Tuesday, July 27, 2010

Natural Ways to Boost Your Metabolism

A fast metabolism is critical to burning fat and managing body weight. While some dieters use diet pills to speed up their metabolisms, the risks and side effects of these drugs make them risky. You can use some safe and natural methods to speed up your metabolism.

Gain Muscle

The American Council on Exercise recommends resistance training for weight management. Think of your muscles as your body's engine. The bigger your engine, the more energy you can burn. Muscle, unlike fat, is active tissue that raises your metabolism just by being there. Adding a resistance training program is a sure method of naturally raising your metabolism. To make the most out of your time in the gym, train three days per week, training your entire body during each session. Use basic, compound exercises such as the leg press and shoulder press.

Keep Hydrated

Inadequate water intake can slow your metabolism. Water is responsible for several metabolic processes, including digestion, waste management and temperature regulation. The Mayo Clinic recommends drinking 2 liters of water daily. You can fight hunger as well as raise your metabolism by drinking a glass before each meal. To provide an extra boost, make sure your water is ice cold. Your body burns extra calories heating it up to room temperature.

Cardiovascular Exercise

Cardiovascular exercises such as walking, jogging and cycling are all effective ways to burn calories and keep your metabolism stoked. If you are just starting out, use a low-impact, low-intensity exercise such as brisk walking or moderate cycling. With more experience, you can graduate to jogging or intense cycling like spinning.

Coffee

Whether you realize it or not, you might already be waking up to an effective natural metabolism booster. The caffeine naturally present in coffee raises metabolism and can improve fat oxidation. Drinking a cup before exercise can also improve alertness and help fight fatigue.


References

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About this Author
Based in the Greater New York area, David Kirschen is a 15-year veteran of the fitness industry. He is co-author of "The Business and Practice of Personal Training" and has lectured to countless fitness professionals. Kirschen holds a degree in physical education from SUNY Cortland.

Thursday, July 22, 2010

Why You Can't Lose Those Last 10 Pounds

by: Stephen Perrine and Heather Hurlock

Why traditional diets don’t work anymore

Because high school biology was likely a while back, here’s a quick refresher: The endocrine system is made up of all the glands and cells that produce the hormones that regulate our bodies. Growth and development, sexual function, reproductive processes, mood, sleep, hunger, stress, metabolism and the way our bodies use food — it’s all controlled by hormones. So whether you’re tall or short, lean or heavy — that’s all determined in a big way by your endocrine system.

But your endocrine system is a finely tuned instrument that can easily be thrown off-kilter. "Obesogens are thought to act by hijacking the regulatory systems that control body weight," says Frederick vom Saal, Ph.D., curators’ professor of biological sciences at the University of Missouri. That’s why endocrine disruptors are so good at making us fat — and that’s why diet advice doesn’t always work — because even strictly following the smartest traditional advice won’t lower your obesogen exposure. See, an apple a day may have kept the doctor away 250 years ago when Benjamin Franklin included the phrase in his almanac. But if that apple comes loaded with obesity-promoting chemicals — nine of the ten most commonly used pesticides are obesogens, and apples are one of the most pesticide-laden foods out there — then Ben’s advice is way out of date.

The obesogen effect is the reason why traditional diet advice — choose chicken over beef, eat more fish, load up on fruits and vegetables — may not work anymore. This is why we’re calling for a New American Diet.

See, while digging up all of this research on obesogens we’ve discovered some good news: There’s no reason why all of our favorite foods — from steak to burgers, from pasta to ice cream — can’t be part of a reasonable weight-loss program. We just need to get rid of old thinking. We can reverse the obesogen effect if we simply adopt these four simple laws of leanness:

Leanness Law No. 1: Know When to Go Organic
The average American is exposed to 10 to 13 different pesticides through food, beverages and drinking water every day and nine of the ten most common pesticides are EDCs. But according to a recent study in the journal Environmental Health Perspectives, eating an organic diet for just five days can reduce circulating pesticide EDCs to non-detectable or near non-detectable levels.

Of course, organic foods can be expensive. But not all organics are created equal—many foods have such low levels of pesticides that buying organic just isn’t worth it. The Environmental Working Group (EWG) calculated that you can reduce your pesticide exposure nearly 80 percent simply by choosing organic for the 12 fruits and vegetables shown in their tests to contain the highest levels of pesticides. They call them "The Dirty Dozen," and (starting with the worst) they are celery, peaches, strawberries, apples, blueberries (domestic), nectarines, sweet bell peppers, spinach, kale/collard greens, cherries, potatoes and grapes (imported). And you can feel good about buying the following 15 conventionally grown fruits and vegetables that the EWG dubbed "The Clean Fifteen," because they were shown to have little pesticide residue: onions, avocado, sweet corn (frozen), pineapples, mango, sweet peas (frozen), asparagus, kiwi fruit, cabbage, eggplant, cantaloupe (domestic), watermelon, grapefruit, sweet potatoes and honeydew melon.

Leanness Law No. 2: Don’t Eat Plastic
This ought to be a no-brainer. Indeed, you’re probably already thinking, Well, I don’t generally eat plastic. Ah, but you do. Chances are that you’re among the 93 percent of Americans with detectable levels of bisphenol-A (BPA) in their bodies, and that you’re also among the 75 percent of Americans with detectable levels of phthalates. Both are synthetic chemicals found in plastics that mimic estrogen — essentially, artificial female hormones. And like pesticides, these plastic-based chemicals trick our bodies into storing fat and not building or retaining muscle. Decreasing your exposure to plastic-based obesogens will maximize your chances both of losing unwanted flab and of building lean muscle mass. Here’s how: 1) Never heat food in plastic containers or put plastic items in the dishwasher, which can damage them and increase leaching. BPA leaches from polycarbonate sports bottles 55 times faster when exposed to boiling liquids as opposed to cold ones, according to a study in the journal Toxicology Letters. 2) Avoid buying fatty foods like meats that are packaged in plastic wrap because EDCs are stored in fatty tissue. The plastic wrap used at the supermarket is mostly PVC, whereas the plastic wrap you buy to wrap things at home is increasingly made from polyethylene. 3) Cut down on canned goods by choosing tuna in a pouch over canned tuna. And get any canned and jarred foods from Eden Organic, one of the only companies that doesn’t have BPA in its cans.

Leanness Law No. 3: Go Lean
Always choose pasture-raised meats, which, studies show, have less fat than their confined, grain-fed counterparts and none of the weight-promoting hormones. Plus, grass-fed beef contains 60 percent more omega-3s, 200 percent more vitamin E and two to three times more conjugated linoleic acid (CLA, a near-magic nutrient that helps ward off heart disease, cancer and diabetes, and can help you lose weight, according to a study in the American Journal of Clinical Nutrition) than conventional beef. If you must choose a conventional cut of beef, choose lean cuts top sirloin, 95 percent lean ground beef, bottom round roast, eye round roast, top round roast or sirloin tip steak. Bison burgers and veggie burgers are also great substitutes when grass-fed beef isn’t available. And select sustainable lean fish with low toxic loads (meaning low levels of toxins like mercury and PCBs). A study in the journal Occupational and Environmental Medicine found that even though the pesticide DDT was banned in 1973, the chemical and its breakdown product DDE can still be found today in fatty fish. Bigger fish eat smaller fish, and so carry a much higher toxic load.

Avoid ahi or bigeye tuna, tilefish, swordfish, shark, king mackerel, marlin and orange roughy — and focus on smaller fish like anchovies, Atlantic herring and mackerel, and wild-caught Alaskan salmon. Choose farmed rainbow trout, farmed mussels, anchovies, scallops (bay, farmed), Pacific cod, Pacific Halibut, Tuna (canned light) and mahimahi. Also, when you cook the fish, broil, poach, grill, boil or bake instead of pan-frying — this will allow contaminants from the fatty portions of fish to drain out.

Leanness Law No. 4: Filter Your Water

The best way to eliminate EDCs from your tap water is an activated carbon water filter. Available for faucets and pitchers, and as under-the-sink units, these filters remove most pesticides and industrial pollutants. Check the label to make sure the filter meets the NSF/American National Standards Institute’s standard 53, indicating that it treats water for both health and aesthetic concerns. Try The Brita Aqualux ($28, brita.com), Pur Horizontal faucet filter ($49, purwaterfilter.com) and Kenmore’s under-sink system ($60, kenmore.com). However, if you have perchlorate (a component of rocket fuel!) in your water (you can find out by asking your municipal water supplier for a copy of its most recent water-quality report) you’ll need a reverse osmosis filter. But for every five gallons of treated water they create per day, they discharge 40 to 90 gallons of wastewater, so make sure it’s necessary before purchasing one.

Thursday, July 8, 2010

4 Reasons Diets Fail

By Joy Bauer, M.S., R.D., C.D.N.
Jun 30, 2010

So many of the weight loss clients I've worked with one-on-one in my New York City practice admit to being professional dieters. They've tried every weight loss plan, scheme, and promise under the sun and failed miserably over and over again. And 9 times out of 10, their attempts flop because of one--or some combination--of the four reasons I discuss below. That being said, awareness is key and if you know what mistakes to watch out for, you're already a step ahead of the pack. Here's what you need to know--and can do--to immediately boost your chance of long-term success.

Reason #1: You're not fully committed.

I always tell clients at our first session together: Weight loss is at least 50 percent attitude. If you're not truly ready to make a full-time commitment to losing weight, chances of long-term success are pretty slim. That's because when efforts are half-hearted from the get-go, people typically lose interest in their diet soon after they start. The sad truth is, it's not really worth starting a weight loss program if your head isn't in the game.

How to Prevail:

My best advice is to do some serious soul-searching and identify a significant and enduring source of personal motivation for finally shedding the extra weight. Maybe it's to better manage health conditions... or to be around for your kids and grandkids... or to finally feel more comfortable in your own skin and boost your energy level.

The bottom line is that this motivation has to come from within YOU. Then, strengthen your resolve and recharge your motivation every single day with positive self talk and daily or weekly goals. I think long term goals are terrific, but short term goals can be even more powerful because they reinforce success every step of the way.

Reason #2: You expect miracles.

Individuals who launch a new diet with unreasonable expectations regarding how much weight they're going to lose each week--or who have an unrealistic goal weight in mind--are signing themselves up for trouble. If you can't match your desired pace of weight loss, you'll more than likely end up terribly disappointed and quickly jump ship.

How to Prevail:

Though you'll probably see a dramatic drop on the scale during the first few weeks on a new diet, most people eventually average out at a loss of one to three pounds per week for the duration of their plan. And if they do shed pounds more quickly than that--say, by fasting for long stretches of time--they're more likely to gain the weight back... and then some.

I know television shows and infomercial success stories lead you to believe that you can melt off fat in a matter of weeks, but the truth is, successful weight loss is a slow and steady process. If you can accept this fact and buckle down for the long haul, you will ultimately be handsomely rewarded with better health, a smashing figure, and newfound confidence.

Reason #3: Your plan isn't sustainable.

If you're following an extreme weight loss plan that doesn't even slightly resemble "normal" eating, there's a good chance your efforts won't last. And, in my opinion, subsisting entirely on shakes, smoothies, cookies, or tonics isn't normal eating. When you view a diet as a short-term deviation from your typical eating habits, rather than a long-term lifestyle change, you will almost certainly have a hard time maintaining your weight loss.

How to Prevail:

A diet should be based on appropriate amounts of healthy foods that keep you feeling satisfied and energized--not cranky and deprived. Most importantly, a diet should be viewed as a launching pad for a long-term lifestyle change. That's because to lose weight and keep it off forever, you really will have to permanently change your eating habits. With that in mind, it's important to choose an eating plan that you can easily transition into lifetime maintenance.

And while I can appreciate how provocative some of these quick-fix, restrictive diet plans can be, they truly are a set-up for failure and yo-yo dieting. Without fail, every restrictive plan has a calorific binge waiting right around the corner. Not the way to go for long term success. Instead, a food plan you can stick with for life is key.

Reason #4: You can't forgive your slip-ups.

This is an incredibly common diet pitfall. When people inevitably give into temptation and subsequently "fall of the wagon" for one meal or one day, they tell themselves they've blown their diet and throw in the towel for good. To be successful, you have to learn to overcome these temporary setbacks. You can't let one binge or one "off day" turn into a full week, or month, of splurging. Unfortunately, it can be incredibly difficult for some individuals to break this cycle of negative thinking.

How to Prevail:

Don't dwell on your mistakes. Instead, shake it off and get right back on track at your very next meal... or the very next day. And always remember, nobody gains weight from one rich dinner or a single slice of cake. The real trouble starts when you allow that one "splurge" to snowball into an all-out eating frenzy. Take it one meal at a time and learn to forgive yourself; every dieter has slip-ups, but the successful ones know how to keep those occasional lapses contained.

Monday, July 5, 2010

Aromatase Inhibitor FAQs: Hormone Therapy (Arimidex, Femara, and Aromasin) for Breast Cancer

Q. I've been on tamoxifen for a couple of years, and now my doctor is switching me to an aromatase inhibitor. I understand how tamoxifen works, but this AI is a whole new thing... how does it work?

A. Aromatase inhibitors (pronounced aroma-tase: just like it looks) come in three basic flavors: Femara® (letrozole), Arimidex® (anastrozole), and Aromasin® (exemestane). They're all known as third-generation AIs, meaning they're the third round of this type of drug to be developed-and the most successful so far.

AI's are the current drug of choice for postmenopausal women with ER- or PR-receptive (estrogen or progesterone receptive) breast cancer-either following a 2-3 year course of tamoxifen, or right out of the gate, post-surgery/chemo/radiation.

So, how does an AI work, exactly? Aromatase is an enzyme that turns the hormone androgen into estrogen. No aromatase = no estrogen. No estrogen = breast cancer cells can't grow (in women with hormone-receptive cancer). An aromatase inhibitor does exactly what it says: it inhibits the enzyme from doing its job. How? By binding itself, either temporarily (Arimidex, Femara) or permanently (Aromasin) to aromatase so that it becomes dysfunctional, and can't turn androgen into estrogen.

Tamoxifen works by preventing estrogen from binding to breast cancer cells and helping them grow. But an AI will actually reduce the amount of estrogen in your body by 90% to 95% - though only in postmenopausal women, which is why AIs are only recommended for women who've stopped having their period. Women whose ovaries are still active, who are still menstruating, produce too much estrogen for AIs to be effective. Thus, the decision for a woman having hormone therapy to start right in on an AI (vs. taking tamoxifen for awhile) may depend on whether her chemotherapy-induced menopause is permanent, or only temporary. If permanent, her doctor might start her on an AI right away. If temporary, and she remains pre-menopausal, she's not a candidate for an AI.

Q. How does the doctor decide whether I should take Aromasin, Arimidex, or Femara? Are they basically all the same, just made by different drug manufacturers?

A. They're all similar, but not exactly the same. Aromasin binds permanently to aromatase. Arimidex and Femara can bind with aromatase, then let go (this is called "reversible binding.") But they're so aggressive that their presence in your body means they will invariably shoulder any aromatase out of the way-kind of like that pushy person who always manages to get a seat in musical chairs.

Understand that all of these third-generation AIs are still very new, and results of long-term clinical trials are barely starting to come in. Some of the larger clinical trials include testing the effectiveness of tamoxifen vs. Arimidex (the ATAC trial, completed in 2005); Femara given after 5 years of tamoxifen vs. no further treatment after 5 years of tamoxifen (MA-17 trial, ended prematurely in 2003 when the results clearly showed Femara reducing recurrence risk significantly); and 5 years of Femara vs. 5 years of tamoxifen, head to head (the BIG trial, completed in 2005). All three trials showed the AI having a significant advantage over tamoxifen. Remember, all of these trials involve post-menopausal women, NOT pre-menopausal.

At this point, there's less data on Aromasin. One study, just completed this year, showed that women who take tamoxifen for 2-3 years, then switch to Aromasin for 2-3 years do better long-term than women who take tamoxifen alone for 5 years. Aromasin seems to extend tamoxifen's benefits. Another large trial, the TEAM trial, is comparing 5 years of Aromasin, taken right out of the gate (no tamoxifen) vs. tamoxifen followed by Aromasin. Results are expected next year.

WHEW! With all that data, how DO physicians decide what to give you? Well, depends on your doctor. There's a lot of data comparing tamoxifen and AIs, but very little comparing the three AIs to one another, in terms of benefits and side effects. It's known that Femara inhibits (suppresses) 99% of aromatase in the body, while Arimidex and Aromasin trail by a couple of percentage points. For some doctors, that's reason enough to recommend Femara. On the other hand, it's been shown that Femara and Aromasin (but not Arimidex) can raise cholesterol levels, thus possibly increasing a woman's risk of heart attack and stroke very slightly; so women at risk for stroke or heart problems may be guided towards Arimidex. Some researchers feel, however, that it is not possible to differentiate which of these drugs truly raise cholesterol and that this may be a problem of trial design - that the raising of cholesterol is probably a "class effect" seen in all three aromatase inhibitors.

Some doctors (mine, for example) feel that Arimidex, which is the "weakest" of the three, actually provides some added benefit by NOT suppressing as much aromatase. They feel that a tiny bit of estrogen in your body is better than none at all. They claim that it doesn't increase your risk of recurrence, and provides other health benefits. So they'll recommend Arimidex ahead of Femara or Aromasin.

As far as FDA approvals go, Arimidex is approved for women with breast cancer that hasn't metastasized past the lymph nodes (early stage disease). Femara is approved for women with early stage disease who've completed 5 years of tamoxifen. And Aromasin has FDA approval for women with early-stage cancer who've completed 2-3 years of tamoxifen; and for women with metastatic cancer who haven't responded to tamoxifen.

Q. Well, I can see why it's not a cut-and-dried decision, which one to take. Sounds like their benefits are pretty similar; but what about their side effects?

A. Actually, their side effects are pretty similar, too, with some minor differences. Many doctors will switch a woman from one AI to another to another based on her reaction to each one, choosing the one that ultimately gives her the fewest negative side effects.

Here are the side effects that are common to all AIs. Remember, YOU may not experience these; every woman's experience with a particular drug is hers and hers alone.
  • joint and muscle pain;
  • hot flashes;
  • vaginal dryness, which can lead to yeast infections and painful intercourse;
  • loss of bone density, leading towards osteoporosis;
  • insomnia;
  • weight gain.


Of these side effects, joint, muscle, and bone pain are the most widely experienced and troublesome. About a third of women who take an AI don't (or barely) experience this side effect; about a third have stiffness and pain upon first getting up in the morning, but once they get going they're fine; and about a third have more frequent or severe pain. As many as 20% of the women in some studies stopped taking AIs because of pain. Which is a shame, because AIs have absolutely been shown to help prevent both breast cancer recurrence, and death from breast cancer.

If you start taking one AI and find the side effects bothersome, ask your doctor if you can switch to one of the others; you may have a better experience.

One of tamoxifen's side effects, risk of uterine or endometrial cancer, is notably absent in AIs: thankfully, none have been shown to lead to another cancer.

Q. And how long will I take whichever aromatase inhibitor it is I end up taking?

A. Just like tamoxifen, you'll take one pill every day. Studies have shown that it's important to take your AI regularly-even more important than it is to take tamoxifen regularly. Don't forget to take it, or let your prescription run out, or otherwise get caught short-taking that little white pill EVERY day is the only way to get its full benefit.

As for how long you'll take it - news at 11. At this point, all of us taking AIs are guinea pigs. (Physician's Note: Doctors might interject here that taking an FDA approved drug after an informed discussion with a licensed and treating physician does not meet their opinion of "guinea pig." Participating in important clinical trials can make a significant different in the way we treat breast cancer, so don't let fear of being a "guinea pig" dissuade you from making an otherwise informed choice about clinical trials). Is 5 years best for aromatase inhibitor use? Is 7 years better? How about 10 years? There just hasn't been sufficient data collected (yet) to draw hard and fast conclusions. You'll probably be on your AI for 3 years minimum, if you're switching over from tamoxifen; or for 5 years minimum, if you haven't taken tamoxifen. Beyond that, who knows? By 2 or 3 or 5 years from now, more studies will have been completed, and there'll be better data on which your oncologist can base his recommendations. Good luck!