Healthy Living

A Holistic Approach to Taking Care of Yourself

Learning to take care of our health should begin when we are young.  As we age, risks of health problems significantly increase. Educating ourselves about age-related diseases is an important first step to improve how we can live healthier.  Several related articles appear in the Healthcare Issues section of our web site.

In this article I would like to summarize steps that have been medically proven to reduce your risk of age-related diseases, improve your health in a natural way, and significantly increase your sense of well-being and your quality of life.

Take Control of What You Eat and Maintain a Healthy Weight

A sedentary and fast food environment makes it easy to be overweight. Slimming down is a difficult and time-consuming thing to do. However, there is no easy way around the medically proven fact that proper eating habits and moderate exercise are crucial to keeping your weight in a healthy range and your body physically and mentally fit. 

What is a Healthy Weight? 
To stay healthy you should keep your weight at a level best suited for your height.  There are two simple ways to determine whether a person is within a normal weight  range.

• Body Mass Index (BMI) - A chart that uses height and weight to indicate whether a person's weight is normal, overweight, obese or extremely obese- your goal should be a BMI of 25 or less. See BMI Chart under Healthcare Issues
• Waist/Hip Ratio - The shape of your body is also a factor in keeping healthy weight. Excess fat in the abdomen ("apple" shape) is believed to be a greater health risk than fat in the hips and thighs ("pear" shape).  To determine your body shape measure your Waist/Hip Ratio as follows:
  • Measure around your waist, near your naval. Stand relaxed and do not pull in your stomach.
  • Measure around your hips, over the buttocks, where they are the largest.
  • Divide your waist measurement by your hip measurement.  A normal ratio is under 0.8 for men and 0.75 for women.
  Research in adults suggests that if the ratio is greater than 1.0, the patient is at greater risk for diabetes and heart disease.
• BodyStat – BodyStat measures body fat, lean body mass, hydration status, weight distribution and metabolism.

What about Fat?
Dietary fat is essential for life.  It provides an important source of energy. As fats are absorbed from the intestine, the calories are used as an immediate source of energy. All excess calories that are not metabolized are stored in fat cells throughout the body. Stored fat is important for insulating body tissues, aiding in the absorption of fat soluble vitamins (A, D, E and K) and in maintaining skin and hair.

If you are overweight, you have too much body fat. When weight is within the normal range for a persons’ height and body shape, fat makes up about 20-25% of a woman’s body weight and  about 15-20% in men.  The shape of a woman’s body is partly the result of the presence of circulating estrogen.  Having too little body fat may cause her estrogen levels to drop to a level where her menstrual periods may become irregular or even stop.  After a woman passes her menopause, the estrogen level becomes very low unless estrogen replacement therapy is prescribed.  One of the many consequences of low estrogen levels is the redistribution of stored fat from the thighs and buttocks to the abdomen and waist (‘apple shape’). 

Good Fat ‘vs.’ Bad Fat
There are three main types of fat:

• Saturated Fat –hydrogen atoms are attached to every carbon atom (Bad)
• Mono-Unsaturated Fat – one pair of hydrogen atoms is missing (Good)
• Poly-Unsaturated Fat – two or more pairs of hydrogen atoms are missing. (Good)

Trans-fatty acids (‘TFA’s) are modified unsaturated fats with a different arrangement of hydrogen   atoms. Natural occurring TFA’S are primarily found in dairy products, beef and pork. (Bad) 

All mono-unsaturated and poly-unsaturated fats (except TFA’s) are beneficial as they lower harmful LDL-cholesterol. All saturated fats and TFA’s are potentially harmful and they raise levels of LDL and total cholesterol. Saturated fats are directly associated with coronary heart disease and are implicated with an increased risk of cancer of the colon, rectum, prostate, pancreas, uterus and breast. A diet high in saturated fat contributes to obesity.  Losing weight can raise your HDL level.

Sources of Fat:

1.	Saturated Fats (Bad):	Animal products (beef, full fat dairy products, fried meats, ground meats); tropical oils (palm,  palm kernel, coconut).
2.	Mono-Unsaturated Fats (Good):	Vegetable oils (olive, canola, peanut); avocados; almonds; pecans and peanuts.
3.	Poly-Unsaturated Fats (Good):	Vegetable oils (safflower, sunflower, corn, flaxseed, soybean); most (Omega-3 Fatty Acids) Nuts; fatty fish (salmon, tuna, mackerel, trout, sardines).
4.	Synthetic TFA’s (Bad):	Some margarines; essentially all pre-packaged prepared foods (frozen meals, breakfast foods, vegetable dishes, desserts); dry mixes; dressings; rice; macaroni; hamburger dishes; chips; baked goods breads, cookies, cakes, crackers); fried fast foods.

Factors That Effect Weight:
Bottom line: people who are overweight generally eat too much and exercise too little. Every function of the body from building cells to moving muscles requires energy.  Energy is measured in calories, which are supplied by the foods we eat.  The body burns the calories it needs for its immediate energy requirements, depending on  physical activity.  Excess calories are stored in the body’s fat cells. An average woman needs about 2200 calories a day for her average metabolism.
Remember: one pound of fat = 3500 stored calories. 

There are a number of physical factors that may affect weight gain:

• Women tend to weigh more as they age.  It is normal for people to be a little heavier as they grow older.  A small amount of weight gain does not pose a threat to a person’s health. 
• A woman might not lose all the weight she gained during pregnancy and with each pregnancy the weight can add up.
• A woman may have a hard time losing weight because of her metabolism – how her body uses the energy from the foods she eats.  People burn calories at different rates.  Even if you do not overeat, you might still find it hard to lose weight and keep a healthy weight, if you do not exercise.
• Low thyroid function

Health Hazards of Being Overweight:
Many health concerns are directly related to being overweight or obese.  The more you weigh over the suggested range as indicated on the BMI, the higher your risk of heart disease.  Heart failure occurs three times more often in obese women than with women with normal weight. There are other risk factors often found in overweight people, including high blood pressure, high cholesterol, diabetes, gallbladder disease, strokes, and numerous cancers.

High cholesterol can lead to coronary artery disease and stroke.  This disease is a clogging of the arteries by cholesterol in the form of fat deposits called ‘plaque’.  With excess weight, the heart has to work harder. The risk of heart disease increases unless blood gets to the heart.  At the same time, arteries in the neck may clog and at some point blood clots may move through the arteries and increase risk of heart attack or stroke. In fact, the risk of stroke among overweight people is four times greater than for people of normal diet. 

Diabetes is one more hazard of being overweight. People with diabetes have levels of sugar in their blood that are too high.  Doctors estimate that 85% of people with diabetes have the type related to being overweight.  These people have enough insulin in their bodies, but the insulin level cannot do its work of keeping sugar levels in the blood under control.  As a result, sugar needed to nourish your body cannot get into the cells.  A healthy diet and regular exercise can go a long way to helping people with diabetes control the disease.  It is not uncommon that when people who have adult onset diabetes and who are overweight begin an exercise and weight loss program their diabetes testing becomes normal.

Overweight women are also more likely to have certain kinds of cancer. Cancer of the endometrium (the lining of the uterus) is five times more common in overweight women than in women with healthy weight.  Breast, colon, and rectal cancers are also more common in overweight women.  These types of cancer may be linked to diet. Eating a healthy, low fat diet and performing regular aerobic exercise reduces the risks. 

What’s the Secret to Healthy Weight Control?
There is no magic answer to taking off weight and keeping it off.  The best way to lose weight is to exercise and eat fewer calories. Losing weight requires a long-term commitment to good eating habits and regular exercise.  “Yo-Yo” or “on-and-off” dieting is not healthy.  Healthy habits help to reduce or reverse the health hazards of being overweight.  A person who loses weight will feel better and find it easier to be more active. 

Losing weight is hard.  However, there are excellent resources with which you can become educated about proper balanced nutrition. Consult the U.S. Dept. of Agriculture’s Nutrition Guide (www.nutrition.gov/home/index.php3). The best place to start is to take stock of your current eating habits. Often I will hear a patient say, ‘I just eat salads for lunch and chicken for dinner and I keep gaining weight’.  Denial or simply not paying attention to all the “snacks” that one consumes is a powerful influence on their weight.  In order to make a realistic change in your diet I believe you must have an honest analysis of what you are currently eating. A recent study published in the New England Journal of Medicine found that when people wrote down what they ate, they had underestimated on average by 1,053 calories a day.

In the beginning create a simple food chart and measure your portion size of your servings. Use a food scale and measuring cup to learn what a single serving looks like. Call it your “food diary”.  It will help you find the patterns of what you eat and why, when and how. If you want to lose weight, look for foods that would eliminate approximately 500 calories a day.  Think ‘one-half cup’ of all your carbohydrate servings and a ‘palm-size’ protein serving of meat, chicken, or fish. Most people have no idea how many calories are in certain foods. Take the time and calculate the approximate calories of each meal.  Your total daily calorie intake should be measured against your level of physical activity and your need to alter your weight. 

The following is a guideline for calories and type of food. Note: each gram of fat contains more than double the calories than either carbohydrate or protein.

The American Heart Association (‘AHA’) Diet recommends the following ratio of calories:

Whatever your starting weight, the most you should lose over the first three months is 10%. For example, if your current weight is 180 lbs, an 18 lb. weight loss or 6 lbs. per month is a realistic goal and timetable.  If you are a smoker, you may be afraid to quit because you may gain weight. Trying to break more than one habit at a time can be difficult, but it’s worth it for your health.  Ask us for advice.

You can learn what constitutes a healthy diet.  A regular diet emphasizing fruits, vegetables and whole grain foods and restricting your intake of saturated fat and sugar is an important step to achieving your goal of healthy living.  Read labels, learn to eyeball the caloric values of portions, restrict buying prepared meals, buy fresh foods, use eye-ball portion control and you are well on your way. When I ask patients who have been successful in losing weight what they did differently, the answer is always the same, “I gave up all my excuses”.

Guidelines:

• Fast 3 hrs. before bedtime (unless you have diabetes) and drink a glass of water
• Cut back on animal fats, sugar, and junk food
• Choose healthy carbohydrates.  Eat more fruits, vegetables and beans.  Eat whole grains instead of refined grains such as white bead or white rice
• Choose lean protein like fish, skinless chicken and turkey breast, beans, and non-fat or low-fat products.  Trim all visible fat.
• Keep portions moderate.  Protein portion should be no larger than the palm of your hand or ¼ of your plate. Vegetables should be ½ of your meal and carbohydrates should be no more than ¼.

Portion Breakdown
 

Remember Obesity is a lifestyle – It is not a disease.

Losing weight long-term and staying healthy is not simply a matter of avoiding carbohydrates or fats, but choosing wisely among them and focusing on calories and good nutrition.  Life long good choices will help to keep you here.

Exercise Regularly

Regular, moderate exercise provides a great way to keep your heart and bones healthy and your weight in check during the middle and later years of your life.  Exercise increases muscle strength and flexibility, relieves stress, lowers blood pressure, helps improve the quality of sleep, improves circulation, lowers cholesterol and improves energy levels and improves balance.  Walking 2 miles in 30 minutes five times a week will show results.  If you cannot speed walk, find an equivalent exercise to increase your heart rate for at least 20 minutes.  Using free weights or using exercise equipment to strengthen your upper and lower body and your abdominal muscles will reshape your figure without creating any bulk. Increased lean body mass will also increase the number of calories your body burns at rest.  Consult a physical trainer to develop a program best suited for your specific needs. Tai Chi is a terrific form of exercise, which can be practiced by persons of all ages.  It is an ancient form of Chinese martial arts and is a moving form of meditation.  Yoga is another form to study.  Both Tai Chi and Yoga will not only improve your physical balance, flexibility and strength, but will create greater spiritual balance in your life. All these programs will make a significant reduction in your stress levels.
Inactive people rarely give their muscles a workout and may never feel relaxed enough to fall asleep easily.  Sleep disorders are common in patients who complain of chronic fatigue. Those who perform regular aerobic exercise often have more energy because physical activity both decreases the time it takes to fall asleep and increases the amount of deep sleep – the period in which there is complete muscle relaxation associated with slow, regular heart and breathing rates. Exercise is the only way for healthy adults to increase the amount of deep (REM) sleep,

Don’t Smoke

If you smoke, it is not too late to quit.  It doesn’t matter how you go about quitting; the important thing is to just do it.  Most people who smoke believe that their habit is not healthy.  Quitting is a personal decision.  The majority of people who successfully stop smoking select a date and quit on their own. If you have tried on your own without success, ask us for assistance. Stop Smoking programs are successful only when one is ready to make that difficult decision and is ready to seek help.  New over-the-counter products, such as nicotine chewing gum or skin patches, can help wean you from the habit. Prescription medications to help stop smoking are now available and have increased the success rate of smoking cessation.  If you smoke and have not had a chest x-ray in over one year, please call so that we can order this important test for you.

Drink Alcohol Only in Moderation

Alcohol poses a special health dilemma for women, who appear to be more vulnerable than men to certain health risks associated with drinking.  Long-term consumption of alcohol interferes with bone growth and calcium absorption. Medical research studies have shown that women having three or more drinks a day on a regular basis is associated with an increased risk of osteoporosis,  increased blood pressure, increased risk of cirrhosis of the liver and liver cancer. Moderate drinking (one or two drinks a day), however, has been found to help protect against heart disease. Pay attention to your regular alcohol consumption.  If you have other risk factors for osteoporosis, you may want to limit your alcohol intake to special occasions.  If you are healthy to begin with, or if you are at a greater than average risk of developing heart disease, one drink a day or less may be fine.  Remember, don’t drink and drive.

Supplements

There is research that clearly demonstrates the health benefits of certain nutritional supplements. Please refer to the article entitled ‘Nutritional Supplements’ on our website  @ www.gunncenter.com and select “Healthcare Topics for Women” on the home page tab section. While you are ‘surfing’ our website, also read the articles listed under “Healthy Heart”.

Changes to Last a Lifetime

Think about what good health means to you. Learn your current risk factors for having or developing heart disease, osteoporosis, cancer, diabetes, and high blood pressure. You may be mildly overweight, but currently have no risk factors affecting you life.  Your motivation for change must be evaluated on an individual basis. What is important to one person is not necessarily important to another. However, any change you choose to make now  will pay off quickly and in the years ahead.  It is not just how long we live; it is the quality of our daily lives. For most of us the motivation for change starts with accepting ourselves and giving ourselves permission to make healthy changes. When you do, stick with it; it’s worth it.  You’re Worth It.

Additional References:

      www.gunncenter.com  - refer to Healthcare Issues
      www.cooperwellness.com
      www.nhlbi.nih.gov/health/public/heart/index.htm
      www.nhlbi.nih.gov/guidelines/obesity/bmi_tbl.pdf   
      '40-30-30 Fat Burning Nutrition' by Joyce & Gene Daoust (Based on ‘The Zone” by Barry Sears)
      'Sugar Busters' by H. Leighton Steward, et al.
      'Fast Food Nation' by Eric Schlosser
      'Intuitive Eating: A revolutionary Program that Works' by Evelyn Tribole, R.D.