Wednesday, April 24, 2013

The Elixir of Exercise

The next 3 blog entries will be about exercise--importance, amount, benefits--all in an effort to convince and motivate you to make physical activity a consistent part of your lifestyle.  It would be impossible to overstate the importance of exercise.

First of all, you cannot experience optimal health without activity/exercise in your life.  Physical activity increases physical and emotional well-being, prevents a long list of diseases, and seems to slow down the very process of aging itself.  Do you know someone who seems to stay perennially “young” looking?  Inevitably they exercise, regularly.   There’s a lot of talk about the anti-aging properties of foods, but hardly a mention about exercise.

Ironically, you will have more energy if you exercise.  I know, it doesn’t make sense.  We have more energy when we spend more energy?  Yup.  I do realize the huge time obstacle most people face—we are maxed out to the limit with a weakening economy and ever-increasing demands on our time, but the truth is you don’t have the time (or money, considering the cost of healthcare) to not exercise.  Improvement in energy translates into feeling better and being more productive with the time you have, not to mention preventing illness, a huge component of our economic well-being, both individual and collective.  Few of us really “have time” to exercise, but I wish my uncles, who all died in their 40’s and 50’s of heart disease, would have taken the time to exercise then--we would have more time with them now.

Then there is prevention of lifestyle disease.  You name the disease, exercise makes it better.  Most people are aware that exercise reduces the major risk factors for heart disease, but let’s strengthen the case and look at each of the individual risk factors for cardiovascular disease.  Exercise reduces “bad” LDL cholesterol, increases “good” HDL cholesterol, reduces triglycerides, reduces high blood pressure, reduces stress, reduces overweight/obesity, and even has anti-inflammatory properties (C-reactive protein, a measure of inflammation in the body, is reduced).  Why do we spend so much more of our resources in the continual search and development of drugs to “help” reduce cardiovascular disease when we rarely tap into the much more effective no-cost exercise?  Many physicians are much quicker to put patients on a drug treatment program than on an exercise program, and we should be asking why.

But the positive effect of exercise does not stop with heart disease.  Exercise has an extremely positive impact on diabetes, obesity, cancer, intestinal disorders (including constipation, diverticulosis, irritable bowel syndrome and Crohn’s disease), alzheimer’s, depression, PMS, osteoporosis, and (perhaps counterintuitively) arthritis.  Exercise even improves sleep!  In fact exercise is SO important to your health that you would very likely be healthier to be a junk food addict who exercises than if you become a “health food nut” in a health food store who does no exercise—and that’s from a dietitian!  That’s how important exercise is.  (Note: I do not condone junk food addict exercisers—that is the addictive cycle of bondage to an eating/body image disorder that ate up 15-20 years of my life).
 
And there simply is no successful weight-management or weight-loss without exercise. . .  

Monday, April 22, 2013

HDL Cholesterol

Recall from the blog entry “Is a Low-Fat Diet Healthiest?” that a low-fat diet is not necessarily the best diet to prevent heart disease because

·        triglycerides increase
·        HDL’s decrease, and
·        insulin-resistance gets worse! 

In previous blogs I discussed insulin-resistance and triglycerides, but what exactly are HDL’s? 

HDL ("high-density lipoprotein") is affectionately known as the "good cholesterol".  Cholesterol is a waxy steroid of fat, and HDL is one of 5 forms of lipoprotein which carry cholesterol in the blood

Wednesday, April 17, 2013

Triglycerides

In the last blog entry I shared a counterintuitive finding—a relatively "high" (40%) fat diet lowers triglycerides (fat in the blood)!  The key: eat predominately plant and fish fat.

Triglycerides consist of three fatty acids (“tri”) attached to a glycerol molecule (“glycerides”).  Triglycerides are one of the components of the atherosclerotic plaque which leads to cardiovascular diseaseTriglycerides may be just as important as cholesterol, if not more important, in the progression of cardiovascular disease.   

Know your triglycerides! 

A serum triglyceride level of 150 milligrams/deciliter or higher is cause for concern and dietary (and exercise) modification.  The American Heart Association recently published a statement recommending that a new “optimal” fasting triglyceride level be defined as 100 mg/dL (Triglycerides and Cardiovascular Disease : A Scientific Statement From the American Heart Association, April 18, 2011 in Circulation).

Our body fat is composed largely of triglycerides.  When excess fat is present in our bodies, the serum triglyceride (blood fat) level may increase.  In fact waist circumference (belly storage fat) is a better predictor of cardiovascular disease and diabetes risk than body weight.  A waist circumference of 35” in women, or 40” in men, will put you at significantly higher risk for cardiovascular disease and diabetes. 

Recommendations for Lowering Triglycerides:

The dietary/lifestyle recommendations for lowering triglycerides are similar to those for lowering cholesterol, with the additional focus on reducing simple carbohydrates and alcohol:

·        ¯ Animal/Saturated Fat
               
·    ¯ Simple Carbohydrates. In “insulin resistant” individuals, eating refined carbohydrates can lead to hyperinsulinemia and high triglycerides.  It is the simple carbohydrates which Americans consume in excess that are known to affect insulin--there is no evidence that complex carbohydrates are to blame.  Research on healthy cultures around the world indicate that an optimal diet (consumed in a variety of ways) is based on 90% plant and 10% animal food based on 50% whole grains, beans, nuts and seeds, 30% vegetables, and 10% fruit, a large carbohydrate intake to be sure, but very different from the largely refined carbohydrates upon which Americans base their Standard American Diet.

·        ¯ Alcohol.  Alcohol contributes 7 calories/gram and virtually no nutrition.  When we consume alcohol it is not immediately burned for calories, but first converted to fatty acids in the liver (cirrhosis of the liver in alcoholics = fatty livers which scar and burst), then the fatty acids are burned for energy secondary to available carbohydrates.  The beer-belly softball player doesn’t burn the beer for energy first, but the hot dog bun instead!  More often the fatty acids are stored.

·        Exercise.  Consistent exercise is very helpful in controlling serum triglyceride levels.

So to lower your triglycerides reduce animal protein, simple (refined) carbohydrates and alcohol, and eat whole grains, beans, nuts and seeds, vegetables, fruit, fish and plant oils with moderate amounts of lean meat and dairy (think Mediterranean).  Remember, counterintuitively, a seemingly "high" 40% fat diet based predominately on plant (especially monounsaturated fat, olive oil) and fish fat lowers triglycerides, likely due to an indirect affect of eating less simple carbohydrates and animal protein.  Finally, consistent exercise can have a major positive effect on your triglycerides, and on your risk for cardiovascular disease and diabetes.

Know your triglycerides.

Eat right, exercise, enjoy!

Diane Preves, M.S., R.D.

Note:  it is not uncommon to see a transient rise in triglycerides during weight-loss (it usually resolves within 6-12 months).


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