Archive for the 'weight' Category

One Ounce That Does a Lot

The thyroid gland is about two inches long and about one inch wide. It sits at the base of the neck, straddling the windpipe. It weighs about an ounce. When your healthcare provider encircles your neck with her hands and asks you to swallow, she is checking the size of your thyroid.

The thyroid’s main job is to control metabolism by secreting hormones.  If you, an adult, have too much thyroid hormone (hyperthyroidism) you will lose weight. If you have too little (hypothyroidism), you will gain weight. But that’s not all. Thyroid hormones have a strong influence on the nervous system, which influences everything. In turn, a change in the nervous system affects the thyroid.  Together, the thyroid and the pituitary in your brain function like the heating/cooling system in your home. For example, if the temperature in your home falls below a preset minimum on your thermostat, the furnace will start and send heat around your house until the preset temperature is reached. Then, once again responding to the temperature on the thermostat, the furnace will stop sending heat. What does all this mean for the way you feel and behave?

If your thyroid gland isn’t functioning properly it will not respond to the pituitary. The level of thyroid hormone in your blood stream will remain the same or drop further.  You may feel tired or not mentally sharp. If this persists, you may feel depressed or moody. You may have difficulty sleeping, in spite of feeling tired and sleepy. Physically, you may begin gaining weight, no matter how little you eat or how much you exercise. Meanwhile, your pituitary is frantically sending out thyroid stimulating hormone (TSH).  If this goes on long enough – the pituitary in overdrive – it may result in enlargement of the pituitary. But most people never reach this stage.  They generally feel sick enough to consult a healthcare provider.

On the other hand, if your thyroid keeps sending out thyroid hormone no matter how little TSH there is in your blood, your symptoms will be different. Emotionally you may feel anxious for no reason or more anxious for the reasons you do have. There’s some evidence that prolonged stress increases your risk for hyperthyroidism. You may be irritable or have difficulty concentrating. You may have difficulty sleeping, just as with low thyroid.  Physically you will begin to lose weight, no matter how many carbs you pile on. You might notice your heart racing, often greater than 100 beats per minute. Your hands may tremble. Eventually your thyroid will enlarge and you will feel or see the enlargement at the base of your neck. But, once again, most people have consulted a healthcare provider before this occurs.

Bottom line? That little gland in your neck is powerful. It can cause both physical and emotional/mental symptoms. The mind and the body are connected. They are both part of us. It may be only one that is causing your symptoms. But always suspect both, not just one, when you aren’t feeling well.

Don’t Look At The Ads!

Want to lose weight? Better not look at ads for exercise. LINK

 

Sometimes I feel overwhelmed by all the advice out there (including my own). It’s difficult to read everything so that I can make an informed decision. For example, I would like to read the original research article from which the above article was derived. But that would mean either going to the closest medical school library (time, gas, parking) or paying the (I think) exorbitant fee to get the .PDF. Then, of course, there is the issue of time, even if I do read the original article. How much time can I reasonably devote to reading one original source?

 

Time management is a real problem: information explosion, pressure to keep or get a job, ever longer commuting times … the list could go on far too long.

 

So, where am I going with this? Towards balance, I think.

 

The above article is interesting, but not interesting enough to pursue the original. I have too many questions. For example, how many hours had elapsed since the study participants had eaten? Was the time the same for both groups? Were the participants regular exercisers or not? In any case, a difference of 6 calories between groups seems rather small even when the larger intake was only 18 calories. It would simply take too much time to get all the answers I want for one short Web article that I found interesting.

 

Balance. Eat a balanced diet. Balance your food intake with your energy output. Balance work with play. Balance interests and pursuits.

 

Balance is a tool in the prevention of illness.

 

Health – it’s about prevention.

Perhaps A Blessing In Disguise

Jane Brody’s column in yesterday’s Science Times echo’s the thoughts in my Monday blog. Perhaps this major recession has a silver lining. It may improve the diet and decrease the weight of Americans. The key is planning and making use of time

 

If you have been “furloughed”, take that extra time and use it well. One way to use it well is to cook nutritious meals. Good nutrition doesn’t have to be expensive. Remember the value of whole grains, vegetables and fruits. Buy frozen vegetables (as, or more, nutritious than fresh) and buy the store brand. If you like your vegetables crunchy, don’t cook them according to the package directions. Less cooking time will result in a crunchier vegetables. Whole grains can be combined with a dairy product or a small amount of meat or fish to give you a satisfying and tasty meal that is good for you. Not only that, but tasty foods high in nutrients and bulk may even help you lose weight!

 

Take that extra time and cook large meals; then divide into smaller servings and freeze for harried week nights. And don’t forget those leftovers! They can be eaten as is or combined into other meals.

 

If you haven’t been “furloughed”, you can still find time on weekends to cook one large meal, then divide and freeze. Use a little ingenuity and creativity. Experiment and see what you and your family like.

 

If you have lost your job, all the more reason to shop and cook wisely and creatively. Now is the time to change bad habits.

 

And, again echoing my Monday blog, use your time, unexpectedly extra or just what you have always had, and spend it with family. Not only will grandparents be full of helpful hints on economizing, they will enjoy the time you spend with them. And children can have good ideas too.

 

If this recession gets Americans back on track to healthier living, it may well be a true blessing in disguise.

More Than Just A Relationship Breaker

What is a common risk factor for:

  • Diabetes
  • Heart attack
  • Heart failure
  • High blood pressure
  • Irregular heart beats
  • Obesity

 

Sleep apnea is a common risk factor for all of the above. The first indication of sleep apnea may be your partner complaining of loud snoring. Listen to your partner’s complaints. You may have sleep apnea.

 

Sleep apnea is defined as one or more pauses in breathing or shallow breaths while you sleep. The most common type of sleep apnea (and the cause that results in snoring) is obstructive sleep apnea. As the name implies, obstructive sleep apnea is caused by a blockage in the airway. As you try to draw air around the obstruction and into your lungs, the air causes a loud noise – snoring. People who are overweight often have obstructive sleep apnea. The sleep apnea then increases the chance of gaining more weight. The increased weight gain is due to the presence of the stress hormones that the body releases in response to the difficulty breathing. These same hormones increase your heart rate, which increases your risk of heart attack, heart failure, high blood pressure and irregular heart beats.

 

The other type of sleep apnea is central sleep apnea. In this type, your brain doesn’t send the normal signals to your sleep muscles. So, you don’t breath for a while. Your brain begins to send the right signals when your body realizes that it is low on oxygen. You may gasp as you begin breathing once more. Snoring is usually absent with central sleep apnea. However, stress hormones are released just as they are with obstructive sleep apnea.

 

Sleep apnea results in disturbances of the sleep cycle. These disturbances cause very brief, often unnoticed, interruptions in sleep. The resulting loss of sleep causes daytime sleepiness, which has been related to driving and other accidents.

 

Signs and symptoms of sleep apnea, both with and without snoring are:

 

  • Morning headaches
  • Memory or learning problems and not being able to concentrate
  • Feeling irritable, depressed, or having mood swings or personality changes
  • Urination at night
  • A dry throat when you wake up

 

If you think you have sleep apnea, consult you healthcare provider. Your healthcare provider may refer you to a sleep specialist. Only a physician can diagnose sleep apnea. Treatment may include devices to help you sleep, lifestyle changes or surgery.

 

Sleep apnea is not just a snoring joke or a relationship breaker. Sleep apnea can cause medical problems or make them worse. It can seriously affect your life.

 

If you think you have sleep apnea, consult you healthcare provider.

 

 

For more information click on these links.

NIH  

American Sleep Apnea Association

National Eating Disorders Awareness Week

According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM), “The Eating Disorders are characterized by severe disturbances in eating behavior.” DSM goes on to say that obesity is included as a general medical condition in the International Classification of Deceases (IC), but it has not been included in DSM because “… it has not been established that it is consistently associated with a psychological or behavioral syndrome.” If such factors are important in the etiology of a “particular” case of obesity, it should be noted as “Psychological Factors Affecting Medical Condition.”

 

I’m left wondering what this means. What condition or conditions are they talking about? The DSM is used for psychological diagnosis (and, of course, for insurance reimbursement). So, does an obese person have to have a major mental disorder in order to have the obesity treated OR does the mental health practitioner have to diagnose a medical condition in order to begin a behavioral weight control program?

 

The above musing aside, Eating Disorders are real AND potentially life threatening. Eating disorders do not (at least yet) include disorders of over-eating with persistent weight gain. Eating disorders include:

  • Anorexia nervosa – a refusal to maintain a minimally normal body weight.
  • Bulimia nervosa – repeated episodes of binge eating followed by inappropriate compensatory behaviors (vomiting, purging, excessive exercise, fasting, misuse of medications).

 

Bulimia is more common than anorexia and, unlike individuals with anorexia, individuals with bulimia are often of normal weight. Both anorexia and bulimia are most prevalent in developed countries. Both disorders are more prevalent among girls/women than among boys/men. However, boys and men do develop both disorders. These are not just “women’s diseases.”

 

There is no one “cause” of eating disorders. There are multiple causes and one may weight more heavily than another in an individual case. The causes can be grouped into four loose categories:

  • Psychological factors
  • Interpersonal factors
  • Social factors
  • Familial factors

National Eating Disorders Association

 

Treatment for eating disorders involves psychological counseling and attention to medical and nutritional needs. It is crucial that treatment be coordinated with a team approach. Eating disorders affect not only weight. They affect the whole body, including the kidneys, heart, GI tract and teeth. Untreated eating disorders can have long term effects and are potentially fatal.

 

February 22 – 28 is National Eating Disorders Awareness week.

 

Or more information on eating disorders access:

NIH and NEDA.

How Much Are You Willing To Risk In Order To Lose Weight?

The number of obese individuals and obesity related illnesses is on the rise world-wide. People in America and in other parts of the developed world have become accustomed to rapid information retrieval, fast food and almost instantaneous communication of all sorts. It’s no wonder, then, that the search for a quick-fix to being overweight seems to obsess the American public. Among the quick fixes are diets, exercise machines and pills. And when a weight loss pill is touted as “natural” and a “dietary supplement” it’s an almost guaranteed best seller.

 

Such was the case with StarCaps, which have been voluntarily withdrawn from the market by its American distributor.

 

StarCaps contain the drug, bumetanide, a potent diuretic that can have serious side effects. It is a violation of the law to dispense bumetanide without a prescription. However, dietary supplements do not require FDA approval before going on the market; so StarCaps and other potentially harmful drugs have passed under the radar. It is only after marketing that the FDA can spot-check and test dietary supplements. Even when contaminated products are found, the FDA has no real jurisdiction over their sale. It is up to the manufacturer or, in the case of foreign manufactured products, the distributor to voluntarily withdraw the product. If these products stay on the market despite FDA calls for voluntary withdrawal, the FDA must go through the courts to get a wholesale withdrawal of the product.

 

The FDA is making a serious effort to identify weight-loss products that contain potentially harmful drugs and bring them to the attention of consumers. There is a Q&A website available to consumers. LINK 

 

So, how much are you will to risk in order to lose weight? Would you risk ingesting products with unknown substances? How long would you take such substances? Until you lost the amount of weight you wanted to lose? Until you felt ill? Would you keep taking them even if you felt ill?

 

There is no quick-fix for weight loss. In order to lose weight you must take in fewer calories than you use. This is not a quick process. If, in addition you want to keep it off, the weight loss must be:

  • gradual (1/2 to 2 pounds per week depending on age and gender)
  • combined with behavioral changes: a permanent increase in activity as well as a permanent decrease in consumption.

 

But it’s your risk, your loss and, ultimately, your decision.

Want to Improve Your Memory? Eat Less.

Significantly less – thirty percent less.

 

Let’s see. If you are a 50 year old woman who is 5 feet 5 inches tall and somewhat active, you will need 1750 calories per day to maintain your weight (Mayo Clinic Calorie Calculator). If you want to improve your memory, you should consume no more than 1225 calories per day. That means cutting out 525 calories per day.

 

Let’s see.

 

4oz orange juice, ½ plain bagel with low fat cream cheese, coffee (black) = 221

 

1oz cheddar cheese, one medium size apple, 10 almonds, tea (black) = 375

 

3 oz canned tuna in water, 1 tsp mayo, 1 slice whole wheat bread, diet soda = 269

 

1 slice whole wheat bread, 1tbsp low sugar jam, 1 tbsp natural (no sugar or added oil) peanut butter, tea (black) = 190

 

3 oz roasted chicken breast, 3 carrots, steamed (no dressing), ½ cup brown rice (plain), diet soda = 345

 

Oops! That equals 1400 calories. Cut out the almonds (170 calories). Now you’ve got 1230 calories! Spit out one bite of apple and you’re home free.

 

What got me thinking about this? An article in today’s New York Times. It was based on an article published Monday in the Proceedings of the National Academy of Sciences. The research participants were 50 healthy men and women with a mean age of 60.5 years, stratified into three groups one of which had the caloric restricts. Verbal memory was measured under (“standardized” conditions – sorry, I read only the abstract) before and after the diet intervention. Those on caloric restriction diets had a significant improvement in memory. The researchers postulate that the increase was due to decreased fasting blood levels of insulin and C-reactive protein.

 

I have a question. Were their moods assessed for depression and anxiety before and after?

 

Just what are we trying to do with people?! Attempts at pre-natal intelligence increases. Genotyping and tracking for sports abilities.

 

I believe in prevention and I believe in a healthy lifestyle. But a person is more than physical health and predetermined abilities. Where are we headed, George Orwell?

 

BTW – I’m not 5 feet 5 inches tall. I’m not 50 years old and I don’t need 1750 calorie per day to maintain my weight. J  J  Sorry to disappoint those of you who are either following this blog or know me in other capacities.


Mary Lou Bernardo, PhD, MSN

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