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For November 24, 2017

  • How to Avoid Gaining Weight as You Age
    How to Avoid Gaining Weight as You Age

    Tips to Battle the Bulge

    (PHYS, September 1999) � You're smart, healthy, young. You eat sensibly and work out regularly. And in 10 years, if you stay faithful to your current diet and exercise program, you'll probably be about 10 pounds heavier than you are today. That unwelcome prediction reflects a basic physiological fact: At approximately age 30, your metabolism starts a gradual slowdown. Diet and exercise as you will, experts declare, it's just not possible to preserve a perfectly lean, youthful body composition into middle age and beyond. That's the bad news. The good news is that new evidence suggests that if you start out lean and fit in your twenties, gaining a couple of pounds in your thirties and forties might increase your odds of surviving to a healthy old age.

    Although there are no quick and easy solutions to the pound-a-year problem, the following are some good strategies for keeping weight gain to a minimum.

    Reduce Your Caloric Intake
    Clearly, you can reduce the effects of your slowing metabolism by cutting down on calorie intake and stepping up on exercise. "Even for the person who is exercising religiously, her food intake is not going to be able to remain the same," says Leslie Bonci, R.D., assistant director for nutrition at the Center for Digestive Health at Allegheny General Hospital in Pittsburgh and nutritionist for the Pittsburgh Steelers. Change doesn't have to be drastic. Bonci says it's relatively easy to trim your daily calorie intake by 100 calories every decade after age 20: "It's just a little bit of a cut-down � light beer instead of regular, one-quarter cup less cereal in the morning. A very subtle change is enough to keep the body in balance."

    Eat a Low-Fat, Vegetable-Rich Diet
    Sticking to a low-fat diet may help to keep your metabolism from slowing down even further. Obviously, eating lots of high-fat foods increases your daily calorie intake. In addition, because high-fat foods cram calories into a small volume, you wind up eating a lot in order to feel full. High-fat diets are also thought to have a subtly nefarious effect on metabolism, Bonci says, turning down the body's metabolic thermostat slightly, so you burn up fewer calories per day even as caloric intake climbs.

    Eating a vegetable-rich diet appears to help avoid spreading middles as well. American Cancer Society scientists who tracked 79,000 men and women for 10 years found that those who ate 19 or more servings of vegetables each week were less liable to add pounds to their waists. On the other hand, those who gobbled up more than three servings of meat per week were more likely to gain at the waist. Why the veggie diet may be so protective isn't yet clear.

    Increase Your Gym Time
    If you plan to lessen weight gain as you age you'll definitely need to increase the time you spend at the gym. "Our data suggest that you can probably compensate for some middle-age weight gain by becoming more active," says Paul T. Williams, Ph.D., an epidemiologist at the Life Sciences Division of Lawrence Berkeley National Laboratory in Berkeley, California. But expect to put in far more than the half hour of moderate physical activity five or more days a week currently recommended for American adults by the Centers for Disease Control and Prevention. "I've always felt that the government exercise recommendations are excellent for the comatose," avers Williams.

    Keep in mind that the amount of fat you burn with exercise seems to decrease with age. In a study comparing moderately fit adults in their twenties with those in their seventies, Samuel Klein, M.D., director of the Center for Human Nutrition at the Washington University School of Medicine in St. Louis, found that older subjects burned up to 30 percent less fat during exercise than did younger ones, even when they did the same amount of work. Older exercisers burned up more carbohydrates. Klein found that elderly subjects began to burn more fat after 16 weeks of intensive exercise. "If older people train, they have more normal patterns of fat oxidation," Klein says. "It goes back to where it is in younger adults."

    All in all, working out regularly will help keep you strong and fit as you go through middle age and beyond. "There's a lot of Scandinavian data that suggests that individuals in their sixties, seventies and eighties who are very physically active tend to live healthier, happier lives," says Metter.

    The real indicator of healthy aging isn't a number on a scale or a measurement on a tape. "On my checklist, the question is how much vitality do I have," Bonci says. "I may be 40, but if I can still run and lift, and if I feel strong and fit and have a lot of energy, I know I'm doing something that's good for my body and good for me."

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  • Interval training.
    Interval training.

    Interval training is a special training technique that involves periods of higher intensity exercise interspersed with periods of rest or light activity. These intervals, which can be used to enhance competitive performance in a specific sport or to improve general fitness can vary in the following ways:

    1. Intensity and duration of the exercise period.
    2. Intensity and duration of the rest period.

    Depending on how the workout varies an athlete can train the specific energy system necessary to develop his or her specific fitness goal.

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  • Calories Burned During Physical Activities
    Calories Burned During Physical Activities

    When you perform a physical activity, your basal metabolic rate will increase, burning more calories. The good news is that your BMR will stay high even after you stop the activity, continuing to burn calories. In addition, the ideal exercise or activity for losing weight is not one where you are "out of breath". It is better to perform an aerobic exercise, where you can continue to hold a conversation while performing the activity. This helps your body to actually burn fat, instead of sugar. The chart below shows the calories burned for one hour of activity for various exercises for both 140 lb and 195 lb people:

    Activity (1 hour)140 lbs195 lbs
    Aerobics, general381 531
    Aerobics, high impact 445 620
    Backpacking 445 620
    Basketball, game 508 708
    Basketball, shooting baskets 286 398
    Bicycling, <10 mph, leisure 254 354
    Bicycling, 10-11.9 mph, light effort 381 531
    Bicycling, 12-13.9 mph, moderate effort 508 708
    Bicycling, 14-15.9 mph, vigorous effort 636 885
    Bicycling, 16-19 mph, very fast, racing 763 1062
    Bicycling, Mountain or BMX 540 753
    Boxing, punching bag 381 531
    Boxing, sparring 572 797
    Canoeing, rowing, moderate effort 445 620
    Dancing, aerobic, swing, ballet or modern, twist 381 531
    Football, touch, flag 508 708
    Golf, carrying clubs 350 487
    Golf, pulling clubs 318 443
    Golf, using power cart 222 310
    Hiking, cross country 381 531
    Hockey, ice 508 708
    Jogging 445 620
    Judo, karate, kick boxing, tae kwon do 636 885
    Mowing lawn 350 487
    Racquetball, casual 445 620
    Rock climbing, ascending rock 699 974
    Rope jumping, moderate 636 885
    Rowing, stationary, moderate effort 604 841
    Running, 5 mph (12 minute mile) 508 708
    Running, 5.2 mph (11.5 minute mile) 572 797
    Running, 6 mph (10 minute mile) 636 885
    Running, 6.7 mph (9 minute mile) 699 974
    Running, 7 mph (8.5 minute mile) 731 1018
    Running, 7.5 mph (8 minute mile) 795 1107
    Running, 8 mph (7.5 minute mile) 858 1195
    Running, 8.6 mph (7 minute mile) 890 1239
    Running, 9 mph (6.5 minute mile) 953 1328
    Running, 10 mph (6 minute mile) 1017 1416
    Running, 10.9 mph (5.5 minute mile) 1144 1594
    Running, stairs, up 953 1328
    Shoveling snow 381 531
    Skateboarding 318 443
    Skating, ice 445 620
    Skating, roller 445 620
    Skiing, cross-country, moderate effort 508 708
    Skiing, snow, downhill, moderate effort 381 531
    Skiing, water 381 531
    Snowmobiling 222 310
    Soccer, casual 445 620
    Softball or baseball 318 443
    Swimming laps, freestyle, light/moderate effort 508 708
    Tennis, singles 508 708
    Tennis, doubles 381 531
    Volleyball, competitive 254 354
    Walking, 3.0 mph, moderate pace 222 310
    Weight lifting, light or moderate effort 191 266
    Weight lifting or bodybuilding, vigorous effort 381 531

    Numbers are from the "Official Journal of the American College of Sports Medicine."

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  • New Drug Fights Osteoporosis
    New Drug Fights Osteoporosis

    Raloxifene regrows thinning bone

    (MSNBC News, Aug. 17 1999) � It is dramatically good news for the 22 million American women at risk for fractures from the bone-thinning disease osteoporosis � a drug that actually regrows bone.

    "WOMEN WHO ALREADY have osteoporosis can take a treatment that will markedly reduce their risk of fractures � reduce that fracture risk by 40 percent," said Dr. Bruce Ettinger of Kaiser Permanente's Division of Research in Oakland, Calif. "So even women in their late 60s who already have fractures can get a tremendous benefit for their health." The findings in the largest study to date of the drug raloxifene were published in Wednesday's Journal of the American Medical Association. The research was funded by Eli Lilly and Co. of Indianapolis, which sells the drug as Evista.

    The news comes only a month after data from the same women revealed that raloxifene appears to lower breast cancer risk by 70 percent. That is a major advantage for postmenopausal women who fear using estrogen for its bone-strengthening benefits because it slightly increases breast-cancer risk with long-term use.

    The drug is already on the market to prevent osteoporosis and it will now join the three other drugs that can treat the disease. Ettinger said the four approved osteoporosis drugs should not be considered competitors, because their benefits and limitations are so different. Doctors say each drug carries risks and benefits, but with the growing number of treatments, almost everyone should get help.

    "We can approach the patient with many choices," explained Dr. Joseph Lane of New York's Hospital for Special Surgery, "There is usually one drug or more than one drug that we can use."

    The four approved osteoporosis drugs are:

    • Alendronate, marketed as Fosamax, is the strongest bone builder and the only drug shown to protect against hip fractures. But it offers no other health benefits and causes many women stomach upsets severe enough to discourage them from taking it.
    • Estrogen, which is almost equal to alendronate as a bone-builder, and research suggests it also protects against heart disease and even mental decline for women past menopause. It relieves menopause's hot flashes and night sweats, but it commonly causes breast tenderness and a resumption of menstrual bleeding, unacceptable to many women.
    • Raloxifene, which has about two-thirds the bone-building power of alendronate but does not relieve menopausal symptoms and may worsen some, such as leg swelling. But it seems to lower "bad" cholesterol levels in the blood and is well tolerated.
    • Calcitonin, marketed as Calcimar, which is the least powerful of the bone-boosters but is offered in an easy-to-take nasal spray.

    Osteoporosis strikes women four times as often as men, usually after menopause. Women with thinning bones can suffer compression fractures in the spine that make them shorter and hunched over � and they are at great risk for debilitating hip fractures if they fall. "One in 20 women in the hospital are recovering from a hip fracture," said Lane. "It leads to profound loss of function."

    As important as treatment is, doctors say it is crucial for women in their 30s, 40s and 50s to start thinking about getting lots of calcium in their diets and taking other steps to prevent osteoporosis. "I think it is actually critical to start as soon as possible," said Lane. "Once you start losing bone we can replace it, but when we replace it we never rebuild the architecture the way God gave it to you and it is always weaker."

    A $150 test called a bone scan is an important way to make sure your bones are not getting weaker. If it shows a woman's bones are weakening, doctors can start her on one of the drug regimens. Four months ago when a bone scan revealed that Anna Borruso, a patient at the Hospital for Special Surgery, was starting to get osteoporosis, her doctor put her on Evista. When she suffered a bad fall, it was not nearly as bad as it could have been. "I was elated that I did not break my arm or my hip or my ribs," Borruso said.

    Doctors say the new drugs could give similar protection to millions of women � sharply reducing one of the worst dangers of aging.

    The Associated Press contributed to this report.

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  • Need Help for Hurting Joints?
    Need Help for Hurting Joints?

    (From "Ask Dr. Weil, August 13 1999)

    Question: I am a 54-year-old yoga teacher and vegetarian. I'm having lots of hip pain, especially at night. I haven't found a movement that relieves it. Any suggestions?

    Answer: I would recommend getting a diagnosis based on a physical exam and X-ray. One possibility is osteoarthritis, a common cause of age-related aches and pains. You're a yoga teacher, so it could also be bursitis.

    Bursitis is usually caused by repetitive overuse or injury to a joint which irritates the bursae, cushioning sacs between the bones. The result can be chronic aching in the outer area of your hip which can radiate down into the buttocks or the outside of your leg.

    Standard medical treatment calls for a steroid injection to relieve the inflammation, but I suggest you try other measures first. The following strategies should help:

    • Take niacinamide. Start with 500 mg twice a day, increasing the dose by 500 mg every three weeks to a maximum daily dose of 2,000 mg.
    • Take one to two grams of powdered ginger per day in capsules.
    • Try boswellia, an Ayurvedic herb. Follow instructions on the package.
    • Soak in hot water as often as possible, and use ice packs if the pain is acute.

    You may also want to follow the advice in "The Arthritis Cure" by Jason Theodosakis, M.D. (St.Martin's Press, 1998) regarding glucosamine sulfate and chondroitin sulfate. Massage, acupuncture, osteopathic manipulation, and visualization may also offer relief.

    Finally, you could try DMSO (dimethyl sulfoxide), a solvent (found in most health food stores) that penetrates the skin and helps heal inflammation. Paint a 70 percent solution over the painful area with absorbent cotton. You may feel some warmth or stinging and may get an odd, garlicky taste in your mouth. Apply three times a day for three days. If your hip feels better, cut down to twice a day for three more days, then once a day for a final three days. If it doesn't help after three days, discontinue use.

    You might also want to take a break from yoga. Simple rest, to keep pressure off your hip, may turn out to be the best treatment of all.

    Copyright 1999 Asklepios Enterprises, Inc.

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  • Orange juice raises "good" cholesterol
    Orange juice raises "good" cholesterol

    ATLANTA (Reuters Health) -- Drinking three glasses of orange juice a day increases high density cholesterol (HDL), the so-called "good" cholesterol, and lowers the ratio between HDL and low density cholesterol (LDL) -- the "bad" cholesterol, according to a study presented at an American Heart Association meeting.

    A team at the University of Western Ontario, London, Canada, asked 16 men and 9 women with high blood cholesterol levels (ranging from 213 to 325 mg/dL) to drink one glass of orange juice a day for 4 weeks, then two glasses a day for 4 weeks, and then three glasses a day for 4 weeks. This was followed by a 5-week washout period, during Dr. Elzbieta M. Kurowska told Reuters Health that once the subjects were drinking three glasses of orange juice a day, their HDL levels increased 21% and the LDL/HDL ratio dropped 16%. Orange juice also resulted in an increase in folate levels, which are known to cause a drop in homocysteine levels. Cardiologists are finding that high homocysteine levels appear to be a risk factor for heart disease.

    "The (cholesterol) effect was still there after the washout period," Kurowska said. While vitamin C levels dropped back down after the end of the study, the improvements in cholesterol persisted, she said. "Maybe these (orange juice) compounds have a prolonged effect," she said.

    The researcher added that none of the subjects reported weight gain, "even though this was a considerable increase in sugar (intake)... The subjects compensated by changing their diets in other ways."

    Kurowska attributes the effects of orange juice on cholesterol to the flavenoid hesperidin found in oranges. She would next like to study the effects of grapefruit juice on cholesterol. "The primary flavenoids in grapefruit juice are different from those in orange juice," the Canadian researcher noted.

    Source: Circulation: Journal of the American Heart Association 1999;100:1958-1963.

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