Can Stress Make You Fat?

By Denis Faye

Stress and poor eating go hand in hand. A hectic lifestyle can leave you with little free time and plenty of exhaustion. For thousands of overworked, under-relaxed Americans, grabbing a quick burger at McGreasy's and skipping yoga class doesn't seem like a choice. It feels like a survival necessity.

It's all about hormones . . .

But in truth, the problem goes beyond how a few (hundred) extra calories can impact your gut. Your bodily functions are regulated by chemicals called hormones—and hormones are regulated by a series of glands throughout your body known as your endocrine system. These glands don't work independently. Much like a government, a soufflé recipe, or a John Irving novel, they're all interconnected and if one part is impacted, it can cause a cascade of health issues, including weight gain.

For example, for most of us, stress prevents you from sleeping well. This is a problem because this stimulates production of a hormone called ghrelin, which tells you to eat and decreases the levels of the hormone leptin, which tells you to stop eating. In other words, when you don't get your 7 to 8 hours of sleep, your hormones send signals to your brain to eat more.

Why are those bad ol' hormones beating you while you're down? Probably because, in primitive times, we didn't sacrifice sleep so that we could sit at a desk for an extra 4 hours or watch an entire season of The Walking Dead in one sitting. Instead, when we didn't sleep, it meant we were on a 24-hour buffalo hunt or our cave had been flooded in the middle of the night so we were seeking shelter. In these situations, we needed to eat more because we needed energy for these demanding tasks.

. . . especially cortisol.

But that's just a small example of how stress can make you fat. The much larger issue has to do with your stress hormones, particularly everyone's favorite biological bugbear, cortisol.

When thrown into a "fight or flight" situation, your endocrine system adapts by jacking your brain with adrenaline (aka epinephrine) in an effort to marshal all your bodily functions into solving the problem at hand. Blood flow to your brain increases to sharpen your wits. Blood is also sent to your extremities so that you can fight your way out of the situation or run away. (Contrary to the title, humans can't actually "fly" in stressful situation, although that would be cool.) To pump all this blood around, your heart beats harder and you breathe harder so that you're getting plenty of oxygen.

But if you remained in this state too long, you'd probably have a heart attack, so the next thing your body does is release noradrenaline into your system to normalize things and flush the excess hormones from your system (this is why people sweat in stressful situations). Then, if the issue isn't completely resolved, the body releases a separate hormone to cope with prolonged stress: cortisol.

When it's doing what it's supposed to do, cortisol is great. It keeps you ready for action. It raises your blood pressure, elevates blood sugar, and diverts energy from other tasks to whatever is mission critical (healing, for example).

But it tears up your body in order to do this. To keep blood pressure up, it retains sodium in your cells. (Oh, hey there, water weight!) To keep blood sugar up, it breaks down lean body mass (muscle). And when it diverts energy, less immediately critical systems, such as digestion, are impaired. What's more, this whole process depletes micronutrients like crazy.

Chronic stress can make you fat in a number of ways. Faulty digestion means you don't absorb nutrients as well, which can also influence your ability to exercise. (I know claiming that cortisol inhibits your ability to exercise sounds contradictory considering its raison d'être is to make you battle ready, but remember that cortisol was never intended for months or years of use—or abuse.)

Want a more direct link? A study in the journal Psychoneuroendocrinology showed that cortisol increased women's desire to eat foods high in sugar and fat. So if you're stressedand you don't sleep, it means that your poor willpower is being hit from all sides by ghrelin and cortisol.1

Even if you can resist those late night fridge raids, you're still at risk. A study in the journalPsychosomatic Medicine showed that excess cortisol directly contributed to visceral adipose tissue around your stomach and intestines (aka "belly fat") because the enzyme 11 beta-hydroxysteroid dehydrogenase that is used to convert inactive cortisol to active cortisol is found in higher concentrations in visceral fat. Visceral fat is associated with increased risk of diabetes and cardiovascular disease. So, cortisol might not make you fatter, but it can give you a beer belly—and potentially, a heart attack.2

What you can do about cortisol

There are supplements out there that claim they can combat cortisol, but they don't work. There are also adaptogens and antioxidants, which are great for fighting some stress-related issues, but they haven't been proven to lower cortisol levels.

But there are a few simple things you can do to reduce cortisol levels:

1. Get Regular Exercise. A sweaty, hard bout of cardio creates a "positive" stress situation that puts that extra cortisol to good use.
2. Meditate. Giving your brain a break reduces anxiety—and that reduces cortisol. I recommend starting with the audiobook Meditation for Beginners by Jack Kornfield.
3. Laugh. Having a good time cuts though stress like a hot knife through coconut oil. Maybe it's time to upgrade yourThree Stooges collection to Blu-ray—just make sure to watch it with some friends. Social interaction helps too.

See a pattern here? The best way to combat stress—not to mention the weight and other health-related issues that come with it—is to do things that help you stop stressing. So do your hormones, your mind, and your waistline a favor. Try to relax a little.

Sources:

1. Epel, E., R. Lapidus, B. McEwen, et al. Stress may add bite to appetite in women: a laboratory study of stress-induced cortisol and eating behavior. Psychoneuroendocrinology 26: 37-49, 2001.
2. Epel, E.S., B. McEwen, T. Seeman, et al. Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat. Psychosomatic Medicine 62:623-632, 2000.

Nature's Best Sugar Blockers

Find which high-fibers foods are the best at blocking sugar in your bloodstream

By Rob Thompson, MD

You may have heard that whole grain products are high in fiber. However, the starch in grains quickly turns to sugar and overwhelms any blood sugar-blocking effect the fiber might have. Of course, all fruits and vegetables contain sugar; that's what makes them carbohydrates. Nevertheless, most contain proportionately more soluble fiber than sugar, so they don't raise blood sugar as much as grain products and other refined carbohydrates do. 

Keeping blood sugar steady is an important tool for preventing insulin spikes, which can lock fat into your cells and prevent it from being used for energy. The substance in our diet that's most responsible for these blood sugar surges is starch. But the good news is you can blunt the blood sugar-raising effects by taking advantage of natural substances in foods—like fiber in fruits and veggies—that slow carbohydrate digestion and entry into the bloodstream.

You can tell which fruits and vegetables have the best balance of fiber to sugar by looking at their glycemic loads (Not sure what that means? Glycemic Impact 101.). All of the carbohydrates that have been associated with increased risk of obesity or diabetes have glycemic loads greater than 100. On the other hand, fruits and vegetables with glycemic loads less than 100 have been associated with reduced risk. Thus, you should avoid fruits or vegetables with glycemic loads higher than 100, even though they contain soluble fiber. Fruits and vegetables whose glycemic loads are between 50 and 100 are themselves acceptable to eat, but they release enough glucose to nullify their usefulness as sugar blockers. The best fruit and vegetable sugar blockers are those with glycemic loads less than 50.

It takes about 10 grams of fiber to reduce the after-meal blood sugar surge from a serving of starch by approximately 25%. No single, typical serving of fruits or vegetables comes close to providing the 10 grams needed to lower your blood sugar by 25%; you would need to include several portions.

A good way to ensure that you get enough soluble fiber to do the job is to have a salad with your meal—preferably before you eat starch. Salads allow you to combine enough sugar blockers to have a beneficial effect. For example, a salad containing 2 cups of romaine (2 grams of fiber), a cup of chopped tomatoes (2 grams), and a cup of red bell peppers (3 grams) provides 7 grams of fiber. Add that, say, to a cup of broccoli (4.5 grams) with your meal and you have 11.5 grams of fiber.

Soluble fiber blocks sugar best when consumed before, rather than after, you eat starch. For instance, if your meal includes a salad, steak, potatoes, and green beans, eat the salad and at least some of the green beans before eating the potatoes.

FRUITS
One difference between fruits and vegetables is that nature intended fruits to be eaten by birds and beasts. That's how they spread their seeds. Animals are enticed by the sugar in fruit. However, the generous sugar content of some fruits counteracts some of their usefulness as sugar blockers. Thanks to the second-meal effect, they might reduce glucose levels after the next meal, but the sugar they release neutralizes the benefits for the first meal.

As fruit ripens, fiber barriers soften and the sugar content rises. Berries, peaches, and apricots have low glycemic loads even when fully ripe. Pears should be eaten while still crisp. Tart-tasting apples, such as Golden Delicious, make good sugar blockers, but the sweeter varieties, such as Fuji and Honeycrisp, contain enough sugar to counteract their usefulness as sugar blockers. Dried fruits have higher glycemic loads than fresh fruit simply because they're smaller, so you tend to eat more of them.

VEGETABLES
As a rule, vegetables make better sugar blockers than fruits do. They have higher fiber contents and lower glycemic loads. Soluble fiber is, well, soluble, so it soaks up water. Boiling vegetables until they're limp and soggy saturates the soluble fiber in them, making them less effective as sugar blockers. Also, the more crisp that vegetables are when you eat them, the chunkier they will be when they reach your stomach. The larger the food particles, the longer it takes to digest them. Carrots, broccoli, cauliflower, green beans, and asparagus all work best when they're cooked just enough for you to be able to puncture their surface with a fork. The rawer they are, the more effective they are as sugar blockers.

For example, Swedish researchers fed a group of subjects raw carrots with a starch-containing meal, and compared their after-meal blood sugar levels with those of a group that was fed cooked carrots. The subjects who ate the raw carrots with their meal not only had lower after-meal blood sugar and insulin levels; they also had significantly higher "satiety ratings," which measure how satisfied they felt.

In addition to their sugar-blocking effects, vegetables can often serve as delicious and satisfying starch substitutes. Said Sugar Blockers Diet tester Jane Wilchak, "Roasted veggies and roasted cauliflowers—that became my new starch."

BEANS
Beans and other legumes are packed with soluble fiber, but they also contain starch. A big serving can have a beneficial second-meal effect, but sometimes beans can release enough glucose to give you a sugar shock immediately after the first meal. Much depends on how you prepare them.

If you start with uncooked beans and serve them slightly crisp, a 1/2 cup or so won't raise blood sugar much and can reduce the blood sugar-raising effects of other foods consumed during the first and second meals. It doesn't take a lot of beans for you to get a good dose of fiber; just a 1/2 cup can provide as much as 7.8 grams of fiber. And as you can see from the table above, if you stick to a 1/2-cup serving, you're in no danger of raising your glycemic load too high. However, if you cook them until they're mushy or let them sit overnight and then reheat them, they'll become starchier and will likely raise your blood sugar.

Holding Your Pee: Health Risks From Ignoring Nature's Call

by Arti Patel

When you gotta go, you gotta go -- and for your health, that's an important thing to keep in mind.

When sitting in a meeting or trying to get through emails, the thought of nature calling probably isn't one of your priorities. Or rather, it might be top of mind, but you feel embarrassed using the office bathroom. Experts tell us, however, that taking care of our kidneys means knowing when they're entering the danger zone.

An average bladder has the capacity to hold about 15 ounces of liquid (eight glasses of water, for example, is roughly 64 ounces), and holding in your urine for a long period of time can stretch your bladder. The automatic feedback mechanism in the bladder sends a signal to the brain when it's full, which then urges you to get to the nearest toilet. But if you keep yourself from peeing often, your body might lose the ability to know when it's time to go, says Dr. Chamandeep Bali, a naturopathic doctor at the Toronto Naturopathic Health Clinic. And that's not the only concern.

"The longer you hold your urine, the bladder can become a breeding ground for bacteria to grow," Dr. Bali says. This bacteria can lead to infections, which can spread to kidneys and cause greater damage to the body.

However, sometimes it really can be difficult to find the time to go. School teachers and crane operators are two professions who often use the washroom fewer times than other occupations, according to urologist Dr. Michael Robinette at the Toronto General Hospital.

Meanwhile, there also seems to be a gender imbalance. Dr. Mark Gordon, a urolgist at the Suncoast Medical Clinic in St. Petersburg, Florida says women are more likely to hold their urine due to hygiene concerns -- and let's face it ladies, sometimes finding that seat cover or squatting over a public toilet is more of a pain than it's worth.

But whether it means keeping a close eye on the restroom door to make sure it's unoccupied or keeping a personal roll of toilet paper with you, it's important to make sure you get to the toilet.

"A 'normal' urination rate is eight to 10 times a day," Dr. Gordon says.

And if your stage fright for going becomes really problematic, just add water. It may sound like an old wives' tale, but according to Dr. Robinette, "some people find that when you turn on the tap, it makes you pass your urine."

Urinary Tract Infection
WHAT: A urinary tract infection (UTI) is a bacterial infection that affects the urinary tract (the organ that stores and releases urine).
HOW: UTIs occur when germs, usually bacteria, enter the urethra and then the bladder. The infection can eventually spread to the kidney.Symptoms include cloudy or bloody urine, a strong need to urinate and a low fever.
FIX IT: If you do feel any of the symptoms above, doctors can distinguish between a small infection or a kidney one -- in most cases, patients are put on antibiotics.


Interstitial Cystitis
WHAT: A interstitial cystitis (IC) is a painful condition that causes inflammation of the bladder's walls.
HOW: Experts say an IC can be caused by a bacterial infection, however, some say the cause of this disease is unknown. Symptoms include a painful pelvis and in some cases, urinating more than 60 times a day.
FIX IT: Currently, there is no cure for IC, but there are treatments depending on the individual to often ease the pain.


Healthy Urine Colours
Dr. Michael Robinette, a urogloist at Toronto General Hospital, says there are several ways to determine a healthy urine colour. "Healthy urine is a pale yellow. If your urine is white, you're drinking too many fluids. However if your urine is too dark, your urine is concentrated and you should be drinking more fluids." he says.


When Your Urine Isn't Yellow
If your urine is bloody, you most likely have an infection. However, there are some foods that can change the colour of your urine naturally. "Beets make the urine red and some vitamin B medication can make it green," Dr. Robinette says. Other urine-changing foods include asparagus, blackberries, carrots and rhubarb.


Kidney Failure
WHAT: Kidney failure is a medical condition when your kidneys fail to filter toxins and waste items from the blood.
HOW: Kidney failures can occur from existing infections, burns or diseases. But in most cases, causes differ depending on the individual. Symptoms include bruises, bloody stool and changes in mental mood.
FIX IT: Treatments include flushing out toxins from your body and restoring your kidney's functions. In some cases, dialysis or even a transplant may be needed.


Kidney Stones
WHAT: Also known as a renal calculus, kidney stones are solid crystals that are formed in the kidney. Even though these crystals are more common among men, some women can also develop kidney stones.
HOW: For the most part, kidney stones can be genetic and stone sizes can also differ. Most people may not realize they have kidney stones until they urinate. Urination can be painful, bloody and cause nausea.
FIX IT: Treatment also differs depending on the stone's size. Some doctors may perform blood tests or abdominal exams while others recommend drinking six to eight glasses of water to let the stones pass.

Understanding Lactate Threshold Heart Rate Training

By Marty Gaal


Two fundamental concepts for improvement in endurance racing and training involve:
Increasing your aerobic endurance
Improving your lactate threshold heart rate (LTHR)

The first is accomplished by completing workouts involving aerobic exercises (swimming, biking, running, rowing, cross-country skiing, and so on) at an easy to moderate effort level. Over time, your ability to continue the exercise will improve through physiological adaptations to the specific exercise.

For example, if you are currently untrained or out of shape, a 30 minute bike ride may be challenging and near the limit of your ability. If you go and ride 20-30 minutes three times per week for a few weeks, your body will adapt by increasing blood flow to the muscles being used, increasing muscle size (hypertrophy) and strength, improving blood flow through a process called capillarization (tiny veins to the muscles), increased mitochondrial density (aerobic enzymes) in the muscles and a few other geeky details.

All these result in the ability to use oxygen as the main exercise energy source more efficiently, meaning you can now ride longer and not be tired at 30 minutes.

The second, improving lactate threshold, is accomplished by completing easier training sessions like the above, plus including more challenging workouts that raise your heart rate.

Lactate threshold is the point in exercise where your body produces more blood lactate than it can reabsorb (and manage other lactate by-products - look up "hydrogen & lactate & exercise" if you want some exciting reading) on a continuous basis. Well-trained athletes can usually continue exercise at just below lactate threshold for about an hour. Go over lactate threshold though, and that time drops to 5-6 minutes.

For most people, the lactate threshold is about 20 heart beats per minute above the steady aerobic threshold. Any aerobic exercise, generally speaking, will help both points go a bit higher. But there is a point of diminishing returns. If you don't also include workouts that challenge your system by going just below to above your current lactate threshold, you will not maximize your ability in short distance to long distance events.

The secret or goal with lactate threshold training is to raise your threshold point to as close as possible to your maximum heart rate, and improve your ability to withstand that discomfort (if it was easy everyone would do it). If you never do harder workouts, then your lactate threshold will always remain below your possible maximum lactate threshold.

Raising your lactate threshold point, for the most part, will bring your steady aerobic threshold point up with it (as the 20 bpm relationship is fairly constant).

So if you're training for an Ironman, from a specificity standpoint you want to train that steady aerobic threshold because that is more or less your race pace. But you should include some LT training as well to raise that point a bit higher.

If you're training for a sprint or Olympic distance race, from a specificity standpoint you want to work more on that 2nd threshold. You should include quite a bit of aerobic steady training as that provides your foundation.

So you’re probably thinking: how do I find my threshold and what are some workouts ideas?

Finding it:
Warm up 15-20 minutes then 30 minutes "race effort" — as hard as you can go for 30 minutes. Take your heart rate average for the last 20 minutes. Bingo, you have your LTHR.

Biking:
2 x 20 minutes just below lactate threshold with 5 minutes easy between
5 x 5 minutes at lactate threshold with 3 minutes easy in between
5 x 3 minutes over lactate threshold with 3-5 minutes easy in between
8 x 1 minute well over lactate threshold with 2-3 minutes easy between

Running:
2 x 10 to 15 minutes (1 to 2 miles) just below threshold with 5 minutes easy between
4 or 5 x 4 minutes (800-1200m) at threshold with 2-3 minutes easy between
5 to 6 x 3 minutes (600-800m) over threshold with 3 minutes easy between
8 x 1 minute over threshold with 1 minute easy between

Generally speaking, running causes more breakdown so total "hard" training volume should not be more than 10-15 percent of weekly mileage.

Swimming:
4 x 400s just below threshold with 1-2 minute between each
12 to 16 x 100s at threshold with 10-15 seconds rest between each
8 x 50 over threshold with 30 seconds to 1 minute rest between each

There are plenty of other workouts, but the theme here is:
sub-threshold workouts take 10-25 percent interval rest
at-threshold workouts take 50-75 percent interval rest
over-threshold workouts take 100-200 percent interval rest

In general, advanced athletes can do more repetitions and/or take less rest; beginner athletes should do less repetitions and take more rest.

'Maximum' Heart Rate Theory Is Challenged

By GINA KOLATA Published: April 24, 2001

Donald Kirkendall, an exercise physiologist at the University of North Carolina, will never forget the time he put a heart-rate monitor on a member of the United States rowing team and asked the man to row as hard as he could for six minutes.

The standard formula for calculating how fast a human heart can beat calls for subtracting the person's age from 220. The rower was in his mid-20's.

Just getting the heart to its actual maximum rate is an immense effort and holding it there for even a minute is so painful that it is all but inconceivable for anyone who is not supremely motivated, Dr. Kirkendall said. But this rower confounded the predictions.

''His pulse rate hit 200 at 90 seconds into the test,'' Dr. Kirkendall said. ''And he held it there for the rest of the test.'' A local cardiologist was looking on in astonishment and told Dr. Kirkendall, ''You know, there's not a textbook in the world that says a person could have done that.''

But maybe, some physiologists and cardiologists are saying, the textbooks are wrong.

The question of how to find maximum heart rates is not just of academic interest, medical experts say. The formula for calculating the maximum rate has become a standard in cardiology and in fitness programs, and an entire industry has grown up around it, with monitors sold to individuals and built into exercise equipment.

''There is a need, a clinical and societal need, to estimate the maximum heart rate,'' said Dr. Douglas Seals, an exercise physiologist at the University of Colorado.

Doctors use the formula when they test patients for heart disease, asking them to walk on treadmills while the speed and incline are gradually increased until their heart rates reach 85 percent of the predicted maximums.

The idea is to look for signs, like chest pain or a sudden drop in the heart rate, indicating that the heart is not getting enough blood. But if doctors underestimate how fast the person's heart can beat, they may stop the test too soon, Dr. Seals noted.

Personal trainers and exercise instructors design fitness programs around the maximum heart rate, often telling people to wear heart rate monitors and then to exercise at 80 to 90 percent of the maximum in brief spurts to build aerobic capacity and at 65 percent to 75 percent to build endurance.

Some heart monitors built into exercise machines even shut the machines down if an exerciser exceeds 90 percent of the predicted maximum. But if the heart rate formula is wrong, these exercise prescriptions are misguided.

''If you're trying to improve their aerobic fitness or to train for certain endurance events, then you want to know with a reasonable accuracy what intensity you're exercising at,'' Dr. Seals said. ''If your estimate is 10 or 20 beats too low, then you're pretty far off.''

Exercise physiologists say, however, that being pretty far off is more common than most people expect.

''The more information we have, the more we realize that that formula is just a very rough consideration,'' said Dr. Jack H. Wilmore, an exercise physiologist at Texas A&M.

And while Dr. Seals is now proposing a new formula to use as a general guide, he and others say it is simplistic to rely on a single formula to predict the maximum heart rates of individuals.

The common formula was devised in 1970 by Dr. William Haskell, then a young physician in the federal Public Health Service and his mentor, Dr. Samuel Fox, who led the service's program on heart disease. They were trying to determine how strenuously heart disease patients could exercise.

In preparation for a medical meeting , Dr. Haskell culled data from about 10 published studies in which people of different ages had been tested to find their maximum heart rates.

The subjects were never meant to be a representative sample of the population, said Dr. Haskell, who is now a professor of medicine at Stanford. Most were under 55 and some were smokers or had heart disease.

On an airplane traveling to the meeting, Dr. Haskell pulled out his data and showed them to Dr. Fox. ''We drew a line through the points and I said, 'Gee, if you extrapolate that out it looks like at age 20, the heart rate maximum is 200 and at age 40 it's 180 and at age 60 it's 160,'' Dr. Haskell said.

At that point, Dr. Fox suggested a formula: maximum heart rate equals 220 minus age.

But, exercise physiologists said, these data, like virtually all exercise data, had limitations. They relied on volunteers who most likely were not representative of the general population. ''It's whoever came in the door,'' Dr. Kirkendall said.

In addition, he and others said, gauging maximum heart rates for people who are not used to exercising is often difficult because many prematurely stop the test.

As the treadmill hills get steeper, people who are not used to exercise will notice that their calves are aching. ''They will say they can't go any further,'' Dr. Kirkendall said.

In addition, Dr. Wilmore, the exercise physiologist, said it was clear from the scattered data points that maximum heart rates could vary widely from the formula. ''If it says 150, it could be 180 and it could be 120,'' Dr. Wilmore said.

But the formula quickly entered the medical literature. Even though it was almost always presented as an average maximum rate, the absolute numbers took on an air of received wisdom in part, medical scientists said, because the time was right.

Doctors urging heart patients to exercise wanted a way to gauge exercise intensity. At the same time, exercise gurus, promoting aerobic exercise to the public, were asking how hard people should push themselves to improve their cardiovascular fitness. Suddenly, there was a desire for a simple formula to estimate maximum heart rates.

''You tell people to exercise at a moderate intensity,'' Dr. Haskell said. ''Well, what's a moderate intensity?''

Soon, there was a worldwide heart-rate monitor industry, led by Polar Electro Inc, of Oulu, Finland, selling more than 750,000 monitors a year in the United States and citing the ''220 minus your age'' formula as a guide for training.

The formula became increasingly entrenched, used to make graphs that are posted on the walls of health clubs and in cardiology treadmill rooms, prescribed in information for heart patients and inscribed in textbooks. But some experts never believed it.

Dr. Fritz Hagerman, an exercise physiologist at Ohio University, said he had learned from more than three decades of studying world class rowers that the whole idea of a formula to predict an individual's maximum heart rate was ludicrous. Even sillier, he said, is the common notion that the heart rate is an indication of fitness.

Some people get blood to their muscles by pushing out large amounts every time their hearts contract, he said. Others accomplish the same thing by contracting their hearts at fast rates. As a result, Dr. Hagerman said, he has seen Olympic rowers in their 20's with maximum heart rates of 220. And he has seen others on the same team and with the same ability, but who get blood to their tissues by pumping hard, with maximum rates of just 160.

''The heart rate is probably the least important variable in comparing athletes,'' Dr. Hagerman said.

Heart rate is an indicator of heart disease, said Dr. Michael Lauer, a cardiologist and the director of clinical research in cardiology at the Cleveland Clinic Foundation. But, he added, it is not the maximum that matters: it is how quickly the heart rate falls when exercise is stopped.

An average healthy person's heart rate drops about 20 beats in a minute and the rates of athletes ''nose dive by 50 beats in a minute,'' Dr. Lauer said.

In three recent studies, Dr. Lauer and his colleagues found that people whose rates fell less than 12 beats within a minute after they stopped exercising vigorously had a fourfold increased risk of dying in the next six years compared with those whose heart rates dropped by 13 or more beats.

Dr. Lauer pays no attention to the standard formula when he gives treadmill tests. More than 40 percent of patients, he said, can get their heart rates to more than 100 percent of their predicted maximum. ''That tells you that that wasn't their maximum heart rate,'' Dr. Lauer said.

The danger, he said, is that when doctors use that formula to decide when to end a treadmill test, they can inadvertently mislead themselves and their patients. Some patients may be stopping too soon and others may seem to have a heart problem because they never can get to what is supposed to be their maximum rate.

''Some people are being pushed and others are not,'' Dr. Lauer said. ''In my view, that is unacceptable.''

Yet, Dr. Seals said, many doctors want some sort of guide for estimating maximum heart rates for treadmill tests. And many people who want to increase their fitness crave a general formula.

So Dr. Seals and his colleagues decided to take another stab at finding an equation.

In a study published in the March issue of The Journal of the American College of Cardiology, Dr. Seals and his colleagues devised a new formula: maximum heart rate equals 208 minus 0.7 times age. They used published studies involving 18,712 healthy people and data from 514 healthy people they recruited. Their formula gives much higher average maximum heart rates for older people, with the new and old heart rate curves starting to diverge at age 40.

But raising doubts about the heart rate formula is unlikely to lead people to abandon it, exercise physiologists say. What would they do without it?

''I've kind of laughed about it over the years,'' Dr. Haskell said. The formula, he said, ''was never supposed to be an absolute guide to rule people's training.'' But, he said, ''It's so typical of Americans to take an idea and extend it beyond what it was originally intended for.''

7 workout habits you should drop now

By Jennifer Cohen, Health.com

Editor's note: Jennifer Cohen is a leading fitness authority, TV personality, best-selling author, and entrepreneur.

(Health.com) -- Are you spending hours working out every week, and not getting the results you want?

Chances are you might have a bad habit or two when it comes to exercising.

Never fear, there's a quick fix for even the most ingrained workout no-nos. Check out these seven workout habits you should drop: Not only will ditching these help you lose the pounds, they will help you become a more efficient exerciser.

1. The elliptical

I'm not a fan of the elliptical. Not only is it the most boring piece of equipment in the gym, it is also extremely ineffective.

First off, the elliptical doesn't use a natural body motion to work your body. Workouts that use natural motions like running, bending, or jumping are much more effective at toning muscles. Sure, the gliding motion of the elliptical burns calories, but that's about it.

It is also easy to slack off on the elliptical. With the treadmill you at least have to keep up with the pace you set. On the elliptical you start off with guns blazing, and 10 minutes later you are crawling along like a turtle.

You are much better off doing a 20-minute cross training circuit (burpees, jumping rope, jumping squats, etc.) than 45 minutes of slogging along on the elliptical.

If you are looking for another low impact exercise, try the rowing machine. This will get your heart rate up, and also work your upper body and back.

2. Working out for long periods of time at a moderate pace

When it comes to working out, slow and steady does not win the race. Maximize your time, people!

Instead of working out for an hour at an easy-to-moderate intensity level, step it up a notch. Challenge yourself to 30 minutes of nonstop, intense exercise. You can take 15- to 30-second breaks, but move quickly from one workout to the next. Give it 100% for 30 minutes, instead of 75% for an hour.

3. Lollygagging

You know that girl at the gym who's always fixing her hair in the mirror? Don't be her. Come to the gym with a time frame and a plan.

This means no wandering around, no texting your boyfriend in between reps. Come with a set workout to complete, limiting your water breaks to specific points in your circuit for a designated amount of seconds.

If this means writing down your regimen, great. Tattoo it to your arm. Whatever. Make the most of your time. Get in, get out. No one likes a gym rat.

4. Too much cardio and too little strength training

But cardio burns more calories, right? Not so fast, lady.

Sure, an hour on the treadmill gives you that instant satisfaction of burning 400 calories. Or so that little blinking screen says. A quick strength training or cross training session, however, will get your heart rate up, burn calories, and develop your lean muscle mass.

Building muscle means that those muscles are able to work throughout the day burning more calories when you aren't working out.

5. Hydrating with sports drinks

Sports drinks may give you a boost, but are full of sugar and calories. During any given daily workout, hydrating with plain ol' water should do the trick just fine.

If you feel tired during your workout, try fueling before. Eating a healthy snack 45 minutes before your workout can give you more energy, and allow you to skip the Gatorade. Try some almond butter on toast.

6. Doing the same exercises over and over again

When you do the same workout routine over and over, your body gets used to it and it becomes easier.

The Stairmaster might have been challenging at one point, but pretty soon your muscles become familiar with that motion. Your body only uses half the energy to complete this task that at one point had you huffing and puffing your way to the locker room.

Mix it up. By changing your workouts daily you will trick your body into working harder and burning more calories. It will also save you from boredom. 

7. Going it alone

Working out alone can be great. It gives you time to clear your mind, listen to music, and feel the burn.

However, sometimes it takes a workout buddy to hold you accountable. Working out with a partner not only makes it more likely that you'll work out, it makes most people try harder than they would on their own. Your partner can cheer you on to finish that last half mile or to finish those last four deadlifts.

And let's not forget the power of good old-fashioned competition. If your friend is doing 50 lunges, don't you suddenly feel inspired to do 51?

Are soy phytoestrogens in soy a problem?

Does Soy “Feminize” Men? Fact Vs. Myth

The benefits and dangers of soy are hotly debated, but one of the more disturbing accusations is that soy promotes the development of breasts in men. Should guys avoid eating this little green bean, or are the rumors overblown?

Soy beans are rich in phytoestrogens, a subclass of a group of antioxidants known as isoflavones. The chemical structure of phytoestrogens is very similar to that of the human sex hormone estrogen (phytoestrogen literally means plant estrogen). The similarity of the structures allows phytoestrogens to sometimes mimic or inhibit the hormone in animals with estrogen receptors (i.e. mammals).

Because they can interact with estrogen receptors, phytoestrogens have the potential to play a role in any biological process that involves estrogen (here is my extensive review on the pros and cons of soy). This introduction of estrogen-like copycats has led some to speculate that soy might “feminize” men if consumed too frequently.

Indeed, studies have shown that diets with very high in phytoestrogens can reduce fertility in rodents, which is more than a little scary. Fortunately, soy consumption has not been shown to act as a potent regulator of sex hormones in the vast majority of human men or in certain primates.

However, there have been some exceptions. One study reported that a 19-year-old male developed decreased libido, erectile dysfunction, and low testosterone after consuming very large quantities of soy as part of a vegan diet. The researchers did not, however, report the presence of gynecomastia (a.k.a male breasts). It should also be noted that the patient had type 1 diabetes, indicating some level of metabolic dysfunction, and relied on soy as his primary protein source. The symptoms disappeared one year after discontinuing his vegan diet.

Another study reported that one 60-year-old man developed breasts, as well as sexual dysfunction, after consuming three quarts of soy milk daily for six months. Again, the symptoms faded after discontinuation of the soy intake.

Extreme case studies aside, soy intake appears to be safe at normal to moderately high levels, even those above the relatively high consumption level of Asian men. Problems only seem to arise when soy is consumed at levels 9 – 10 times the norm for several months at a time.

If you’re a man and trying to avoid even small amounts of something that may lead to breast development, that’s probably not the right approach. There are benefits of soy that may make regular consumption worthwhile, such as its role in protecting against prostate cancer. Remember, it’s the dose that makes the poison.

To summarize, in very high doses, soy may cause some reversible sexual disruption in men (and possibly breasts), but in normal-to-high ranges, soy consumption appear to be safe and may offer health benefits.

- See more at: http://blog.zocdoc.com/does-soy-feminize-men-fact-vs-myth/#sthash.HKPKmjmF.dpuf

10 Meatless High-Protein Foods

If you prefer chickpeas to chicken, keep in mind you still need 2 to 3 servings of protein per day. These 10 meatless foods are high in protein and will help to keep your body strong and healthy, sans the meat. 

By: Michelle Klug

Vegetarian Protein Sources

Whether you’ve decided to go meatless once a week or adopted a full vegetarian lifestyle, you need to keep nutrition on the front burner. Since you’ve nixed the meat, making sure your body is getting enough protein to stay strong is crucial. Protein functions to build and maintain your body, fight off disease, and keep energy levels high to you can stay alert all day. While it may seem difficult to get a full dose of protein per day (on average 46g for women, 56g for men), implementing a few of these high-protein foods into your diet can help you reach those protein goals.

Eggs

Protein: 6g per egg

Start your day off right with protein-packed eggs. This will give your morning a boost and fuel you until lunch. Cooking with eggs brings breakfast to a whole new level. Mix it up a bit with omelets and quiche or try cooking eggs scrambled, poached, hard-boiled, or sunny-side-up.

Cottage Cheese

Protein: 13g per ½-cup 

Cottage cheese serves as great snack. It’s affordable, comes in reduced-fat versions, and also contains calcium to keep your bones strong. But you can also hide it in creamy dishes, or sub it out for ricotta cheese or sour cream in certain dishes too. Try combining with fresh veggies for a savory treat, or adding fruit and cinnamon for something more sweet.

Quinoa

Protein: 8g per 1 cup (cooked)

Pronounced KEEN-WAH, this wonder grain is not only high in protein but also low in cholesterol and a good source of iron and fiber. Eating quinoa often is a good idea for vegetarians or anyone looking for a healthy protein. Plus, some varieties only take 20 minutes to cook – you’ll know it’s done when it turns slightly translucent.

You can make quinoa salads, or use instead of rice for a higher protein whole-grain.

Pumpkin Seeds

Protein: 7g per 1 oz 

Also known as pepitas, pumpkin seeds are a great grab-and-go snack or topping for salads and soups. While they are available year-round in stores, you can roast fresh seeds at home in fall, when pumpkins come into season. Nuts and seeds can be high in calories and fat so be mindful of your serving sizes.

Dried Beans

Protein: 12g per 1 cup (black beans)

Dried black beans, kidney beans, lentils, chickpeas, and pinto beans are all delicious choices for low-fat, fiber-filled protein. Using dried beans allows you to control the sodium and additives that go into the dish. Soak dried beans overnight in a large bowl of water, rinse until the water runs clean, then simmer for 2 hours on medium/low heat to enjoy. Spice with cumin, garlic, red pepper, or other spices.

Soy Milk

Protein: 8g per 1 cup 

While all soy, including tofu and soybeans, are excellent sources of protein, soy milk is convenient and versatile, making it the perfect thing to have around. In addition, some brands offer options that are fortifed with extra calcium. Chocolate flavors are available for when your sweet tooth strikes, vanilla is great in cereal and coffee, and original is a great substitute for baked goods and smoothies.

Greek Yogurt

Protein: 15g per 6-oz container

Greek yogurt packs as much as double the protein as regular yogurt. It’s also thick, filling, tart, and less sweet than some regular varieties, all while staying in the low-calorie range. It’s great on its own, with fruit, or as a substitute for sour cream.

Peanut Butter

Protein: 8g per 2 Tbsp 

Bring back this crunchy or creamy childhood favorite by spreading peanut butter on toast instead of butter for more protein to your morning routine. Also try using it in smoothies and baked goods, or just keep some stashed away with a package of whole-wheat crackers for when you belly is rumbling.

Seitan

Protein: 18g per 3 oz serving

Seitan, AKA wheat-meat, is hailed by vegetarians because of its substantial texture and high protein. Unlike tofu, seitan is a meat substitute that mocks the texture of chicken, making it ideal for sandwiches, soups, or anywhere you would traditionally use meat. Made from wheat gluten, seitan may not be sold in all grocery stores, so stock up at specialty markets, or make a batch from a recipe like this. 

Almonds

Protein: 6g per 1 oz

Go nuts over almonds – the monounsaturated fats they contain have been shown to reduce heart disease. A serving size is about one handful of almonds, or 2 tablespoons of almond butter. Try sliced almonds on top of salads or create your own spice recipe to liven them up a bit.

Testosterone, aka The Fountain of Youth

By Adam Swenson

Let’s do a quick mental exercise. Imagine a young man in tip-top health. Physically, emotionally, and mentally he is at his best. He could be out playing sports, at work, or reading a book. What characteristics does this man have?

Odds are the man you pictured is strong, lean and athletic, has abundant energy, is generally upbeat and optimistic, and has a sharp mind and a good memory.

This, in broad strokes at any rate, is what most men aspire to. This state of being, men feel, will allow them to enjoy all life has to offer and feel good about themselves.

Now imagine this young man 20 years older. He may be a little weaker, a little less taut in the midsection, a little slower, maybe more docile, moody, not as quick mentally, and he loses things. A decade further down the line, the picture worsens for our poor example man.

Has this man replaced carrots with Cheetos, running marathons with movie marathons? If so, lifestyle adjustments may be able to bring back some of the lost luster. But some men do everything right and just can’t get their mojo back.

The answer lies in the quintessential male hormone: testosterone. Many American men have low testosterone (low T), some critically low. This manifests itself as unexplained fatigue, depression, or lethargy; erectile dysfunction or obvious loss of libido; diminished strength and physical stamina. Sound familiar?

And The Survey Says…

A recent study of low-T men (average age of 57) broke them into four groups, monitoring body composition for one year. The first group served as a control—they had no intervention. The second group did testosterone replacement therapy (TRT) and worked under a nutritionist and a trainer. The third group did only TRT, and the fourth group only worked with a nutritionist and trainer.

Somewhat predictably, those that did nothing gained body fat, and those who had TRT and worked with the trainer lost the most weight. The surprising finding, however, was that those who only received TRT had more positive changes in body composition than those that did only the lifestyle changes.

In another study, a group of men receiving long-term TRT lost an average of 36 pounds over a two-year period. And perhaps this shouldn’t be that surprising. Alan Christianson, NMD, is a hormone balance specialist and the founder of Integrative Health in Scottsdale, AZ. But before he had any letters behind his name, he spent his childhood on a farm in northern Minnesota where he got perhaps an uncomfortably close look at the link between low testosterone and fat. “Growing up on a farm, we wanted our pigs to be as heavy as possible by the time they got to market,” he said. “The first thing we would do is we would castrate them.”

Low Testosterone by the Numbers

A 1996 study checked an average of 175 non-diabetic men in five-year age groupings (25-29, 50-54, etc). It found that mean total testosterone in men under 25 was 692 ng/DL, whereas men aged 55-59 averaged 552. Another study tracked men all the way up to 85-100—their mean total level was 376.

Christianson says a borderline number for low testosterone is 450—below that the picture becomes clearer. “There is a state at which testosterone being low is actually a medical risk. It actually raises the risk of total mortality, cardiovascular mortality, and diabetes. That is somewhere around 250. Sometimes if men are deficient by a small amount, you can work with what they have and coax it out, but when men are as low as 250 and below, even if they don’t have symptoms, it is medically appropriate to treat the same way you would treat for high blood pressure or high cholesterol. It is just an unhealthy physical state that they are in at that point.”

A recent study showed that 2.4 million American men ages 40 to 69 suffered from hypogonadism. Christianson says, “Hormones you think about as being on a continuum, and hypogonadism is where your testicles have pretty much failed: those are by far the most severe cases. As you look at those that haven’t had testicular failure but aren’t making optimal amounts of hormone, it ends up being a substantial amount of the aging population.”

You can discover your testosterone level through a simple blood test—that is considered the most accurate. Salivary and urine tests are relative newcomers and are certainly less invasive, though they are often not as accurate. Christianson tested himself with blood, saliva, and urine tests within a two day window. The saliva and urine tests gave completely different readings. On top of that, the blood test is the one most commonly covered by insurance, so it makes for a clear plan A.

(The other tests do have their strong suits: urine tests are helpful in showing a large number of hormones and giving doctors insight into how the conversion and breakdown process is occurring in that particular patient. The salivary tests are very good for testing cortisol as that has to be tested at multiple points throughout the day.)

The Culprits: Natural and Pharmacological

Low T can have a variety of causes. As men age, production will drop off naturally. (As referenced earlier, the under-25 set averaged 692, while the over-85 set averaged 376—a 46 percent drop.) In hypogonadism, the testes fail and testosterone plummets. Lifestyle factors, namely inactivity and the accompanying excess fat, can certainly play a role. A 2010 study of 2,165 men age 45 and up found that 40 percent of obese participants had lower-than-normal T readings. Among obese men with diabetes, that level rose to 50 percent. Testosterone decreased markedly as BMI rose. Also, men with diabetes—obese or not—showed lower T levels than their non-diabetic counterparts.

To further obfuscate the issue, there are a wide variety of medications that either play an active role in lowering testosterone or have side effects that mimic low T levels. Statins (cholesterol-lowering medications) have a clear effect. “Cholesterol is actually the backbone for testosterone,” says Christianson. “Biochemically, steroid means every hormone of cholesterol. Kind of a simple rule of thumb is hormones that come from below our waist—so from ovaries, from testicles, or from the adrenal gland—are all steroids. They are all just slightly repurposed cholesterol molecules. If we are not synthesizing cholesterol the way our bodies want to, that can alter how we form our steroids and how we form certain hormones. That is the cholesterol tie-in.”

There are other medications that will mimic the effects of low T, even though they have no effect on T itself. Blood pressure medications can affect the erectile function. Selective serotonin reuptake inhibitor (SSRI) meds impact some of the brain steroids related to cholesterol that give us the psychological sex drive. Analgesics and antihistamines are sedating and can therefore diminish energy and exercise capacity, two hallmark symptoms of low T.

One other factor to consider: a naturopathic doctor might spend a little more time with a patient before diagnosing them with low T and writing a script. “Some men are simply carrying a big burden of cadmium or lead in their bodies and some may have issues with not properly breaking down precursor hormones by their liver,” he said. “Some may have nutritional things that they are lacking. We do screen pretty thoroughly and there are times where—especially in men that may be low before we would expect based on their age, or low by a smaller amount—there can be factors short of replacement therapy that can correct them.”

The Manifestations of Low T

Metabolic syndrome (also known as the somewhat more catchy “diabesity”) is getting a lot of press right now, and appropriately so. According to recent Center for Disease Control (CDC) findings, 33.8 percent of Americans are obese. Low T plays a key role in metabolic resistance and the consequent greater production of insulin. “Think of it as a seesaw: on one side is testosterone, and on the other side is insulin. When the testosterone gets lower in the body, we have a hard time managing our blood sugar, and we have to make more and more insulin to process the same amount of carbohydrate. The more insulin we make, the more we store our calories and the less effectively we burn calories,” Christianson says.

A recent study published in Endocrine Journal said, “Testosterone has neurobehavioral, somatic, and metabolic effects in adult men. Patients with hypogonadism not only have loss of libido and erectile dysfunction, but also have several other problems such as fatigue, increased body fat, osteoporosis, mild anemia, gynecomastia [enlarged breasts], sleep disturbances, and hair and skin changes.” With typical academic understatement, the study goes on to say, “All of these conditions may cause anxiety and depression in these patients.”

Treatment Options and Guidelines

The goal with TRT is to restore someone with low T to the level that would be typical for a healthy male in his mid-30s: about 600 to 850. In a critically low patient (250 or under) that can mean tripling his levels. “The idea is that you want to give the lowest dose that will bring someone back to that level. If the dose you’re giving takes someone way above the body’s normal level, then it’s just not what our chemistry is adapted to and also it will depress your own output. If you bring someone back to normal ranges, but not well above that, there is no substantial suppression on what their own output is.”

That is a very relevant point. Very high doses of testosterone can lead to bad hormone byproducts and shrinking of the testicles—best not to go there. And since unnaturally high doses suppress the body’s natural ability to produce testosterone (bodily production is no longer needed), this patient would dip to perilously low levels should he lose access to the medication. Proper dosing prevents those risk factors that people sometimes associate with testosterone supplementation.

And, as you might suspect, testosterone is not all created equal. Christianson advocates bioidentical hormone replacement therapy (BHRT), meaning that the hormones are in the same molecular configuration as the T made by the body—hence the term bioidentical.

“There are a lot of molecules out there that do things kind of like testosterone can do but aren’t really testosterone,” he says. “Those were used in the past for replacement therapy or more so [currently] for steroid abuse purposes. Using the same molecule your body is engineered for really makes it work the smoothest. It is just like running your car on gasoline rather than kerosene.”

Interestingly, bioidentical hormones are sourced from plant hormones—there are a variety of plants that make precursors to cholesterol called dioxygens. These can be turned into testosterone, estrogen, or progesterone.

Testosterone can be administered orally, topically, or via injection, though injection is the best of the three. Pills have fallen out of favor because they must first go through the liver, where hormones can get broken down in undesirable ways. Topical applications face a similar problem as skin enzymes convert hormones as well.

“When men who are very, very obese develop breast tissue, it is because fat tissue converts testosterone into estrogen. When testosterone comes into the body by crossing the skin, there is more of a chance of it being converted that way,” Christianson says. This would, obviously, be counterproductive.

Shots enter the bloodstream directly from muscle tissue and best approximate the body’s own production—they are thus the delivery method of choice. There is a long-lasting supplement administered via subdermal shot that Christianson particularly likes. It’s about the size of a grain of rice and lasts about three months.

Outcomes (Desired and Otherwise)

The aforementioned study in Endocrine Journal had this to say regarding the outcomes from TRT. “TRT restores normal sexual functions and improves libido, fatigue, sense of well-being, bone density, muscle mass, body composition, mood status, and cognition. Overall, the restoration of the above parameters is expected to improve the quality of life.” Again, a fair assumption. TRT has been linked to various health problems in the past, mostly due to improperly high dosing or hormones that were not bioidentical. Prostate cancer was at one point linked to TRT, though that has been definitively cleared. TRT is a culprit for prostate enlargement, the more benign type that causes frequent urination.

As far as desired outcomes go, if a man goes from 275 to 650 on the scale, Christianson says, “There is a very, very strong positive correlation to healthy libido.” The psychological aspect improves pretty quickly (two to eight weeks) but the physiological side sometimes takes a little longer. “Most men have seen a good [physiological] change within four to six months, but there are some where it does take a full year.”

Memory and concentration have also been shown to improve with TRT. “There are a variety of compounds that the brain makes that we are learning a lot about lately called neurosteroids. Basically, they’re neurotransmitters that are products of testosterone. Many papers have shown now that low testosterone is a big factor in triggering early Alzheimer’s disease and also non-Alzheimer’s age-related dementia … It seems that a certain amount of our memory is tied into a healthy, normal amount of assertiveness or aggression. If we have an extreme excess of these neurosteroids, we are inappropriately aggressive. If we have a deficit, there is a connection between being apathetic and not having healthy drive and not having good memory for events or good spatial memory: where are you at or how do you get home, things like that.”

A Return to Form

Consider our conceptual young man in tip-top health. As men age, many resign themselves to less-than-ideal body composition, sexual function, mood, memory, and mental acuity, but that need not be the case.

As the great poet Dylan Thomas wrote, “Do not go gentle into that good night, Old age should burn and rave at close of day; Rage, rage against the dying of the light.”



Low T: It’s Not Just an Old Boys’ Club

Testosterone also plays a vitally important role in women. In general the ratio of testosterone found in men and women is about 10 to 1, and low T in women manifests itself with many of the same symptoms: libido, lethargy, depression, and so on.

“By their mid-40s, I would argue that probably 80 percent of women are below optimal in testosterone nowadays,” Christianson says. “Somewhere around 40 to 90 is the healthiest range for women and many are below that—some in the single digit range. They can just see phenomenally good changes to their health and their life when that is corrected.”

The North American Menopause Society’s statement on the issue says that “Published evidence from randomized controlled trials, although limited, indicates that exogenous testosterone, both oral and nonoral formulations, has a positive effect on sexual function, primarily desire, arousal, and orgasmic response, in women after spontaneous or surgically induced menopause.”

They caution against TRT without concomitant estrogen therapy and also state that doctors must be careful to rule out causes not related to T levels—then be sure there’s no physiological cause for reduced T levels—before prescribing.