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Archive for July 26th, 2011

WebMD – How to Avoid Gaining Weight When You Quit Smoking

Posted by 4love2love on July 26, 2011

By Peter Jaret
WebMD Feature
Reviewed by Louise Chang, MD

Many smokers worry that they’ll gain weight if they try to quit. Some even use that concern as a reason not to quit.

“That’s a bad idea for many reasons,” says Scott McIntosh, PhD, associate professor of community and preventive medicine at the University of Rochester in New York and director of the Greater Rochester Area Tobacco Cessation Center. “Not every smoker who quits gains weight.” Even those who do, he points out, gain on average just 4 to 10 pounds.

Indeed, for many ex-smokers, putting on a few pounds is healthy. Research shows that smoking actually makes some people unhealthily thin.

Still, if you’re worried, remember this: a few simple strategies can help limit weight gain while you kick the habit. Once you have successfully broken the addiction to tobacco, you can work on losing any weight you’ve gained.

Smoking and Metabolism

Research shows that nicotine from tobacco boosts the body’s metabolic rate, increasing the number of calories it burns. Immediately after you smoke a cigarette, your heart rate increases by 10 to 20 beats a minute. The unnatural stimulant effect of nicotine is one reason smoking causes heart disease.

When smokers quit, metabolic rate quickly returns to normal. That’s a healthy change. But if ex-smokers keep getting the same number of calories as before, they put on pounds.

Be Smart About What You Put in Your Mouth

When smokers quit, nicotine isn’t all they crave. They also discover that they miss the habit of lighting a cigarette and putting it to their mouths. Many smokers turn to food to satisfy this so-called need for “oral gratification.”

That’s fine if it helps you to quit. But by choosing low-calorie or zero-calorie foods, you can avoid putting on weight. Some smart alternatives include:

  • Sugar-free gum
  • Sugar-free hard candies
  • Celery or carrot sticks
  • Sliced sweet peppers
  • Slices of jicama

Experiment to find which alternatives work best for you. Research shows that some smokers who quit experience a sharpened “sweet tooth.” They’re better off finding foods sweetened with artificial sugar. Some smokers really miss the oral gratification of smoking. They do best finding alternatives that require unwrapping something and chewing or sucking on it, such as sugar-free gum and hard candy.

Another trick is to brush your teeth frequently throughout the day. This can satisfy a passing craving for oral gratification. When your mouth is fresh and clean, you may have less of an urge to smoke.

Avoid Crash Diets

Choose healthy foods that are rich in nutrients and low in calories whenever you can. But experts advise against radical changes in how you eat. “Quitting is tough enough without adding the stress of extreme dieting,” says Steven Schroeder, MD, director of the Smoking Cessation Leadership Center at the University of San Francisco.

Be Realistic in Your Expectations

Many smokers do gain some weight. It’s fine to resolve to do everything you can to keep your weight down. But don’t make weight a make-or-break issue. “It’s important to tell yourself right at the beginning that it’s OK to put on some weight,” says McIntosh. “Don’t be too tough on yourself.”

Stay Busy

To distract yourself from the urge to smoke, fill your day with things to do that don’t involve eating. Physical activities — walking, gardening, doing chores — are a great choice. They burn calories, of course. And research shows that they also have a positive effect on mood. But any kind of distraction from the urge to smoke will help. Examples include:

  • Watching a movie
  • Attending a concert
  • Going to the library to read
  • Visiting a local museum
  • Calling a friend
  • Volunteering

“Fortunately, it’s easier than ever to find smoke-free places to go these days,” says Schroeder. “That trend has helped to make it easier for smokers to quit.”

Talk With Your Doctor

A variety of products and medications are available that have been found to help smokers quit. Several also appear to help quitters keep weight off. In a 2009 review, researchers found that the antismoking drug buproprion and the antidepressant fluoxetine, as well as nicotine replacement therapies and cognitive behavioral therapy, helped limit the amount of weight that smokers gained while quitting.

Keep Your Health in Perspective

If you do gain extra pounds while you kick the habit, don’t let that derail your efforts. “By quitting smoking, you can add years to your life — and years of being in good health rather than sick and disabled,” says McIntosh. “Those extra pounds are a small price to pay.” Once you’re tobacco-free, you’ll have plenty of time to get into shape and achieve a healthy weight.

Reviewed on January 24, 2011
© 2011 WebMD, LLC. All rights reserved.
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WebMD – 8 Diet Dos and Don’ts to Ease PMS

Posted by 4love2love on July 26, 2011

These strategies may help curb PMS symptoms.
By Cari Nierenberg
WebMD Feature

Premenstrual syndrome (PMS) is such a regular occurrence for many women that they consider it a normal part of getting their period. About 8% to 20% of women get moderate to severe symptoms a week or two before their monthly cycle begins.

These symptoms include a range of physical and emotional changes. The biggest complaint is often mood-related, such as feeling extremely grouchy or unhappy, often to the point where family members know when your period is coming, says gynecologist Rebecca Kolp, MD, medical director of Mass General West in Waltham, Mass. Abdominal bloating, breast tenderness, and headache are other frequent gripes she hears from patients.

Although the causes of PMS aren’t well understood, fluctuating levels of hormones and brain chemicals are thought to play a role. What a woman eats and drinks can also have an effect.

“There’s evidence that diet is involved in either the development of PMS or contributes to the severity of symptoms,” says Elizabeth Bertone-Johnson, ScD, an associate professor of epidemiology at the University of Massachusetts in Amherst, who has studied nutrition’s role in PMS.

With that in mind, here are eight diet-related suggestions to help ease PMS symptoms.

1. Do enjoy high-quality calcium foods.

In studies of college-aged women and nurses, women with the highest intakes of calcium andvitamin D were less likely to develop PMS, Bertone-Johnson tells WebMD.

“With calcium, those results were stronger when it came from foods than from foods plus supplements or a supplement alone,” she says. Her research found a food benefit from calcium at about 1,200 milligrams a day (RDA for women 19-50 is 1000 mg) and at 700 IU of vitamin D (RDA for women is 600 IU aged 70 and below.)

To get these amounts, aim for at least three servings of calcium-rich foods a day, such as low-fat milk, cheese, yogurt, fortified orange juice, or soy milk. It’s difficult to get enough vitamin D from diet alone (salmon and fortified milk are good sources), but women can make up the difference with a daily multivitamin or a supplement. Many calcium supplements also contain vitamin D.

As for why these nutrients may ease PMS, Bertone-Johnson suspects that calcium works in the brain to relieve depressive symptoms or anxiety, and vitamin D may also influence emotional changes.

Of course, you need adequate calcium and vitamin D for many other health reasons, including the health of your bones. Curbing PMS may be a fringe benefit.

2. Don’t skip breakfast or other meals.

“The hormone storm from PMS can lead to a domino effect on appetite,” says Elizabeth Somer, an Oregon-based dietitian and author of Eat Your Way to Happiness.

To avoid becoming overly hungry, eat regular meals and snacks throughout the day. If you’re feeling blue from PMS, then skipping a meal will only make you more irritable as blood sugar levels plummet.

3. Do include whole grains, lean protein, fruits, and vegetables.

Eating well all month long is a better approach to PMS than tweaking your diet when you have symptoms. So enjoy plenty of colorful, fiber-packed fruits and vegetables, as well as whole grains, such as brown rice, oatmeal, and rye bread.

Fortified breads and cereals also supply B-vitamins. Recent research  found that women with higher intakes of thiamine (vitamin B-1) and riboflavin (vitamin B-2) had a significantly lower risk of PMS. This was true for women who got B-vitamins from food, but not from supplements.

4. Don’t overload on sugar.

“If you’re craving sugar, you’re craving it for a reason,” Somer says. That reason is shifting levels of the hormones estrogen and progesterone, which can also decrease levels of the chemical serotonin in the brain. These changes may affect a woman’s mood and trigger PMS symptoms.

In fact, studies have shown that some women with PMS may take in 200 to 500 more calories a day. Those additional calories typically come from fats, carbohydrates, or sweet foods.

Rather than turning to sugar to boost serotonin levels, Somer advises eating whole grains instead.

5. Do pay attention to what you’re drinking.

Some, but not all, studies have revealed that alcohol use is more common in women who are experiencing PMS or Premenstrual Dysphoric Disorder (PMDD), perhaps as an attempt to self-treat symptoms. PMDD is a more severe form of PMS, in which emotional symptoms are more predominant. It affects fewer women than PMS.

Although women are often advised to cut back on alcohol and even caffeine, there’s not a lot of evidence these steps are necessarily beneficial, Bertone-Johnson says. Her own research did not find that alcohol increased PMS risk. Still, she says, there’s no downside to easing up on alcohol and caffeine, and doing so may ease breast tenderness and bloating.

Somer likes to remind women to drink plenty of water to reduce bloating. This may sound counterintuitive, but she says a bloated body is holding on to too much water, likely because of too much salt.

6. Don’t overlook salt.

Since nearly everything that comes in a bottle, bag, package, or can is loaded with salt, it’s almost impossible to eliminate sodium. But slashing some of it may reduce the uncomfortable bloating and water retention from PMS, Somer says.

To halt the salt, focus on whole foods, rather than overly processed or convenience foods, because sodium is often added during manufacturing. “And if you can’t cut back enough, drink lots of water,” Somer says, so your body can get rid of the excess sodium.

7. Do consider supplements.

Besides encouraging her patients to eat a healthy diet, Kolp also recommends that they first treat PMS symptoms with a combination of exercise, stress reduction, and some supplements.

She suggests a daily multivitamin, 100 milligrams of vitamin B-6 a day, 600 milligrams of calcium carbonate with vitamin D daily, along with at least one calcium-rich food serving, as well as 400 milligrams of magnesium oxide.

Taking B-6 and magnesium at these levels may temper mood changes, and magnesium may reduce water retention.

As always, tell your doctor about any supplements you’re taking to avoid any possible drug interactions, and let her know if PMS is causing you a lot of problems.

8. Don’t ignore other lifestyle habits.

There’s some evidence that maintaining a healthy body weight may help prevent PMS, and that overweight or obese women are more likely to have symptoms.  Being physically active helps keep your waistline in check and works wonders to release stress.

“Stress plays a huge role in the intensity of PMS symptoms,” Kolp tells WebMD. So find ways to relax your mind, whether it’s exercising, deep breathing, or doing yoga.

Feeling tired is yet another sign of PMS, so you might need more sleep than usual. Lastly, ditch the butts: A recent study showed that smoking, especially in yourteens or early 20s, may increase a woman’s risk for moderate to severe PMS.

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WebMD – Expert Q&A: Fighting Midlife Weight Gain

Posted by 4love2love on July 26, 2011

An interview with Pamela Peeke, MD
By Kathleen Doheny
WebMD Feature
Reviewed by Louise Chang, MD

First, you notice shopping for clothes isn’t as fun or simple as it used to be. Next comes the “muffin top” spilling over the jeans. Then the scale delivers dire news: You’re 10, 15, maybe 20 pounds beyond your “normal” weight.

Midlife weight gain is common. Many Americans gain a pound or so every year as they make their way through young adulthood, ending up fat and flabby at age 40 and beyond.

But it is not inevitable, says Pamela Peeke, MD, MPH, the author of the best-seller Fight FatAfter Forty. Peeke also serves as the chief medical correspondent for Discovery Health TV and often appears as a medical commentator on television news and talk shows.

Why do so many people gain weight in midlife?

Blame it on hormones in convergence with poor lifestyle choices, overeating, not exercising enough, and stress.

But hormones only account for about 2 to 5 pounds. The rest is the result of overeating, poor lifestyle choices — such as not exercising enough — and stress.

How can I not be one of those people who gains?

The keys are three: mind, mouth, muscle.

Use your mind to control stress. If you walk around and everything is stressful, you have a problem. You may respond to stress by making poorer lifestyle choices, such as not eating healthfully and not exercising enough.

Look at your nutrition — in terms of quality, quantity, and frequency of eating. You should eat often.

Quality is all about eating whole foods, fruits, and vegetables, whole grains, lean protein.

Processed foods are bad. Anything that comes in a family-size bag, turn in the opposite direction and run.

Quantity is where a lot of people fall. The majority are baffled by what a serving size should look like. When eating out, and in doubt, eat half of it or less.

Be accountable for calories. You need a general idea of how many calories you need. An average woman, not an athlete, in her 40s or 50s, needs about 1,500 to 1,600 calories a day, on average, if she is exercising. A middle-aged man, average height and not an athlete but exercising, needs about 1,800 to 2,000.

Muscle, of course, refers to the need to exercise and, of course, to weight train.

Should my goal weight increase when I hit midlife?

A better goal than focusing on scale weight is to keep track of body fat. The goals should be to decrease body fat and optimize bone strength.

For a man, a body fat percentage of 18% to 25% is not bad for 40-plus. For women 40-plus, 22% to 27% is not bad.

To get that body fat percentage, you need to have excellent fitness to maintain a good muscle base.

Also, a man should have a waist circumference below 40 inches and a woman below 35 inches.

I’m 40-plus, eating right, and exercising but not losing weight. Why do I have midlife weight gain?

If you have tailored your portion sizes to ones that are appropriate, look at the frequency of your eating. Eat every three or four hours. But not too late at night. The later you eat, the lighter you eat is a good rule.

Eat a balance of lean protein, fats, and carbs. Make the fat good fat, not palm oil or hydrogenated oil, but high-quality good fats [such as those in nuts]. The protein should be lean — a turkey burger or a veggie burger.

Most people have been doing the same exercise routine for years, and your body acclimates. Fat cells at 40 are reticent to give it up. Mix up the exercise routine. Exercise at least five times a week, and I mean cardio.

Add intensity. Add some level of weight training, and challenge yourself with the weights. [Getting professional instruction is advised if you’re a novice.] Weight train two or three times a week.

Building muscle gives you that metabolic edge, since muscle mass burns more calories than fat.

Does HRT cause midlife weight gain, is that the culprit?

You can’t blame the low doses of HRT in use today for midlife weight gain, at least not for any more than a few pounds. You do get a little more bloated on it, but it does not cause body fat accumulation. Overeating, not exercising, and stress do.

What’s up with this belly? I never ever had one before.

I call it the menopot. On a man, it’s the manopot.

Excess body fat occurring in the lower abdomen is associated with aging, after 40. This excess body fat in the normal range is usually only 2 to 5 pounds. And you do get a little pooch.

How can I lose this belly?

You minimize it by following the mind-mouth-muscle concepts.

But it’s probably unrealistic to expect a stomach as flat as your 20-something stomach.

Can I boost my metabolism?

Absolutely. You can optimize your metabolism throughout life relative to your age by maintaining the highest level of training you can, within the limits and constraints of your life.

If you lose muscle mass [by not exercising], obviously your metabolism is going to drop.

Of course strength or weight training is crucial.

What workout or workouts are best for midlife people?

Creative cardio. Burn 400 to 500 calories a day in cardio. On the elliptical, for instance, you can burn about 400 calories in about 35 minutes. Cross train as much as you can. Burn the 400 to 500 calories all at once or accrue it.

And don’t forget the weight training.

What’s your weakness? What’s the hardest part, for you, of staying on track and fighting flab after 40?

Because of long days and all my commitments, getting enough sleep. I remind myself: the poorer your sleep, the wider your girth.

Eating dinner not too late. Sometimes I am on a plane or a train, I don’t have the control I want over how late I eat. In general, do not eat dinner past 8:30. I like to eat right about 7.

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