to change their recommendation. In the meantime, it doesn’t hurt for healthy people to increase their vitamin D intake to up to 4,000 IU daily.
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Over the years, I’ve noticed that clients who added a certain item to their diet seemed more likely to lose weight. And this happened even when their calorie intake remained the same. What is this superfood? It’s nothing weird, it’s not a supplement, it’s cheap and found everywhere — And it’s a product that may go back to Neolithic times: yogurt.
For years, I’ve wondered why this versatile food worked so well, and now, new scientific research is backing my observations. It turns out that the bacterial organisms in the digestive tract — about 100 million of them (10 times the number of human cells), collectively called the microbiome — are akin to a fully functioning organ, and can have a positive or negative effect on human health.
At a National Institutes of Health conference entitled “The Human Microbiome: Implications for Nutrition and Clinical Practice,” held in March in Bethesda, Md., Cindy Davis of the Office of Dietary Supplements at the National Institutes of Health, shared some findings. “The microbiome is influenced by several dietary components,” she said. One of which is yogurt.
Probiotics plus prebiotics
Why is this? Yogurt contains a class of bacteria called probiotics that “remain alive during processing and shelf life, survive digestion and then cause health benefits,” said Jo Ann Hattner, a registered dietitian, consultant at the Stanford University School of Medicine and co-author of “Gut Insight.” She added that together with certain foods known as prebiotics, probiotics create a symbiotic relationship that profoundly benefit your microbiome and your health.
“Prebiotics are nondigestible, fermentable carbohydrates that stimulate and promote activity of beneficial gut bacteria,” Hattner co-wrote in a recent issue of San Francisco Medicine, a publication of the San Francisco Medical Society. “Prebiotics are the booster substance for probiotics. As the beneficial gut microbes increase in number, pathogenic bacteria — such as Salmonella, Campylobacter and E. coli — decrease.””Ingesting prebiotics is a practical way of manipulating the microbiota, since they support and increase the beneficial bacteria population in the gut,” Hattner added. “Together, probiotics and prebiotics are an important duo. In addition, prebiotic fibers are components of the healthiest foods on the planet — natural plant foods.”
To achieve maximum benefit, you need both kinds of food: probiotics and prebiotics, and new research is finding the health benefits may be vast.
“These bacteria protect us by preventing infection and enhancing immunity, and that makes gastrointestinal health critical to overall health,” Hattner said.
More benefits of the microbiome
In addition, research is finding that a healthy microbiome may play a role in reducing inflammation, a risk factor involved in illnesses ranging from colds to cancer, heart disease, arthritis and cognitive decline.
These bacteria may also help burn body fat and reduce insulin resistance, a precursor to diabetes, according to a recent study published in the journal Nutrients. Interestingly, “Mother’s milk contains both pre[biotics] and probiotics,” said Hattner. So it transfers the health benefits to the baby. This may explain studies that show people who were not breastfed are more likely to be overweight.
Prebiotics are important because they nourish the probiotics, increasing their effectiveness — and prebiotics are in a host of foods.
Still, nutritionists are in the initial phases of human research, and there is much to be learned. In the meantime, the message is clear: Eat a plant-based diet and plenty of yogurt!
1. Eat probiotics like yogurt, kefir and soy yogurt
2. Eat prebiotics (from Hattner’s article) such as:
– fruits like apples, bananas, berries, raisins and kiwifruit
– greens, onions, garlic and leeks
– lentils, chickpeas and beans
– brown rice, corn, buckwheat, flaxseed, whole wheat, whole rye, barley
– green tea
3. Use artificial sweeteners with caution. (A preliminary study found that artificial sweeteners may effect the microbiome negatively, increasing body fat and insulin resistance.)
5. Breastfeed your baby.
6. Don’t count on probiotic pills or supplements to improve your microbiome, as there isn’t one that has passed the tests needed for a health claim. (This was also a point made by scientists at the NIH conference.)
The importance of your digestive system’s microbiome should not be underestimated. It affects every organ in the body, bringing about sickness or health. Many experts believe this research is bringing about a revolution in health care.
Interestingly, the recommendations registered dietitians and nutritionists have been making for decades is being proven correct: “Eat a plant-based diet!” Just be sure to include fermented foods, such as yogurt!
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Katherine’s 5 Tips are at the end of the article…
For years, my clients have asked me, “Is it better to eat ‘sugar-free’ yogurt? Or, yogurt with fruit on the bottom with all that sugar? What about sugar in my coffee? Sugar-sweetened beverages, like soft drinks?” My answer has alway been, to my clients’ surprise, “A little sugar won’t hurt. Eat the yogurt you enjoy the most, even if there’s a little jam at the bottom! And a teaspoon of sugar in your coffee shouldn’t do any harm.” New scientific research may prove my moderate approach has been right all along.
Artificially sweetened beverages and foods are seen as guilt-free pleasures, because they are lower in calories – or even zero calories – compared to other similar foods. You may think of them as a great choice when you’re trying to lose weight or trying to keep blood sugar in check. But some surprising new research suggests that artificial sweeteners might actually do the opposite, “by changing the microbes living in our intestines ,” according to experts at The National Institutes of Health.*
To explore the impact of various kinds of sweeteners on the zillions of microbes living in the human intestine (referred to as the gut microbiome), an Israeli research team first turned to mice. One group of mice was given water that contained one of two natural sugars: glucose or sucrose; the other group received water that contained one of three artificial sweeteners: saccharin (the main ingredient in Sweet’N Low®), sucralose (Splenda®), or aspartame (Equal®, Nutrasweet®). Both groups ate a diet of normal mouse chow.
To their surprise, the researchers discovered that many animals in the artificial sweetener groups—especially those that drank saccharin-sweetened water—developed a condition called glucose intolerance, which is characterized by high blood glucose levels and is an early warning sign of increased risk for developing type 2 diabetes. In contrast, the animals that drank sugar water remained healthy.
The result was puzzling. These mice weren’t consuming natural sugars, so what was raising their blood glucose levels? The researchers had a hunch that the answer might lie in the gut microbiome—since those microbes play a vital role in digestion. Their suspicions were borne out. When they used DNA sequencing to analyze the artificial sweetener group’s gut microbiome, they found a distinctly different collection of microbes than in the animals drinking sugar water.
The next step was to distinguish whether these changes in the microbiome resulted from high blood glucose, or caused it. When the researchers used antibiotics to wipe out the artificial sweetener group’s gut microbes, their blood glucose levels returned to normal—evidence that the gut microbes were actively causing glucose intolerance. Additional proof came from experiments in which the researchers transplanted microbes from both groups of mice into the intestines of a mouse strain that had been raised in a sterile environment from birth. The germ-free mice that received microbes from the artificial sweetener group developed glucose intolerance; those getting microbes from the sugar group did not.
But what about humans?
The research team examined clinical data from 400 people taking part in an ongoing nutrition study. That analysis showed that, compared to people who didn’t use artificial sweeteners, long-term users of artificial sweeteners tended to have higher blood glucose levels and other parameters often associated with metabolic diseases like diabetes, obesity, and fatty liver.
Next, the researchers asked seven healthy human volunteers, who had never previously consumed foods or beverages containing artificial sweeteners, to consume the daily maximum dose of saccharin allowed by the U.S. Food and Drug Administration for six consecutive days. Of the seven volunteers, four developed glucose intolerance, while three maintained normal blood glucose regulation. The researchers then took intestinal microbes from human volunteers and transplanted them into germ-free mice. Microbes from humans with glucose intolerance also triggered glucose intolerance in the mice, while microbes from humans with normal blood glucose had no effect.
Previous studies have associated changes in the gut microbiome with obesity and diabetes in humans [2, 3, 4]. But the latest findings, which still must be confirmed in larger studies and by other groups, advance our knowledge one step further by suggesting that artificial sweeteners may be one of what’s likely to be an array of factors with the power to shape such changes. Who knows what the next piece of that fascinating puzzle might be?
Katherine’s 5 Tips
- Use artificial sweeteners with caution,
- Just a spoonful of sugar/jam/honey can’t hurt – maximum 10% of your calorie needs – for example, if you need 1,500 calories per day, enjoy 150 calories worth of sweets per day,
- As usual, moderation is key. If you have trouble eating too many sweets, find out why and click for strategies,
- Eat plenty of yogurt, which contains natural probiotics, to populate your gastrointestinal tract with healthy microbes (they may help reduce body fat and insulin resistance),
- Eat plenty of high fiber foods, considered “prebiotics,” which increase the effectiveness of the probiotics, helping your gastrointestinal tract stay healthy,
- If you have an interest in learning more about sugar substitutes, take a look at the Center for Science and Public Interest’s “Sweet Nothings: Safe or Scary… The Inside Scoop on Sugar Substitutes.”
 Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Suez J, Korem T, Zeevi D, Zilberman-Schapira G, Thaiss CA, Maza O, Israeli D, Zmora N, Gilad S, Weinberger A, Kuperman Y, Harmelin A, Kolodkin-Gal I, Shapiro H, Halpern Z, Segal E, Elinav E. Nature. 2014 Sep 17.
 Microbial ecology: human gut microbes associated with obesity. Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Nature. 2006 Dec 21;444(7122):1022-3.
 A metagenome-wide association study of gut microbiota in type 2 diabetes. Qin J, Li Y, Cai Z, Li S, Zhu J, Zhang F, Liang S, Zhang W, Guan Y, Shen D, Peng Y, Zhang D, Jie Z, Wu W, Qin Y, Xue W, Li J, Han L, Lu D, Wu P, Dai Y, Sun X, Li Z, Tang A, Zhong S, Li X, Chen W, Xu R, Wang M, Feng Q, Gong M, Yu J, Zhang Y, Zhang M, Hansen T, Sanchez G, Raes J, Falony G, Okuda S, Almeida M, LeChatelier E, Renault P, Pons N, Batto JM, Zhang Z, Chen H, Yang R, Zheng W, Li S, Yang H, Wang J, Ehrlich SD, Nielsen R, Pedersen O, Kristiansen K, Wang J. Nature. 2012 Oct 4;490(7418):55-60.
 Gut metagenome in European women with normal, impaired and diabetic glucose control.Karlsson FH, Tremaroli V, Nookaew I, Bergström G, Behre CJ, Fagerberg B, Nielsen J, Bäckhed F. Nature. 2013 Jun 6;498(7452):99-103.
*The article above is from the National Institutes of Health
Photo by www.sugar.org
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BRAIN MAY FLUSH OUT TOXINS DURING SLEEP
An NIH-funded study suggests sleep clears the brain of damaging molecules associated with neurodegeneration. A good night’s rest may literally clear the mind. Using mice, researchers showed for the first time that the space between brain cells may increase during sleep, allowing the brain to flush out toxins that build up during waking hours. These results suggest a new role for sleep in health and disease. The study was funded by the National Institute of Neurological Disorders and Stroke (NINDS), part of the NIH.
“Sleep changes the cellular structure of the brain. It appears to be a completely different state,” said Maiken Nedergaard, M.D., D.M.Sc., co-director of the Center for Translational Neuromedicine at the University of Rochester Medical Center in New York, and a leader of the study.
For centuries, scientists and philosophers have wondered why people sleep and how it affects the brain. Only recently have scientists shown that sleep is important for storing memories. In this study, Dr. Nedergaard and her colleagues unexpectedly found that sleep may be also be the period when the brain cleanses itself of toxic molecules.
Their results, published in Science, show that during sleep a plumbing system called the glymphatic system may open, letting fluid flow rapidly through the brain. Dr. Nedergaard’s lab recently discovered the glymphatic system helps control the flow of cerebrospinal fluid (CSF), a clear liquid surrounding the brain and spinal cord.
“It’s as if Dr. Nedergaard and her colleagues have uncovered a network of hidden caves and these exciting results highlight the potential importance of the network in normal brain function,” said Roderick Corriveau, Ph.D., a program director at NINDS.
Initially the researchers studied the system by injecting dye into the CSF of mice and watching it flow through their brains while simultaneously monitoring electrical brain activity. The dye flowed rapidly when the mice were unconscious, either asleep or anesthetized. In contrast, the dye barely flowed when the same mice were awake.
“We were surprised by how little flow there was into the brain when the mice were awake,” said Dr. Nedergaard. “It suggested that the space between brain cells changed greatly between conscious and unconscious states.”
To test this idea, the researchers inserted electrodes into the brain to directly measure the space between brain cells. They found that the space inside the brains increased by 60 percent when the mice were asleep or anesthetized.
“These are some dramatic changes in extracellular space,” said Charles Nicholson, Ph.D., a professor at New York University’s Langone Medical Center and an expert in measuring the dynamics of brain fluid flow and how it influences nerve cell communication.
Certain brain cells, called glia, control flow through the glymphatic system by shrinking or swelling. Noradrenaline is an arousing hormone that is also known to control cell volume. Similar to using anesthesia, treating awake mice with drugs that block noradrenaline induced unconsciousness and increased brain fluid flow and the space between cells, further supporting the link between the glymphatic system and consciousness.
Previous studies suggest that toxic molecules involved in neurodegenerative disorders accumulate in the space between brain cells. In this study, the researchers tested whether the glymphatic system controls this by injecting mice with labeled beta-amyloid, a protein associated with Alzheimer’s disease, and measuring how long it lasted in their brains when they were asleep or awake. Beta-amyloid disappeared faster in mice brains when the mice were asleep, suggesting sleep normally clears toxic molecules from the brain.
“These results may have broad implications for multiple neurological disorders,” said Jim Koenig, Ph.D., a program director at NINDS. “This means the cells regulating the glymphatic system may be new targets for treating a range of disorders.”
The results may also highlight the importance of sleep.
“We need sleep. It cleans up the brain,” said Dr. Nedergaard.
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One of my 50-something clients, who lost twenty pounds with a few “Diet Simple” tricks, increased pedometer steps, and weight training, confided in me that she feels sexy for the first time in years! On the tennis court, she performs better, is more flexible, stronger and quicker. Who could ask for more in your 40s, 50s, 60s – or even older?
My clients regularly ask me, “How do I maximize my workouts to gain muscle as quickly and effectively as possible?”
My answer: “What you eat and when you eat it profoundly improves your ability to build muscle mass and strength, and new surprising studies show an ancient beverage and a simple stretching routine can make a huge difference, too. Let me explain…”
1. Your Workout
While nutrition is important, the quality of your strength training workout is a key factor for building muscle mass. The National Institute on Aging recommends strength training all of your major muscle groups at least three times a week for 30 minutes. I encourage all my clients to get some kind of strength training so that when they lose weight, they not only look more toned and have more strength (who wants to be a flabby skinny person?), they’re healthier. This can be accomplished by working with a skilled trainer, but also through vigorous yoga and pilates – whenever there is resistance and you work your muscles to exhaustion – that is, you can’t do just one more pushup – you’re building muscle.
It’s also important to build muscle because the more lean muscle you have, the more calories your body burns because muscle mass increases metabolism. That’s why a man who weighs the same as a woman can eat so much more, and will lose weight more easily. He has relatively more muscle so he burns more calories, even at rest!
Studies of 80-year-olds show muscular strength can mean the difference between independence and a nursing home… it improves balance, walking, and reduces falls.
But it’s not easy to build muscle for a variety of reasons.
First, muscle mass declines as you age, starting in your mid 30s. An average person will lose five to seven pounds of muscle between age 35 to age 50 due to disuse. For every pound of muscle lost, you lose the capacity to burn 35 to 50 calories per day. That means if you’ve lost seven pounds of muscle by the age of 50, at 50 calories per muscle, that’s 350 calories you can’t eat just to prevent weight gain, let alone lose weight.
Second, weight loss causes muscle loss. When you lose weight, about half of what you lose is muscle -though you can minimize muscle loss by eating right (so read on!). This makes it even harder to keep the weight off because you’re reducing your muscle and therefore your metabolism as you lose pounds.
This brings us to the obvious: Building muscle as you age, eating the right kinds of foods to make that happen – and to minimize muscle loss as you lose weight – is essential to keeping lean.
Now for the nutrition…
Protein is essential for healthy living. It is one of the most important nutrients in the human body, second only to water. Bone health, muscle function, muscle strength, muscle mass and immune function — all are impaired with a low protein intake. But how much protein do we need?
New research has found that eating the right amount of protein – and at the right times – is essential not only for your health, but also for effective muscle gain and weight loss. Eating enough protein while losing weight is more likely to minimize muscle loss and maximize fat loss. Keeping muscle stores high is critical as losing muscle decreases resting metabolic rate, making it harder to maintain a healthy weight and lose body fat.
The National Academy of Sciences, in a recent report, recommended Americans eat at least 15% of their calories as protein but never exceed 35 percent, as that may be when adverse symptoms begin to appear (Low carb diets are often as high as 80% protein, and have many adverse health consequences).
If you’re losing weight or are worried about muscle or bone loss, consider increasing your protein.
How Much Protein? A personalized formula: The studies of aging populations find about 1.2 grams of protein per kilogram of (2.2 lbs is 1 kg) helps to reduce age-related muscle – and bone – loss. This amount should also be adequate for you to maximize your workouts, especially if you are in your mid-30s or older. Though some in the body-building community believe you can go as high as 1.6 grams of protein per kg of body weight. You may also need this higher amount if you’re sick or bed-bound to minimize muscle loss.
Example: So, if you weigh 150 pounds, this means the amount of protein you should eat is: 150 lbs (divided by 2.2 lbs per kilogram) = 68 kg; 68 kg X 1.2 grams of protein per kg of ideal body weight = 82 grams protein daily. For the maximum amount of protein, multiply 68 kg X 1.6 grams of protein per kg = 109 grams of protein per day
Where Do I Get Protein? Protein can be found in a wide range of foods. Animal protein is in seafood, dairy, meat, poultry and eggs. Vegetarian protein can be found in legumes, soy, vegetables and grains. And while it’s true that high-protein foods often bring fat and calories along as uninvited guests, it doesn’t have to be that way. The lowest-calorie animal protein sources are the leanest. Go for seafood, poultry with no skin, lean veal cuts, pork tenderloin, lean beef cuts such as the round or tenderloin or 95 percent lean hams (less than 3 grams of fat per ounce). Skim milk, nonfat yogurt, lowfat cheeses are also great options. Soy products also provide great low-calorie options and are high quality proteins similar to meat.
Toss four ounces of lean beef, chicken or seafood or 12 ounces of spiced tofu into your salad and gain 28 grams of high-quality protein and no more than 150 to 200 calories.
8 ounces milk/yogurt: 8 grams protein
8 ounces Greek Yogurt: 20 grams
1/2 cup cooked beans/tofu: 8 grams protein
1 ounce meat/fish/chicken/cheese (the leaner the meat,the more protein and the fewer calories): 7 grams protein
1 large egg: 7 grams protein
1/2 cup cooked or one ounce dry (1 slice bread) grain: 3 grams protein
1/2 cup cooked or one cup raw vegetables: 2 grams protein
3. Timing is Everything!
Eat a food or beverage high in protein 20 minutes before, and again, immediately after your strength training workout or after a vigorous cardiovascular workout, such as tennis, swimming, or kayaking, or even just a long walk. When you work out, you break down your muscles. Taking in protein when your muscles are being broken down and are metabolically active will build your muscle mass and strength more effectively. You also need to make sure you hydrate yourself properly!
My personal regimen includes drinking some skim milk before my workout – all you need is about 1/2 cup – and eating yogurt immediately after my workout or after yoga. If I forget the yogurt, I’ll run to the nearest coffee shop after my workout and buy a skim latte for my protein, which contains milk, or soy milk. But, I like yogurt the best: It contains important probiotics which keep your gastrointestinal tract healthy. It also contains high quality protein, carbohydrate, calcium, potassium and magnesium – important nutrients which you need to replenish your muscles. Eating immediately after your workout could have other benefits: It prevents the “extreme hungries” some people feel after heavy exercise, and it could prevent muscle cramps, according to a client who used to have muscle cramps regularly until she started eating yogurt after her exercise.
Current thinking among protein researchers is that protein is most bioavailable for your muscles (and your cells and organs) if eaten in relatively small quantities through the day. For women, 20 grams per meal is what the body can utilize efficiently. For men, that can go up to 30 grams per meal. So, with my personal protein goal being 60 grams per day, I’m sure to have about 20 grams in the morning, 20 grams mid-day and about 20 grams in the evening, as my body may not benefit from more at one sitting.
If you’re a man who needs 100 grams per day, you could spread out your protein intake through the day to 4 meals – separated by at least two hours – of about 25 grams each. So an 8 ounce steak at night, containing 56 grams of protein, just won’t cut it!
A new study found tea improves muscular strength. Tea? Apparently, as we age, oxidative stress and inflammation cause age-related muscle and bone breakdown. Tea’s healthy compounds, called “polyphenols,” reduce oxidative stress and inflammation, preventing this breakdown, and even improve muscular strength and bone mass. In a recent study funded by the National Institutes of Health’s National Center for Complementary and Alternative Medicine, when post-menopausal women with osteopenia (the beginning of osteoporosis – brittle bones) were given tea and/or Tai Chi exercises, after six months, the tea alone caused an improvement in muscle strength and bone-building biomarkers. Learn more about the health benefits of tea… So did the Tai Chi alone – certainly not a rigorous or impactful exercise, which we’ve been taught all along was necessary for muscle and bone building! Apparently, Tai Chi also reduces inflammation and oxidative stress.
With the amazing results of this study in mind, it makes sense that any foods high in anti-oxidants and anti-inflammatory compounds, such as fruits and vegetables, may help improve bone and muscle strength. And, if Tai Chi helps improve bone and muscle mass, shouldn’t other forms of meditation or meditative exercise, such as yoga? More research is needed to establish the facts, but these results certainly are promising.
See more specifics of my own personal regimen below!
In the meantime, I’m drinking tea every day, doing vigorous yoga at least 2 to 3 times a week, working with a trainer once a week, walking A LOT to keep body fat down, at least 10,000 pedometer steps is a daily average, in my posture-improving MBT shoes, from Comfort One Shoe Store (ask for Manager, Shawn O’Neill), eating plenty of yogurt, and my own delicious batch recipes filled with healthy foods found in Diet Simple and Diet Simple Farm to Table Recipes (only $4.95) to keep my muscles and bones strong, and my body in shape!
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My clients regularly ask me: Could the height/weight charts in doctors’ offices be correct?
My answer: That depends…
(This article was also published in The Huffington Post)
Don’t use height/weight charts alone to determine your ideal body weight. Researchers designed the latest body mass index (BMI) charts for use in combination with additional personal information. A group of scientists from the National Institutes of Health (NIH) who specialize in how weight affects health crafted the guidelines after reviewing hundreds of studies conducted over the past several decades — only then did the experts make their recommendations to health professionals.
The guidelines help physicians, and registered dietitians like me, evaluate and make recommendations for clients. But you can also use the BMI charts, along with your doctor’s advice, to help you decide what your appropriate weight should be.
- Determine your Body Mass Index (BMI), or the relationship between weight and height that researchers have associated with body fat and health risk. BMI is calculated by dividing your weight in kilograms by height in meters squared (kg/m2). But there is a BMI chart (below) so you don’t have to make the calculation yourself!
- If you are categorized as “overweight,” it is ideal for you to lose weight. That said, weight loss treatment is particularly important – and recommended – when you have two or more health risk factors, such as smoking, inactivity. I would define “inactivity” as under 10,000 pedometer steps daily (averaged over a week), or any of the following: High blood pressure, low HDL (good) cholesterol, high LDL (bad) cholesterol, high triglycerides (blood fat), impaired fasting glucose, a family history of premature heart disease, or a high waist circumference – measured at the belly button – of greater than 35″ for women or 40″ for men. The presence of abdominal fat is correlated with disease risk. We used to think body fat was inert, but it isn’t, it’s toxic! Fat tissue produces hormones and pro-inflammatory chemicals, which regulate metabolism, the immune system, inflammation, the progression of artery hardening, and the development of cancers, so that when you have less body fat, you get many biological benefits.
- If you are categorized as “obese,” weight loss treatment is recommended,
- Your initial weight loss goal should be to reduce body weight by about 10% from your starting weight. This should take about six months, depending on how much you have to lose. You can lose one-half to three pounds per week safely (assuming your calorie intake is appropriate, the more cardiovascular exercise you do, the faster you can lose),
- If more weight loss is needed, another attempt at weight reduction can be made,
- After the desired weight loss is achieved, a weight maintenance program consisting of dietary therapy, physical activity, and behavior therapy should be continued indefinitely,
- You will need to follow lifestyle therapy for at least six months, according to the NIH guidelines, before your doctor prescribes drug therapy or surgery. Though the safety of drug therapy has not been established and 50% of surgery patients re-gain the weight,
- For the very obese, with a BMI over 40, or a BMI over 35 with significant adverse health conditions, obesity surgery may be an appropriate option.
NOTE: Highly muscular people, usually professional athletes or body builders, may register as “overweight,” but that may be because of high muscle mass, instead of fat. More muscle is not generally thought of as unhealthy, so if you’re categorized as “overweight” because you have more muscle, weight loss would not be recommended in these cases.
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My clients regularly ask me: Do certain foods affect my brain and cognition?
My answer: an emphatic Yes! What you eat profoundly affects the brain, memory, and mental function.
Are you eating “Smart” foods? Please let me know by commenting at the end of this article in “Comments.”
“Nutrients are essential for brain function, and because all human beings must eat, we are all exposed,” said Martha Clare Morris, at a National Institutes of Health conference on brain function and preventing cognitive decline.
“The dietary components with the strongest evidence to date for dementia prevention include antioxidant nutrients, fat composition, and B vitamins,” said Morris, director of Nutrition and Nutritional Epidemiology at Rush Medical College in Chicago.
“The brain is particularly vulnerable to oxidative damage due to its high metabolic activity and the presence of relatively few antioxidant enzymes… Antioxidant nutrients (vitamin E, vitamin C, carotenoids, flavonoids) are a natural defense mechanism… Of the antioxidant nutrients, the evidence for brain protection is strongest for vitamin E; that for carotenoids, vitamin C, and flavonoids is limited and inconsistent but promising,” said Morris.
But when it comes to nutrients, both too little or too much can be dangerous. So I recommend you get those nutrients from food, not from supplements, which can be harmful and may disturb the natural nutritional balance of your brain.
Some examples of foods high in brain-protecting antioxidant nutrients:
Vitamin E: Sunflower seeds, almonds, sunflower oil, safflower oil, canola oil, hazelnuts, pine nuts, spinach, turnip greens, beet greens, dandelion greens, canned pumpkin, carrot juice, broccoli, sweet potato, sweet red peppers, mangos, papayas
Carotenoids, such as Beta-Carotene (orange), Lycopene (red), and Lutein (yellow/green): Orange, red, and deep green veggies and fruits, particularly…Carrot juice, carrots, butternut squash, pumpkin (or any orange-colored winter squash), sweet potato, greens such as spinach, collards, kale, turnip greens, beet greens, avocados, orange melons such as cantaloupe, red peppers, apricots, broccoli, plums, mangos papayas, plantains, Brussels sprouts, watermelon, asparagus, tomatoes, watermelon, pistachios
Vitamin C: Citrus fruits such as orange, lemons and grapefruit, peaches, sweet and hot peppers, papayas, pineapple, strawberries, broccoli,kiwi fruit, sweet potatoes, Brussels sprouts, kohlrabi
Flavonoids: Cocoa, green and black tea, citrus fruits, dark chocolate, red wine, apples, grapes, berries (read “Berry Bonanza” for more facts about berries), numerous fruits and vegetables. Tea is filled with antioxidants and anti-inflammatory nutrients, both of which reduce brain decline, and even slow down muscle and bone breakdown. Read about tea’s health benefits in my recent Washington Post article.
Fat is an essential nutrient. But the type of fat you eat trumps everything. Fat ends up in all of your body’s cells, including your brain cells. It acts as a cell lubricant, improves flexibility and communication between cells. If the fat you eat is saturated – solid at room temperature – as in butter or animal fat – this stiffens and decreases cellular flexibility and functioning. Saturated fat also raises LDL cholesterol, and high cholesterol is correlated with cognitive decline. This may be why people who eat diets high in meat and animal fats suffer from a higher rate of dementia and Alzheimer’s.
A diet high in fish, on the other hand, is correlated with a reduced incidence of brain decline. Fish oil – omega-3-fatty-acid – concentrations are highest in the brain and nervous system. They are necessary for optimal functioning of the neurons, protect cells, decrease cell death and improve nerve transmission. Emerging research indicates Omega 3s may boost levels of the brain chemicals serotonin and dopamine, decreasing depression and violence.
“In 5 out of 6 of the clinical trials where people were given either a placebo or omega-3 fatty acids, on average, the symptoms of depression have been reduced by about 50%,” says Joseph Hibbeln, a psychiatrist at the National Institutes for Alcohol Abuse and Alcoholism. “This is true even when the subjects were already on anti-depressants and failing to respond to them.”
Hibbeln’s studies found an increase in depression, violence and homicides in countries who eat less fish as compared to countries who eat more fish. It may even improve conditions such as bipolar disorder and schizophrenia.
“Vitamin B12 and folate … are widely believed to be protective risk factors of cognitive decline and Alzheimer’s disease,” said Martha Clare Morris. “Vitamin B12 deficiency results in a neurologic syndrome that involves impaired cognition. Recent interest in folate deficiency as a risk factor for dementia is primarily due to its effect on raising homocysteine concentration, which has been related to the risk of developing Alzheimer’s disease… Both low vitamin B12 and low folate status are associated with cognitive decline, and high folate exposure in persons with low vitamin B12 also may be associated with cognitive decline,” said Morris.
Balance is key, so eat food high in these nutrients instead of risking an imbalance caused by an overdose.
Folic Acid (Folate): Spinach, lentils, pinto beans, black beans, blackeyed peas, greens, soybeans, broccoli, asparagus
Vitamin B12: Found naturally only in animal foods such as seafood, chicken, fat free or low fat yogurt, milk
Physical Activity is the primary lifestyle factor impacting your brain’s health, as well as cardiovascular disease and diabetes prevention.
“Physical activity and exercise have been found, over the past several decades, to reduce the risk of a multitude of diseases including cardiovascular disease, breast and colon cancer, obesity, and type II diabetes,” said Arthur F. Kramer, at the National Institutes of Health’s conference on brain function and preventing cognitive decline. “Many of these diseases have been associated with diminished cognitive and brain health and serve as risk factors for age-associated neurodegenerative disorders such as Alzheimer’s disease. Therefore, physical activity appears to enhance cognition and brain health through disease reduction and prevention, but also has more direct effects on both brain health and cognition,” said Kramer, professor of psychology and neuroscience, Beckman Institute, University of Illinois, Urbana.
During just one exercise bout, your brain releases chemicals called endorphins into the blood stream. They reduce pain, increase feelings of well-being and elevate your mood. If you are regularly physically active, these benefits multiply. A study published in the Archives of Internal Medicine found that a brisk 30-minute walk just three times a week relieved major depression just as effectively as an antidepressant in middle-aged and older people.
Physical activity increases the oxygen to your brain, particularly the frontal regions where it increases reaction times, as reported in the journal, Nature. Physical activity also improves memory, mental function and reduces your chances for dementia and Alzheimer’s disease. Those who walked 18 miles or more per week experienced the most improvements. These studies were reported in the Archives of Internal Medicine and the journal, Neurology.
“A rich social network may provide better social support and consequently better access to resources and material goods. Large social networks also may enhance brain reserve by providing intellectual stimulation,” said Laura Fratiglioni at NIH’s conference on brain function and preventing cognitive decline. “In addition, neuropathological data have shown that subjects with a similar amount of neuropathological lesions had higher cognitive performances if they also had larger social networks,” said Fratiglioni, Professor of Geriatric Epidemiology, Karolinska Institute in Stockholm, Sweden.
Most studies have suggested “a protective effect of leisure activities, especially mentally stimulating activities, against dementia,” said Fratiglioni. “These activities, which include reading, playing board games and musical instruments, knitting, gardening, and dancing, often have been associated with a reduced risk of dementia. Furthermore, a recent review of prospective studies also has concluded that physical activity may reduce the risk of Alzheimer’s by approximately 45%. However, most physical activities also include social and mental components in addition to the physical component. Indeed, complex leisure activities composed of all three components of physical, mental, and social activities seem to have the most beneficial effect.”
Are you engaging in a “Smart” Lifestyle? Eating plenty of “Smart” foods? Please comment below in “comments,” and let me know how you are doing!
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“There are many health benefits to being more mindful,” says Jack Killen, MD, Deputy Director of the National Institutes of Health’s National Center for Complementary and Alternative Medicine.
Meditation – and similarly centering prayer – for the religious among you, establishes pathways in the brain which improve impulse control, helping you work through problems and decisions more effectively. This simple, yet powerful, tool can transform your health and your life as it helps you make the decisions you need to make your life more satisfying, for instance, decisions about eating and exercise can be done more thoughtfully and purposefully..
In the Diet Simple chapter, “How to Beat Emotional Eating,” I give you a step-by-step guide to understanding how your feelings influence your eating.
The following are excerpts from a recent interview with Jack Killen explaining how meditation works to help you regulate your emotions, so you can reign them in to make healthier decisions for your long-term benefit:
Katherine: What is mindfulness?
Dr. Killen: Mindfulness is the ability to be present, more focused, and clear; for concentration to be more sustained, and for attention to be on what’s happening, instead of on thoughts, memories, and associations.
Katherine: Why is it important to be mindful? What are some scientifically proven benefits?
Dr. Killen: There is neurobiological research demonstrating that mindfulness engages pathways in the brain associated with emotion and impulse control, attention, and focusing. It allows your brain to be focused on what is here and now so you are better able to respond to situations appropriately. People who are more mindful are better able to handle emotional situations in more appropriate ways, are more able to think through a problem, are less likely to be distracted by issues that won’t help… There is evidence that you improve at mental tests, that emotion regulation is better and more appropriate, blood pressure is lower, stress hormones are lower, thereby reducing stress.
Katherine: How can one become more mindful? I understand prayer or meditation may be helpful?
Dr. Killen: There is a lot of evidence accumulating that meditation in all of its forms has beneficial physiological effects. Meditation is a way of exercising neurological pathways in the brain which help us become more mindful. But it is a bit like going to the gym and working out your muscles, it takes time and practice for the beneficial brain pathways to become established, similar to building muscular strength and flexibility.
Katherine: What are some examples of meditation which may have these kinds of emotional and behavioral benefits?
Dr. Killen: There are many ways you can train your mind to be more mindful. The jury is still out as to whether one is better than another. More likely, certain types of meditation will work well for certain people, and other kinds for other people. We are still working on how to measure and study meditation.
There are several types of meditation. “Mantra” meditation is repeating a phrase, or something with deep meaning over and over, or focusing on a candle, for instance. “Mindfulness” meditation is focusing on what is happening now instead of on thoughts, memories, and associations.
Katherine: Are yoga, tai chi, and other forms of exercise considered good ways to achieve mindfulness?
Dr. Killen: While mind/body interventions are difficult to research, there are some encouraging data. Yoga and meditation are intertwined in many ways. Studies suggest yoga is useful in increasing lung capacity, improving mood, well-being, posture, and there are similar benefits with Tai Chi. But there is a larger body of research on meditation and its benefits.
Katherine: Is there scientific evidence that these mind/body interventions such as meditation or yoga will promote healthier lifestyles?
Dr. Killen: This is what we are studying at the Center for Complementary and Alternative Medicine. Getting definitive answers to those questions through rigorous scientific research could make these kinds of health interventions more widely available. Important work going on right now is defining research methods. We need to understand, for instance, which yoga postures (“asana”) benefit your health and in what specific ways? If we want to make health interventions more widely available and accepted, we need to be able to describe their effects better, thus magnifying their benefits. We are currently studying if these mind-body interventions are a means to help people with metabolic syndrome, if they’d be useful in weight-control programs, helping people eat less, or more healthfully.
Katherine: In “Mindfulness in Eating and Living Part II,” I will further investigate mindfulness, clarify methods for achieving mindfulness, and how you can use it to improve your health and your life. In the meantime, read “How to Beat Emotional Eating,” in Diet Simple. Stay tuned!