Dietician’s Blog

Submitted by Fitness & Health with Dr. Gabe Mirkin

How foods affect blood-sugar levels varies from person to person and from one time to another in a single individual. For example, if you eat a jelly donut in the evening, your blood sugar may rise well over 200 (it should never be higher than 160). If you eat the jelly donut when you have been riding your bike for an hour, your blood sugar level may not rise at all.

Researchers at University Medical Center in Utrecht, the Netherlands showed that eating sugar and flour markedly increases risk for heart attacks in middle-aged women. Being overweight increased the risk even more. More than 15,000 healthy Dutch women, ages 49-70, were followed for nine years. They suffered 556 cases of coronary heart disease and 243 strokes. The ones most likely to be afflicted were overweight women who ate a diet high in foods that cause a high rise in blood sugar. Journal reference

The only places that you can store sugar in your body are your liver and muscles. If you eat lots of sugar or flour when your muscles are full of sugar, sugar goes from your intestines, into your bloodstream and then can spike to high levels. However, during or after prolonged exercise, sugar goes from your intestines into your bloodstream and then directly into your muscles, so it does not spike. For diabetics or overweight people, the safest time to eat foods that cause a high rise in blood sugar is while they are exercising. More on glycemic load of foods; refined carbohydrates; preventing diabetes

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Submitted by Fitness & Health with Dr. Gabe Mirkin

People who have longer lower leg lengths (the distance from knee to ankle) will usually have greater endurance during running or walking than those with shorter lower leg lengths. In a study reported in the Journal of Human Evolution, researchers at the University of Wisconsin showed that people with longer lower legs use less energy when they run.

In a previous paper in the same journal, these authors showed that people with longer lower legs are better able to prevent heat build-up, which slows you down and makes you tired. When you exercise, almost 80 percent of the energy that you use to power your muscles is lost as heat. So the harder you exercise, the more heat you produce and the harder your heart has to work to get rid of the extra heat. You prevent heat buildup by your heart pumping hot blood from your muscles to the skin where it is cooled by sweat and conduction and radiation. Journal references

People with longer lower limbs use up less oxygen and produce less carbon dioxide for the same energy expenditure. Therefore they are more efficient and can go further because their bodies require less oxygen.

You can’t change the length of your lower legs, but you can increase running efficiency

Submitted by Fitness & Health with Dr. Gabe Mirkin

The Recommended Allowance for protein for most people is about 70 grams per day. Many types of foods contain protein, and it is easy to meet your protein requirements with a typical varied diet. For example, you would meet your daily requirement for protein if you ate two of cups each of beans and whole grains such as barley, brown rice or oatmeal, three ounces of tuna, and two glasses of milk or a vegetarian milk substitute. If you are not sure whether you eat enough protein, keep track by checking the labels of the foods you eat for a few days. You will probably find that you get plenty of protein without any special effort.

Protein is made up of protein building blocks called amino acids. Your stomach acids and enzymes in the stomach and intestines break down proteins into these building blocks, which pass from the intestine into the bloodstream. If your body needs to build protein, your liver combines amino acids to form body proteins. If you don’t need all of the protein you have eaten, it is broken down into organic acids and ammonia, which can be used for energy or be converted to fat. If you take in more protein than you need on any given day, it will be stored as fat because you cannot store protein in your body.

Competitive athletes or heavy exercisers need more protein to repair muscles after workouts. Muscles heal from a hard workout when amino acids and other nutrients travel from your bloodstream into the muscles. Eating any foods, particularly those that are good sources of protein, immediately after a workout helps muscles heal faster. More

Submitted by Fitness & Health with Dr. Gabe Mirkin

Everyone can enjoy an occasional meal in a restaurant without worrying about the consequences. But if you have to eat in restaurants several times a week, you need to devise ways to make healthful choices and avoid the temptation to over-eat. If you are trying to control weight, diabetes, cholesterol or high blood pressure, you must find ways to meet your special requirements.

First, choose restaurants that gives you a fighting chance. Find a restaurant with a good salad bar and load up on fresh vegetables. Order broiled fish for your entree. Ask to have it prepared with lemon juice instead of butter. Have steamed vegetables as an accompaniment, without added butter, and fresh fruit or fruit ice for dessert.

Asian restaurants often have a wide array of tasty dishes with lots of vegetables. Thai and Vietnamese restaurants and Mongolian grills are good choices if you stick to the vegetarian and seafood entrees. Go easy on the white rice.

Your chances of finding whole grains in a restaurant are slim to none, but if you travel a lot, you might want to pack or shop for your own cereal to eat in your hotel. Large cities and college towns often have vegetarian restaurants that offer varied, flavorful meals made with vegetables, beans and sometimes even whole grains. Whatever you order, watch out for the huge portions that many restaurants serve. Divide it up at the beginning of the meal and save some for the next day’s lunch, share with a friend, or just leave it.

List of national chain restaurants that offer good to excellent salad bars and some other healthier choices for people on the go

Submitted by Fitness & Health with Dr. Gabe Mirkin

For exercise to help you control weight, you must exercise fairly intensely or else you need to exercise for many hours, and most people do not have the time to exercise for three or four hours or more every day. A study from the University of Massachusetts in Boston shows that middle-aged women who exercise at very low intensity are fatter and gain weight far more easily than women who exercise more intensely. Journal reference

This is what you would expect. When you exercise intensely enough to raise a sweat, you can increase your metabolism and continue to burn extra calories for several hours after you stop exercising. When you exercise at very low intensity, you do not increase your metabolism and you have to exercise for a very long time to burn a significant number of calories. If walking is your exercise choice for weight loss, walk vigorously enough to sweat and breathe hard.

People who want to use exercise to control weight should first check with their doctors. They should pick an activity that they can do regularly and try to do it every day. On some days, they should try to exercise more intensely, feel sore on the next day, go at low intensity for as many day as it takes for the soreness to go away and then exercise intensely again. People are more likely to stick with an exercise program if they do it with a spouse, a good friend or a personal trainer, or in a social setting such as a class or club.
More

Submitted by Fitness & Health with Dr. Gabe Mirkin

Bicycle racers in long events such as the Tour de France take sugar supplements while they ride to increase their endurance. If you plan to exercise for more than two hours, you can help yourself last longer by taking a source of sugar after 30 minutes and several times more throughout your event.

When you exercise, you convert food to energy for your muscles by stripping off electrons and hydrogen from the foodstuffs. This process manufactures a chemical called ATP that provides energy that does not require oxygen. A study from the University of Waterloo in Ontario, Canada shows that taking sugar during prolonged exercise raises levels of ATP. At exhaustion, ATP levels were at the same low levels in both the group taking sugar and those taking artificial sweeteners. However, prior to exhaustion, those taking sugar had higher levels to help them exercise longer. Journal reference

You do not get this benefit from sugar eaten before you exercise because high blood sugar levels that result will cause your pancreas to release large amounts of insulin. The extra insulin will deplete the sugar stored in your muscles faster and tire you earlier. Thus if you want to exercise intensely for more than a couple of hours, you need to eat or drink a source of carbohydrates at frequent intervals during your activity.

Submitted by Fitness & Health with Dr. Gabe Mirkin

Aerobic capacity is a measure of your ability to use oxygen to do work. If your body can process more oxygen than that of another person, usually you will be able to run faster, walk or work longer, and have more energy than that person.

The loss of aerobic capacity with aging explains why older people cannot compete effectively against younger ones in endurance events. The good news is that a regular exercise program can help you compensate for this loss by strengthening skeletal muscles and increasing your maximum heart rate.

Tasks that you did without effort when you were younger can become major ordeals that leave you exhausted when you are older. It takes more effort and time to walk up stairs, mow the lawn, fix a faucet or wash the dishes. Dr. Jerome Fleg, a cardiologist at the National Heart, Lung, and Blood Institute, tested 800 men and women over several years and found that their ability to sustain exercise decreased rapidly as they aged. The older they became the faster they lost aerobic capacity.
The men and women lost three to six percent per decade in their 20’s and 30’s, and 20 percent per decade in their 70’s. The men lost aerobic capacity faster than the women. The men lost 8.3 percent of aerobic capacity in their 40’s and 23 percent per decade in their 70’s. This study was done with people who were healthy enough for vigorous exercise on a treadmill that measured their exercise capacity. People who have had heart attacks, strokes, diabetes or other wasting diseases would lose aerobic capacity much faster than healthy people. Journal reference

A regular exercise program can increase exercise capacity by up to 25 percent, which would give the older participants the same exercise capacity as you would expect in people who are twenty years younger.

With vigorous exercise, you develop stronger skeletal muscles. When you contract your leg muscles, they squeeze against the veins in your legs and pump blood toward your heart. When your leg muscles relax, the veins dilate and fill with blood. This alternate contacting and relaxing pumps extra blood toward your heart. The extra blood returned to the heart stretches and strengthens the heart muscle, causing it to beat faster and with more force. So strengthening your leg muscles increases your maximum heart rate, even as you age.

Submitted by Fitness & Health with Dr. Gabe Mirkin>

Many recent reports show that vitamin D is far more than just a hormone that strengthens bones. It is necessary for maintaining a healthy immune system. Every day, your body produces millions of cancer cells, and your immunity is supposed to search out and destroy these cells. However, when you lack vitamin D, your immunity is less able to destroy cancer cells. A study from Creighton University in Omaha, Nebraska, showed that women had a 77 percent lower rate of cancer in the second through fourth years of taking calcium and vitamin D pills than women taking placebos. Journal reference

The only really rich food source of vitamin D is fatty fish. Very few people are able to meet their needs for vitamin D from the foods that they eat and have to depend on sunlight to cause their skins to manufacture it. But concern about skin cancer has encouraged many people to avoid direct exposure to sunlight. Vitamin D deficiency is common in northen latitudes, particularly in people who have dark skin that blocks ultraviolet light. It is also common in overweight people because fat cells hold on to vitamin D and prevent it from being utilized. People who are at risk for vitamin D deficiency can ask their doctors to order a blood test to measure vitamin D levels. If low, they may need more sunlight, more fatty fish or vitamin D supplements.

Submitted by Fitness & Health with Dr. Gabe Mirkin

If your resting heart rate is greater than 70, check with your doctor to see if your thyroid is overactive, you are anemic, or you have an infection, hidden tumor, a weak heart or other cause of a rapid heart rate. Having a resting heart rate greater than 70 increases your chances of suffering a heart attack. Journal reference

At this time, there is not enough solid data to show that taking drugs to slow heart rate, by itself, will help to prevent heart disease when no cause is found. However, those with chest pain during exercise or blocked blood flow to the heart do benefit from drugs to slow heart rate. Several ongoing studies are trying to determine if all people with heart rates over 80 should take drugs to slow heart rate. Drugs that can be used to slow heart rate and prevent heart attacks include beta blockers, ACE inhibitors, angiotensin receptor blockers, statins or aspirin.

Your “Recovery Heart Rate” is likely to be even more important. Recovery Heart Rate is a measure of fitness and a slow recovery from exercise means that you are out of shape. This test can cause irregular heart beats in people with damaged hearts, so check with your physician before you try it.

To measure recovery heart rate, you exercise on a treadmill (or any other activity) until you are breathing hard, record your heart rate, and hold that pace for at least a minute. Then stop, and measure your pulse rate exactly one minute after stopping. If your heart does not slow down at least thirty beats in the first minute, you are in poor shape and at increased risk for a heart attack. If your heart rate slows down more than fifty beats in the first minute, you are in excellent shape.

You can also use the recovery heart rate to measure your improvement as you get into shape. More

I was recently watching the Larry King Show and I was particularly intrigued by listening to Jenny McCarthy speaking about Autism. According to the Autism Speaks Website:

1 in 150 individuals is diagnosed with autism, making it more common than pediatric cancer, diabetes, and AIDS combined. Autism impairs a person’s ability to communicate and relate to others. It is also associated with rigid routines and repetitive behaviors, such as obsessively arranging objects or following very specific routines. Symptoms can range from very mild to quite severe.

McCarthy as well as other parents of autistic children have placed their children on a new diet. The program encourages a diet that is free of wheat and gluten. Gluten is a special type of protein that is commonly found in rye, wheat and barley. Therefore, it is found in most types of cereals and in many types of bread.

According to Dr. Jerry Kartiznel, a doctor who works with autistic children, “Gluten in the body has been theorized to make a morphine-like substance, and that morphine-like substance….. will affect the brain.”

Dr. Kartzinel can be reached at:

Jerrold Kartzinel M.D.
Pediatric Partners of Ponte Vedra Beach
5270 Palm Valley Rd.
Ponte Vedra Beach, FL 32082
Telephone: 904-543-1288
Fax: 904-543-1289

This is one of the more informative discussions that I have even seen regarding the issue of starch versus veggies in a plant-based diet.

The experts on the panel are Dr. McDougall and Dr. Fuhrman.

And self preservation, That’s right, self preservation.

If everyone in New York State followed a low fat vegetarian diet, then New York State could directly support about 32% of its population.

Today’s high-fat diets coupled with meat and dairy allow the state to support only about 22% of its population. A diet with a lot of meat needs an incredible 2.11 acres per person compared with less than an acre for low-fat vegetarian diets.

The study conducted by Cornell researchers suggests that vegetarian diets use more high quality land.

All the things that you can read about health and diet all tell me one thing, dieting is much about common sense. You would have to search long and hard to find a dietician that would not tell you that you should eat a lot of fruits and vegetables. An apple a day to keep the doctor away. Also, grains, leafy vegetables and fish that are rich in Omega-3 fatty acids aren’t bad either.

New findings that have been published in the October Issue of the Journal of the American Dietetic Association have placed the Atkins Diet in dead last. The findings were used to measure dietary components as related to the risk of heart disease. The Ornish diet plan placed first out of eight leading weight loss plans which were the focus of the study.

The results of the study were indexed with the highest possible score being 70. The Atkins Diet scored 42.3 while the Ornish Diet Plan scored 64.6.

In favor of high protein diets, the study’s author did say, “All the diets have the potential to be healthy.”.

A good question makes you think. Do diets that cause you to lose weight actually make you healthier? Many leading dieticians are saying no. In fact, most leading dieticians would promote a balanced diet that is plentiful in fruits and vegetables, whole grains, low-fat dairy products and lean meat over the diets such as Atkins which promote the benefit of weight loss.

Dr. Thomas H. Lee, Editor in Chief of the Harvard Heart Letter and Professor of Medicine at Harvard Medical School recently said, “Weight isn’t the only thing that determines whether you get heart disease.“

Here are some dietary guidelines from the American Heart Association.